Comorbidity and familial aggregation of back/neck pain in the NIMH Family Study of Affective Spectrum Disorders

Magnitude, temporal trend and inequality in burden of neck pain: an analysis of the Global Burden of Disease Study 2019

BACKGROUND

This study aimed to comprehensively assess the magnitude, temporal trends, and inequalities associated with socioeconomic development in neck pain (NP) based on the Global Burden of Disease Study 2019.

METHODS

An assessment of incidence and years of life with disability (YLD) at the global, regional, and country levels by age, sex and year was conducted for NP. Joinpoint regression (JPR) was used to analyze trends between 1990 and 2019. Decomposition analysis was used to explore the extent to which population growth, aging, and epidemiological changes influenced the changes in incidence and YLD. A Bayesian Age-Period-Cohort (BAPC) model was constructed to predict trends over the next 25 years. Concentration curve and concentration index were used to examine the cross-country relative inequality of the burden of NP at the socio-demographic index (SDI) level.

RESULTS

In 2019, the global ASIR and ASDR of NP were 579.085 and 267.348 per 100,000 individuals, respectively. JPR analysis showed that the global ASIR and ASDR have decreased slightly over the past 30 years, although an increase was observed between 2011 and 2019. The BAPC model predicted that this upward trend would continue over the next 25 years. Decomposition analysis showed that the global increase in incidence and YLD in 2019 compared to 1990 was mainly driven by population growth. The burden of NP was higher in the middle-aged, old-age, and female groups, with differences in regional distribution. The analysis of cross-country inequality showed that the burden of NP was disproportionately concentrated in countries with a high SDI, and this phenomenon continued to increase over the 30-year study period.

CONCLUSIONS

Globally, NP remains an important public health problem, and governments are urgently required to raise public awareness about NP and its risk factors, implement targeted prevention and control policies, and deliver the necessary health services.

Functional Principal Component Analysis for Continuous Non-Gaussian, Truncated, and Discrete Functional Data

Mobile health studies often collect multiple within-day self-reported assessments of participants' behavior and well-being on different scales such as physical activity (continuous scale), pain levels (truncated scale), mood states (ordinal scale), and the occurrence of daily life events (binary scale). These assessments, when indexed by time of day, can be treated and analyzed as functional data corresponding to their respective types: continuous, truncated, ordinal, and binary. Motivated by these examples, we develop a functional principal component analysis that deals with all four types of functional data in a unified manner. It employs a semiparametric Gaussian copula model, assuming a generalized latent non-paranormal process as the underlying generating mechanism for these four types of functional data. We specify latent temporal dependence using a covariance estimated through Kendall'sτ $$ \tau $$ bridging method, incorporating smoothness in the bridging process. The approach is then extended with methods for handling both dense and sparse sampling designs, calculating subject-specific latent representations of observed data, latent principal components and principal component scores. Simulation studies demonstrate the method's competitive performance under both dense and sparse sampling designs. The method is applied to data from 497 participants in the National Institute of Mental Health Family Study of Mood Spectrum Disorders to characterize differences in within-day temporal patterns of mood in individuals with the major mood disorder subtypes, including Major Depressive Disorder and Type 1 and 2 Bipolar Disorder. Software implementation of the proposed method is provided in an R-package.

Specificity of affective dynamics of bipolar and major depressive disorder

OBJECTIVE

Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD).

METHODS

Participants aged 11-85 years (n = 362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2 weeks. Individuals with lifetime mood disorder subtypes of bipolar-I, bipolar-II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross-lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models.

RESULTS

All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar-I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar-I. Bipolar-II was characterized by higher lability of sad and anxious mood compared to bipolar-I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross-augmentation of sadness and anxiety, and sadness blunted energy.

CONCLUSION

Bipolar-I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary.

The influence of cultural and religious factors on cross-national variations in the prevalence of chronic back and neck pain: an analysis of data from the global burden of disease 2019 study

Introduction

Low back pain and neck pain are among the most commonly reported forms of chronic pain worldwide, and are associated with significant distress, disability and impairment in quality of life. Though these categories of pain can be analyzed and treated from a biomedical perspective, there is evidence that they are both related to psychological variables such as depression and anxiety. The experience of pain can be significantly influenced by cultural values. For example, cultural beliefs and attitudes can influence the meaning attached to the experience of pain, the responses of others to a sufferer's pain, and the likelihood of seeking medical care for particular symptoms. Likewise, religious beliefs and practices can influence the both experience of pain and the responses to it. These factors have also been associated with variations in the severity of depression and anxiety.

Methods

In the current study, data on the estimated national prevalence of both low back pain and neck pain, obtained from the 2019 Global Burden of Disease Study (GBD 2019), is analyzed in relation to cross-national variations in cultural values, as measured using Hofstede's model (n =115 countries) and in religious belief and practice, based on the most recent Pew Research Center survey (n = 105 countries). To address possible confounding factors, these analyses were adjusted for variables known to be associated with chronic low back or neck pain, namely smoking, alcohol use, obesity, anxiety, depression and insufficient physical activity.

Results

It was found that the cultural dimensions of Power Distance and Collectivism were inversely correlated with the prevalence of chronic low back pain, and Uncertainty Avoidance was inversely correlated with the prevalence of chronic neck pain, even after adjustment for potential confounders. Measures of religious affiliation and practice were negatively correlated with the prevalence of both conditions, but these associations were not significant after adjusting for cultural values and confounders.

Discussion

These results highlight the existence of meaningful cross-cultural variations in the occurrence of common forms of chronic musculoskeletal pain. Psychological and social factors that could account for these variations are reviewed, along with their implications for the holistic management of patients with these disorders.

Characterization of Ferroptosis-Related Molecular Subtypes with Immune Infiltrations in Neuropathic Pain

Background

Neuropathic pain (NP) caused by a lesion or disease of the somatosensory nervous system is a common chronic pain condition that has a major impact on quality of life. However, NP pathogenesis remains unclear. The purpose of this study was to identify differentially expressed genes (DEGs) and specific and meaningful gene targets for the diagnosis and treatment of NP.

Methods

Data from rat spinal nerve ligations and the sham group were downloaded from the Gene Expression Omnibus (GEO) database. Based on the single-sample gene set enrichment analysis (ssGSEA) method, 29 immune gene sets were identified in each sample, and these samples were correlated with the immune infiltration phenotype. LASSO regression modeling was used to screen key genes to identify diagnostic gene markers. According to GSEA and GSVA, NP is concentrated in a large number of immune-related pathways and genes. Additionally, we used the DGIdb database and correlation test to construct gene-drug and transcription factor interaction networks for differentially expressed genes relevant to NP-related ferroptosis. We used WGCNA to identify gene co-expression modules of NP, and explored the relationship between gene networks and phenotypes. Finally, we crossed core genes with diagnostic markers and analyzed gene correlation with molecular subtypes and immune cells.

Results

We identified 224 DEGs, including 191 upregulated genes and 33 downregulated genes. APC co-stimulation, CCR, cytolytic activity, humid-promoting, neutrophils, NK cells, and RGS4, CXCL2, DRD4 and other 7 genes related to ferroptosis were involved in NP development. Key genes of RGS4 and HIF-1 signaling pathway were screened.

Conclusion

This study contributes to our understanding of the neuroimmune mechanism of neuropathic pain, provides a reference for NP biomarkers and drug targets. Ferroptosis may be the next research direction to explore NP mechanism.