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Silişteanu SC, Antonescu E, Duică L, Totan M, Cucu AI, Costea AI. Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities. Healthcare (Basel) 2024; 12:853. [PMID: 38667615 PMCID: PMC11050304 DOI: 10.3390/healthcare12080853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.
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Affiliation(s)
- Sînziana Călina Silişteanu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Elisabeta Antonescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Lavinia Duică
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Andrei Ionuţ Cucu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Andrei Ioan Costea
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
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Lavigne GJ, Pires GN, Dal Fabbro C, Herrero Babiloni A, Martel MO, Morin CM, Andersen ML, Tufik S, Palombini L. Doctor, can napping help relieve my pain? Research path to assess the potential benefits/harms of napping for individuals with chronic pain. Sleep 2024; 47:zsae043. [PMID: 38457532 DOI: 10.1093/sleep/zsae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Affiliation(s)
- Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, CIUSS Nord lle de Montreal and Faculty of Dental Medicine, Universite de Montreal, Montreal, QC, Canada
- Sleep Institute, Sao Paulo, Brazil
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Gabriel Natan Pires
- Sleep Institute, Sao Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Cibele Dal Fabbro
- Center for Advanced Research in Sleep Medicine, CIUSS Nord lle de Montreal and Faculty of Dental Medicine, Universite de Montreal, Montreal, QC, Canada
- Sleep Institute, Sao Paulo, Brazil
| | - Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, and Department of Anesthesia, McGill University, Montreal, QC, Canada
| | - Marc O Martel
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, and Department of Anesthesia, McGill University, Montreal, QC, Canada
| | - Charles M Morin
- Ecole de Psychologie, Universite Laval, and Centre D'etude des Troubles du Sommeil, Centre de Recherche CERVO, Institut Universitaire en Sante Mentale de Quebec, Quebec City, QC, Canada
| | - Monica Levy Andersen
- Sleep Institute, Sao Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Sleep Institute, Sao Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Luciana Palombini
- Sleep Institute, Sao Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Lucena L, Lavigne G, Fabbro CD, Andersen ML, Tufik S, Hachul H. Association between night pain and quality of life in women: A general population sleep study. Eur J Pain 2023; 27:401-412. [PMID: 36516369 DOI: 10.1002/ejp.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Women with pain present decreased sleep duration and quality of life, but little is known about the consequences of nighttime pain on overall health. Our goal was to compare levels of anxiety, depression and fatigue in women with pain during the night with those without pain. We hypothesized that pain perception is associated with the worsening of fatigue and mood. METHODS In total, 244 women aged 20-80 years who took part in the Epidemiologic Sleep Study (EPISONO) met the inclusion criteria, 85 in the self-reported pain group and 171 in the control group. Participants were assigned to the pain group if they both responded (i) they generally had pain, according to Pre-Sleep Questionnaire (PSQ) and (ii) their pain generally interfered with their sleep 3 or more times a week, according to Pittsburg Sleep Quality Index (PSQI). Those who answered negatively to both questions were allocated to the control group. All participants underwent a full night laboratory polysomnography, and completed questionnaires related to fatigue, depression, anxiety and quality of life. RESULTS Pain group participants had a significantly lower perception of quality of life, and significantly higher levels of fatigue (5.4 times), anxiety and depression. Pain perception was also correlated to levels of anxiety and depression in the psychological (rs = -0.463, -0.607, respectively) and social (rs = -0.423, -0.438, respectively) quality of life domains. CONCLUSIONS Nighttime pain in women was associated with decreased quality of life, worsening mood and fatigue. Our data shows the importance of investigating pain and its deleterious effects on women's health. SIGNIFICANCE Our study highlights that women experiencing nighttime pain also reported worse mood outcomes and decreased quality of life, regardless of the level and type of pain. Our data, based on association analysis and not investigating causality, suggest it is important to consider nighttime pain in clinical care to improve quality of life and general health.
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Affiliation(s)
- Leandro Lucena
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS Nord lle de Montréal and Stomatology, CHUM, Montréal, Canada
| | - Cibele Dal Fabbro
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS Nord lle de Montréal and Stomatology, CHUM, Montréal, Canada
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ginecologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Scheer JK, Costa F, Janela D, Molinos M, Areias AC, Moulder RG, Lains J, Bento V, Yanamadala V, Correia FD. Sleep Disturbance in Musculoskeletal Conditions: Impact of a Digital Care Program. J Pain Res 2023; 16:33-46. [PMID: 36636267 PMCID: PMC9830709 DOI: 10.2147/jpr.s394421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Background Musculoskeletal (MSK) pain is highly prevalent worldwide, resulting in significant disability, and comorbid sleep disturbances. Digital therapy for MSK pain can provide significant improvements in care access, alongside pain and disability reductions. However, studies on the effect of such programs on sleep are lacking. Purpose To evaluate the impact on pain-related sleep impairment after a 12-week remote multimodal digital care program (DCP) for MSK conditions. Patients and Methods This is an ad-hoc analysis of a decentralized single-arm study into engagement and clinical outcomes after a DCP for MSK rehabilitation. Patients were stratified by baseline sleep disturbance, based on sleep questions in the questionnaires: Oswestry Disability Index, Neck Disability Index, and the Quick Disabilities of the Arm, Shoulder and Hand questionnaire. Additional outcomes were pain, Generalized Anxiety Disorder 7-item scale, Patient Health 9-item questionnaire, Work Productivity, and Activity Impairment, and program engagement. Results At baseline, 5749 patients reported sleep disturbance (78.0% of eligible patients). These reported significantly worse clinical outcomes at baseline than patients without sleep disturbance (all p<0.001). Patients with comorbid sleep disturbance showed improvements in sleep, with a significant proportion reporting full recovery at program completion: 56% of patients with upper limb conditions (including 10% of patients with severe sleep disturbance at baseline), and 24% with spine conditions. These patients also reported significant improvements in all clinical outcomes at program completion. Engagement and satisfaction were high, and also higher than in patients without sleep impairment. Conclusion This is the first study of its kind investigating the effect of a completely remote DCP for MSK pain on sleep. Patients reporting comorbid sleep disturbance had significant improvement in sleep, alongside pain, mental health and work productivity at program completion. The results suggest that a DCP for MSK pain can improve sleep disturbances in patients with upper limb and spine conditions.
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Affiliation(s)
- Justin K Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | | | | | | | | | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal,Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | | | - Vijay Yanamadala
- Sword Health, Inc, Draper, UT, USA,Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA,Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
| | - Fernando Dias Correia
- Sword Health, Inc, Draper, UT, USA,Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal,Correspondence: Fernando Dias Correia, Sword Health Inc, 13937 Sprague Lane Ste 100, Draper, UT, 84020, USA, Tel +1 385-308-8034, Fax +1 801-206-3433, Email
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Abe S, Huynh NT, Kato T, Rompré PH, Landry-Schönbeck A, Landry ML, de Grandmont P, Kawano F, Lavigne GJ. Oral appliances reduce masticatory muscle activity-sleep bruxism metrics independently of changes in heart rate variability. Clin Oral Investig 2022; 26:5653-5662. [PMID: 35538329 DOI: 10.1007/s00784-022-04520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 04/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Sleep bruxism (SB) is associated with physiological activities including sympathetic autonomic system dominance and sleep micro-arousal. While oral appliances (OA) are used to prevent SB harmful effects, the influence of OAs physiological mechanisms during sleep is unknown. The aim of this study is to assess whether heart rate variability (HRV) changes, as a marker of autonomic nervous system activity, would be associated with the OA mechanism of action on SB using occlusal splint (OS) and mandibular advancement splint (MAS). MATERIALS AND METHODS A retrospective analysis, from data previously collected in 21 participants with SB (25.6 ± 4.5 years) with polysomnographic recordings, was done. HRV data were compared between a reference night (no-device) and ones during which OS or MAS was used in a crossover study design. Rhythmic masticatory muscle activity (RMMA) index was compared between nights. HRV was evaluated using autoregressive model analysis for three sections: baseline (distance from RMMA), immediately before, and after RMMA period. RESULTS A significant reduction in RMMA index, when wearing OA during sleep, was observed (P < 0.01), but was not associated with HRV parameters change. HRV significantly changed after RMMA onset for nights with OA during non-REM sleep in comparison with baseline (P < 0.02). CONCLUSIONS The usage of OAs for SB participants reduced RMMA, but most likely independently of changes in HRV linked to the mechanism associated with SB genesis. CLINICAL RELEVANCE Wearing OA seems to reduce grinding noise and protect from dental injuries but does not seem to influence SB genesis.
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Affiliation(s)
- Susumu Abe
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 boul, Gouin Ouest, Québec, H4J 1C5, Montréal, Canada. .,Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada. .,Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
| | - Nelly T Huynh
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Pierre H Rompré
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Anaïs Landry-Schönbeck
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Marie-Lou Landry
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Pierre de Grandmont
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Fumiaki Kawano
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 boul, Gouin Ouest, Québec, H4J 1C5, Montréal, Canada.,Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
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Shirota A, Kamimura M, Kishi A, Adachi H, Taniike M, Kato T. Discrepancies in the Time Course of Sleep Stage Dynamics, Electroencephalographic Activity and Heart Rate Variability Over Sleep Cycles in the Adaptation Night in Healthy Young Adults. Front Physiol 2021; 12:623401. [PMID: 33867997 PMCID: PMC8044772 DOI: 10.3389/fphys.2021.623401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/12/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The aim of the present study was to characterize the cyclic sleep processes of sleep-stage dynamics, cortical activity, and heart rate variability during sleep in the adaptation night in healthy young adults. METHODS Seventy-four healthy adults participated in polysomnographic recordings on two consecutive nights. Conventional sleep variables were assessed according to standard criteria. Sleep-stage continuity and dynamics were evaluated by sleep runs and transitions, respectively. These variables were compared between the two nights. Electroencephalographic and cardiac activities were subjected to frequency domain analyses. Cycle-by-cycle analysis was performed for the above variables in 34 subjects with four sleep cycles and compared between the two nights. RESULTS Conventional sleep variables reflected lower sleep quality in the adaptation night than in the experimental night. Bouts of stage N1 and stage N2 were shorter, and bouts of stage Wake were longer in the adaptation night than in the experimental night, but there was no difference in stage N3 or stage REM. The normalized transition probability from stage N2 to stage N1 was higher and that from stage N2 to N3 was lower in the adaptation night, whereas that from stage N3 to other stages did not differ between the nights. Cycle-by-cycle analysis revealed that sleep-stage distribution and cortical beta EEG power differed between the two nights in the first sleep cycle. However, the HF amplitude of the heart rate variability was lower over the four sleep cycles in the adaptation night than in the experimental night. CONCLUSION The results suggest the distinct vulnerability of the autonomic adaptation processes within the central nervous system in young healthy subjects while sleeping in a sleep laboratory for the first time.
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Affiliation(s)
- Ai Shirota
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Mayo Kamimura
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Akifumi Kishi
- Graduate School of Education, The University of Tokyo, Bunkyo-ku, Japan
| | - Hiroyoshi Adachi
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Osaka University Health and Counseling Center, Toyonaka, Japan
| | - Masako Taniike
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Japan
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Hirotsu C, Frange C, Hirata PH, Cremaschi RC, Coelho FM, Andersen ML, Tufik S. Sleepiness comorbid to musculoskeletal pain is associated with worse quality of life and mood symptoms in a general population sample. Sleep Sci 2019; 12:79-87. [PMID: 31879539 PMCID: PMC6922546 DOI: 10.5935/1984-0063.20190071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives Musculoskeletal (MSK) pain and hypersomnolence (HPS) are very disabling conditions that may share some pathophysiological factors. This study aimed to evaluate the interaction between MSK pain and HPS and its association with mood symptoms, fatigue, quality of life, and both objective and subjective sleep quality. Design Cross-sectional study. Setting General population based sample. Participants 510 individuals from EPISONO cohort, São Paulo (Brazil). Measurements All participants completed questionnaires, had clinical assessment and underwent a full-night polysomnography. HPS was defined according to Epworth Sleepiness Scale while the presence of MSK pain was defined by structured questionnaire. The sample was allocated into 4 groups: control (CTRL, n=281), HPS (n=141), MSK (n=50), and both conditions (HPS+MSK, n=38). Results MSK pain and HPS by themselves were associated with worse mood symptoms and quality of life. However, individuals with both associated conditions (HPS+MSK) presented higher frequencies of moderate to severe depression (44.1%) and anxiety symptoms (45.7%), as well as an additional decrease in quality of life compared to the other groups. There were no differences between HPS+MSK and MSK groups in objective sleep pattern. With regard to subjective sleep, HPS+MSK presented a higher prevalence of sleep attacks and cataplexy compared to all other groups. Conclusions The combination of MSK pain and HPS was associated with worse mood symptoms, quality of life and HPS-related features. This study suggests that sleepiness may be an important symptom to be investigated and treated in MSK pain-related conditions for a better quality of life.
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Affiliation(s)
- Camila Hirotsu
- Centre Hospitalier Universitaire Vaudois, Centre Hospitalier Universitaire Vaudois - Lausanne - Lausanne - Switzerland
| | - Cristina Frange
- Universidade Federal de São Paulo, Department of Neurology and Neurosurgery - São Paulo - São Paulo - Brazil
| | - Patricia H Hirata
- Universidade Federal de São Paulo, Department of Psychobiology - São Paulo - São Paulo - Brazil
| | - Renata C Cremaschi
- Universidade Federal de São Paulo, Department of Psychobiology - São Paulo - São Paulo - Brazil
| | - Fernando M Coelho
- Universidade Federal de São Paulo, Department of Neurology and Neurosurgery - São Paulo - São Paulo - Brazil.,Universidade Federal de São Paulo, Department of Psychobiology - São Paulo - São Paulo - Brazil
| | - Monica L Andersen
- Universidade Federal de São Paulo, Department of Psychobiology - São Paulo - São Paulo - Brazil
| | - Sergio Tufik
- Universidade Federal de São Paulo, Department of Psychobiology - São Paulo - São Paulo - Brazil
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Stroemel-Scheder C, Karmann AJ, Ziegler E, Heesen M, Knippenberg-Bigge K, Lang PM, Lautenbacher S. Sleep, Experimental Pain and Clinical Pain in Patients with Chronic Musculoskeletal Pain and Healthy Controls. J Pain Res 2019; 12:3381-3393. [PMID: 31908522 PMCID: PMC6930837 DOI: 10.2147/jpr.s211574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Everyday variations in night sleep in healthy pain-free subjects are at most weakly associated with pain, whereas strong alterations (eg, sleep deprivation, insomnia) lead to hyperalgesic pain changes. Since it remains unclear how substantial sleep alterations need to be in order to affect the pain system and lead to a coupling of both functions, the present study aimed at providing sufficient variance for co-variance analyses by examining a sample consisting of both healthy subjects and chronic pain patients. Methods A sample of 20 chronic musculoskeletal pain patients and 20 healthy controls was examined. This sample was assumed to show high inter-individual variability in sleep and pain, as pain patients frequently report sleep disturbances, whereas healthy subjects were required to be pain-free and normal sleepers. Sleep of two non-consecutive nights was measured using portable polysomnography and questionnaires. Experimental pain parameters (pressure pain thresholds (PPT), temporal summation of pain (TSP), conditioned pain modulation (CPM)) and situational pain catastrophizing (SCQ) were assessed in laboratory sessions before and after sleep. Pain patients’ clinical pain was assessed via questionnaire. Results As expected, both groups differed in several sleep parameters (reduced total sleep time and sleep efficiency, more time awake after sleep onset, lower subjective sleep quality in the patients) and in a few pain parameters (lower PPTs in the patients). In contrast, no differences were found in TSP, CPM, and SCQ. Contrary to our expectations, regression analyses indicated no prediction of overnight pain changes by sleep parameters. Conclusion Since sleep parameters were hardly apt to predict overnight pain changes, this leaves the association of both systems mainly unproven when using between-subject variance for verification.
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Affiliation(s)
| | | | | | - Michael Heesen
- Department of Anesthesiology and Pain Therapy, Kantonsspital Baden, Baden, Switzerland
| | | | - Philip M Lang
- Department of Anesthesiology and Pain Therapy, Sozialstiftung Bamberg, Bamberg, Germany
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Eydipour Z, Nasehi M, Vaseghi S, Jamaldini SH, Zarrindast MR. The role of 5-HT4 serotonin receptors in the CA1 hippocampal region on memory acquisition impairment induced by total (TSD) and REM sleep deprivation (RSD). Physiol Behav 2019; 215:112788. [PMID: 31863855 DOI: 10.1016/j.physbeh.2019.112788] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/06/2019] [Accepted: 12/18/2019] [Indexed: 01/20/2023]
Abstract
Sleep is a circadian rhythm that is modulated by endogenous circadian clock located in the suprachiasmatic nucleus (SCN). Sleep modulates memory acquisition and promotes memory consolidation. Studies have shown that sleep deprivation (SD) impairs different types of memory including passive avoidance. Furthermore, the hippocampus plays a significant role in modulating passive avoidance memory. On the other hand, 5-HT4 receptors are expressed in the hippocampus and involved in learning and memory processes. In this study, we aimed to investigate the role of CA1 hippocampal 5-HT4 receptors in memory acquisition impairment induced by total sleep deprivation (TSD: 24 h) and REM sleep deprivation (RSD: 24 h). The water box apparatus was used to induce TSD, while multi-platform apparatus was applied to induce RSD. Passive avoidance memory test was also used to evaluate memory acquisition. The results showed that, intra-CA1 pre-training injection of RS67333 (5-HT4 agonist) and RS23597 (5-HT4 antagonist) at the doses of 0.01 and 0.1 µg/rat decreased memory acquisition, but did not alter pain perception and locomotor activity. Furthermore, TSD and RSD decreased memory acquisition; however, only TSD decreased locomotor activity and induced analgesic effect. The sub-threshold doses of RS67333 and RS23597, 0.001 and 0.0001 µg/rat, respectively, reversed the effect of TSD on memory acquisition and locomotor activity. In addition, only RS23597 reversed TSD-induced analgesia. In RSD condition, the subthreshold dose of RS23597 improved RSD-induced memory acquisition deficit. In conclusion, CA1 hippocampal 5-HT4 receptors play an important role in TSD/RSD-induced cognitive alterations.
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Affiliation(s)
- Zainab Eydipour
- Department of Biology, Damghan Branch, Islamic Azad University, Semnan, Iran
| | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Salar Vaseghi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Seyed Hamid Jamaldini
- Department of Genetic, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohammad-Reza Zarrindast
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroendocrinology, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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10
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Marshansky S, Mayer P, Rizzo D, Baltzan M, Denis R, Lavigne GJ. Sleep, chronic pain, and opioid risk for apnea. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:234-244. [PMID: 28734941 DOI: 10.1016/j.pnpbp.2017.07.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/15/2017] [Accepted: 07/15/2017] [Indexed: 01/21/2023]
Abstract
Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain). Pain and sleep management strategies should be personalized to reflect the patient's history and ongoing complaints. Understanding the pain-sleep interaction requires assessments of: i) sleep quality, ii) potential contributions to fatigue, mood, and/or wake time functioning; iii) potential concomitant sleep-disordered breathing (SDB); and more importantly; iv) opioid use, as central apnea may occur in at-risk patients. Treatments include sleep hygiene advice, cognitive behavioral therapy, physical therapy, breathing devices (continuous positive airway pressure - CPAP, or oral appliance) and medications (sleep facilitators, e.g., zolpidem; or antidepressants, e.g., trazodone, duloxetine, or neuroleptics, e.g., pregabalin). In the presence of opioid-exacerbated SDB, if the dose cannot be reduced and normal breathing restored, servo-ventilation is a promising avenue that nevertheless requires close medical supervision.
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Affiliation(s)
- Serguei Marshansky
- CIUSSS du Nord de l'Île de Montréal, Hôpital Sacré-Cœur, Québec, Canada; Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Faculté de Médecine, Université de Montréal, Québec, Canada
| | - Pierre Mayer
- Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Faculté de Médecine, Université de Montréal, Québec, Canada
| | - Dorrie Rizzo
- Jewish General, Université de Montréal, Montréal, Québec, Canada
| | - Marc Baltzan
- Faculty of Medicine, McGill University, Mount Sinai Hospital, Montréal, Canada
| | - Ronald Denis
- CIUSSS du Nord de l'Île de Montréal, Hôpital Sacré-Cœur, Québec, Canada
| | - Gilles J Lavigne
- CIUSSS du Nord de l'Île de Montréal, Hôpital Sacré-Cœur, Québec, Canada; Faculty of Dental Medicine, Université de Montréal, Department of Stomatology, CHUM, Montréal, Québec, Canada.
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Chouchou F, Dang-vu TT, Rainville P, Lavigne G. The Role of Sleep in Learning Placebo Effects. International Review of Neurobiology 2018. [DOI: 10.1016/bs.irn.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Tracy LM, Ioannou L, Baker KS, Gibson SJ, Georgiou-karistianis N, Giummarra MJ. Meta-analytic evidence for decreased heart rate variability in chronic pain implicating parasympathetic nervous system dysregulation. Pain 2016; 157:7-29. [DOI: 10.1097/j.pain.0000000000000360] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Aytekin E, Demir SE, Komut EA, Okur SC, Burnaz O, Caglar NS, Demiryontar DY. Chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and the relationship between sleep disorder and pain level, quality of life, and disability. J Phys Ther Sci 2015; 27:2951-4. [PMID: 26504332 PMCID: PMC4616133 DOI: 10.1589/jpts.27.2951] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/18/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to ascertain the prevalence of chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and to assess the relationship between sleep disorder and pain, quality of life, and disability. [Subjects and Methods] Seventy-four patients were included in the study and classified as having mild, moderate, or severe obstructive sleep apnea. Chronic widespread pain, quality of life, and disability were evaluated. [Results] Forty-one patients (55.4%) had chronic widespread pain. Female patients had a higher incidence of chronic pain, and female patients with chronic pain had higher body mass indexes, pain levels, and disability scores than did male patients. Physical component scores of female patients with chronic pain were lower than those of male patients. No correlation was observed between the degree of sleep disorder and severity of pain, pain duration, disability, or quality of life in obstructive sleep apnea patients with pain. [Conclusion] This study showed a 55.4% prevalence of chronic widespread pain in patients with obstructive sleep apnea and a greater risk of chronic pain in female than in male patients. Female patients with obstructive sleep apnea and chronic pain have higher pain and disability levels and a lower quality of life.
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Affiliation(s)
- Ebru Aytekin
- Ministry of Health, Istanbul Training and Research
Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Saliha Eroglu Demir
- Physical Medicine and Rehabilitation Department, Bezmialem
Vakif University, Turkey
| | - Ece Akyol Komut
- Ministry of Health, Istanbul Training and Research
Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Sibel Caglar Okur
- Ministry of Health, Istanbul Training and Research
Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Ozer Burnaz
- Ministry of Health, Istanbul Training and Research
Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Nil Sayiner Caglar
- Ministry of Health, Istanbul Training and Research
Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
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Bjurstrom MF, Irwin MR. Polysomnographic characteristics in nonmalignant chronic pain populations: A review of controlled studies. Sleep Med Rev 2015; 26:74-86. [PMID: 26140866 DOI: 10.1016/j.smrv.2015.03.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 12/18/2022]
Abstract
Sleep and pain are critical homeostatic systems that interact in a bidirectional manner. Complaints of sleep disturbance are ubiquitous among patients with chronic pain disorders, and conversely, patients with persistent insomnia symptoms commonly report suffering from chronic pain. Sleep deprivation paradigms demonstrate that partial or complete sleep loss induce hyperalgesia, possibly due to shared mechanistic pathways including neuroanatomic and molecular substrates. Further, chronic pain conditions and sleep disturbances are intertwined through comorbidities, which together cause detrimental psychological and physical consequences. This critical review examines 29 polysomnography studies to evaluate whether nonmalignant chronic pain patients, as compared to controls, show differences in objective measures of sleep continuity and sleep architecture. Whereas these controlled studies did not reveal a consistent pattern of objective sleep disturbances, alterations of sleep continuity were commonly reported. Alterations of sleep architecture such as increases in light sleep or decreases in slow-wave sleep were less commonly reported and findings were mixed and also inconsistent. Methodological flaws were identified, which complicated interpretation and limited conclusions; hence, recommendations for future research are suggested. Knowledge of abnormalities in the sleep process has implications for understanding the pathophysiology of chronic pain conditions, which might also direct the development of novel intervention strategies.
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Affiliation(s)
- Martin F Bjurstrom
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, USA.
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, USA
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Chouchou F, Khoury S, Chauny JM, Denis R, Lavigne GJ. Postoperative sleep disruptions: A potential catalyst of acute pain? Sleep Med Rev 2014; 18:273-82. [DOI: 10.1016/j.smrv.2013.07.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/08/2013] [Accepted: 07/09/2013] [Indexed: 12/29/2022]
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Andrews NE, Strong J, Meredith PJ, D'Arrigo RG. Association between physical activity and sleep in adults with chronic pain: a momentary, within-person perspective. Phys Ther 2014; 94:499-510. [PMID: 24231224 DOI: 10.2522/ptj.20130302] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Individuals with chronic pain consider improved sleep to be one of the most important outcomes of treatment. Physical activity has been shown to have beneficial effects on sleep in the general population. Despite these findings, the physical activity-sleep relationship has not been directly examined in a sample of people with chronic pain. OBJECTIVE This study aimed to examine the association between objective daytime physical activity and subsequent objective sleep for individuals with chronic pain while controlling for pain and psychosocial variables. DESIGN An observational, prospective, within-person study design was used. METHODS A clinical sample of 50 adults with chronic pain was recruited. Participation involved completing a demographic questionnaire followed by 5 days of data collection. Over this period, participants wore a triaxial accelerometer to monitor their daytime activity and sleep. Participants also carried a handheld computer that administered a questionnaire measuring pain, mood, catastrophizing, and stress 6 times throughout the day. RESULTS The results demonstrated that higher fluctuations in daytime activity significantly predicted shorter sleep duration. Furthermore, higher mean daytime activity levels and a greater number of pain sites contributed significantly to the prediction of longer periods of wakefulness at night. LIMITATIONS The small sample size used in this study limits the generalizability of the findings. Missing data may have led to overestimations or underestimations of effect sizes, and additional factors that may be associated with sleep (eg, medication usage, environmental factors) were not measured. CONCLUSIONS The results of this study suggest that engagement in high-intensity activity and high fluctuations in activity are associated with poorer sleep at night; hence, activity modulation may be a key treatment strategy to address sleep complaints in individuals with chronic pain.
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Khoury S, Chouchou F, Amzica F, Giguère JF, Denis R, Rouleau GA, Lavigne GJ. Rapid EEG activity during sleep dominates in mild traumatic brain injury patients with acute pain. J Neurotrauma 2013; 30:633-41. [PMID: 23510169 DOI: 10.1089/neu.2012.2519] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chronic pain is a highly prevalent post-concussion symptom occurring in a majority of patients with mild traumatic brain injury (mTBI). About half of patients with mTBI report sleep-wake disturbances. It is known that pain can alter sleep quality in this population, but the interaction between pain and sleep is not fully understood. This study aimed to identify how pain affects subjective sleep (Pittsburgh Sleep Quality Index [PSQI]), sleep architecture, and quantitative electroencephalographic (qEEG) brain activity after mTBI. Twenty-four mTBI patients complaining of sleep-wake disturbances, with and without pain (8 and 16, respectively), were recruited 45 (±22.7) days post-trauma on average. Data were compared with those of 18 healthy controls (no sleep or pain complaints). The PSQI, sleep architecture, and qEEG activity were analyzed. Pain was assessed using questionnaires and a 100-mm visual analogue scale. Patients with mTBI reported three times poorer sleep quality than controls on the PSQI. Sleep architecture significantly differed between patients with mTBI and controls but was within normal range. Global qEEG showed lower delta (deep sleep) and higher beta and gamma power (arousal) at certain EEG derivations in patients with mTBI compared with controls (p<0.04). Patients with mTBI with pain, however, showed greater increase in rapid EEG frequency bands, mostly during REM sleep, and beta bands in non-REM sleep compared with patients with mTBI without pain and controls (p<0.001). Pain in patients with mTBI was associated with more rapid qEEG activity, mostly during REM sleep, suggesting that pain is associated with poor sleep and is a critical factor in managing post-concussion symptoms.
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Affiliation(s)
- Samar Khoury
- Centre for Advanced Research in Sleep Medicine, Sacré-Cœur Hôspital, Montreal, Québec H4J 1C5, Canada
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Paul-Savoie E, Marchand S, Morin M, Bourgault P, Brissette N, Rattanavong V, Cloutier C, Bissonnette A, Potvin S. Is the deficit in pain inhibition in fibromyalgia influenced by sleep impairments? Open Rheumatol J 2012; 6:296-302. [PMID: 23091577 PMCID: PMC3474944 DOI: 10.2174/1874312901206010296] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 08/13/2012] [Accepted: 08/31/2012] [Indexed: 11/22/2022] Open
Abstract
It has been proposed that a deficit in inhibitory conditioned pain modulation (ICPM) underlies the pathophysiology of fibromyalgia (FM), but there is high variability in ICPM efficacy in this syndrome that remains poorly understood. Based on emerging data showing that age, anxiety, depression and sleep can modulate ICPM efficacy, the main objective of this study was to determine the clinical correlates of experimentally-induced pain perception in FM. Fifty FM patients and 39 healthy controls (HC) were tested. Anxiety, depression, sleep and FM symptoms were measured with questionnaires or interview-type scales. Experimental pain testing consisted of two tonic heat pain stimulations separated by a 2-minute cold pressor test (CPT). Thermal pain thresholds and tolerance were higher in HC compared to FM patients. Pain ratings during the CPT were lower in HC relative to FM patients. ICPM efficacy was stronger in HC compared to FM patients. Finally, sleep quality was the only factor significantly related to ICPM efficacy. To our knowledge, this is the first study to report this association in FM. Future studies will need to replicate this finding, to determine whether impaired sleep is primary or secondary to deficient pain inhibition, and to characterize the neurobiological mechanisms underlying this association.
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Affiliation(s)
- Emilie Paul-Savoie
- Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke; Sherbrooke, Québec, Canada
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Lavigne GJ, Nashed A, Manzini C, Carra MC. Does Sleep Differ Among Patients with Common Musculoskeletal Pain Disorders? Curr Rheumatol Rep 2011; 13:535-42. [DOI: 10.1007/s11926-011-0209-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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