Evidence map›Paper›PMID 18088561›Full record

ReviewThe journal of pain2008

Pain and stress in a systems perspective: reciprocal neural, endocrine, and immune interactions.

C Richard Chapman, Robert P Tuckett, Chan Woo Song

Registry-linked trialAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The journal of pain, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05071352 (Adjuvant Continuous Infusion of Nefopam Versus Standard of Care in Mechanically Ventilated Critically Ill Patients), which is not on this map. Cited by 209 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
209citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05071352 phase3completednot on this mapstarted 2021, after this paper: background citation

Adjuvant Continuous Infusion of Nefopam Versus Standard of Care in Mechanically Ventilated Critically Ill Patients: Randomized Double-blind Controlled Study

TypeinterventionalSponsorCairo UniversityRan2021 to 2023Enrolled60ConditionsAnalgesia, Critical Illness, Mechanical Ventilation, SedationArmsNefopam, Standard of care in the ICU for assessment and management of pain, sedation, and delirium.
3 · Its place in the literature

Who cites it

209 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  16. Daily Associations Between Perceived Stress, Pain Intensity, and Alcohol Use Among Veterans With and Without Moderate-to-Severe Chronic Pain.Stress and health : journal of the International Society for the Investigation of Stress · 2026
    Article
  17. Review
  18. Article
  19. Article
  20. Article

149 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

C Richard ChapmanPain Research Center, Department of Anesthesiology, University of Utah, Salt Lake City, Utah 84108, USA. crc20@utah.edu
Robert P Tuckett
Chan Woo Song

Funding

PAIN AND THE DEFENSE RESPONSER01CA074249 · NCI · UNIVERSITY OF WASHINGTON · PI CHAPMAN, C RICHARD · 1997 to 2006
$3.1M
NCI NIH HHS R01 CA074249
6 · The paper itself

Abstract

unlabelledThis paper advances a psychophysiological systems view of pain in which physical injury, or wounding, generates a complex stress response that extends beyond the nervous system and contributes to the experience of pain. Through a common chemical language comprising neurotransmitters, peptides, endocannabinoids, cytokines, and hormones, an ensemble of interdependent nervous, endocrine, and immune processes operates in concert to cope with the injury. These processes act as a single agent and comprise a supersystem. Acute pain in its multiple dimensions, and the related symptoms that commonly occur with it, are products of the supersystem. Chronic pain can develop as a result of unusual stress. Social stressors can compound the stress resulting from a wound or act alone to dysregulate the supersystem. When the supersystem suffers dysregulation, health, function, and sense of well-being suffer. Some chronic pain conditions are the product of supersystem dysregulation. Individuals vary and are vulnerable to dysregulation and dysfunction in particular organ systems due to the unique interactions of genetic, epigenetic and environmental factors, as well as the past experiences that characterize each person. PERSPECTIVE: Acute tissue injury activates an ensemble of interdependent nervous, endocrine, and immune processes that operate in concert and comprise a supersystem. Some chronic pain conditions result from supersystem dysregulation. Individuals vary and are vulnerable to dysregulation due to the unique interactions of genetic, epigenetic, and environmental factors and past experiences that characterize each person. This perspective can potentially assist clinicians in assessing and managing chronic pain patients.

Indexed as

Chronic DiseaseHumansNeuroimmunomodulationPainStress, Psychological

Identifiers

PMID18088561
PMCPMC2278005

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.