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Clinical therapies for chronic pain are limited. While targeted drugs are promising therapies for chronic pain, they exhibit insufficient efficacy and poor targeting. The occurrence of chronic pain partly results from central changes caused by alterations in neurons in the rostral ventromedial medulla (RVM) in the brainstem regulatory pathway. The RVM, which plays a key role in the descending pain control pathway, greatly contributes to the development and maintenance of pain. However, the exact roles of the RVM in chronic pain remain unclear, making it difficult to develop new drugs targeting the RVM and related pathways. Here, we first discuss the roles of the RVM and related circuits in chronic pain. Then, we analyze synaptic transmission between RVM neurons and spinal cord neurons, specifically focusing on the release of neurotransmitters, to explore the cellular mechanisms by which the RVM regulates chronic pain. Finally, we propose some ideas for the development of drugs targeting the RVM.
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http://dx.doi.org/10.1515/revneuro-2020-0121 | DOI Listing |
J Neurosurg Case Lessons
September 2025
Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Background: Breast cancer is one of the most common malignancies worldwide and is often treated with surgery. Post-mastectomy pain syndrome (PMPS) can have disabling consequences. The incidence of PMPS ranges from 20% to 68%.
View Article and Find Full Text PDFJMIR Res Protoc
September 2025
Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, Medical School, University of Minnesota-Twin Cities, Minneapolis, MN, United States.
Background: Approximately 69% of Americans with spinal cord injury (SCI) have neuropathic pain. Research suggests that impairments in mental body representations (MBRs; ie, representations of the body in the brain) likely contribute to neuropathic pain. Clinical trials in adults with SCI, focused on restoring MBR, led to improvements in sensation and movement as well as neuropathic pain relief.
View Article and Find Full Text PDFPain Manag
September 2025
Pain Management Unit, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.
Aims: The aim of this observational study is to describe the use of epiduroscopy to decrease the enlargement of the ligamentum flavum (LF) in patients with spinal stenosis, as well as the selection of the appropriate patient and the safety measures that enhance procedural success.
Materials & Methods: We introduce the patient selection protocol, define the appropriate indication and the safety measures to use the epiduroscopy as a tool to decrease the size of the LF and increase space, reducing possible complications.
Results: Among patients included in the study, there were no cases of access difficulty or coccydynia, and one case of urinary incontinence occurred in a patient with Schizas grade D (very severe) stenosis.
Curr Obes Rep
September 2025
Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ, USA.
Purpose Of The Review: This review aimed to summarize current evidence on the effectiveness of medical nutrition therapy (MNT) in the management of obesity and endometriosis, with a focus on dietary patterns such as the Mediterranean and Ketogenic diets, as well as nutritional supplementation. Additionally, it highlights the central role of the clinical nutritionist in implementing individualized, evidence-based interventions within multidisciplinary care.
Recent Findings: Although the literature reports the existence of an inverse relationship between risk of endometriosis and body mass index, clinical evidence jointly reports that a condition of obesity is associated with greater disease severity.
Clin Transl Gastroenterol
September 2025
Lynda K and David M Underwood Center for Digestive Health, Houston Methodist, Houston, TX, USA.
Introduction: Pharmacological therapies for chronic idiopathic constipation (CIC) are useful, but many patients report dissatisfaction from a lack of efficacy and occurrence of adverse events. The vibrating capsule (VC) is an FDA approved non-pharmacologic, treatment for CIC. However, its long-term usefulness in a community setting is unknown.
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