Esther Yakobov

The role of perceived injustice in the prediction of pain and function after total knee arthroplasty.

&NA; Perceived injustice prospectively predicted more severe postsurgical pain after total knee arthroplasty, even when controlling for other pain‐related psychological variables. &NA; Emerging evidence suggests that the appraisal of pain and disability in terms of justice‐related themes contributes to adverse pain outcomes. To date, however, research on the relation between perceived injustice and pain outcomes has focused primarily on individuals with musculoskeletal injuries. The primary aim of this study was to investigate the role of perceived injustice in the prediction of pain and disability after total knee arthroplasty (TKA). The study sample consisted of 116 individuals (71 women, 45 men) with osteoarthritis of the knee scheduled for TKA. Participants completed measures of pain severity, physical disability, perceptions of injustice, pain catastrophizing, and fear of movement before surgery, and measures of pain and disability 1 year after surgery. Prospective multivariate analyses revealed that perceived injustice contributed modest but significant unique variance to the prediction of postsurgical pain severity, beyond the variance accounted for by demographic variables, comorbid health conditions, presurgical pain severity, pain catastrophizing, and fear of movement. Pain catastrophizing contributed significant unique variance to the prediction of postsurgical disability. The current findings add to a growing body of evidence supporting the prognostic value of perceived injustice in the prediction of adverse pain outcomes. The results suggest that psychosocial interventions designed to target perceptions of injustice and pain catastrophizing before surgery might contribute to more positive recovery trajectories after TKA.

Validation of the Injustice Experiences Questionnaire Adapted for Use withPatients with Severe Osteoarthritis of the Knee

Objective: Recent research has linked perceptions of injustice to problematic recovery outcomes for individuals with musculoskeletal injuries. However, the measure currently used to assess perceived injustice is not readily applicable to individuals who have a pain condition, such as osteoarthritis (OA), where pain onset is insidious as opposed to traumatic. The purpose of this study was to validate a modified version of the Injustice Experiences Questionnaire (IEQ-chr) for patients with OA of the knee. Methods: The IEQ-chr was administered along with measures of pain catastrophizing, fear of movement, depressive symptoms, pain severity and physical function to 110 individuals with severe OA of the knee. Results: Principal component analyses yielded a factor structure similar to that in the original validation study. The IEQ-chr had high internal consistency (Chronbach alpha=0.88), and was significantly correlated with pain catastrophizing, fear of movement, depressive symptoms, pain severity and physical function. Regression analyses revealed that the IEQ-chr contributed significant unique variance to prediction of pain severity and physical function, beyond the variance accounted for by measures of pain catastrophizing and fear of movement. Conclusions: The findings of the present study support the construct validity of the IEQ-chr in the context of osteoarthritis, and suggest that this measure may be useful in psychosocial assessment of individuals at risk for adverse pain outcomes. The discussion addresses theoretical and clinical implications of these findings.

Functional Preference for Object Sounds and Voices in the Brain of Early Blind and Sighted Individuals

Sounds activate occipital regions in early blind individuals. However, how different sound categories map onto specific regions of the occipital cortex remains a matter of debate. We used fMRI to characterize brain responses of early blind and sighted individuals to familiar object sounds, human voices, and their respective low-level control sounds. In addition, sighted participants were tested while viewing pictures of faces, objects, and phase-scrambled control pictures. In both early blind and sighted, a double dissociation was evidenced in bilateral auditory cortices between responses to voices and object sounds: Voices elicited categorical responses in bilateral superior temporal sulci, whereas object sounds elicited categorical responses along the lateral fissure bilaterally, including the primary auditory cortex and planum temporale. Outside the auditory regions, object sounds also elicited categorical responses in the left lateral and in the ventral occipitotemporal regions in both groups. These regions also showed response preference for images of objects in the sighted group, thus suggesting a functional specialization that is independent of sensory input and visual experience. Between-group comparisons revealed that, only in the blind group, categorical responses to object sounds extended more posteriorly into the occipital cortex. Functional connectivity analyses evidenced a selective increase in the functional coupling between these reorganized regions and regions of the ventral occipitotemporal cortex in the blind group. In contrast, vocal sounds did not elicit preferential responses in the occipital cortex in either group. Nevertheless, enhanced voice-selective connectivity between the left temporal voice area and the right fusiform gyrus were found in the blind group. Altogether, these findings suggest that, in the absence of developmental vision, separate auditory categories are not equipotent in driving selective auditory recruitment of occipitotemporal regions and highlight the presence of domain-selective constraints on the expression of cross-modal plasticity.

The prognostic value of pain catastrophizing in health-related quality of life judgments after Total knee arthroplasty

BackgroundTotal knee arthroplasty (TKA) is a highly effective procedure that yields reductions in pain and disability associated with end stage osteoarthritis (OA) of the knee. Quality of life instruments are frequently used to gauge the outcomes of total knee arthroplasty (TKA). However, research suggests that post-TKA reductions in symptom severity may not be the sole predictors of quality of life post-TKA. The primary objective of the present study was to examine the prognostic value of catastrophic thinking in health-related quality of life (HRQoL) judgments in patients with severe OA after TKA.MethodsIn this study we used a prospective cohort design to examine the value of pain catastrophizing in predicting HRQoL 1 year after TKA. Participants with advanced OA of the knee who were scheduled for TKA were recruited at one of three hospitals in Canada. The study sample consisted of 116 individuals (71 women, 45 men) who completed study questionnaires at their pre-surgical evaluation and 1 year after surgery. Hierarchical regression analysis was used to assess the unique contribution of pre-surgical pain catastrophizing to the prediction of post-surgical HRQoL judgments.ResultsThe results of the hierarchical regression equation revealed that the overall model was significant, F (9,106) = 8.3, p < 001, and accounted for 36.4% of the variance in the prediction of post-surgical physical component score of HRQoL. Pain catastrophizing was entered in the last step of the equation and contributed significant unique variance (β = −.35, p < .001) to the prediction of post-surgical physical component score of HRQoL above and beyond the variance accounted for by demographic variables, co-morbid health conditions, baseline HRQoL, and post-surgical reductions in pain, joint stiffness and physical disability.ConclusionsThe current findings highlight the importance of pre-surgical catastrophic cognitions in influencing HRQoL judgments after TKA. The findings suggest that psychosocial interventions designed to reduce pain catastrophizing before TKA might contribute to better quality of life outcomes following surgery.

Functional Preference for Object Sounds but Not for Voices in the Occipitotemporal Cortex of Early Blind Individuals.

Sounds activate occipital regions in early blind individuals. How different sound categories map onto specific regions of the occipital cortex remains however debated. We used fMRI to characterize brain responses of early blind and sighted individuals to familiar object sounds, human voices and their respective low-level control sounds. Sighted participants were additionally tested when viewing pictures of faces, objects and phase-scrambled control pictures. In both early blind and sighted, a double dissociation was evidenced in bilateral auditory cortices between responses to voices and object sounds: voices elicited categorical responses in bilateral superior temporal sulci while object sounds elicited categorical responses along the lateral fissure bilaterally, including the primary auditory cortex and planum temporale. Outside of the auditory regions, object sounds additionally elicited categorical responses in left lateral and ventral occipito-temporal regions in both groups. These regions also showed response preference for images of objects in the sighted, thus suggesting a functional specialization in these regions that is independent of sensory input and visual experience. Between-group comparisons revealed that only in the blind group, categorical responses to object sounds extended more posteriorly into the occipital cortex. Functional connectivity analyses evidenced a selective increase in the functional coupling between these reorganized regions and regions of the ventral occipito-temporal cortex in the early blind. In contrast, vocal sounds did not elicit preferential responses in the occipital cortex in either group. Nevertheless, enhanced voice-selective connectivity between the left temporal voice area and the right fusiform gyrus were found in the blind. Altogether, these findings suggest that separate auditory categories are not equipotent in driving selective auditory recruitment of occipito-temporal regions in the absence of developmental vision, highlighting domain-region constraints on the expression of crossmodal plasticity.