TY  - JOUR
AB  - BACKGROUND: Chronic pain is frequent in elderly people and, especially if widespread, associated with poor mental health. We investigated whether a resilient personality protects older adults against the adverse effects of chronic pain. METHODS: Pain status [no pain, chronic local pain (CLP) and chronic widespread pain (CWP)] was determined using the American College of Rheumatologists' criteria for widespread pain in a cross-sectional sample of 724 participants aged 68-92 years drawn from the population-based KORA-Age study in Southern Germany. Depressive symptoms and resilience were assessed via the scales GDS-15 and RS-5. The relation between pain, resilience and depressive symptoms was modelled using logistic and quantile regression. RESULTS: CLP prevalence and CWP prevalence were 57.5% and 12.3%, respectively. Confounder-adjusted logistic regression indicated a fourfold risk of depressed mood (GDS-15 ≥ 5) in CWP, vs. no pain (OR = 4.08, 95% CI 1.90-8.74). However, in quantile regression, the adverse effect of CWP was significantly attenuated by resilience when looking at the GDS-15 score lower quartile (p = 0.011) and median (p = 0.011). This effect appeared to be mainly driven by participants aged 75-84 years. Confounder adjustment reduced the effect of CLP on depressive symptoms to non-significance, and effect modification by resilience was undetectable in regression models of CLP. CONCLUSIONS: Resilience was protective in the association of CWP with depressive symptoms in this analysis. Older adults with CWP may potentially benefit from interventions supporting resilience. Prospective research should investigate the protective role of resilience in the potentially self-perpetuating relation between chronic pain and depressed affect. WHAT DOES THIS STUDY ADD?: The association of chronic widespread pain with depressive symptoms in the elderly population is attenuated by resilience.
AU  - Bauer, H.
AU  - Emeny, R.T.
AU  - Baumert, J.J.
AU  - Ladwig, K.-H.
C1  - 47967
C2  - 39814
CY  - Hoboken
SP  - 1253-1265
TI  - Resilience moderates the association between chronic pain and depressive symptoms in the elderly.
JO  - Eur. J. Pain
VL  - 20
IS  - 8
PB  - Wiley-blackwell
PY  - 2016
SN  - 1090-3801
ER  - 

TY  - JOUR
AB  - BACKGROUND: Smad-interacting protein 1 (also named Zeb2 and Zfhx1b) is a transcription factor that plays an important role in neuronal development and, when mutated, causes Mowat-Wilson syndrome (MWS). A corresponding mouse model carrying a heterozygous Zeb2 deletion was comprehensively analysed in the German Mouse Clinic. The most prominent phenotype was the reduced pain sensitivity. In this study, we investigated the role of Zeb2 in inflammatory and neuropathic pain. METHODS: For this, we tested mutant Zeb2 animals in different models of inflammatory pain like abdominal constriction, formalin and carrageenan test. Furthermore, we studied the pain reactivity of the mice after peripheral nerve ligation. To examine the nociceptive transmission of primary sensory dorsal root ganglia (DRG) neurons, we determined the neuronal activity in the spinal dorsal horn after the formalin test using staining of c-Fos. Next, we characterized the neuronal cell population in the DRGs and in the sciatic nerve to study the effect of the Zeb2 mutation on peripheral nerve morphology. RESULTS: The present data show that Zeb2 is involved in the development of primary sensory DRG neurons, especially of C- and Aδ fibres. These alterations contribute to a hypoalgesic phenotype in inflammatory but not in neuropathic pain in these Zeb2+/- mice. CONCLUSION: Our data suggest that the under-reaction to pain observed in MWS patients results from a reduced responsivity to nociceptive stimulation rather than an inability to communicate discomfort.
AU  - Pradier, B.*
AU  - Jeub, M.*
AU  - Markert, A.*
AU  - Mauer, D.*
AU  - Tolksdorf, K.*
AU  - van de Putte, T.*
AU  - Seuntjens, E.*
AU  - Gailus-Durner, V.
AU  - Fuchs, H.
AU  - Hrabě de Angelis, M.
AU  - Huylebroeck, D.*
AU  - Beck, H.*
AU  - Zimmer, A.*
AU  - Rácz, I.*
C1  - 26611
C2  - 32301
CY  - Hoboken
SP  - 249-257
TI  - Smad-interacting protein 1 affects acute and tonic, but not chronic pain.
JO  - Eur. J. Pain
VL  - 18
IS  - 2
PB  - Wiley-Blackwell
PY  - 2014
SN  - 1090-3801
ER  - 

TY  - JOUR
AB  - Although there is increasing knowledge of the prevalence of neuropathic pain, little has been done to isolate the cost of neuropathic pain, especially with reference to the frequent complaint of back pain. AIMS: To estimate the prevalence of neuropathic components in back pain and associated costs. METHODS: We used available epidemiological data to model the prevalence of neuropathic back pain in the general adult population, combining three studies: painDETECT 1, painDETECT 2, and the German back pain research network (GBPRN) study, representing a total of 21,047 subjects. The painDETECT screening questionnaire was used in the former two surveys to assess neuropathic pain components. Costing data were obtained from 1718 participants in the GBPRN survey. RESULTS: According to our model, approximately 4% of the general adult population experienced back pain with a neuropathic component. Owing to the greater severity of neuropathic pain, its costs were found to be disproportionately high: among patients with persistent back pain, typical costs associated with a person suffering neuropathic back pain were higher than those of an average back pain patient, and as much as 67% higher than those of a patient with nociceptive back pain only. Approximately, 16% of the total costs associated with back pain were attributable to pain with a neuropathic component. CONCLUSIONS: Back pain with neuropathic components is likely to affect a relevant proportion of the general adult population and cause a disproportionately high share of back pain-related costs.
AU  - Schmidt, C.O.*
AU  - Schweikert, B.
AU  - Wenig, C.M.
AU  - Schmidt, U.*
AU  - Gockel, U.*
AU  - Freynhagen, R.*
AU  - Tölle, T.R.*
AU  - Baron, R.*
AU  - Kohlmann, T.*
C1  - 1132
C2  - 27336
SP  - 1030-1035
TI  - Modelling the prevalence and cost of back pain with neuropathic components in the general population.
JO  - Eur. J. Pain
VL  - 13
IS  - 10
PB  - Elsevier
PY  - 2009
SN  - 1090-3801
ER  - 

TY  - JOUR
AB  - With 12-month prevalence rates of more than 70%, back pain is currently one of the major health problems for German adults and entails major economic consequences. The aim of this study was to estimate back pain-related costs from a societal perspective and to determine the impact of sociodemographic variables on costs. Based on back pain-related survey data of a large German adult sample (9267 respondents, response rate 60%), costs were assessed using a prevalence-based bottom-up approach. Direct costs caused by utilisation of healthcare services, as well as indirect costs due to back pain-related production losses were considered. All prices are expressed in 2005 Euros. Average total back pain costs per patient were estimated to be €1322 (95% CI [1173–1487]) per year. These costs are split between direct (46%) and indirect (54%) costs. Bivariate analysis showed considerable differences in total costs between the Von Korff back pain grades (GCPS Group I: Mean 414.4, 95% CI [333.2–506.3]; II: 783.6 [574.5–1044.4]; III: 3017.2 [2392.9–3708.6]; IV: 7115.7 [5418.5–9006.5]). Male gender, increasing age, single status, low education, unemployment, and increasing back pain grade had a significant positive impact on the cost magnitude in multivariate analysis. Despite several limitations, this study provides important information concerning the relevance of back pain as a health problem and its socioeconomic consequences. The information may be of value for decision-making and allocation of research fund resources.
AU  - Wenig, C.M.
AU  - Schmidt, C.O.*
AU  - Kohlmann, T.*
AU  - Schweikert, B.
C1  - 86
C2  - 26354
SP  - 280-286
TI  - Costs of back pain in Germany.
JO  - Eur. J. Pain
VL  - 13
IS  - 3
PB  - Elsevier Inc.
PY  - 2009
SN  - 1090-3801
ER  - 

TY  - JOUR
AB  - The lowest glycemic threshold for and the risk factors associated with neuropathic pain have not been established. The aim of this study was to determine the prevalence and risk factors of neuropathic pain in survivors of myocardial infarction with diabetes, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), normal glucose tolerance (NGT). Subjects aged 25-74 years with diabetes (n = 214) and controls matched for age and sex (n = 212) from the population-based KORA (Cooperative Health Research in the Region of Augsburg) Myocardial Infarction Registry were assessed for neuropathic pain by the Michigan Neuropathy Screening Instrument using its pain-relevant questions and an examination score cutpoint >2. An oral glucose tolerance test was performed in the controls. Among the controls, 61 (28.8%) had IGT (either isolated or combined with IFG), 70 (33.0%) had isolated IFG, and 81 had NCT. The prevalence of neuropathic pain was 21.0% in the diabetic Subjects, 14.8% in those with IGT, 5.7% in those with IFG, and 3.7% in those with NCT (overall p < 0.001). In the entire population studied (n = 426), age, waist circumference, peripheral arterial disease (PAD), and diabetes were independent factors significantly associated with neuropathic pain, while in the diabetic group it was waist circumference, physical activity, and PAD (all p < 0.05). In conclusion, the prevalence of neuropathic pain is relatively high among survivors of myocardial infarction with diabetes and IGT compared to those with isolated IFG and NGT. Associated cardiovascular risk factors including abdominal obesity and low physical activity may constitute targets to prevent neuropathic pain in this population.
AU  - Ziegler, D.*
AU  - Rathmann, W.*
AU  - Meisinger, C.
AU  - Dickhaus, T.*
AU  - Mielck, A.
C1  - 840
C2  - 26566
SP  - 582-587
TI  - Prevalence and risk factors of neuropathic pain in survivors of myocardial infarction with pre-diabetes and diabetes. The KORA Myocardial Infarction Registry.
JO  - Eur. J. Pain
VL  - 13
IS  - 6
PB  - Elsevier Sci Ltd
PY  - 2009
SN  - 1090-3801
ER  -