The evolving landscape of publishing in the field of pain: An automated bibliometric analysis from 1975 to 2020.

BACKGROUND: The aims of this bibliometric analysis were (1) a longitudinal analysis of the publication landscape in the field of pain (1975-2020) and (2) to characterize the overall publication profiles for two selected journals: European Journal of Pain and PAIN® utilizing an automated approach. METHODS: Database searches in Scopus extracted all journals with 'pain' in their title. For the two specific journals, papers were manually/automatically profiled into preclinical, human and translational studies. RESULTS: A gross list of 64 journals in the field of pain consisting of both active and ceased journals in Scopus were included in this analysis which identified 62,565 papers with approximately 4000 papers published/year. These papers include 2759 and 9156 papers in Eur. J. Pain and PAIN®, respectively. Currently, there are 24 active 'pain' journals. Authors/paper increase from 2 to 7 indicating a development from mono-disciplinary to multi-disciplinary studies. The overall publication profiles assessing preclinical, human (experimental/clinical) and translational papers in Eur. J. Pain and PAIN® were almost similar (14%, 75% and 10% versus 26%, 63% and 10%). Papers have changed over the years from mono-disciplinary studies (e.g. behavioural studies) to multi-disciplinary studies (e.g. combined behavioural and cell studies). After optimization, the search model matched the manual screening by 100%, 98% and 96% for the preclinical, clinical and healthy volunteer categories. CONCLUSIONS: Over the last 45 years, more than 60,000 pain-related papers have been published. Papers develop over the years from mono-disciplinary to multi-disciplinary studies. The overall publication profile including preclinical, human (experimental/clinical) and translational papers was almost similar in Eur. J. Pain and PAIN®. SIGNIFICANCE: The bibliometric analysis of a pain journal provides information on which specific areas of research are published, how this may have changed over the years and how a journal is positioned compared with other journals in the field.

Development of disturbing dreams during adolescence and their relation to anxiety symptoms.

STUDY OBJECTIVES: This work assesses the prevalence and development of disturbing dreams among adolescents and the association of these dreams with anxiety. DESIGN: Sex differences in prevalence were analyzed with chi-square analyses. Changes over time were assessed with Wilcoxon tests and cross-tabulation tables. Associations with anxiety and DSM-III-R symptoms were assessed with ANOVA designs. SETTING: N/A. PARTICIPANTS: A total of 610 boys and girls rated their recall of disturbing and normal dreams at both 13 and 16 years of age. Subgroups of subjects were evaluated for anxiety symptoms at age 13 and for DSM-III-R symptoms of separation anxiety (SA), overanxious disorder (OD) and generalized anxiety disorder (GAD) at age 16. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The recall of disturbing dreams was more prevalent for girls than for boys at both ages, and increased over time for girls while it decreased for boys. The recall of normal dreams was also more prevalent for girls at both ages, but this difference could not fully account for the difference in recall of disturbing dreams. Normal dream recall increased from age 13 to 16 for both sexes. The frequent occurrence of disturbing dreams was associated with anxiety at age 13 and with GAD, SA and OD symptoms at age 16 for both sexes. Evidence of more numerous OD symptoms for girls with frequent disturbing dreams suggests that this form of anxiety may partially account for the observed sex difference in disturbing dream prevalence. CONCLUSIONS: The findings highlight a prevalence of disturbing dreams that is especially marked for adolescent girls. Unlike previous cross-sectional studies, which have found the same sex difference, this longitudinal design also calls attention to within-subjects changes in disturbing dream recall. The results also confirm that the frequent recall of disturbing dreams is associated with pathological symptoms of trait anxiety-apparently even as young as 13 years of age. Further study of disturbing dreams may contribute to understanding of associated pathophysiological factors which, too, vary by sex (e.g., PTSD, insomnia, depression).

Nodular tertiary syphilis mimicking granuloma annulare.

We describe a 47-year-old man with annular plaques on the arms and torso that were treated as granuloma annulare, based on clinical and histopathologic findings. Exacerbation of the lesions during treatment with topical corticosteroids prompted a search for an infectious cause, which proved to be syphilis in the tertiary stage. The clinician should maintain a high index of suspicion for syphilis in the differential diagnosis of unusual annular skin lesions in a patient with noncaseating granulomas seen on skin biopsy.

A review of mentation in REM and NREM sleep: "covert" REM sleep as a possible reconciliation of two opposing models.

Numerous studies have replicated the finding of mentation in both rapid eye movement (REM) and nonrapid eye movement (NREM) sleep. However, two different theoretical models have been proposed to account for this finding: (1) a one-generator model, in which mentation is generated by a single set of processes regardless of physiological differences between REM and NREM sleep; and (2) a two-generator model, in which qualitatively different generators produce cognitive activity in the two states. First, research is reviewed demonstrating conclusively that mentation can occur in NREM sleep; global estimates show an average mentation recall rate of about 50% from NREM sleep--a value that has increased substantially over the years. Second, nine different types of research on REM and NREM cognitive activity are examined for evidence supporting or refuting the two models. The evidence largely, but not completely, favors the two-generator model. Finally, in a preliminary attempt to reconcile the two models, an alternative model is proposed that assumes the existence of covert REM sleep processes during NREM sleep. Such covert activity may be responsible for much of the dreamlike cognitive activity occurring in NREM sleep.

Variations in EEG coherence as an index of the affective content of dreams from REM sleep: relationships with face imagery.

EEG coherence was examined in relation to four measures of socioemotional dream content, including a new measure--the proportional representation of a character's face. Twenty-four healthy subjects, recorded for sleep stages and EEG activity, were awakened from REM sleep to report dream mentation and to rate it on these variables. Coherence scores were calculated for homologous interhemispheric electrode pairs (Fp1-Fp2, F3-F4, F7-F8, C3-C4, P3-P4, O1-O2, T3-T4, T5-T6) and for left and right intrahemispheric pairs for delta, theta, alpha, beta1, and beta2 frequencies. These were correlated with the mentation measures. Positive correlations were found between average interhemispheric coherence in most bands and the character face measure. A breakdown by gender revealed that this relationship was most evident for women, whereas for men positive correlations were observed between coherence and negative self-feeling. That similar relationships also obtained for both left and right intrahemispheric coherence is consistent with the hypothesis that dreamed socioemotional interactions reflect the integrative functioning of many brain regions in both hemispheres.

Neurofollicular hamartoma with strong diffuse S-100 positivity: a case report.

Neurofollicular hamartoma is a recently described lesion with a distinct pilosebaceous and spindle cell proliferation. Neurofollicular hamartoma is composed of spindle cells haphazardly arranged in a fibromyxoid stroma closely associated with an abnormal hyperplasia of folliculosebaceous units. Although this histologic pattern has been classified as "neurofollicular," all cases reported thus far have had only scattered spindle cells with S-100 positivity. We present a case of neurofollicular hamartoma with strong and diffusely positive staining of spindled cells for S-100 protein. This lesion also shows scattered positivity of spindle cells for monoclonal neuron specific enolase and synaptophysin. We interpret the results of immunostains of this lesion as evidence for neural differentiation. This case validates the concept of "neurofollicular" hamartoma.

Was Anna O.'s black snake hallucination a sleep paralysis nightmare? Dreams, memories, and trauma.

The final traumatic event recalled by Anna O. during her treatment with Josef Breuer was a terrifying hallucination she once had of a black snake attacking her ailing father. This event has been variously interpreted as indicating an underlying psychodynamic conflict, as a temporal lobe seizure, and as an hypnotic confabulation. We argue, however, that the hallucination--during which Anna O.'s arm was reportedly "asleep" due to nerve blockage--was probably a sleep paralysis nightmare. Sleep paralysis nightmares continue to be overlooked or misdiagnosed in clinical practice, and, in recent years, have been implicated in the controversy surrounding memories of trauma and sexual abuse.

Sebaceous neoplasm with reticulated and cribriform features: a rare variant of sebaceoma.

Troy and Ackerman defined the term sebaceoma (Am J Dermatopathol 1984: 6: 7-13) as benign neoplasm of basaloid cells with varying numbers of mature sebocytes. Steffen and Ackerman (Neoplasms with sebaceous differentiation. Philadelphia: Lee and Febiger, 1994: 401-425) illustrated many examples of sebaceoma, two of which had a reticulated and cribriform pattern. We report a case of sebaceoma from the scalp of a 52-year-old white female. Histologically, it displayed reticulated and cribriform basaloid epithelial islands. This is the third reported case of sebaceoma, to our knowledge, with these unusual features.

Prevalence of auditory, olfactory, and gustatory experiences in home dreams.

Although numerous studies have investigated the content of laboratory and home dream reports, surprisingly little is known about the prevalence of various sensory modes in dreams. 49 men and 115 women completed a battery of questionnaires and kept a home dream diary for two to three consecutive weeks. Retrospective responses to the questionnaire indicate that approximately 33% of men and 40% of women recalled having experienced sensations of smell or taste in their dreams. A total of 3372 dream reports were collected and scored for unambiguous references to auditory, olfactory, and gustatory experiences. Auditory experiences were reported in approximately 53% of all dream reports. Olfactory and gustatory sensations occurred in approximately 1% of all dream reports. A significantly greater percentage of women than men reported one or more dreams containing references to olfactory sensations. The results lend support to previous studies which have shown that a variety of sensory experiences, although relatively rare, can occur in dreams.

Cigarette smoking as a risk factor or an exacerbating factor for restless legs syndrome and sleep bruxism.

Cigarette smoking has been associated with sleep disturbances. However, little is known about how smoking affects restless legs syndrome (RLS) and sleep bruxism, two movement disorders associated with sleep. From a nationwide survey of 2,019 Canadian adults, we estimated the prevalence of smoking to be 36%. Although there was no difference between smokers and nonsmokers for RLS prevalence, almost twice as many smokers (12%) as nonsmokers (7%) were aware of experiencing sleep bruxism. The estimated risk of a smoker suffering from RLS was nonsignificant. On the other hand, the risk of a smoker grinding his or her teeth was moderate (odds ratio = 1.9). Analysis of sleep laboratory findings revealed no differences in motor RLS and periodic leg movements in sleep (PLMS) indices between smoking and nonsmoking patients; after adjustment for age, there were no differences in sleep efficiency, latency, number of awakenings, or the arousal index for the RLS/PLMS patients. Among those suffering from bruxism, smokers had more tooth-grinding episodes than did nonsmokers (35.0 vs. 7.0; p = 0.056); none of the sleep variables differentiated sleep bruxism smokers from nonsmokers. It appears that cigarette smoking does not influence RLS/PLMS, whereas the risk that smoking and tooth grinding are concomitant is moderate. Smoking was not significantly associated with more motor activity in RLS/PLMS, but more grinding was noted in sleep bruxism.

Is interhemispheric connectivity reduced after callosotomy? A critique.

A recent case report of interhemispheric correlational measures in a callosotomized patient by Corsi-Cabrera, Trías, Guevara, Haro, and Hernández in 1995 provided evidence taken by the authors of the study to suggest that the corpus callosum may not be crucial to interhemispheric coupling. This conclusion was proposed even though (1) presurgical correlation measures necessary for evaluating coherence changes produced by surgery were not available for this subject and (2) previous studies presenting evidence inconsistent with their conclusions were not discussed. In view of these two shortcomings, the authors' conclusion concerning callosal function may be premature.

Speculations in "Temporal delays in incorporation of events into dreams": a reply to Roll.

Previously we pointed out similarities between patterns of delayed incorporations of daytime stimuli into dreams and delayed memory processes in rats. In commenting upon this article, Roll argued that this reductionistic leap is unwarranted. We contend that it would be remiss not to make note of this potential connection, especially in view of recent major contributions of animal research to the understanding of REM sleep and dreams. We also suggest that the disruption-avoidance-adaptation model constitutes a preferable psychological explanation for the dream-lag effect than Roll's psychoanalytic model of repression and repetition compulsion.

Temporal delays in incorporation of events into dreams.

20 subjects viewed an emotionally arousing video and then recorded their dreams at home for seven nights. Dreams were subsequently rated for the likelihood that some aspect of the video had been incorporated. For subjects who showed strong evidence of incorporation, mean likelihood of incorporation ratings followed a U-shaped pattern, with significantly higher scores on Nights 1, 6, and 7 than on Night 4. The similarity of this temporal pattern with REM sleep patterns observed in rats exposed to various learning experiences is noted, and the role of the hippocampus as a possible neural mechanism for delayed incorporations is discussed.

Pain in dreams.

Little is known about pain in dreams. Some studies indicate that it is rare and that it may be beyond the representational capability of dreaming. However, the present study describes experiences of dreamed pain that were reported incidentally in experiments on the effects of somatosensory stimulation administered during rapid eye movement (REM) sleep. Dreams were selected from five subjects who had reported at least one instance of dreamed pain in these studies. The subjects had undergone 42 stimulation trials over 20 nights and had reported a total of 13 dreams (31%) with one or more references to pain. Most often, these references appeared to be direct, untransformed incorporations of real sensations produced by stimulation. Pain was the principal motivating agent in a majority of these dreams and was in many cases associated with strong emotion--typically anger. Dreams often depicted the subjects' attempts to obtain relief from pain, in some cases by repetition of actions, in others by metaphoric renditions of the goal. The results indicate that although pain is rare in dreams, it is nevertheless compatible with the representational code of dreaming. Further, the association of pain with dream content may implicate brainstem and limbic centers in the regulation of painful stimuli during REM sleep.

The 'dream-lag' effect: a 6-day temporal delay in dream content incorporation.

The temporal relationship between daily events and their incorporation into dreams was studied. In two experiments, a 6-day delay between event occurrence and dream incorporation was found. Moreover, variations in incorporation across a 7-day-period were found to follow a sinusoidal pattern. These results implicate dream incorporation in the learning consolidation functions of REM sleep.

Effects of dream reflection on waking affect: awareness of feelings, rorschach movement, and facial EMG.

The clinical and research literature suggests that waking dream reflection increases awareness of feelings. To examine this possibility, 16 male and 16 female participants spent a single night in the sleep laboratory while rapid eye movement (REM) sleep physiology and facial electromyogram (EMG) were monitored. Participants in the dream imagery condition were awakened from REM sleep and asked to reflect on their dreams. Participants in the fantasy imagery condition were awakened from REM sleep and asked to reflect on guided fantasies modeled on dream narratives. Participants were asked to reflect either on the affective connotations of their imagery or on the cognitive aspects of their imagery. Unexpectedly, self-reported awareness of feelings was less common during either affective or cognitive reflection on dreams than during such reflection on fantasies, especially for females. Also, kinesthetic sensitivity, as indicated by Rorschach movement responses, was less after dream reflection than after reflection on fantasy imagery, again especially for females. In contrast, facial EMG activity was greater during dream reflection than during fantasy reflection. Since facial EMG during REM sleep and during dream reflection was correlated with self-reported orienting within dream imagery, these results are understandable as evidence for the "carry-over" of REM orienting activity during dream reflection, resulting in reduced affective/kinesthetic sensitivity and reduced awareness of feelings.