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1. Modulation of Pain Sensitivity by a Hyperventilatory Breathing Exercise and Cold Exposure Training

Author

Zwaag J, Timmerman H, Pickkers P, and Kox M

Subjects
pain thresholds, hyperventilation, breathing, cold exposure, inflammation, endotoxin., Medicine (General), R5-920
Abstract

Jelle Zwaag,1,2 Hans Timmerman,3,4 Peter Pickkers,1,2 Matthijs Kox1,2 1Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; 2Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands; 3University of Groningen, University Medical Center Groningen, Department of Anesthesiology, Pain Center, Groningen, the Netherlands; 4Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the NetherlandsCorrespondence: Matthijs Kox, Radboud University Medical Center, Department of Intensive Care Medicine (710), Geert Grooteplein Zuid 10, PO Box 9101, Nijmegen, 6500 HB, the Netherlands, Email matthijs.kox@radboudumc.nlBackground: Evidence indicates that healthy individuals who follow a training program comprised hyperventilatory breathing exercises and cold exposure can voluntarily activate their sympathetic nervous system and attenuate their systemic inflammatory response during experimental endotoxemia (intravenous administration of bacterial endotoxin). Furthermore, trained participants reported less endotoxemia-induced flu-like symptoms. However, it remained to be determined whether the effects on symptoms are due to the mitigated inflammatory response or involve direct analgesic effects of (elements of) the training program.Methods: In the present study, we used Nijmegen-Aalborg Screening Quantitative sensory testing (NASQ) to objectively map pain sensitivity using non-invasive stimuli to address this question. First, NASQ parameters were evaluated in 20 healthy volunteers before, during, and after the conduct of the hyperventilatory breathing exercise. Second, NASQ measurements were performed before and after 48 healthy volunteers followed different modalities of the training program: breathing exercise training, cold exposure training, the combination of both, or no training. Lastly, NASQ measurements were performed in these 48 subjects during experimental endotoxemia.Results: Electrical pain detection thresholds increased during the breathing exercise (p = 0.001) as well as four hours afterwards (p = 0.03). Furthermore, cold exposure training resulted in lower VAS scores during hand immersion in ice water (p < 0.001). Systemic inflammation induced by administration of endotoxin nullified the decreased pain perception during the ice water test in subjects trained in cold exposure.Conclusion: A hyperventilatory breathing exercise decreases pain perception induced by an electrical stimulus. Furthermore, cold exposure training may decrease pain perception induced by hand immersion in ice water.Keywords: pain thresholds, hyperventilation, breathing, cold exposure, inflammation, endotoxin

Published
2023

2. The added value of bedside examination and screening QST to improve neuropathic pain identification in patients with chronic pain

Author

Timmerman H, Wilder-Smith OHG, Steegers MAH, Vissers KCP, and Wolff AP

Subjects
Pain, Neuropathic Pain, NePC, Neuropathic pain component, Bedside examination, QST, Quantitative sensory testing, NASQ, Nijmegen-Aalborg Screening QST, Clinical assessment, Diagnostic accuracy., Medicine (General), R5-920
Abstract

Hans Timmerman,1 Oliver HG Wilder-Smith,1,2 Monique AH Steegers,3 Kris CP Vissers,3 André P Wolff4 1Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; 2Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark; 3Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; 4Department of Anesthesiology, Pain Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Background: The assessment of a neuropathic pain component (NePC) to establish the neurological criteria required to comply with the clinical description is based on history taking, clinical examination, and quantitative sensory testing (QST) and includes bedside examination (BSE). The objective of this study was to assess the potential association between the clinically diagnosed presence or absence of an NePC, BSE, and the Nijmegen–Aalborg screening QST (NASQ) paradigm in patients with chronic (≥3 months) low back and leg pain or with neck shoulder arm pain or in patients with chronic pain due to suspected peripheral nerve damage.Methods: A total of 291 patients participated in the study. Pain (absence or presence of neuropathic pain) was assessed independently by two physicians and compared with BSE (measurements of touch [finger, brush], heat, cold, pricking [safety pin, von Frey hair], and vibration). The NASQ paradigm (pressure algometry, electrical pain thresholds, and conditioned pain modulation) was assessed in 58 patients to generate new insights.Results: BSE revealed a low association of differences between patients with either absent or present NePC: heat, cold, and pricking sensations with a von Frey hair were statistically significantly less common in patients with present NePC. NASQ did not reveal any differences between patients with and without an NePC.Conclusion: Currently, a standardized BSE appears to be more useful than the NASQ paradigm when distinguishing between patients with and without an NePC. Keywords: quantitative sensory testing, NASQ, Nijmegen–Aalborg screening QST, clinical assessment, diagnostic accuracy

Published
2018

7. The effect of preferred music versus disliked music on pain thresholds in healthy volunteers. An observational study.

Author

Timmerman, H., Boekel, R.L.M. van, Linde, L.S. van de, Bronkhorst, E.M., Vissers, K.C.P., Wal, S.E.I. van der, Steegers, M.A.H., Timmerman, H., Boekel, R.L.M. van, Linde, L.S. van de, Bronkhorst, E.M., Vissers, K.C.P., Wal, S.E.I. van der, and Steegers, M.A.H.

Abstract

Contains fulltext : 291134.pdf (Publisher’s version ) (Open Access), Pain is a prevalent and debilitating healthcare problem. Since pharmacological treatments have numerous side-effects, additional treatment could be beneficial. Music has been shown to affect the pain perception and the pain threshold. The objective of this observational study was to evaluate the effect of preferred music as opposed to disliked music on pain (tolerance) thresholds and perceived pain intensity in healthy volunteers. Pain thresholds were measured via quantitative sensory testing. The volunteers were randomly assigned to either handheld pressure algometry to assess the pressure pain threshold to or electrical measurements to assess the electrical pain tolerance threshold while listening to preferred and disliked music. The pain thresholds were administered on the dorsal side of the forearm. The perceived pain intensity was assessed via a numerical rating scale, ranging from 0 (no pain) to 10 (worst pain imaginable). In total 415 volunteers were included in this study. The pressure pain threshold was assessed in 277 volunteers and in the electrical pain tolerance threshold test 138 volunteers were entered. In both groups, preferred music yielded higher pain thresholds than disliked music (P<0.001) and lower perceived pain intensity during the stimulus (P = 0.003). Moreover, the highest pain thresholds of both pressure pain and electrical pain tolerance thresholds were obtained when the preferred music was preceded by disliked music. Listening to preferred music when receiving noxious stimuli leads to higher pain thresholds and lower perceived pain scores in comparison with disliked music. Preferred music could be beneficial for patients with pain or undergoing painful procedures.

Published
2023

8. Modulation of Pain Sensitivity by a Hyperventilatory Breathing Exercise and Cold Exposure Training.

Author

Zwaag, J., Timmerman, H., Pickkers, P., Kox, M., Zwaag, J., Timmerman, H., Pickkers, P., and Kox, M.

Abstract

Item does not contain fulltext, BACKGROUND: Evidence indicates that healthy individuals who follow a training program comprised hyperventilatory breathing exercises and cold exposure can voluntarily activate their sympathetic nervous system and attenuate their systemic inflammatory response during experimental endotoxemia (intravenous administration of bacterial endotoxin). Furthermore, trained participants reported less endotoxemia-induced flu-like symptoms. However, it remained to be determined whether the effects on symptoms are due to the mitigated inflammatory response or involve direct analgesic effects of (elements of) the training program. METHODS: In the present study, we used Nijmegen-Aalborg Screening Quantitative sensory testing (NASQ) to objectively map pain sensitivity using non-invasive stimuli to address this question. First, NASQ parameters were evaluated in 20 healthy volunteers before, during, and after the conduct of the hyperventilatory breathing exercise. Second, NASQ measurements were performed before and after 48 healthy volunteers followed different modalities of the training program: breathing exercise training, cold exposure training, the combination of both, or no training. Lastly, NASQ measurements were performed in these 48 subjects during experimental endotoxemia. RESULTS: Electrical pain detection thresholds increased during the breathing exercise (p = 0.001) as well as four hours afterwards (p = 0.03). Furthermore, cold exposure training resulted in lower VAS scores during hand immersion in ice water (p < 0.001). Systemic inflammation induced by administration of endotoxin nullified the decreased pain perception during the ice water test in subjects trained in cold exposure. CONCLUSION: A hyperventilatory breathing exercise decreases pain perception induced by an electrical stimulus. Furthermore, cold exposure training may decrease pain perception induced by hand immersion in ice water.

Published
2023

9. Olanzapine as an add‐on, pre‐operative anti‐emetic drug for postoperative nausea or vomiting: a randomised controlled trial.

Author

Grigio, T. R., Timmerman, H., Martins, J. V. B., Slullitel, A., Wolff, A. P., and Sousa, A. M.

Subjects
*POSTOPERATIVE nausea & vomiting, *RANDOMIZED controlled trials, *OLANZAPINE, *PREOPERATIVE risk factors, *DISEASE risk factors, *INTRAVENOUS anesthesia
Abstract

Summary: Postoperative nausea or vomiting occurs in up to 40% in patients with multiple risk factors, despite prophylaxis. Olanzapine is an antipsychotic drug that is used to prevent nausea and vomiting in palliative care and to treat chemotherapy‐induced nausea and vomiting. This study aimed to examine whether pre‐operative olanzapine, as a prophylactic anti‐emetic added to intra‐operative dexamethasone, ondansetron and total intravenous anaesthesia, reduced the incidence of postoperative nausea or vomiting. We performed a multiply‐blinded randomised controlled trial in patients aged 18–60 years with cancer at high risk of postoperative nausea or vomiting (three or four risk factors according to the Apfel criteria) plus a previous history of chemotherapy‐induced nausea and vomiting. Patients were allocated at random to receive 10 mg olanzapine or placebo orally 1 h before surgery in addition to a two‐drug regimen (dexamethasone and ondansetron) and propofol anaesthesia to prevent postoperative nausea or vomiting. The primary outcome was the incidence of postoperative nausea or vomiting in the first 24 h after surgery. In total, 100 patients were enrolled; 47 in the olanzapine group and 49 in the control group completed the study. The baseline characteristics of the groups were similar. The incidence of postoperative nausea or vomiting in the first 24 h after surgery was lower in the olanzapine group (12/47, 26%) than in the control group (31/49, 63%) (p = 0.008, RR 0.40 (95%CI 0.21–0.79)). Adding pre‐operative oral olanzapine to intra‐operative dexamethasone and ondansetron was highly effective in reducing the risk of postoperative nausea or vomiting in the first 24 hours after surgery in patients with a previous history of chemotherapy‐induced nausea and vomiting and at least three Apfel risk factors for postoperative nausea or vomiting. [ABSTRACT FROM AUTHOR]

Published
2023
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12. The histamine H3-receptor: A target for developing new drugs

Author

Leurs, R., Timmerman, H., Jucker, Ernst, editor, Bachrach, Uriel, Saxena, Anil K., Saxena, Mridula, Leurs, R., Timmerman, H., Lee, Betty, Ciardelli, Thomas L., Margaglione, Maurizio, Grandone, Elvira, Di Minno, Giovanni, Schultz, Richard M., Whittake, V. P., Männistö, P. T., Ulmanen, I., Lundström, K., Taskinen, J., Tenhunen, J., Tilgmann, C., Kaakkola, S., and Wechter, William J.

Published
1992
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13. Correction: Protocol of the Healthy Brain Study: An Accessible Resource for Understanding the Human Brain and How It Dynamically and Individually Operates in Its Bio-Social Context

Author

Healthy Brain Study consortium, Aarts, E, Akkerman, A, Altgassen, M, Bartels, R, Beckers, D, Bevelander, K, Bijleveld, E, Davidson, EB, Boleij, A, Bralten, J, Cillessen, T, Claassen, J, Cools, R, Cornelissen, I, Dresler, M, Eijsvogels, T, Faber, M, Fernández, G, Figner, B, Fritsche, M, Füllbrunn, S, Gayet, S, van Gelder, MMHJ, van Gerven, M, Geurts, S, Greven, CU, Groefsema, M, Haak, K, Hagoort, P, Hartman, Y, van der Heijden, B, Hermans, E, Heuvelmans, V, Hintz, F, den Hollander, J, Hulsman, AM, Idesis, S, Jaeger, M, Janse, E, Janzing, J, Kessels, RPC, Karremans, JC, de Kleijn, W, Klein, M, Klumpers, F, Kohn, N, Korzilius, H, Krahmer, B, de Lange, F, van Leeuwen, J, Liu, H, Luijten, M, Manders, P, Manevska, K, Marques, JP, Matthews, J, McQueen, JM, Medendorp, P, Melis, R, Meyer, A, Oosterman, J, Overbeek, L, Peelen, M, Popma, J, Postma, G, Roelofs, K, van Rossenberg, YGT, Schaap, G, Scheepers, P, Selen, L, Starren, M, Swinkels, DW, Tendolkar, I, Thijssen, DHJ, Timmerman, H, Tutunji, R, Tuladhar, A, Veling, H, Verhagen, M, Verkroost, J, Vink, J, Vriezekolk, V, Vrijsen, J, Vyrastekova, J, van der Wal, S, Willems, R, Willemsen, A, and Language, Communication and Cognition

Subjects
Questionnaires, Male, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], COVID-19/diagnosis, 230 Affective Neuroscience, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13], lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Social Sciences, Social Environment, 330 000 Food & Cognition, Social Development, Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12], Analytical Chemistry, RC1200, Experimental Psychopathology and Treatment, Study Protocol, Cognition, Surveys and Questionnaires, 130 000 Cognitive Neurology & Memory, Affect/physiology, Medicine and Health Sciences, Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14], Psychology, Public and Occupational Health, Cognition/physiology, Work, Health and Performance, Intelligence Tests, Grammar, Psycholinguistics, Multidisciplinary, Non-nativeness in Communication, Brain, 220 Statistical Imaging Neuroscience, 180 000 Predictive Brain, Cognitive artificial intelligence, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Semantics, Research Design, Medicine, Female, Behavioral and Social Aspects of Health, Institute for Management Research, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], Personality Tests, Adult, 110 000 Neurocognition of Language, Psychometrics, Science, Decision Making, Sensation, BF, Neuroimaging, Research and Analysis Methods, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Language and Speech, Learning and Therapy, QH301, All institutes and research themes of the Radboud University Medical Center, Humans, Speech Production and Comprehension, Sensation/physiology, 320 000 MR Structural Quantitative Imaging, Behavior, Survey Research, Behaviour Change and Well-being, Neurodevelopmental disorders Donders Center for Medical Neuroscience [Radboudumc 7], Neuro- en revalidatiepsychologie, Action, intention, and motor control, Neuropsychology and rehabilitation psychology, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Cognitive Psychology, Biology and Life Sciences, COVID-19, Linguistics, Brain/diagnostic imaging, QP, Language & Communication, Communication and Media, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Affect, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Narrative, Cognition & Communication, RC0321, Cognitive Science, Digital Security, 170 000 Motivational & Cognitive Control, Developmental Psychopathology, Neuroscience
Abstract

The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30–39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods/access. Trail registration: https://www.trialregister.nl/trial/7955.

Published
2022

14. Correction: Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context

Author

Fernandez, G., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Figner, B., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, Martin, Janse, E., Janzing, J.G., Kessels, R.P.C., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., Willemsen, A.E.C.A.B., Fernandez, G., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Figner, B., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, Martin, Janse, E., Janzing, J.G., Kessels, R.P.C., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., and Willemsen, A.E.C.A.B.

Abstract

Contains fulltext : 248974.pdf (Publisher’s version ) (Open Access)

Published
2022

15. Buprenorphine/naloxone versus methadone opioid rotation in patients with prescription opioid use disorder and chronic pain: Study protocol for a randomized controlled trial

Author

Ellerbroek, H., Heuvel, S.A.S. van den, Dahan, A., Timmerman, H., Kramers, C., Schellekens, A.F.A., Ellerbroek, H., Heuvel, S.A.S. van den, Dahan, A., Timmerman, H., Kramers, C., and Schellekens, A.F.A.

Abstract

Contains fulltext : 253681.pdf (Publisher’s version ) (Open Access), Background: Opioids are effective in pain-management, but long-term opioid users can develop prescription opioid use disorder (OUD). One treatment strategy in patients with OUD is rotating from a short-acting opioid to a long-acting opioid (buprenorphine/naloxone (BuNa) or methadone). Both BuNa and methadone have been shown to be effective strategies in patients with OUD reducing opioid misuse, however data on head-to-head comparison in patients with chronic non-malignant pain and prescription OUD are limited. Methods: This two-armed open-label, randomized controlled trial aims to compare effectiveness between BuNa and methadone in patients with chronic non-malignant with prescription OUD (n = 100). Participants receive inpatient rotation to either BuNa or methadone with a flexible dosing regimen. The primary outcome is opioid misuse 2 months after rotation. Secondary outcomes include treatment compliance, side effects, analgesia, opioid craving, quality of life, mood symptoms, cognitive and physical functioning over 2- and 6 months follow-up. Linear mixed model analysis will be used to evaluate change in outcome parameters over time between the treatment arms. Discussion: This is one of the first studies comparing buprenorphine/naloxone and methadone for treating prescription OUD in a broad patient group with chronic non-malignant pain. Results may guide future treatment for patients with chronic pain and prescription OUD. Trial registration https://www.trialregister.nl/, NL9781

Published
2022

16. Correction: Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context

Author

Healthy Brain Study consortium, ., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Figner, B., Fernandez, G., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E.J., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, Martin, Janse, E., Janzing, J.G., Kessels, R.P.C., Karremans, J.C.T.M., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J.F., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., Willemsen, A.E.C.A.B., Healthy Brain Study consortium, ., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Figner, B., Fernandez, G., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E.J., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, Martin, Janse, E., Janzing, J.G., Kessels, R.P.C., Karremans, J.C.T.M., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J.F., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., and Willemsen, A.E.C.A.B.

Abstract

Contains fulltext : 248974.pdf (Publisher’s version ) (Open Access)

Published
2022

17. Changes in quantitative sensory testing and patient perspectives following spinal cord stimulation for persistent spinal pain syndrome: An observational study with long-term follow-up

Author

Plantaz, Y., Dongen, R.T.M. van, Witkam, R.L., Vissers, K.C.P., Timmerman, H., Plantaz, Y., Dongen, R.T.M. van, Witkam, R.L., Vissers, K.C.P., and Timmerman, H.

Abstract

Contains fulltext : 282451.pdf (Publisher’s version ) (Open Access), BACKGROUND: Spinal cord stimulation (SCS) can impact sensory, pain and tolerance thresholds in various ways, which can be accessed via quantitative sensory testing (QST). The objectives of this study were to (1) assess the subjective sensory responses using QST in patients following SCS therapy for PSPS and (2) to get a clinical impression of the results of SCS during an interview of these patients with PSPS and SCS during long term follow-up. METHODS: Forty patients with PSPS who received SCS treatment underwent QST via electrical and mechanical pressure stimuli. QST was performed at four different moments (1) pre-implantation SCS, (2) two weeks postoperatively, (3) three months after permanent SCS implantation and (4) six months after permanent SCS implantation. Patients' perspectives on pain, use of drugs and quality of life were assessed via semi-structured interviews during a follow-up between 5 and 11 years. RESULTS: We found statistical significant differences in the changes of sensory, pain and tolerance thresholds. A decrease in pain complaints and analgesics use were reported by the patients during follow-up. The quality of life in patients increased from three to eight (NRS 0 [worst QoL imaginable] -10 [best QoL imaginable]) after receiving SCS. CONCLUSIONS: The increased thresholds on areas without pain or being covered by the SCS induced paresthesias may indicate that there are central changes contributing to these deviations in thresholds. The overall QoL in patients improved greatly after receiving SCS. SIGNIFICANCE: This study provides an overview of the effect of SCS on sensory, pain and tolerance thresholds in patients with PSPS throughout the SCS treatment process. In addition, this study presents data from 40 patients with PSPS treated with SCS, analysing several long-term patient-reported outcome measures. The results serve to give more insight into the mechanism of SCS and document SCS as a possible treatment for PSPS.

Published
2022

20. List of Contributors

Author

Alldrick, A.J., primary, Andersen, E.V.M., additional, Ariosti, A., additional, Aventín, E. Espada, additional, Bugge, E., additional, Burfoot, D., additional, Christian, G.K., additional, Crevel, R.W.R., additional, Demirci, A., additional, Fikiin, K., additional, Fischer, A.R.H., additional, Frewer, L.J., additional, Friis, A., additional, Fryer, P.J., additional, Gabrić, D., additional, Galić, K., additional, Goode, K.R., additional, Graßhoff, A., additional, Griffith, C., additional, Gueguen, D., additional, Hasting, A.P.M., additional, Holah, J., additional, Hoogland, H., additional, Huisman, I.H., additional, Jensen, B.B.B., additional, Kaptan, G., additional, Kold, J., additional, Kostyukovsky, M., additional, Lelieveld, H.L.M., additional, Lukasse, L.J.S., additional, Mager, K., additional, Maillard, J.-Y., additional, McConnon, Á., additional, McHardy, M., additional, Miettinen, H., additional, Moerman, F., additional, Mogensen, P.K., additional, Mortimore, S.E., additional, Motarjemi, Y., additional, Oner, M.E., additional, Overbosch, P., additional, Partington, E., additional, Pierce, P.D., additional, Puri, V.M., additional, Quinn, E., additional, Redfern, J., additional, Regan, Á., additional, Regenstein, Joe M., additional, Rosner, D., additional, Salo, S., additional, Schmidt, R.H., additional, Schmitt, R., additional, Schonrock, F. Tracy, additional, Shaaya, E., additional, Silverman, C., additional, Smith, D.L., additional, Stahlkopf, R., additional, Straver, J.M., additional, Taylour, J., additional, van Velzen, E.U. Thoden, additional, Timmerman, H., additional, van Asselt, E.D., additional, Van Rijn, I., additional, Verran, J., additional, Vidaček, S., additional, Vintilă, Iuliana, additional, Wallace, C.A., additional, Wang, X., additional, West, S., additional, Wirtanen, G., additional, and Zwietering, M.H., additional

Published
2016
Full Text
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21. Music and low-frequency vibrations for the treatment of chronic musculoskeletal pain in elderly: A pilot study

Author

Eshuis, T.A.H. (Thom), Stuijt, P.J.C. (Peter), Timmerman, H. (Hans), Nielsen, P.M. (Peter Michael ), Wolff, A.P. (André Paul ), and Soer, R. (Remko)

Subjects
Critical care, Anesthesiology, Chronic Pain, Pain Measurement
Abstract

BackgroundTranscutaneous vagal nerve stimulation has analgesic potential and might be elicited by abdominally administered low-frequency vibrations. The objective was to study the safety and effect of a combination of music and abdominally administered low-frequency vibrations on pain intensity in elderly patients with chronic musculoskeletal pain.MethodsThis trial was an international multicenter, randomized controlled pilot study. Patients at age ≥ 65 years with musculoskeletal pain for ≥ 3 months and a daily pain score ≥ 4 out of 10 were recruited at three centers. They were randomized to receive either a combination of music and low-frequency (20–100 Hz) vibrations administered to the abdomen, or a combination with the same music but with higher frequency (200–300 Hz) vibrations administered to the abdomen. Low-frequency vibrations were expected to result in pain reduction measured with a numeric pain rating scale (NRS). Patients in both groups received eight treatments of the music combined with the vibrations in three weeks. Primary outcomes were safety (Serious Adverse Events) and pain intensity measured at baseline, after the last treatment and at six weeks follow-up. Multilevel linear model analyses were performed to study group and time effects.ResultsA total of 45 patients were analyzed according to intention-to-treat principle. After 344 treatments, 1 Adverse Event was found related to the intervention, while 13 Adverse Events were possibly related. A multilevel linear model showed that the interaction effect of group by time did not predict pain intensity (F[1, 45.93] = 0.002, p = 0.97) when comparing pain intensity at baseline, after the last treatment and at follow-up.ConclusionsThe combination of music and abdominally administered vibrations was found to be safe and well tolerated by the elderly patients. However, over time, neither the low-frequency treatment group nor the high-frequency treatment group provided clinically meaningful pain relief. There is no evidence that the low-frequency treatment elicited vagal nerve stimulation.

Published
2021

26. Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context

Author

Fernandez, G., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Figner, B., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, Martin, Janse, E., Janzing, J.G., Kessels, R.P.C., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., Willemsen, A.E.C.A.B., Fernandez, G., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Figner, B., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, Martin, Janse, E., Janzing, J.G., Kessels, R.P.C., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., and Willemsen, A.E.C.A.B.

Abstract

Contains fulltext : 242453.pdf (Publisher’s version ) (Open Access), The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30-39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods. https://www.trialregister.nl/trial/7955

Published
2021

27. The Effect of Protein Supplementation versus Carbohydrate Supplementation on Muscle Damage Markers and Soreness Following a 15-km Road Race: A Double-Blind Randomized Controlled Trial

Author

Haaf, D.S.M. ten, Flipsen, Martin A., Horstman, Astrid M. H., Timmerman, H., Steegers, M.A.H., Groot, Lisette C. P. G. M. de, Eijsvogels, T.M.H., Hopman, M.T.E., Haaf, D.S.M. ten, Flipsen, Martin A., Horstman, Astrid M. H., Timmerman, H., Steegers, M.A.H., Groot, Lisette C. P. G. M. de, Eijsvogels, T.M.H., and Hopman, M.T.E.

Abstract

Contains fulltext : 232099.pdf (Publisher’s version ) (Open Access)

Published
2021

28. Persistent Pain after Breast Cancer Surgery: Towards Mechanism-Based Prediction and Prevention

Author

Vissers, K.C.P., Steegers, M.A.H., Timmerman, H., Wal, S.E.I. van der, Helmond, N. van, Vissers, K.C.P., Steegers, M.A.H., Timmerman, H., Wal, S.E.I. van der, and Helmond, N. van

Abstract

Radboud University, 12 oktober 2021, Promotores : Vissers, K.C.P., Steegers, M.A.H. Co-promotores : Timmerman, H., Wal, S.E.I. van der, Contains fulltext : 236656.pdf (Publisher’s version ) (Open Access)

Published
2021

29. Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context

Author

Healthy Brain Study consortium, ., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Fernandez, G., Figner, B., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E.J., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, M., Janse, E., Janzing, J.G., Kessels, R.P.C., Karremans, J.C.T.M., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J.F., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., Willemsen, A.E., Healthy Brain Study consortium, ., Aarts, E., Akkerman, A., Altgassen, A.M., Bartels, R.H.M.A., Beckers, D.G.J., Bevelander, K.E., Bijleveld, E., Blaney Davidson, E.N., Boleij, A., Bralten, J.B., Cillessen, A.H.N., Claassen, J.A., Cools, R., Cornelissen, I.M., Dresler, M., Eijsvogels, T.M.H., Faber, M., Fernandez, G., Figner, B., Fritsche, M., Füllbrunn, S.C., Gayet, S., Gelder, M.M.H.J. van, Gerven, M.A.J. van, Geurts, S.A.E., Greven, C.U., Groefsema, M.M., Haak, K.V., Hagoort, P., Hartman, Y.A.W., Heijden, B.I.J.M. van der, Hermans, E.J., Heuvelmans, V.R., Hintz, F., Hollander, J.W. den, Hulsman, A.M., Idesis, S.A., Jaeger, M., Janse, E., Janzing, J.G., Kessels, R.P.C., Karremans, J.C.T.M., Kleijn, W.P.E. de, Klein, M., Klumpers, F., Kohn, N., Korzilius, H.P.L.M., Krahmer, B., Lange, F.P. de, Leeuwen, J.M.C. van, Liu, H., Luijten, M., Manders, P., Manevska, K., Marques, J.P., Matthews, J., McQueen, J.M., Medendorp, W.P., Melis, R.J.F., Meyer, A.S., Oosterman, J.M., Overbeek, L.I.H., Peelen, M.V., Popma, J.A.M., Postma, G.J., Roelofs, K., Rossenberg, Y.G.T. van, Schaap, G.J., Scheepers, P.T., Selen, L.P.J., Starren, M.B.P., Swinkels, D.W., Tendolkar, I., Thijssen, D.H.J., Timmerman, H., Toutounji, R.T., Tuladhar, A.M., Veling, H.P., Verhagen, M., Verkroost, J., Vriezekolk, V., Vrijsen, J.N., Vyrastekova, J., Wal, S.E.I. van der, Willems, R.M., and Willemsen, A.E.

Abstract

Contains fulltext : 242453.pdf (Publisher’s version ) (Open Access), The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30-39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods. https://www.trialregister.nl/trial/7955

Published
2021

31. Central Sensitisation and functioning in patients with chronic low back pain: protocol for a cross-sectional and cohort study

Author

Echeita, Jone Ansuategui, Schiphorst Preuper, Henrica R., Dekker, R., Stuive, Ilse, Timmerman, H., Wolff, Andre P., Reneman, Michiel F., Echeita, Jone Ansuategui, Schiphorst Preuper, Henrica R., Dekker, R., Stuive, Ilse, Timmerman, H., Wolff, Andre P., and Reneman, Michiel F.

Abstract

Contains fulltext : 218544.pdf (publisher's version ) (Open Access)

Published
2020

33. Is Preoperative Quantitative Sensory Testing Related to Persistent Postsurgical Pain? A Systematic Literature Review

Author

Helmond, N. van, Aarts, H.M., Timmerman, H., Olesen, S.S., Drewes, A.M., Wilder-Smith, O.H.G., Steegers, M.A.H., Vissers, K.C.P., Helmond, N. van, Aarts, H.M., Timmerman, H., Olesen, S.S., Drewes, A.M., Wilder-Smith, O.H.G., Steegers, M.A.H., and Vissers, K.C.P.

Abstract

Contains fulltext : 225328.pdf (Publisher’s version ) (Closed access), Persistent postsurgical pain (PPSP) is a common complication of surgery that significantly affects quality of life. A better understanding of which patients are likely to develop PPSP would help to identify when perioperative and postoperative pain management may require specific attention. Quantitative sensory testing (QST) of a patient's preoperative pain perception is associated with acute postoperative pain, and acute postoperative pain is a risk factor for PPSP. The direct association between preoperative QST and PPSP has not been reviewed to date. In this systematic review, we assessed the relationship of preoperative QST to PPSP. We searched databases with components related to (1) preoperative QST; (2) association testing; and (3) PPSP. Two authors reviewed all titles and abstracts for inclusion. Inclusion criteria were as follows: (1) QST performed before surgery; (2) PPSP assessed ≥3 months postoperatively; and (3) the association between QST measures and PPSP is investigated. The search retrieved 905 articles; 24 studies with 2732 subjects met inclusion criteria. Most studies (22/24) had moderate to high risk of bias in multiple quality domains. Fourteen (58%) studies reported a significant association between preoperative QST and PPSP. Preoperative temporal summation of pain (4 studies), conditioned pain modulation (3 studies), and pressure pain threshold (3 studies) showed the most frequent association with PPSP. The strength of the association between preoperative QST and PPSP varied from weak to strong. Preoperative QST is variably associated with PPSP. Measurements related to central processing of pain may be most consistently associated with PPSP.

Published
2020

45. High Body Mass Index Is a Potential Risk Factor for Persistent Postoperative Pain after Breast Cancer Treatment

Author

Helmond, N., Timmerman, H., Dasselaar, N. T., Pol, C. C., Olesen, S. S., Drewes, A. M., Vissers, K. C., Wilder-Smith, O. H., and Monique Steegers

Subjects
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Abstract

Item does not contain fulltext BACKGROUND: Risk factors associated with persistent pain after breast cancer treatment are needed to develop prevention and treatment strategies to improve the quality of life for patients with breast cancer. OBJECTIVES: To identify factors associated with persistent pain in women undergoing breast cancer treatments. STUDY DESIGN: Retrospective study. SETTING: Regional hospital in the Netherlands. METHODS: The primary outcome was pain associated with surgery at more than 6 months postoperatively and patients were stratified based on the associated visual analog" scale score they reported: reporting no pain as "no pain," pain 1 - 29 mm as "mild pain," and pain 30 - 100 mm as "moderate/severe pain." Secondary outcomes were function, symptom, and total quality of life scores. Predefined risk factors analyzed for association with outcomes included: age, smoking status, diabetes, body mass index (BMI), disease stage, surgery type, axillary lymph node dissection, reoperation, chemotherapy, radiotherapy, and hormone therapy. RESULTS: Of the 718 patients who were approached, 492 were included (follow-up 2.5 +/- 1.8 years). Thirty-five percent of patients developed persistent pain (n = 122 "mild pain," n = 53 "moderate/severe pain'"). Age, BMI, surgery type, axillary lymph node dissection, disease stage, reoperation, chemotherapy, and radiotherapy were identified as potential risk factors in univariate ordinal regression analyses (P < 0.10). Age (P < 0.01) and BMI (P = 0.04) remained independently predictive in the multivariate model. BMI and age were associated with odds ratios (ORs) of 1.04 (95% confidence intervals (CI): 1.00 - 1.08) and 0.97 (95% CI: 0.95 - 0.99), respectively per point and year increase. BMI was associated with a higher symptom score (r = 0.14, P < 0.01), a lower level of function (r = -0.11, P = 0.01), and lower total quality of life scores (r = -0.13, P < 0.01). LIMITATIONS: The retrospective nature of this study makes it prone to response and misclassification bias. CONCLUSIONS: BMI and age may be risk factors for persistent postoperative pain after breast cancer treatment. KEY WORDS: Persistent postsurgical pain, breast cancer treatment, BMI, age, chronic postoperative pain, breast cancer surgery.

Published
2017

48. Pins and Needles, Facts and Feelings. Efficacy of Screening Tools for Neuropathic Pain in Daily Clinical Practice

Author

Timmerman, H., Vissers, K.C.P., Wolff, A.P., Steegers, M.A.H., Wilder-Smith, O.H.G., and Radboud University Nijmegen

Subjects
Radboud Institute for Health Sciences, Healthcare improvement science [Radboudumc 18], Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Abstract

Contains fulltext : 202623.pdf (Publisher’s version ) (Open Access) Radboud University, 03 mei 2019 Promotores : Vissers, K.C.P., Wolff, A.P. Co-promotores : Steegers, M.A.H., Wilder-Smith, O.H.G.

Published
2019

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