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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two-thirds of patients with Paget's disease seeking medical attention present with pain. We studied patterns of pagetic pain in relation to physical activity, and the effect of coexistent osteoarthritis (OA)/pagetic arthropathy on pain and physical activity before and after treatment with pamidronate. Patients with lower-segment Paget's disease (lumbar spine, pelvis or lower limbs), raised alkaline phosphatase (ALP), and pain as a symptom were included. Two subgroups were identified based on the absence (P group), or presence (POA group) of radiological OA in the lower segment. They received 2-4 fortnightly infusions of pamidronate 30-60 mg and were followed up at 6 weeks, 3 months and 6 months. Outcome measures were visual analog scales for pain at rest, on standing, on walking and at night; standing time, walking distance, 50-yard walking time, and ALP. Twenty-five patients (12 men, 13 women, mean age 70.1+/-1.9 years), received a mean of 142+/-9.7 mg of pamidronate. The P group had higher mean ALP (p=0.003) and higher scores for pain (not significant) at baseline than the POA group. Compared to baseline, P group had significant improvements (p<0.01) at 6 months in rest pain, standing pain and walking pain. The POA group had non-significant changes in pain at 6 months. ALP improved significantly at 6 months in both subgroups (p<0.01). The whole group also improved at 6 months in standing time (55.7%, not significant), walking distance (33.9%, not significant), and 50-yard walking time (24.2%, p<0.05). Paget's patients with coexistent joint disease had less severe pain and bone disease at baseline than those without coexistent joint disease, and responded less well to pamidronate, although they did have significant improvement in ALP levels. Radiographic assessment for coexisting joint disease prior to treatment might improve prognostication from the patient's point of view, and improve treatment compliance.
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PMID:Patterns of pain in Paget's disease of bone and their outcomes on treatment with pamidronate. 1467 9

Modulation of spinal nociception from the anterior hypothalamus/preoptic area (AH/POA), and consequent alterations in the pain experience may contribute to integrated responses brought into play during fear or stress and as part of the sickness response. This study was designed to compare the effects of descending control from AH/POA on A- versus C-fibre-evoked spinal nociception, since any differential control is of behavioural and clinical importance given that A-fibre and C-fibre nociceptors convey different qualities of the pain signal (first and second pain, respectively), and play different roles in the development and maintenance of chronic pain states. In anaesthetised rats, electromyographic responses were recorded to monitor thresholds of withdrawal to slow (2.5 degrees Cs(-1)) or fast (7.5 degrees Cs(-1)) rates of skin heating of the hindpaw, to preferentially activate C- or A-nociceptors, respectively. Neuronal activation by microinjection of dl-homocysteic acid at sites within a specific region of AH/POA, lateral area of the anterior hypothalamus (LAAH), significantly increased response thresholds to slow heating rates (p<0.02, n=11), but not those to fast rates of heating (p=0.48, n=10). Injection of DLH adjacent to LAAH (n=9) had no significant effect on responses to slow (n=8) or fast (n=9) rates of skin heating. The functional significance of differential descending control of spinal processing of C- and A-nociceptive inputs is discussed with respect to roles both of the LAAH in pain processing, and of C- and A-nociceptive inputs in acute and chronic pain.
Pain 2008 Jun
PMID:Selective inhibition from the anterior hypothalamus of C- versus A-fibre mediated spinal nociception. 1782 51

Pain is a multidimensional experience emerging from the flow of information between multiple brain regions. A growing body of evidence suggests that pathological pain causes plastic changes of various brain regions. Here, we hypothesized that the induction of neuropathic pain alters distributed patterns of the resting-state brain activity in animal models, and capturing the altered pattern would enable identification of neuropathic pain at the individual level. We acquired micro-positron emission tomography with [(18)F]fluorodeoxyglucose (FDG micro-PET) images in awake rats with spinal nerve ligation (SNL) and without (sham) (SNL group, n=13; sham group, n=10). Multivariate pattern analysis (MVPA) with linear support vector machine (SVM) successfully identified the brain with SNL (92.31% sensitivity, 90.00% specificity, and 91.30% total accuracy). Predictive brain regions with increased metabolism were mainly located in prefrontal-limbic-brainstem areas including the anterior olfactory nucleus (AON), insular cortex (IC), piriform cortex (PC), septal area (SA), basal forebrain/preoptic area (BF/POA), amygdala (AMY), hypothalamus (HT), rostral ventromedial medulla (RVM) and the ventral midbrain (VMB). In contrast, predictive regions with decreased metabolism were observed in widespread cortical areas including secondary somatosensory cortex (S2), occipital cortex (OC), temporal cortex (TC), retrosplenial cortex (RSC), and the cerebellum (CBL). We also applied the univariate approach and obtained reduced prediction performance compared to MVPA. Our results suggest that developing neuroimaging-based diagnostic tools for pathological pain can be achieved by considering patterns of the resting-state brain activity.
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PMID:Identifying neuropathic pain using (18)F-FDG micro-PET: a multivariate pattern analysis. 2412 Oct 88