Neuropathic Pain: From Mechanisms to Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 17956

Special Issue Editor


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Guest Editor
Department of Interdisciplinary Intensive Care, Jagiellonian University, Medical College, Krakow, Poland
Interests: neuropathic pain

Special Issue Information

Dear Colleagues,

Neuropathic pain is caused by a lesion or disease of the somatosensory nervous system. It results from maladaptive changes that can occur in injured sensory neurons and along the entire nociceptive pathway within the central nervous system. It usually manifests as spontaneous shooting or burning pain and is often accompanied by hyperalgesia and allodynia; however, the mechanisms and symptoms are extremely complex and multifactorial. Neuropathic pain has a significant impact on quality of life, including social relationships, daily activities, and work productivity, and thus represents a great socioeconomic burden on society.

The treatment of neuropathic pain is very difficult; only a minority of people experience clinically relevant benefits from a single interventions. A multidisciplinary approach is now advocated, with pharmacological interventions combined with physical or psychological interventions and interventional or surgical treatments.

The purpose of this Special Issue is to improve our understanding of the pathophysiology of neuropathic pain, as well as to present an update on possible treatment modalities.

Dr. Anna Wrzosek
Guest Editor

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Keywords

  • neuropathic pain
  • chronic pain
  • analgesics
  • neuropathy

Published Papers (5 papers)

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Research

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17 pages, 3474 KiB  
Article
Early Diagnosis of Fibromyalgia Using Surface-Enhanced Raman Spectroscopy Combined with Chemometrics
by Haona Bao, Kevin V. Hackshaw, Silvia de Lamo Castellvi, Yalan Wu, Celeste Matos Gonzalez, Shreya Madhav Nuguri, Siyu Yao, Chelsea M. Goetzman, Zachary D. Schultz, Lianbo Yu, Rija Aziz, Michelle M. Osuna-Diaz, Katherine R. Sebastian, Monica M. Giusti and Luis Rodriguez-Saona
Biomedicines 2024, 12(1), 133; https://doi.org/10.3390/biomedicines12010133 - 09 Jan 2024
Viewed by 4618
Abstract
Fibromyalgia (FM) is a chronic muscle pain disorder that shares several clinical features with other related rheumatologic disorders. This study investigates the feasibility of using surface-enhanced Raman spectroscopy (SERS) with gold nanoparticles (AuNPs) as a fingerprinting approach to diagnose FM and other rheumatic [...] Read more.
Fibromyalgia (FM) is a chronic muscle pain disorder that shares several clinical features with other related rheumatologic disorders. This study investigates the feasibility of using surface-enhanced Raman spectroscopy (SERS) with gold nanoparticles (AuNPs) as a fingerprinting approach to diagnose FM and other rheumatic diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), osteoarthritis (OA), and chronic low back pain (CLBP). Blood samples were obtained on protein saver cards from FM (n = 83), non-FM (n = 54), and healthy (NC, n = 9) subjects. A semi-permeable membrane filtration method was used to obtain low-molecular-weight fraction (LMF) serum of the blood samples. SERS measurement conditions were standardized to enhance the LMF signal. An OPLS-DA algorithm created using the spectral region 750 to 1720 cm−1 enabled the classification of the spectra into their corresponding FM and non-FM classes (Rcv > 0.99) with 100% accuracy, sensitivity, and specificity. The OPLS-DA regression plot indicated that spectral regions associated with amino acids were responsible for discrimination patterns and can be potentially used as spectral biomarkers to differentiate FM and other rheumatic diseases. This exploratory work suggests that the AuNP SERS method in combination with OPLS-DA analysis has great potential for the label-free diagnosis of FM. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Mechanisms to Therapeutic Approaches)
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20 pages, 17615 KiB  
Article
Electroacupuncture Induces Bilateral S1 and ACC Epigenetic Regulation of Genes in a Mouse Model of Neuropathic Pain
by Xingjie Ping, Junkai Xie, Chongli Yuan and Xiaoming Jin
Biomedicines 2023, 11(4), 1030; https://doi.org/10.3390/biomedicines11041030 - 27 Mar 2023
Cited by 2 | Viewed by 1692
Abstract
Clinical and animal studies have shown that acupuncture may benefit controlling neuropathic pain. However, the underlying molecular mechanisms are poorly understood. In a well-established mouse unilateral tibial nerve injury (TNI) model, we confirmed the efficacy of electroacupuncture (EA) in reducing mechanical allodynia and [...] Read more.
Clinical and animal studies have shown that acupuncture may benefit controlling neuropathic pain. However, the underlying molecular mechanisms are poorly understood. In a well-established mouse unilateral tibial nerve injury (TNI) model, we confirmed the efficacy of electroacupuncture (EA) in reducing mechanical allodynia and measured methylation and hydroxy-methylation levels in the primary somatosensory cortex (S1) and anterior cingulate cortex (ACC), two cortical regions critically involved in pain processing. TNI resulted in increased DNA methylation of both the contra- and ipsilateral S1, while EA only reduced contralateral S1 methylation. RNA sequencing of the S1 and ACC identified differentially expressed genes related to energy metabolism, inflammation, synapse function, and neural plasticity and repair. One week of daily EA decreased or increased the majority of up- or downregulated genes, respectively, in both cortical regions. Validations of two greatly regulated genes with immunofluorescent staining revealed an increased expression of gephyrin in the ipsilateral S1 after TNI was decreased by EA; while TNI-induced increases in Tomm20, a biomarker of mitochondria, in the contralateral ACC were further enhanced after EA. We concluded that neuropathic pain is associated with differential epigenetic regulations of gene expression in the ACC and S1 and that the analgesic effect of EA may involve regulating cortical gene expression. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Mechanisms to Therapeutic Approaches)
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Review

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12 pages, 242 KiB  
Review
Interventional Treatment of Complex Regional Pain Syndrome
by Lamberta Ghaly, Vincent Bargnes, Sadiq Rahman, George-Abraam Tawfik, Sergio Bergese and William Caldwell
Biomedicines 2023, 11(8), 2263; https://doi.org/10.3390/biomedicines11082263 - 14 Aug 2023
Cited by 1 | Viewed by 1795
Abstract
Complex regional pain syndrome (CRPS) is a rare but debilitating chronic pain disorder characterized by persistent pain disproportionate to any preceding injury. CRPS can have a significant impact on a person’s quality of life, often leading to disability and psychological distress. Despite being [...] Read more.
Complex regional pain syndrome (CRPS) is a rare but debilitating chronic pain disorder characterized by persistent pain disproportionate to any preceding injury. CRPS can have a significant impact on a person’s quality of life, often leading to disability and psychological distress. Despite being recognized for over a century, finding the right treatment for CRPS can be challenging. In this article, we will explore the causes, symptoms, and interventional treatment options for CRPS, as well as the latest research on this complex and often misunderstood condition. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Mechanisms to Therapeutic Approaches)
19 pages, 3658 KiB  
Review
Epidural and Intrathecal Drug Delivery in Rats and Mice for Experimental Research: Fundamental Concepts, Techniques, Precaution, and Application
by Md. Mahbubur Rahman, Ji Yeon Lee, Yong Ho Kim and Chul-Kyu Park
Biomedicines 2023, 11(5), 1413; https://doi.org/10.3390/biomedicines11051413 - 10 May 2023
Cited by 2 | Viewed by 6569
Abstract
Epidural and intrathecal routes are the most effective drug administration methods for pain management in clinical and experimental medicine to achieve quick results, reduce required drug dosages, and overcome the adverse effects associated with the oral and parenteral routes. Beyond pain management with [...] Read more.
Epidural and intrathecal routes are the most effective drug administration methods for pain management in clinical and experimental medicine to achieve quick results, reduce required drug dosages, and overcome the adverse effects associated with the oral and parenteral routes. Beyond pain management with analgesics, the intrathecal route is more widely used for stem cell therapy, gene therapy, insulin delivery, protein therapy, and drug therapy with agonist, antagonist, or antibiotic drugs in experimental medicine. However, clear information regarding intrathecal and epidural drug delivery in rats and mice is lacking, despite differences from human medicine in terms of anatomical space and proximity to the route of entry. In this study, we discussed and compared the anatomical locations of the epidural and intrathecal spaces, cerebrospinal fluid volume, dorsal root ganglion, techniques and challenges of epidural and intrathecal injections, dosage and volume of drugs, needle and catheter sizes, and the purpose and applications of these two routes in different disease models in rats and mice. We also described intrathecal injection in relation to the dorsal root ganglion. The accumulated information about the epidural and intrathecal delivery routes could contribute to better safety, quality, and reliability in experimental research. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Mechanisms to Therapeutic Approaches)
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Other

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18 pages, 1003 KiB  
Systematic Review
Therapeutic Approach for Trigeminal Neuralgia: A Systematic Review
by Muhammad Haseeb Rana, Abdul Ahad Ghaffar Khan, Imran Khalid, Muhammad Ishfaq, Mukhatar Ahmed Javali, Fawaz Abdul Hamid Baig, Mohammad Zahir Kota, Mohasin Abdul Khader, Mohammad Shahul Hameed, Sharaz Shaik and Gotam Das
Biomedicines 2023, 11(10), 2606; https://doi.org/10.3390/biomedicines11102606 - 22 Sep 2023
Cited by 1 | Viewed by 2763
Abstract
This umbrella review aimed to determine the various drugs used to treat trigeminal neuralgia (TN) and to evaluate their efficacies as well as side effects by surveying previously published reviews. An online search was conducted using PubMed, CRD, EBSCO, Web of Science, Scopus, [...] Read more.
This umbrella review aimed to determine the various drugs used to treat trigeminal neuralgia (TN) and to evaluate their efficacies as well as side effects by surveying previously published reviews. An online search was conducted using PubMed, CRD, EBSCO, Web of Science, Scopus, and the Cochrane Library with no limits on publication date or patients’ gender, age, and ethnicity. Reviews and meta-analyses of randomized controlled trials pertaining to drug therapy for TN, and other relevant review articles added from their reference lists, were evaluated. Rapid reviews, reviews published in languages other than English, and reviews of laboratory studies, case reports, and series were excluded. A total of 588 articles were initially collected; 127 full-text articles were evaluated after removing the duplicates and screening the titles and abstracts, and 11 articles were finally included in this study. Except for carbamazepine, most of the drugs had been inadequately studied. Carbamazepine and oxcarbazepine continue to be the first choice for medication for classical TN. Lamotrigine and baclofen can be regarded as second-line drugs to treat patients not responding to first-line medication or for patients having intolerable side effects from carbamazepine. Drug combinations using carbamazepine, baclofen, gabapentin, ropivacaine, tizanidine, and pimozide can yield satisfactory results and improve the tolerance to the treatment. Intravenous lidocaine can be used to treat acute exaggerations and botulinum toxin-A can be used in refractory cases. Proparacaine, dextromethorphan, and tocainide were reported to be inappropriate for treating TN. Anticonvulsants are successful in managing trigeminal neuralgia; nevertheless, there have been few studies with high levels of proof, making it challenging to compare or even combine their results in a statistically useful way. New research on other drugs, combination therapies, and newer formulations, such as vixotrigine, is awaited. There is conclusive evidence for the efficacy of pharmacological drugs in the treatment of TN. Full article
(This article belongs to the Special Issue Neuropathic Pain: From Mechanisms to Therapeutic Approaches)
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