The phenomenon of migration of nociogenic structures in the human sensor-algic system (results of clinical and neurophysiological studies and morphological experiments)

2020 ◽  
pp. 16-24
Author(s):  
Maksim Vladimirovich Shpagin ◽  
Mikhail Valerievich Kolesnikov ◽  
Olga Yurievna Khutorskaya ◽  
Dmitriy Evgenievich Timoshkin ◽  
Artem Andreevich Belikin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Pain Syndrome ◽  
Point Of View ◽  
Chronic Pain Syndrome ◽  
Integrative Therapy ◽  
Neurophysiological Studies ◽  
Positive Results ◽  
Structural Point ◽  
Chronicity Of Pain

From the informational and structural point of view, the chronicity of pain is associated with the migration of nociogenic zones. The phenomenon of migration is based on the mechanisms of neuroplasticity, compensatory-restorative processes in the nervous system. On the basis of the phenomenon of migration of the nociogenic zone, a system of regional integrative therapy of chronic pain syndrome has been developed. Recommendations on the advisability of invasive shutdown of the nociogenic zone using invasive pharmacotherapy or surgical denervation have been proposed. In the course of studying the characteristics of chronic pain, depending on the duration of the disease, a direct proportional correlation was revealed between the increase in the components of pain and the duration of the pain syndrome, which can be explained by the increase in the number of nociogenic structures that form the complexity and stability of the pain syndrome. Thus, the necessity of neurodestructive interventions increases for attaining positive results. An important area of therapy is the inclusion of psychotherapy, pharmacotherapy and neuromodulation into the system of regional-integrative influence.

scholarly journals Neuropathic pain in rheumatoid arthritis

2020 ◽  
Vol 12 (5) ◽  
pp. 60-65
Author(s):  
E. S. Filatova ◽  
A. M. Lila ◽  
V. A. Parfenov
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Paindetect Questionnaire ◽  
Somatosensory Nervous System

Objective: to identify the signs of neuropathic pain (NP) in patients with rheumatoid arthritis (RA) on the basis of the PainDETECT questionnaire and neurological examination.Patients and methods. A total of 208 RA patients (39 men and 169 women; mean age, 47.7 years) with chronic pain syndrome were examined. The patients underwent rheumatological and neurological examinations; NP was diagnosed using the PainDETECT questionnaire; inflammation severity (DAS28 index), pain intensity (VAS), affective disorders (HADS), and quality of life (EQ-5D) were assessed.Results and discussion. 172 (82.7%) patients had moderate and high disease activity according to the DAS28. The signs of possible and highly probable NP according to the PainDETECT questionnaire were detected in 29.8 and 26.9% of patients, respectively; they were significantly more likely to be detected in patients with more severe pain syndrome, clinically significant anxiety, and worse quality of life, but were unassociated with RA activity according to the DAS28. Somatosensory nervous system injury (polyneuropathy, tunnel syndromes, and cervical myelopathy) was found in 77.6% of patients with possible NP and in 80.4% with highly probable NP. In other patients, NP might be caused by central sensitization. Conclusion. In patients with a RA exacerbation, chronic pain syndrome is caused not only by an active inflammatory process in the joint area and adjacent tissues, but also by somatosensory nervous system injury and central sensitization.

scholarly journals Research Of Motor Function In Patients With Chronic Pain Syndrome At Radiculopathies Of Different Genesis

2020 ◽  
Vol 02 (10) ◽  
pp. 14-21
Author(s):  
Sokhiba Ziyadullayevna Khakimova ◽  
◽  
Dildora Alisherovna Atokhodjaeva ◽  
Farakhnoz Muradovna Hamrokulova ◽  
◽  
...  
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Peripheral Nervous System ◽  
Motor Function ◽  
Pain Syndrome ◽  
Neurological Status ◽  
Chronic Pain Syndrome ◽  
Significant Limitation

In patients with radiculopathies of various origins, along with chronic pain syndrome, various prolapse of the pyramidal sphere of the peripheral nervous system is observed [1]. In groups of patients with radiculopathies, the motor sphere was investigated using the described methods of studying the neurological status Skoromets A. A, which revealed a statistically significant limitation of the motor sphere [2]. The performed electroneuromyography confirmed the lesion in the motor fibers in patients with chronic pain syndrome with radiculopathies of various origins [4].

CHRONIC PAIN SYNDROME IN PEDIATRIC ONCOLOGICAL PALLIATIVE PATIENTS IN RUSSIA

2019 ◽  
Vol 98 (1) ◽  
pp. 115-121
Author(s):  
A.V. Pshonkin ◽  
◽  
I.V. Serkova ◽  
N.V. Myakova ◽  
N.N. Kotskaya ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Palliative Patients

Alexithymia and hypnotisability in the chronic pain syndrome

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S333 ◽  
Author(s):  
F.R. James ◽  
R.G. Large
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome

scholarly journals Relationship between catechol-o-methyltransferase gene polymorphism and pain syndrome in breast cancer patients

2020 ◽  
Vol 14 (2) ◽  
pp. 72-85
Author(s):  
Arina P. Spasova ◽  
I. V. Kurbatova ◽  
O. Y. Barysheva ◽  
G. P. Tikhova
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Postoperative Period ◽  
Mutant Allele ◽  
Pain Syndrome ◽  
Comt Gene ◽  
Nucleotide Polymorphisms ◽  
Chronic Pain Syndrome ◽  
Narcotic Analgesics ◽  
Single Nucleotide

The goal of the study was to explore the influence of single-nucleotide polymorphisms of the COMT gene on the formation and features of pain syndrome, the level of anxiety, and the need for narcotic analgesics in patients with breast cancer. Materials and methods. The intensity of pain and opioid consumption in the postoperative period were evaluated in 58 patients who met the inclusion criteria of the study and were operated for breast cancer. The frequency of chronic pain syndrome after mastectomy was studied in the same group of patients after a year by using short pain questionnaires, McGill Pain Questionnaire and PainDetect. The anxiety level was assessed by using the HADS questionnaire. Genotyping was performed for single-nucleotide polymorphisms, rs4680, rs740603, rs2097603 = rs2070577, rs4633, of the COMT gene localized in the 22q11.21 region in the studied group of patients. The relationship between the carrier of different genotypes and the intensity of acute and chronic pain, the severity of the pain rating index for sensory and affective characteristics, the presence of a neuropathic component of pain, and the severity of anxiety were studied in the entire sample. The use of narcotic analgesics was evaluated in the postoperative period (IU/day and IU/course) and for the relief of chronic pain. Results. It is shown that the intensity of postoperative pain and the severity of anxiety do not depend on the presence of a mutant allele for the studied polymorphisms of the COMT gene, while the postoperative consumption of opioids in patients with the rs4680 missense mutation in the exon of this gene is significantly less. The dependence of the intensity of chronic pain syndrome and the severity of anxiety on the presence of a mutant allele for the polymorphic locus rs4680 localized in the exon of the COMT gene was established. No significant relationship was observed between the mutant alleles and the use of opioids for chronic pain relief after mastectomy. Conclusion. Genotyping for the COMT gene polymorphisms can be useful for choosing the optimal tactics of pain management in patients with breast cancer.

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