scholarly journals Cannabinoid Therapeutics in Chronic Neuropathic Pain: From Animal Research to Human Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Raquel Maria P. Campos ◽  
Andrey F. L. Aguiar ◽  
Yolanda Paes-Colli ◽  
Priscila Martins Pinheiro Trindade ◽  
Bruna K. Ferreira ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Molecular Mechanisms ◽  
Scientific Evidence ◽  
Endocannabinoid System ◽  
Physiological System ◽  
Chronic Neuropathic Pain ◽  
Long Period ◽  
Medicinal Cannabis

Despite the importance of pain as a warning physiological system, chronic neuropathic pain is frequently caused by damage in the nervous system, followed by persistence over a long period, even in the absence of dangerous stimuli or after healing of injuries. Chronic neuropathic pain affects hundreds of millions of adults worldwide, creating a direct impact on quality of life. This pathology has been extensively characterized concerning its cellular and molecular mechanisms, and the endocannabinoid system (eCS) is widely recognized as pivotal in the development of chronic neuropathic pain. Scientific evidence has supported that phyto-, synthetic and endocannabinoids are efficient for pain management, while strong data arise from the therapeutic use of Cannabis-derived products. The use of medicinal Cannabis products is directed toward not only relieving symptoms of chronic pain, but also improving several aspects of patients’ welfare. Here, we review the involvement of eCS, along with other cellular and molecular elements, in chronic neuropathic pain pathology and how this system can be targeted for pain management.

scholarly journals Dorsal Root Ganglion (DRG) and Chronic Pain

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Amnon A. Berger ◽  
Yao Liu ◽  
HarLee Possoit ◽  
Anna C. Rogers ◽  
Warner Moore ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Dorsal Root ◽  
Randomized Trials ◽  
Pain Treatment ◽  
Common Condition ◽  
Significant Morbidity ◽  
Chronic Neuropathic Pain

Context: Chronic neuropathic pain is a common condition, and up to 11.9% of the population have been reported to suffer from uncontrolled neuropathic pain. Chronic pain leads to significant morbidity, lowered quality of life, and loss of workdays, and thus carries a significant price tag in healthcare costs and lost productivity. dorsal root ganglia (DRG) stimulation has been recently increasingly reported and shows promising results in the alleviation of chronic pain. This paper reviews the background of DRG stimulation, anatomical, and clinical consideration and reviews the clinical evidence to support its use. Evidence Acquisition: The DRG span the length of the spinal cord and house the neurons responsible for sensation from the periphery. They may become irritated by direct compression or local inflammation. Glial cells in the DRG respond to nerve injury, producing inflammatory markers and contribute to the development of chronic pain, even after the resolution of the original insult. While the underlying mechanism is still being explored, recent studies explored the efficacy of DRG stimulation and neuromodulation for chronic pain treatment. Results: Several reported cases and a small number of randomized trials were published in recent years, describing different methods of DRG stimulation and neuromodulation with promising results. Though evidence quality is mostly low, these results provide evidence to support the utilization of this technique. Conclusions: Chronic neuropathic pain is a common condition and carries significant morbidity and impact on the quality of life. Recent evidence supports the use of DRG neuromodulation as an effective technique to control chronic pain. Though studies are still emerging, the evidence appears to support this technique. Further studies, including large randomized trials evaluating DRG modulation versus other interventional and non-interventional techniques, are needed to further elucidate the efficacy of this method. These studies are also likely to inform the patient selection and the course of treatment.

scholarly journals Interrelationship of Neurogenic Obesity and Chronic Neuropathic Pain in Persons With Spinal Cord Injury

2021 ◽  
Vol 27 (1) ◽  
pp. 75-83
Author(s):  
Elizabeth R. Felix ◽  
David R. Gater
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Negative Impact ◽  
Chronic Neuropathic Pain ◽  
Excess Adiposity ◽  
Cord Injury ◽  
Significant Negative Impact ◽  
Prevalence Of Obesity

The prevalence of obesity and of neuropathic pain are both estimated at above 50% in the population of people with chronic spinal cord injury (SCI). These secondary consequences of SCI have significant negative impact on physical functioning, activities of daily living, and quality of life. Investigations of relationships between weight or body composition and chronic neuropathic pain in people with SCI are lacking, but investigations in non-SCI cohorts suggest an association between obesity and the presence and severity of neuropathic pain conditions. In the present article, we present a review of the literature linking obesity and neuropathic pain and summarize findings suggesting that metabolic syndrome and chronic, systemic inflammation due to excess adiposity increase the risk for neuropathic pain after an SCI.

scholarly journals Botulinum toxin type A in chronic neuropathic pain in refractory leprosy

2019 ◽  
Vol 77 (5) ◽  
pp. 346-351 ◽  
Author(s):  
Emanuel de Jesus Soares de Sousa ◽  
Gustavo Celeira de Sousa ◽  
Vitor Ferreira Baia ◽  
Danusa Neves Somensi ◽  
Marília Brasil Xavier
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Botulinum Toxin ◽  
Therapeutic Option ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Chronic Neuropathic Pain ◽  
Specific Protocol

ABSTRACT Neuropathic pain is a chronic syndrome that is difficult to treat and often affects patients with leprosy. Recommended treatment includes the the use of analgesic drugs, codeine, tricyclic antidepressants, neuroleptics, anticonvulsants and thalidomide, but without consensus on uniform dose and fully satisfactory results. Objective: To analyze botulinum toxin type A (BoNT-A) effectiveness in treatment of chronic neuropathic pain in refractory leprous patients, as well as evaluate and compare the quality of life of patients before and after using the medication. Methods: We used a specific protocol including clinical, demographic, DN4 protocol, analogue scale (VAS), sensory evaluation and evaluation of the WHOQOL-BREF. Therapeutic intervention was performed with BOTOX® BTX-A 100U administered subcutaneously. Fifteen patients were evaluated on days 0, 10 and 60. Results: Patients on VAS showed pain between 5 and 10, in one case there was complete pain relief in 60 days, while others showed improvement in the first week with the return of symptoms with less intensity after this period. WHOQOL-BREF's domains Quality of Life and Physical to have a significant increase in QOL. Conclusion: BoNT-A proved to be a good therapeutic option in relieving pain with improved quality of life for these patients.

scholarly journals Peripheral straightjacket (α2δ Ca 2+ channel subunit) expression is required for neuropathic sensitization in Drosophila

2019 ◽  
Vol 374 (1785) ◽  
pp. 20190287 ◽  
Author(s):  
Thang M. Khuong ◽  
Zina Hamoudi ◽  
John Manion ◽  
Lipin Loo ◽  
Arjun Muralidharan ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Nerve Injury ◽  
Pain Perception ◽  
Analgesic Drug ◽  
Chronic Neuropathic Pain ◽  
Thermal Pain ◽  
Subunit Expression ◽  
Central Inhibition ◽  
Maladaptive Response

Nerve injury leads to devastating and often untreatable neuropathic pain. While acute noxious sensation (nociception) is a crucial survival mechanism and is conserved across phyla, chronic neuropathic pain is considered a maladaptive response owing to its devastating impact on a patient's quality of life. We have recently shown that a neuropathic pain-like response occurs in adult Drosophila . However, the mechanisms underlying this phenomenon are largely unknown. Previous studies have shown that the α2δ peripheral calcium channel subunit straightjacket ( stj ) is a conserved factor required for thermal pain perception. We demonstrate here that stj is required in peripheral ppk+ sensory neurons for acute thermal responses and that it mediates nociceptive hypersensitivity in an adult Drosophila model of neuropathic pain-like disease. Given that calcium channels are the main targets of gabapentinoids (pregabalin and gabapentin), we assessed if these drugs can alleviate nociceptive hypersensitivity. Our findings suggest that gabapentinoids may prevent nociceptive hypersensitivity by preserving central inhibition after nerve injury. Together, our data further highlight the similarity of some mechanisms for pain-like conditions across phyla and validates the scientific use of Drosophila neuropathic sensitization models for analgesic drug discovery. This article is part of the Theo Murphy meeting issue ‘Evolution of mechanisms and behaviour important for pain’.

scholarly journals PNL23 CHRONIC NEUROPATHIC PAIN (NEP) IMPACT ON PATIENT QUALITY OF LIFE AND DISABILITY: RESULTS FROM THE DONEGA STUDY

2004 ◽  
Vol 7 (6) ◽  
pp. 794 ◽  
Author(s):  
R Gálvez ◽  
MV Ribera ◽  
J Rejas ◽  
X Masramón ◽  
M Ruíz
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Chronic Neuropathic Pain

scholarly journals Cannabis for pain management: Pariah or panacea?

2018 ◽  
Vol 87 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Roger Hudson ◽  
Nirushan Puvanenthirarajah
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Therapeutic Potential ◽  
Cannabis Use ◽  
Clinical Practices ◽  
Therapeutic Benefits ◽  
Pharmacodynamic Profile ◽  
Cellular Excitability ◽  
History Of ◽  
Medicinal Cannabis

Cannabis has been used in a medicinal context throughout recorded history and across diverse cultures to aid in the treatment of a wide array of ailments. Remarkably, clinical and preclinical investigations are only recently beginning to reveal the neurobiological mechanisms responsible for the clinically-relevant actions of cannabis that have been acknowledged by medical pharmacopeia for millennia. The therapeutic potential of cannabis-derived phytochemicals such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are currently being explored in several contexts. Experimental evidence suggests that modulation of signal transduction pathways underlying cellular excitability, as well as interactions with the endocannabinoid and serotonin systems, which modulate emotion and pain sensitivity under physiological conditions, are among the mechanisms responsible for its clinical efficacy. Interestingly, the diverse pharmacodynamic profile of CBD suggests a synergistic interaction with current first- and second-line medications used in the treatment of neuropathic pain to produce clinically meaningful therapeutic benefits. To advance understanding of the neurobiological mechanisms underlying therapeutic cannabis use in pain management and to integrate its use into modern clinical practices, it is important to understand medicinal cannabis use in historic and medical contexts. This review highlights the copious history of medical practices incorporating the use of cannabis, and discusses the potential pharmacological mechanisms responsible for its therapeutic efficacy in the management of neuropathic pain.

507 EPIDURAL ANALGESIA PLUS PREGABALIN IMPROVES QUALITY OF LIFE IN CHRONIC NEUROPATHIC PAIN PATIENTS

2010 ◽  
Vol 4 (S1) ◽  
pp. 143-144
Author(s):  
P. Arambatzis ◽  
C. Pourzitaki ◽  
E. Haftoura ◽  
E. Toutounopoulou ◽  
D. Kouvelas
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Epidural Analgesia ◽  
Chronic Neuropathic Pain ◽  
Pain Patients
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