Hugo Leite-Almeida

European survey and position paper of the European Pain Federation EFIC. Eur J Pain, 29(1), e4767. [1] traduzido e republicado no presente número da revista DOR.

Chronic pain affects all life domains including social interaction and responding. The aim of this study was to track spontaneous behaviors in an experimental chronic pain model to uncover alternative pain indicators in a socially and physically enriched home-cage setting. The spared nerve injury (SNI) was used to model neuropathic pain in Wistar Han male and female rats housed in the PhenoWorld (PhW). Spontaneous behavior of animals was recorded in their home cages once a week following SNI during both the dark and light phases of the light-dark cycle using focal sampling in order to assess alterations induced by neuropathic pain. Males and females with SNI demonstrated significantly lower threshold to von Frey test (VF) in the ipsilateral hind paws compared to sham controls. SNI significantly increased huddling time in both males and females during light and dark phases. Males showed increased grooming and play fighting during the dark phase compared to females while during the light phase females huddled significantly more than males. No significant effects were observed on other behaviors analyzed. This study showed that peripheral nerve injury has an impact on spontaneous behavior, specifically on huddling. This finding provides new perspective into pain evaluation and suggests the possibility of considering spontaneous behavior as an additional method of assessing pain-related behavior in rodents. To bridge the current gap between basic research and development of novel analgesics, there is a need to develop non-evoked behavioral assays to investigate changes in animal wellbeing and spontaneous pain. Our findings raise the possibility of discovering new outcome measures, however, additional study to reverse these behaviors with analgesics should be conducted.

Background and Objective: The neuroimmune system plays a critical role at all phases of chronic pain including at its onset. We therefore hypothesized that preemptive immunomodulation could decrease susceptibility and/or offer protection to pain. Materials and Methods: Six days before the spared nerve injury (SNI), Wistar Han rats were treated with either the immunomodulator minocycline (MIN) or vehicle (VEH). After that, half of the animals from each group switch treatments for additional 7 days, resulting in 4 groups: continuous treatment (MIN/MIN), pretreatment (MIN/VEH), early treatment (VEH/MIN) and the control (VEH/VEH). Mechanical allodynia was recorded using Von Frey test until 4 weeks after SNI where depressive-like behaviors of the animals were also assessed using sucrose preference test. Results: The continuous treatment provided sustained protection against mechanical allodynia, with rats in this group showing a significantly higher threshold to pain sensitivity compared to those in VEH/VEH. In contrast, pain relief effects were not observed with MIN/VEH and VEH/MIN. Additionally, animals in MIN/MIN, and VEH/MIN exhibited decreased anhedonic-like behavior at 30 days after SNI, relative to the control. Conclusions: The exposure to an anti-inflammatory drug circa the installation of a neuropathic lesion had a positive impact on allodynia and on anhedonic behavior for a relatively long period after treatment cessation. The results support the assertions that pain trajectories can be altered at pain early stages by targeting the neuroimmune system. This proof-of-concept has the potential to be broadened to other drugs and/or therapeutical schemes. Highlights: Chronic pain susceptibility varies across individuals. (endo)phenotypes of susceptibility manifest prior/circa pain onset. Preemptive minocycline treatment transiently decreases allodynia. Preemptive minocycline treatment provides sustained reduction of depressive-like behavior. Immune system modulation prior to pain onset or at early stages have beneficial outcomes.

Accreditation processes for health care professions are designed to ensure that individuals and programs in these fields meet established standards of quality and effectiveness. The accelerating pace of globalization in the health care professions has increased the need for a shared understanding of the vocabulary of evaluation, assessment, and accreditation. The psychometric principles of valid and reliable assessment are commonly accepted, but the terminology is confusing. We believe that all stakeholders – evaluators, faculty, students but also the community – will benefit from a shared language and common set of definitions. We recognize that not all readers will agree with the definitions we propose, but we hope that this guide will help to ensure clarity, consistency, transparency, and fairness, and that it will promote through the stimulation of a debate greater collaboration across national and international boundaries.