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There is evidence of sex differences in the prevalence of chronic musculoskeletal pain as well as in experimental pain sensitivity. However, the neurobiological mechanisms contributing to these sex differences are poorly understood, especially with respect to brain structure. The aim of the present study is to examine sex differences in brain structure in persons with knee osteoarthritis (KOA) pain. Participants (mean age=58 years) with KOA pain (n=146, 65% female) completed demographic, self-reported and experimental pain assessments including temporal summation and conditioned pain modulation along with a 3T high-resolution, T1-weighted anatomical scan at 2 study sites in the US. FreeSurfer software (v.7.1.0, http://surfer.nmr.mgh.harvard.edu ) was used to examine sex differences in gray matter volume and cortical thickness as well as associations with experimental variables. Maps were set at a vertex-wise threshold of P 0.05). The results suggest that brain morphological differences between females and men with KOA pain are associated with distinct pain modulatory measures in men, but not in women. Future studies are needed to characterize potential neurobiological mechanisms underlying endogenous pain modulatory capacity across the sexes to further understand the individualized pain experience. R01AG059809, R01AG067757.

Background: The taxanes and platinum agents provide substantial improvement in the treatment of breast and other cancers. Neuropathy is often the dose limiting toxicity of these agents and can devastatingly affect the patient due to diminished fine motor skills and pain in the hands and feet that diminishes the ability to exercise and interact in normal life. Clinically significant neuropathy occurs in 40% of patients and >10% will persist past a year causing permanent effects on quality of life. Perhaps more devastating, patients often have to discontinue effective treatment due to the development of these symptoms. Additionally, anemia contributes to dose reductions and delays that compromise therapy and cause significant fatigue that diminishes quality of life. Interventions that could reduce these symptoms would provide a substantial improvement in the ability to care for these patients. Toward this end we have developed a non-toxic dietary approach that incorporates supplementation with several natural products. Together, this therapeutic approach, called CS.001 is able to alleviate many of the negative side effects of breast cancer chemotherapy. Methods: C57BL/6 mice were treated with Paclitaxel weekly or Oxaliplatin three times weekly. Animals were tested for neuropathic pain using a cold sensitivity test [acetone test] and sensitivity to mechanical stimulus [Von Frey Test]. A CBC and CMP were performed to assess systemic toxicity. Animals were provided with a nutritional complete diet that limited their carbohydrates to 10% of total caloric input and were additionally supplemented with the following natural products: [1] Medium chain triglycerides [30g/kg], [2] Curcumin [1200mg/kg], [3]EGCG [1200mg/kg] and [4]broccoli sprout powder [20g/kg]. Animals were placed on the CS.001 diet 1 week before beginning chemotherapy. Results: Paclitaxel & Oxaliplatin treatment resulted in a statistically significantly increase in sensitivity to cold stimulus [Acetone test, p Conclusion: Dietary intervention combined with a supplementation of 4 natural products was able to attenuate chemotherapy induced anemia and neuropathy following chemotherapy treatment in mice. This combination is a promising quality of life intervention to evaluate in cancer patients receiving taxanes or platinums. Citation Format: Coy D Heldermon, Ben G Griffith, Matt Bloom, Jennifer Owen, Regina J Martuscello, Yosef Schwartz, Brent A Reynolds, Loic P Deleyrolle. A combination natural product therapy attenuates common side effects associated with chemotherapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-15-10.