Incidence of contralateral neurosensitive changes and persistent postoperative pain 6 months after mastectomy

Masgoret, Paula; Soto, Inés de; Caballero, A.; Ríos, José; Gomar, C.

doi:10.1097/md.0000000000019101

Cited by 11 publications

(5 citation statements)

References 37 publications

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“…Based on the results, anxiety (hidden or explicit) can predict postoperative neuropathic pain, which is consistent with the results of other similar studies (22)(23)(24). Based on the literature, high levels of anxiety can explain 35% of the pain associated with breast cancer surgery.…”

Section: Discussionsupporting

confidence: 90%

Investigating the Factors Affecting the Severity of Neuropathic Pain Before and After the Coronavirus Infection in Patients Having Breast Cancer Surgery

Charsouei

Ghaderi

Anvari

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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Objectives: Approximately one-third of women having breast surgery experience neuropathic pain although no study has so far identified its risk factors. It seems that the coronavirus infection increases the likelihood of neuropathic pain through influencing the neuropsychological system. Therefore, the current study aimed to investigate factors affecting the severity of neuropathic pain before and after coronavirus disease 19 (COVID-19) in patients who had breast cancer surgery. Materials and Methods: The current descriptive-analytical study was conducted six months before June 4, 2020. In total, 40 women having breast surgery participated in this study. Postoperative neuropathic pain and its influencing factors were evaluated using demographic tools, Spielberger anxiety, and a 36-item short-form health survey for measuring the quality of life (QoL). Finally, data were analyzed by multivariate regression. Results: Neuropathic pain significantly increased during the COVID-19 pandemic. Mastectomy (P=0.009), removal of lymph nodes (P=0.011), number of radiotherapy sessions (P=0.003), history of chemotherapy (P=0.009), disease stage (P=0.015), hidden anxiety (P=0.005), and explicit anxiety (P=0.001), and all domains of QoL (P<0.05) significantly predicted neuropathic pain. Conclusions: In general, adverse effects of coronavirus pandemic reduced the QoL while increasing anxiety (hidden and explicit), thus leading to an increase in the severity of postoperative neuropathic pain.

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Section: Discussionsupporting

confidence: 90%

Investigating the Factors Affecting the Severity of Neuropathic Pain Before and After the Coronavirus Infection in Patients Having Breast Cancer Surgery

Charsouei

Ghaderi

Anvari

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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“…MIP has been reported in many clinical cases, mostly under neuropathic pain backgrounds (Huge et al, 2011;Konopka et al, 2012;Giglio and Gregg, 2018;Maatman et al, 2019;Masgoret et al, 2020). MIP is sporadic in human but common in animal models of neuropathic pain (Arguis et al, 2008;Cao et al, 2014;C.…”

Section: Discussionmentioning

confidence: 99%

Contralateral Projection of Anterior Cingulate Cortex Contributes to Mirror-Image Pain

Zhang

Xia

et al. 2021

J. Neurosci.

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Long-term limb nerve injury often leads to mirror-image pain (MIP), an abnormal pain sensation in the limb contralateral to the injury. Although it is clear that MIP is mediated in part by central nociception processing, the underlying mechanisms remain poorly understood. The anterior cingulate cortex (ACC) is a key brain region that receives relayed peripheral nociceptive information from the contralateral limb. In this study, we induced MIP in male mice, in which a unilateral chronic constrictive injury of the sciatic nerve (CCI) induced a decreased nociceptive threshold in both hind limbs and an increased number of c-Fos-expressing neurons in the ACC both contralateral and ipsilateral to the injured limb. Using viral-mediated projection mapping, we observed that a portion of ACC neurons formed monosynaptic connections with contralateral ACC neurons. Furthermore, the number of cross-callosal projection ACC neurons that exhibited c-Fos signal was increased in MIP-expressing mice, suggesting enhanced transmission between ACC neurons of the two hemispheres. Moreover, selective inhibition of the cross-callosal projection ACC neurons contralateral to the injured limb normalized the nociceptive sensation of the uninjured limb without affecting the increased nociceptive sensation of the injured limb in CCI mice. In contrast, inhibition of the non-cross-callosal projection ACC neurons contralateral to the injury normalized the nociceptive sensation of the injured limb without affecting the MIP exhibited in the uninjured limb. These results reveal a circuit mechanism, namely, the cross-callosal projection of ACC between two hemispheres, that contributes to MIP and possibly other forms of contralateral migration of pain sensation.

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“…Chronic neuropathic pain (NP) results from multiple etiological factors that initiate diverse mechanisms and express both within, and across different disease states [ 1 ]. It is now clear that peripheral nerve inflammation or lesion can affect contralateral healthy structures, and thus results in mirror-image pain [ 2 – 10 ], a clinical pain-associated phenomenon [ 11 – 14 ]. Although the contralateral/mirror pain is commonly reported, it is hard to achieve satisfying therapeutic effect.…”

Section: Introductionmentioning

confidence: 99%

Neuroinflammation in the anterior cingulate cortex: the potential supraspinal mechanism underlying the mirror-image pain following motor fiber injury

Chen

Liu

et al. 2022

J Neuroinflammation

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Background Peripheral nerve inflammation or lesion can affect contralateral healthy structures, and thus result in mirror-image pain. Supraspinal structures play important roles in the occurrence of mirror pain. The anterior cingulate cortex (ACC) is a first-order cortical region that responds to painful stimuli. In the present study, we systematically investigate and compare the neuroimmune changes in the bilateral ACC region using unilateral- (spared nerve injury, SNI) and mirror-(L5 ventral root transection, L5-VRT) pain models, aiming to explore the potential supraspinal neuroimmune mechanism underlying the mirror-image pain. Methods The up-and-down method with von Frey hairs was used to measure the mechanical allodynia. Viral injections for the designer receptors exclusively activated by designer drugs (DREADD) were used to modulate ACC glutamatergic neurons. Immunohistochemistry, immunofluorescence, western blotting, protein microarray were used to detect the regulation of inflammatory signaling. Results Increased expressions of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) and chemokine CX3CL1 in ACC induced by unilateral nerve injury were observed on the contralateral side in the SNI group but on the bilateral side in the L5-VRT group, representing a stronger immune response to L5-VRT surgery. In remote ACC, both SNI and L5-VRT induced robust bilateral increase in the protein level of Nav1.6 (SCN8A), a major voltage-gated sodium channel (VGSC) that regulates neuronal activity in the mammalian nervous system. However, the L5-VRT-induced Nav1.6 response occurred at PO 3d, earlier than the SNI-induced one, 7 days after surgery. Modulating ACC glutamatergic neurons via DREADD-Gq or DREADD-Gi greatly changed the ACC CX3CL1 levels and the mechanical paw withdrawal threshold. Neutralization of endogenous ACC CX3CL1 by contralateral anti-CX3CL1 antibody attenuated the induction and the maintenance of mechanical allodynia and eliminated the upregulation of CX3CL1, TNF-α and Nav1.6 protein levels in ACC induced by SNI. Furthermore, contralateral ACC anti-CX3CL1 also inhibited the expression of ipsilateral spinal c-Fos, Iba1, CD11b, TNF-α and IL-6. Conclusions The descending facilitation function mediated by CX3CL1 and its downstream cascade may play a pivotal role, leading to enhanced pain sensitization and even mirror-image pain. Strategies that target chemokine-mediated ACC hyperexcitability may lead to novel therapies for the treatment of neuropathic pain.

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Incidence of contralateral neurosensitive changes and persistent postoperative pain 6 months after mastectomy

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 37 publications

Investigating the Factors Affecting the Severity of Neuropathic Pain Before and After the Coronavirus Infection in Patients Having Breast Cancer Surgery

Investigating the Factors Affecting the Severity of Neuropathic Pain Before and After the Coronavirus Infection in Patients Having Breast Cancer Surgery

Contralateral Projection of Anterior Cingulate Cortex Contributes to Mirror-Image Pain

Neuroinflammation in the anterior cingulate cortex: the potential supraspinal mechanism underlying the mirror-image pain following motor fiber injury

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