Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect
| العنوان: | Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect |
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| المؤلفون: | Edward Michna, Srdjan S. Nedeljkovic, David Janfaza, Marc O. Martel, Zacharia Isaac, Jeffrey N. Katz, Robert N. Jamison, Andrew J. Dolman, Ajay D. Wasan, Robert R. Edwards |
| المصدر: | Pain Medicine. 17:1882-1891 |
| بيانات النشر: | Oxford University Press (OUP), 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Pain Threshold, Analgesic, Administration, Oral, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Threshold of pain, Back pain, Humans, Medicine, Prospective Studies, Aged, Pain Measurement, business.industry, Cold pressor test, Chronic pain, General Medicine, Middle Aged, medicine.disease, Analgesics, Opioid, Pessimism, Treatment Outcome, Anesthesiology and Pain Medicine, Opioid, Back Pain, Anesthesia, Hyperalgesia, Anxiety, Female, OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION, Neurology (clinical), Chronic Pain, medicine.symptom, business, human activities, 030217 neurology & neurosurgery, medicine.drug |
| الوصف: | Objective. Opioids are frequently prescribed for chronic low back pain (CLBP), but there are broad individual differences in the benefits and risks of opioid therapy, including the development opioid-induced hyperalgesia. This study examined quantitative sensory testing (QST) data among a group of CLBP patients undergoing sustained oral opioid treatment. We investigated whether individual differences in psychological characteristics were related to opioid-induced changes in pain perception and pain modulation. Design. The six-month, open-label trial evaluated patients with low to high levels of negative affect (e.g., symptoms of distress, depression and anxiety); participants underwent QST at baseline (prior to initiating treatment) and during oral opioid treatment. Setting . A chronic pain management center. Patients. The 31 study participants had chronic discogenic back pain, with a pain intensity rating >3/10. Participants were divided into groups with high vs. low levels of Negative Affect (NA). Results. In the previously-published manuscript describing the clinical outcomes of the trial, high NA patients achieved only about half of the analgesic effect observed in the low NA group (Wasan AD, Michna E, Edwards RR, et al. Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain. Anesthesiology 2015;123:86172). The QST findings reported here suggested that tolerance to experimental (cold pressor) pain and conditioned pain modulation tended to decrease in the high NA group over the course of opioid treatment, while temporal summation of mechanical pain declined in the low NA group. Conclusions. These results reveal that while the low NA group seemed to exhibit a generally adaptive, analgesic pattern of changes during opioid management, the high NA group showed a pattern more consistent with opioid-induced hyperalgesic processes. A greater susceptibility to hyperalgesia-promoting changes in pain modulation among patients with high levels of distress may contribute to a lower degree of benefit from opioid treatment in high NA patients. |
| تدمد: | 1526-4637 1526-2375 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3f21b27e6dc3f56af3eca881dcac7f43 https://doi.org/10.1093/pm/pnw010 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3f21b27e6dc3f56af3eca881dcac7f43 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15264637 15262375 |
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