Not Reviewed

To assess the efficacy of pain neuroscience education combined with physiotherapy for the management of migraine. Physiotherapy can significantly reduce the frequency of migraine, but the evidence is based only on a few studies. Pain neuroscience education might pose a promising treatment, as it addresses migraine as a chronic pain disease. In this non-blinded randomized controlled trial, migraine patients received physiotherapy + pain neuroscience education or physiotherapy alone, preceded by a three-month waiting period. Primary outcomes were frequency of headache (with and without migraine features), frequency of migraine and associated disability. Eighty-two participants were randomized and analyzed. Both groups showed a decrease of headache frequency (p = 0.02, d = 0.46) at post-treatment (physiotherapy: 0.77 days, 95%CI: -0.75 to 2.29 and physiotherapy + pain neuroscience education: 1.25 days, 95%CI: -0.05 to 2.55) and at follow-up (physiotherapy: 1.93, 95%CI: 0.07 to 3.78 and physiotherapy + pain neuroscience education: 3.48 days, 95%CI: 1.89 to 5.06), with no difference between groups (p = 0.26, d = 0.26). Migraine frequency was reduced significantly in the physiotherapy + pain neuroscience education group, and not in the physiotherapy group, at post-treatment (1.28 days, 95%CI: 0.34 to 2.22, p = 0.004) and follow-up (3.05 days, 95%CI: 1.98 to 5.06, p < 0.0001), with a difference between groups at follow-up (2.06 days, p = 0.003). Migraine-related disability decreased significantly in both groups (physiotherapy: 19.8, physiotherapy + pain neuroscience education: 24.0 points, p < 0.001, d = 1.15) at follow-up, with no difference between groups (p = 0.583). Secondary outcomes demonstrated a significant effect of time with no interaction between time and group. No harm or adverse events were observed during the study. In comparison to physiotherapy alone, pain neuroscience education combined with physiotherapy can further reduce the frequency of migraine, but had no additional effect on general headache frequency or migraine-related disability. The study was pre-registered at the German Clinical Trials Register (DRKS00020804).

Corticotropin-releasing factor (CRF) neurones in the paraventricular nucleus (PVN) of the hypothalamus (PVN neurones) can promote wakefulness and are activated under anaesthesia. However, whether these neurones contribute to anaesthetic effects is unknown.

This post-hoc analysis from three phase 3 treatment trials of rimegepant 75 mg – an oral small molecule calcitonin gene-related peptide receptor antagonist for acute and preventive treatment of migraine – assessed efficacy in adults with migraine based on triptan treatment experience.

To analyse the methylation status of the Long Interspersed Nuclear Element-1 (LINE-1) and Short Interspersed Nuclear Element Alu (Alu) of peripheral blood mononuclear cells (PBMCs) from patients with migraine compared with healthy control subjects.

Greater occipital nerve blockade for the prevention of chronic migraine has a limited evidence base. A robust randomized double-blind, placebo-controlled trial is needed.

Osteoarthritis (OA) is a chronic osteoarthropathy characterized by the progressive degeneration of articular cartilage and synovial inflammation. Early OA clinical treatments involve intra-articular injection of glucocorticoids, oral acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), which are used for anti-inflammation and pain relief. However, long-term use of these agents will lead to inevitable side effects, even aggravate cartilage loss. At present, there are no disease-modifying OA drugs (DMOADs) yet approved by regulatory agencies. Polarization regulation of synovial macrophages is a new target for OA treatment. Inhibiting M1 polarization and promoting M2 polarization of synovial macrophages can alleviate synovial inflammation, relieve joint pain and inhibit articular cartilage degradation, which is a promising strategy for OA treatment. In this study, we describe the molecular mechanisms of macrophage polarization and its key role in the development of OA. Subsequently, we summarize the latest progress of strategies for OA treatment through macrophage reprogramming, including small molecule compounds (conventional western medicine and synthetic compounds, monomer compounds of traditional Chinese medicine), biomacromolecules, metal/metal oxides, cells, and cell derivatives, and interprets the molecular mechanisms, hoping to provide some information for DMOADs development.

We present the case of a 65-year-old man undergoing open-heart surgery through a full sternotomy with the use of bilateral intercostal cryo nerve block (cryoNB) as adjunctive therapy for postoperative analgesia. CryoNB has been previously demonstrated as safe and effective for pain control in thoracotomy procedures as well as bilaterally in adolescent patients with pectus excavatum undergoing Nuss procedure. Herein, we describe for the first time, the cryoNB procedure for postoperative pain management in a patient undergoing full sternotomy.

Alopecia is associated with erenumab post-marketing, but no cases have been described.

The white matter structural network changes remain poorly understood in patients with temporal lobe epilepsy and comorbid headache (PWH). This study aimed at exploring topological changes in the structural network.

Fibromyalgia syndrome (FMS) is a common clinical syndrome. At present, the lack of epidemiological data from large-sample studies in our country persists, and there are many difficulties in diagnosis and treatment. It is imperative to formulate diagnosis and treatment guidelines for FMS in our country. As such, a project was jointly initiated by the China Association of Chinese Medicine Rheumatology Society, the Fibromyalgia Research Group of Traditional Chinese and Western Medicine in Rheumatology and Immunology, and the Capital Institute of Rheumatology and Immunology of Integrated Chinese and Western Medicine, which adopted the Grading of Recommendations Assessment, Development, and Evaluation grading system and the Reporting Items for Practice Guidelines in Health Care for guideline development. Detailed evidence-based recommendations on 11 clinical problems of FMS that concern Chinese first-line physicians are given in the guideline, aiming to encourage the departments of rheumatology, psychology, pain, and other related departments to attach great importance to the comprehensive management, early identification and intervention, and assessment of FMS to improve the quality of life of patients with FMS.