慢性疼痛不同治疗方法对认知功能的影响:系统性审查
Allan Botura Brennecke1, Eduardo Silva Reis Barreto1, Liliane Lins-Kusterer1
1School of Medicine, Federal University of Bahia, Salvador, Brazil.
British journal of pain
|January 8, 2025
概括
这一系统性审查发现,目前的证据不能证实慢性疼痛治疗是否改善认知功能. 需要更严格的研究来理解疼痛管理和认知之间的联系.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 认知神经系统和中央疼痛处理之间存在相互影响.
- 疼痛回路和免疫系统之间的双向通信会影响行为,情绪和认知.
- 关于疼痛干预措施是否可以逆转认知衰退,缺乏共识.
研究的目的:
- 系统地审查随机对照试验治疗干预措施改善慢性疼痛患者认知功能的有效性.
- 作为次要结果,评估这些干预措施对免疫学标志物的影响.
主要方法:
- 在PubMed,EMBASE和Scopus中对随机对照试验 (RCT) 的系统审查.
- 包括任何病因的慢性疼痛.
- 专注于认知功能 (初级) 和免疫学标记 (二级).
主要成果:
- 综合了12项研究 (2003-2021年) 的1432名参与者.
- 在12项研究中,只有6项报告认知能力的改善,主要是注意力.
- 纤维肌痛是最受研究的疾病;米尔纳西普兰是经常进行的干预;免疫学数据很少.
结论:
- 目前的证据不足以证实,慢性疼痛干预措施可以增强认知功能.
- 审查强调需要新的研究方向和更强大的方法论方法.
- 需要进一步研究以澄清疼痛管理策略与认知结果之间的关系.
相关概念视频
Analgesia and Pain Management
490
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
490
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
95
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
95
CNS Stimulants: Cocaine, Amphetamines and Cannabinoids
160
CNS stimulants, such as cocaine, amphetamines, and cannabinoids, have varying structures and mechanisms of action that lead to different therapeutic effects and side effects. Cocaine, with its molecular formula C17H21NO4, is a tropane alkaloid and a tertiary amino compound. It has two chemical forms: the hydrochloride salt and the "freebase." The former is in powder form, while the latter involves removing the hydrochloride salt to create a form that can be smoked. Cocaine exerts its...
160
Alzheimer's Disease: Treatment
161
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
161


