Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis
Objective: Pain sensitization, in the form of knee tenderness and anatomically spread hyperalgesia, is notably common in patients with knee OA and is often refractory to conventional interventions. Tapentadol, as an opioid receptor agonist and noradrenaline reuptake inhibitor, has been proposed as a...
| Autores: | , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Universitat Pompeu Fabra |
| Repositorio: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/53692 |
| Acceso en línea: | http://hdl.handle.net/10230/53692 http://dx.doi.org/10.1093/rheumatology/keab761 |
| Access Level: | acceso abierto |
| Palabra clave: | Brain activation Functional MRI Opioids Osteoarthritis Pain sensitization Sensory cortex |
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Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritisPujol Martí, Jesús, 1981-Martínez-Vilavella, GerardDoreste, AndreaBlanco Hinojo, Laura, 1981-Ojeda Morillo, Fabiola AlejandraLlorente-Onaindia, J.Polino, LucianoDeus, JoanMonfort Faure, JorgeBrain activationFunctional MRIOpioidsOsteoarthritisPain sensitizationSensory cortexObjective: Pain sensitization, in the form of knee tenderness and anatomically spread hyperalgesia, is notably common in patients with knee OA and is often refractory to conventional interventions. Tapentadol, as an opioid receptor agonist and noradrenaline reuptake inhibitor, has been proposed as a potentially effective symptomatic treatment for pain-sensitized OA patients. We empirically tested whether tapentadol could attenuate brain response to painful stimulation on the tender knee using functional MRI. Methods: Painful pressure stimulation was applied to the articular interline and the tibial surface, a commonly sensitized site surrounding the joint. Thirty patients completed the crossover trial designed to compare prolonged release tapentadol and placebo effects administered over 14 days. Results: We found no effects in the direction of the prediction. Instead, patients administered with tapentadol showed stronger activation in response to pressure on the tender site in the right prefrontal cortex and somatosensory cortices. The somatosensory effect was compatible with the spread of neural activation around the knee cortical representation. Consistent with the functional MRI findings, the patients showed higher clinical ratings of pain sensitization under tapentadol and a significant positive association was identified between the number of tapentadol tablets and the evoked subjective pain. Conclusion: The tapentadol effect paradoxically involved both the spread of the somatosensory cortex response and a stronger activation in prefrontal areas with a recognized role in the appraisal of pain sensations. Further studies are warranted to explore how OA patients may benefit from powerful analgesic drugs without the associated risks of prolonged use.Oxford University Press202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/53692http://dx.doi.org/10.1093/rheumatology/keab761reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglés© Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology (Oxford, England) following peer review. The version of record Pujol J, Martínez-Vilavella G, Doreste A, Blanco-Hinojo L, Ojeda F, Llorente-Onaindia J, et al. Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis. Rheumatology (Oxford). 2022 May 30; 61(6): 2335-45, is available online at: https://academic.oup.com/rheumatology/article/61/6/2335/6390823?login=true.info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/536922026-06-12T07:21:37Z |
| dc.title.none.fl_str_mv |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| title |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| spellingShingle |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis Pujol Martí, Jesús, 1981- Brain activation Functional MRI Opioids Osteoarthritis Pain sensitization Sensory cortex |
| title_short |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| title_full |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| title_fullStr |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| title_full_unstemmed |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| title_sort |
Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis |
| dc.creator.none.fl_str_mv |
Pujol Martí, Jesús, 1981- Martínez-Vilavella, Gerard Doreste, Andrea Blanco Hinojo, Laura, 1981- Ojeda Morillo, Fabiola Alejandra Llorente-Onaindia, J. Polino, Luciano Deus, Joan Monfort Faure, Jorge |
| author |
Pujol Martí, Jesús, 1981- |
| author_facet |
Pujol Martí, Jesús, 1981- Martínez-Vilavella, Gerard Doreste, Andrea Blanco Hinojo, Laura, 1981- Ojeda Morillo, Fabiola Alejandra Llorente-Onaindia, J. Polino, Luciano Deus, Joan Monfort Faure, Jorge |
| author_role |
author |
| author2 |
Martínez-Vilavella, Gerard Doreste, Andrea Blanco Hinojo, Laura, 1981- Ojeda Morillo, Fabiola Alejandra Llorente-Onaindia, J. Polino, Luciano Deus, Joan Monfort Faure, Jorge |
| author2_role |
author author author author author author author author |
| dc.subject.none.fl_str_mv |
Brain activation Functional MRI Opioids Osteoarthritis Pain sensitization Sensory cortex |
| topic |
Brain activation Functional MRI Opioids Osteoarthritis Pain sensitization Sensory cortex |
| description |
Objective: Pain sensitization, in the form of knee tenderness and anatomically spread hyperalgesia, is notably common in patients with knee OA and is often refractory to conventional interventions. Tapentadol, as an opioid receptor agonist and noradrenaline reuptake inhibitor, has been proposed as a potentially effective symptomatic treatment for pain-sensitized OA patients. We empirically tested whether tapentadol could attenuate brain response to painful stimulation on the tender knee using functional MRI. Methods: Painful pressure stimulation was applied to the articular interline and the tibial surface, a commonly sensitized site surrounding the joint. Thirty patients completed the crossover trial designed to compare prolonged release tapentadol and placebo effects administered over 14 days. Results: We found no effects in the direction of the prediction. Instead, patients administered with tapentadol showed stronger activation in response to pressure on the tender site in the right prefrontal cortex and somatosensory cortices. The somatosensory effect was compatible with the spread of neural activation around the knee cortical representation. Consistent with the functional MRI findings, the patients showed higher clinical ratings of pain sensitization under tapentadol and a significant positive association was identified between the number of tapentadol tablets and the evoked subjective pain. Conclusion: The tapentadol effect paradoxically involved both the spread of the somatosensory cortex response and a stronger activation in prefrontal areas with a recognized role in the appraisal of pain sensations. Further studies are warranted to explore how OA patients may benefit from powerful analgesic drugs without the associated risks of prolonged use. |
| publishDate |
2022 |
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2022 2022 2022 |
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info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion |
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article |
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acceptedVersion |
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http://hdl.handle.net/10230/53692 http://dx.doi.org/10.1093/rheumatology/keab761 |
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http://hdl.handle.net/10230/53692 http://dx.doi.org/10.1093/rheumatology/keab761 |
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Inglés |
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Inglés |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf application/pdf |
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Oxford University Press |
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Oxford University Press |
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reponame:Repositorio Digital de la UPF instname:Universitat Pompeu Fabra |
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Universitat Pompeu Fabra |
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Repositorio Digital de la UPF |
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