Regenerative peripheral neuropathic pain: novel pathological pain, new therapeutic dimension

2017 ◽  
Vol 28 (1) ◽  
pp. 65-76 ◽  
Author(s):  
You-Quan Ding ◽  
Wei-Ze Xie ◽  
Jian-Guo Qi
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Neural Circuits ◽  
Rodent Models ◽  
Peripheral Nerve Injuries ◽  
Behavioral Phenotypes ◽  
Peripheral Neuropathic Pain ◽  
Peripheral Nerve Damage ◽  
Pathological Pain ◽  
Therapeutic Dimension

AbstractAfter peripheral nerve damage, injured or stressed primary sensory neurons (PSNs) transmitting pathological pain (pathopain) sensitize central nervous system (CNS) neural circuits and determine behavioral phenotypes of peripheral neuropathic pain (PNP). Therefore, phenotypic profiling of pathopain-transmitting PSNs is vital for probing and discovering PNP conditions. Following peripheral nerve injuries (PNIs), PNP might be potentially transmitted by distinct classes of damaged or stressed PSNs, such as axotomized PSNs without regeneration (axotomy-non-regenerative neurons), axotomized PSNs with accurate regeneration (axotomy-regenerative neurons), and spared intact PSNs adjacent to axotomized neurons (axotomy-spared neurons). Both axotomy-non-regenerative neurons and axotomy-spared neurons have been definitely shown to participate in specific PNP transmission. However, whether axotomy-regenerative neurons could transmit PNP with unique features has remained unclear. Recent studies in rodent models of axonotmesis have clearly demonstrated that axotomy-regenerative neurons alone transmit persistent pathological pain with unique behavioral phenotypes. In this review, we exclusively review this novel category of PNP, reasonably term it ‘regenerative peripheral neuropathic pain’, and finally discuss its potential clinical significance as a new therapeutic dimension for PNIs beyond nerve regeneration.

Chronic neuropathic pain after traumatic peripheral nerve injuries in the upper extremity: prevalence, demographic and surgical determinants, impact on health and on pain medication

2019 ◽  
Vol 20 (1) ◽  
pp. 95-108
Author(s):  
Adriana Miclescu ◽  
Antje Straatmann ◽  
Panagiota Gkatziani ◽  
Stephen Butler ◽  
Rolf Karlsten ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Upper Extremity ◽  
Nerve Injury ◽  
Persistent Pain ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Chronic Neuropathic Pain ◽  
Younger Age

AbstractBackground and aimsAside from the long term side effects of a nerve injury in the upper extremity with devastating consequences there is often the problem of chronic neuropathic pain. The studies concerning the prevalence of persistent pain of neuropathic origin after peripheral nerve injuries are sparse. The prevalence and risk factors associated with chronic neuropathic pain after nerve injuries in the upper extremity were assessed.MethodsA standardized data collection template was employed prospectively and retrospectively for all patients with traumatic nerve injuries accepted at the Hand Surgery Department, Uppsala, Sweden between 2010 and 2018. The template included demographic data, pain diagnosis, type of injured nerve, level of injury, date of the lesion and repair, type of procedure, reoperation, time since the procedure, S-LANSS questionnaire (Self report-Leeds Assessment of Neuropathic Symptoms and Signs), RAND-36 (Item short form health survey), QuickDASH (Disability of Shoulder, Arm and Hand) and additional questionnaires concerned medication, pain intensity were sent to 1,051 patients with nerve injuries. Partial proportional odds models were used to investigate the association between persistent pain and potential predictors.ResultsMore than half of the patients undergoing a surgical procedure developed persistent pain. Prevalence of neuropathic pain was 73% of the patients with pain (S-LANSS ≥ 12 or more). Multivariate analysis indicated that injury of a major nerve OR 1.6 (p = 0.013), years from surgery OR 0.91 (p = 0.01), younger age OR 0.7 (p < 0.001), were the main factors for predicting pain after surgery. The type of the nerve injured was the strongest predictor for chronic pain with major nerves associated with more pain (p = 0.019).ConclusionsA high prevalence of chronic pain and neuropathic pain with a negative impact on quality of life and disability were found in patients after traumatic nerve injury. Major nerve injury, younger age and less time from surgery were predictors for chronic pain.

Traumatic peripheral nerve injuries: epidemiological findings, neuropathic pain and quality of life in 158 patients

2010 ◽  
Vol 15 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Palma Ciaramitaro ◽  
Mauro Mondelli ◽  
Francesco Logullo ◽  
Serena Grimaldi ◽  
Bruno Battiston ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

scholarly journals Relationship of Anti-interleukin-6 Receptor Antibody to Interleukin-6 Level and Inducible Nitrite Oxide Levels in Peripheral Nerve Injury in Chronic Constriction Injury-Induced Rats: A Case-Control Study in Indonesia

2022 ◽  
Vol 10 (A) ◽  
pp. 1-5
Author(s):  
Riki Sukiandra ◽  
Eti Yerizel ◽  
Yuliarni Syafrita ◽  
Eryati Darwin
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Interleukin 6 ◽  
Peripheral Nerve Injury ◽  
Sandwich Elisa ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Receptor Antibody ◽  
Male Wistar Rats

BACKGROUND: Interleukin-6 (IL-6) and inducible Nitric oxide Synthase (iNOS) have an effect on neuropathic pain in the inflammatory process in peripheral nerve injuries. AIM: This study aims to examine the effect of anti-IL-6 receptor antibody on IL-6 and iNOS levels as a consideration for the treatment of neuropathic pain in a rat model of peripheral nerve injury. METHODS: Twenty-eight young adult male Wistar rats were treated for peripheral nerve injury and then divided into two groups. Fourteen treatment groups (Group P) were given anti-IL-6 receptor antibody by injection at a dose of 100 g/day by injection into the saphenous vein in the rat’s leg for 3 days. In both groups, the serum IL-6 and iNOS levels were assessed on the 3rd day after administration of anti-IL-6 receptor antibody in group P, using the sandwich ELISA method. RESULTS: The results showed that the administration of anti-IL-6 receptor antibody did not have a significant effect on reducing IL-6 and iNOS levels in group P (p > 0.05). Administration of anti-IL-6 receptor antibody had more effect on IL-6 levels on iNOS levels, where a decrease in IL-6 levels caused a decrease in iNOS levels in group P (p = 0.004 and r = 0.693). CONCLUSIONS: We conclude that the present administration of anti-IL-6 receptor antibody cannot be considered as a treatment for neuropathic pain in peripheral nerve injuries, but can be used to influence IL-6 levels on iNOS levels.

Post-Traumatic Neuralgia

2018 ◽  
pp. 81-90
Author(s):  
Magdalena Anitescu ◽  
Joshua Frenkel ◽  
Bradley A. Silva
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Nerve Damage ◽  
Neurological Injury ◽  
Nerve Blocks ◽  
Pharmacological Agents ◽  
Peripheral Nerve Damage ◽  
Post Traumatic ◽  
Double Crush

Peripheral nerve damage is classified into three categories based on severity: neurapraxia, axonotmesis, and neurotmesis. Peripheral nerve damage is the second most common category of in anesthesia related complications. The “double-crush” phenomenon is a term used to describe preexisting neurological injury that limits the neurological reserve of affected nerves. The risk of clinical deficits from a subsequent nerve injury is increased with the double crush phenomenon. Noniatrogenic traumatic nerve injury is most common in young adult males. Management of post-traumatic neuralgia often involves consultation with pain medicine, neurology, and neurosurgery. This multidisciplinary approach has two central goals, restoring nerve function and minimizing chronic neuropathic pain. Pharmacotherapy and procedural therapies are the treatments for neuropathic pain. Pharmacological agents include secondary amine tricyclic antidepressants (e.g., nortriptyline, desipramine), calcium channel α‎-2-δ‎ ligand anticonvulsants (e.g., pregabalin, gabapentin), opioids, ketamine, and topical lidocaine. Procedural interventions may be indicated when pain remains refractory to multiple pharmacological therapies. Procedures include nerve blocks, ablation, and neurostimulation, designed to interfere with, interrupt, or modulate pain pathways.

scholarly journals Peripheral Nerve Stimulation of the Lateral Femoral Cutaneous and Superior Gluteal Nerves for Treating Proximal Neuropathy Hip Pain

2020 ◽  
pp. 221-224
Author(s):  
Niek Vanquathem
Keyword(s):  
Drug Delivery ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Spinal Cord Stimulation ◽  
Hip Pain ◽  
Peripheral Nerve Stimulation ◽  
Peripheral Neuropathic Pain ◽  
Intrathecal Drug Delivery

Background: Chronic postoperative hip pain is estimated to occur in 10% to 35% of patients undergoing total hip replacement. Proximal peripheral neuropathic pain of the lateral femoral cutaneous and superior gluteal nerves has proven to be a difficult disorder to treat. Opioids are often ineffective in the treatment of neuropathic pain. Interventional methods such as peripheral nerve stimulation are minimally invasive options capable of relieving neuropathic pain. Stimulators powered by an implantable pulse generator (IPG), however, may not be suitable for peripheral nerve stimulation because of difficulty finding an appropriate pocket site. The introduction of wireless peripheral nerve stimulation has improved the ability to offer this modality. Case Presentation: We present a case of proximal peripheral neuropathic pain of the lateral femoral cutaneous and superior gluteal nerves that failed all other treatment modalities including spinal cord stimulation and intrathecal drug delivery. Two quadripolar, tined, wireless electrode arrays were positioned over the lateral femoral cutaneous and superior gluteal nerves. A stimulation scheme with a pulse rate of 1.5 kHz and pulse width of 30 μs at 2.0 mA was tested and found effective. Conclusion: This patient had proximal neuropathic hip pain and failed a variety of chronic pain treatment options, including conventional IPG-based spinal cord stimulation and an intrathecal drug delivery system. She was successfully treated with a wireless peripheral nerve stimulation system. Key words: Hip pain, lateral femoral cutaneous nerve, peripheral nerve stimulator, peripheral neuropathy, superior gluteal nerve

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