Methylphenidate hydrochloride (MPH/Ritalin) is a stimulant used for off-label management of cancer-related fatigue and sedation; however, its use in pain treatment is still relatively rare. This study 1) compares the antinociceptive effect of MPH and its combination with morphine (MOR) in adult male Wistar rats after a single administration of MPH, MOR or their combination, and 2) compares the analgesic effects of opioids and Ritalin co
mbined therapy with opioid monotherapy in patients with cancer pain. To
objectively assess physical activity during a three-week monitoring period, patients were equipped with Actiwatch Score Actigraph. Patients performed daily evaluations of pain intensity and frequency, and the extent to which pain interfered with their daily life. Our research with rats supports the evidence that MPH in lower doses has the ability to enhance the analgesic properties of morphine when the two drugs are used in combination. Results from the patient arm of our study found that short
-term treatment had no significant effect on intensity or frequency of
pain, however it decreased the overall burden of pain; the combined treatment of opioid and Ritalin also showed anti-sedation effects and resulted in mild improvement in one of our patient’s quality of life.
Pain increased the number of free radicals in the body.
Previously, we studied changes mainly in oxygen and nitroxide
free radicals and described these changes relative to the lipids
and saccharides. In this article we focus on changes relative to
proteins. Assessment of AGE products (advanced glycation
end-products) was carried out by measuring fluorescence.
Patients were divided into two groups: 15 patients with acute
pain and 17 patients with chronic pain. Acute pain was
associated with a variety of surgical procedures and patients
were examined before and after surgical procedures. The group
of patients with chronic pain suffered from various types of
chronic pain, but mainly back pain. In patients with acute pain,
total protein (TP) decreased after surgery, as did the level of AGE
and the AGE/TP ratio. Nonetheless, post-operative pain
increased. In patients with chronic pain, neither total protein,
AGE, or AGE/TP changed, despite significant pain relief being
reported after treatment. Changes in proteins, as biochemical
markers, before and after pain treatment did not show any
significant changes. In patients with acute pain, the recorded
changes only lasted for 3-5 days after the operation. While in
chronic pain, there were no significant changes at all. The
assumption that changes in proteins, as biomarkers, would have
the same importance as changes in lipids and saccharides was
not proven.
Theta burst stimulation (TBS) is a modified form of highfrequency repetitive transcranial magnetic stimulation (rTMS) with promising effect in chronic pain. The aim of our doubleblind, sham-controlled, parallel-group, randomized study was to assess an efficacy of intermittent TBS (iTBS) in the treatment of patients with chronic orofacial pain. Nineteen patients (twelve females) with chronic orofacial pain were prospectively included and randomly assigned to single session of an active (iTBS) or sham (intermediate TBS; imTBS) stimulation delivered to the primary motor cortex (M1) contralateral to painful side. The primary outcome was pain relief assessed using a visual analogue scale (VAS) after stimulation and at the end of two-week followup. The secondary outcomes were changes in the quantitative sensory testing (QST). QST set the threshold for thermal and tactile (touch) sensation in the affected facial area. Intermittent TBS, compared with the sham, showed significant improvement in VAS after stimulation, but not at the end of two-week followup. Regarding the secondary outcomes (QST), we failed to find any significant difference between iTBS and sham. Our findings demonstrate that iTBS of M1 transiently provides transient and modest subjective pain relief in chronic orofacial pain.