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Multiple Cranial Nerve Blocks as an Alternative Preventative Therapy for Chronic Migraine.

The objective of this prospective cohort study is to evaluate the efficacy of multiple cranial nerve blocks (MCNBs) as a preventative therapy for chronic migraine.

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Cryo-EM structures of the ATP release channel pannexin 1.

The plasma membrane adenosine triphosphate (ATP) release channel pannexin 1 (PANX1) has been implicated in many physiological and pathophysiological processes associated with purinergic signaling, including cancer progression, apoptotic cell clearance, inflammation, blood pressure regulation, oocyte development, epilepsy and neuropathic pain. Here we present near-atomic-resolution structures of human and frog PANX1 determined by cryo-electron microscopy that revealed a heptameric channel architecture. Compatible with ATP permeation, the transmembrane pore and cytoplasmic vestibule were exceptionally wide. An extracellular tryptophan ring located at the outer pore created a constriction site, potentially functioning as a molecular sieve that restricts the size of permeable substrates. The amino and carboxyl termini, not resolved in the density map, appeared to be structurally dynamic and might contribute to narrowing of the pore during channel gating. In combination with functional characterization, this work elucidates the previously unknown architecture of pannexin channels and establishes a foundation for understanding their unique channel properties.

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Phase dependent hypothalamic activation following trigeminal input in cluster headache.

Task-free imaging approaches using PET have shown the posterior hypothalamus to be specifically activated during but not outside cluster headache attacks. Evidence from task related functional imaging approaches however is scarce.

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Longitudinal pain and pain interference in long-term survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

The objective of this study was to characterize the prevalence and risk of pain, pain interference, and recurrent pain in adult survivors of childhood cancer in comparison with siblings.

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Two-Hour CGRP Infusion Causes Gastrointestinal Hyperactivity: Possible Relevance for CGRP Antibody Treatment.

The monoclonal antibodies against calcitonin gene-related peptide (CGRP) or its receptor are new antimigraine drugs from which many patients already benefit. Very few side effects have been reported from the antibody trials, including very few gastrointestinal (GI) side effects. The current data derive from a double-blind cross-over study of CGRP infusion for 2 hours. We present the GI side effects of the infusion and raise the question if underreporting of GI symptoms in CGRP antibody trials has occurred. We also discuss why constipation may be more likely with CGRP receptor blockade than with CGRP neutralizing antibodies.

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Migraine Care in the Era of COVID-19: Clinical Pearls and Plea to Insurers.

To outline strategies for the treatment of migraine which do not require in-person visits to clinic or the emergency department, and to describe ways that health insurance companies can remove barriers to quality care for migraine.

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Necessary Components of Psychological Treatment for Chronic Pain: More Packages for Groups or Process-Based Therapy for Individuals?

This journal recently published a paper by Sharpe et al., entitled "Necessary components of psychological treatments in chronic pain management programs: A Delphi study" (Sharpe, Jones, Ashton-James, Nicholas, & Refshauge, 2020). These researcher sought the views of authors of relevant RCTs published up to September 2016 and supplemented these with input from psychologists working in pain management programs in Australia.

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Merely Possessing a Placebo Analgesic Improves Analgesia Similar to Using the Placebo Analgesic.

Placebo analgesia studies generally reported that the actual use of a placebo analgesic reduces pain. Yeung VW, Geers A, Kam SM. Merely possessing a placebo analgesic reduced pain intensity: Preliminary findings from a randomized design. Curr Psychol. 2019;38(1):194-203 found that the mere possession (without use) of a placebo analgesic also reduces pain.

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The Unique and Interactive Effects of Patient Race, Patient Socioeconomic Status, and Provider Attitudes on Chronic Pain Care Decisions.

Compared to White and high socioeconomic status (SES) patients, Black and low SES patients receive less adequate pain care. Providers may contribute to these disparities by making biased decisions that are driven, in part, by their attitudes about race and SES.

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An Innovative Electronic Health Toolkit (Our Whole Lives for Chronic Pain) to Reduce Chronic Pain in Patients With Health Disparities: Open Clinical Trial.

Chronic pain affects millions of Americans. Our Whole Lives, an electronic health (eHealth) toolkit for Chronic Pain (Our Whole Lives for Chronic Pain [OWLCP]), is a mind-body chronic pain management platform that teaches self-management strategies to reduce pain impact and pain medication use.

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