Danish Pain Research Center

ABSTRACT We examine the effect of managerial overoptimism on discretionary disclosure of subjective information, such as earnings forecasts. The market applies a discount upon disclosure to capture the possibility that the revealed subjective expectation is too optimistic. While this discount is correct on average, it is too high (low) for a truly objective (overoptimistic) manager. Consequently, overoptimistic managers disclose more frequently, and their firms are overvalued. We show that higher levels of overoptimism or a greater fraction of overoptimistic managers amplify the market discount, which ultimately reduces overall disclosure in equilibrium.

Chronic pain frequently co-occurs with multiple somatic comorbidities. However, little is known about how these conditions naturally cluster in patients with high-impact chronic pain. This study aimed to describe somatic comorbidities and identify clusters of co-occurring diseases in patients with high-impact chronic pain referred to specialised interdisciplinary treatment and to examine associations between these clusters and patient-reported physical health, mental health and pain distribution. A cross-sectional study was conducted with 10,256 chronic pain patients referred to specialised interdisciplinary pain treatment using data from the Danish PainData registry. Somatic comorbidities were self-reported from a list of 16 diseases and conditions. Exploratory factor analysis with tetrachoric correlations identified clusters of comorbidities. Physical and mental health were evaluated using the PROMIS-10 Global Health questionnaire and pain distribution was assessed by a 71-area pain drawing. Statistical analyses, including ANOVA and Kruskal-Wallis tests, evaluated differences in patient-reported outcomes between disease clusters. Patients reported a median of three somatic comorbidities, with migraine (56%), herniated disc/spinal disorders (53%) and osteoarthritis (42%) being most prevalent. Factor analysis revealed six disease clusters, including systemic illness, cardiovascular disease, musculoskeletal disorders, metabolic-vascular conditions, allergy-respiratory issues and neurosensory disturbances. Distinct clusters of co-occurring diseases and conditions were associated with poorer physical health and more widespread pain. Somatic comorbidities were highly prevalent in this large chronic pain cohort, with six disease clusters associated with varying levels of physical health and pain distribution. These findings highlight the need for stratified approaches in pain care, informed by somatic disease clustering. This study identifies distinct clusters of somatic comorbidities among patients with high-impact chronic pain and links them to health outcomes. Understanding these clusters may help clinicians tailor more precise, stratified pain interventions and offers basic scientists insight into potential underlying mechanisms connecting chronic pain with systemic disease patterns.

Abstract Gendered educational aspirations are a key mechanism in the reproduction of gender inequalities. While previous research has linked gender gaps in students' STEM aspirations to differences in competence beliefs and task value, such psychological mechanisms are typically assumed to operate similarly across contexts. In this article, we examine the cross‐national robustness of these mechanisms using data from the International Computer and Information Literacy Study (ICILS 2018) covering eight countries. We focus on technology as a particularly male‐dominated STEM domain and analyse eighth‐grade students' aspirations for a technology career. We use logistic regression and the Karlson–Holm–Breen (KHB) decomposition method to assess the extent to which gender differences in competence beliefs, utility value, skills and attitudes explain differences in aspirations. Our results confirm that girls are systematically less likely than boys to aspire to technology‐related careers. While psychological factors explain part of this gap in all countries, the strength and pattern of these factors vary widely. These findings suggest that psychological explanations of educational inequality are themselves context dependent. We argue that research on inequality should consider how these mechanisms differ across national and cultural settings, because processes that seem universal may actually hide context‐specific dynamics.

BackgroundLumbar radiculopathy, due to nerve root compression, leads to significant pain and functional impairment. Surgical decompression is a treatment option, but not all patients achieve good outcomes. This protocol for an ongoing randomized controlled trial aims to compare the outcomes of surgical planning with a diagnostic selective nerve root block and surgical planning without a diagnostic selective nerve root block (standard of care).MethodsThe PLAN trial is a multicenter, block-randomized, controlled, non-inferiority trial that will enroll patients diagnosed with unilateral lumbar radiculopathy. Participants who have been deemed surgical candidates will be randomly assigned to one of two groups: Group A will receive standard surgical decompression, while Group B will undergo selective nerve root block to determine what nerve root is causing the patient’s pain, followed by surgical decompression or conservative management. The primary outcome measure is the difference in the Numerical Rating Scale for Leg Pain from baseline to 3 months with a non-inferiority margin of 1.6 points. Secondary outcomes are the difference in proportions of patients reaching ≥ 1.6 points on the Numerical Rating Scale for Leg Pain, the difference in scores and time course on Numerical Rating Score for Leg Pain and Back Pain, Short-Form 36, EuroQol-5D-3 L, and Oswestry Disability Index. Analysis will also be performed after 1 year.ConclusionThis trial seeks to provide high-quality evidence on the effectiveness of integrating selective nerve root blocks to guide surgical decompression or avoid surgery in treating lumbar radiculopathy. The findings aim to inform clinical decision-making and optimize patient outcomes.​Trial registrationClinicaltrials.gov registration NCT06143813. Registration date November 9, 2023. Last update May 2, 2024, version 1.1.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12891-025-09395-0.

Diabetic neuropathy is characterized by nerve damage and chronic neuropathic pain and lacks effective treatment. Botulinum neurotoxin type A (BoNT/A), a neurotoxin with established therapeutic use in neurological disorders, has emerged as a potential analgesic agent. This study investigated the effects of a recombinant form of BoNT/A1 (rBoNT/A1) on neuropathic pain induced by spared nerve injury (SNI) in a diabetic mouse model. Thirty-two adult male C57BL/6JRj diabetic mice were subjected to SNI or sham surgery. Fourteen days post surgery, mice received an intraplantar dose of rBoNT/A1 or vehicle. Mechanical allodynia was assessed using von Frey filaments, and spinal cord and sciatic nerve tissues were analyzed via immunohistochemistry and transmission electron microscopy to evaluate glial activation, neurotransmitter receptor expression, and axonal morphology. The results demonstrated that rBoNT/A1 significantly alleviated mechanical allodynia and caused a marked reduction in Iba1-positive microglial activation in the spinal cord, whereas no significant changes were observed in astrocyte (GFAP) density or GABAAR subunit expression. Additionally, rBoNT/A1 treatment did not significantly alter axon diameter, myelin thickness, or C-fiber morphology. In conclusion, intraplantar administration of rBoNT/A1 reduced SNI-induced mechanical allodynia in diabetic mice, potentially by attenuating spinal microglial activation, supporting the therapeutic promise of rBoNT/A1 in managing diabetic neuropathic pain.

We have previously shown that proton therapy results in considerable reduced doses to abdominal organs at risk (OAR) which likely reduces the patient's risk of a second malignant tumor, which is vital for this young population with favourable prognosis. Here, we present dosimetric results after implementing intensity modulated proton therapy (IMPT) as a national standard for seminoma. Patient/material and methods: Thirty patients with stage IIA and IIB (< 3 cm) seminoma were treated with five-field robustly multi-field optimised (MFO) proton therapy to 20-24 Gy (relative biological effectiveness [RBE]) to the dog-leg retroperitoneal volume followed by a boost of 10-16 Gy (RBE) to the nodal metastasis. Control CTs were performed routinely, and target coverage evaluated. A standard two cone-beam CT (CBCT) set-up strategy with four match structures was developed, enabling implementation of a standard adaptive scheme. The median clinical target volume (CTV-E) length in the craniocaudal direction was 26.9 cm, with a median volume of 551.4 cm3. Target coverage V95% = 100% for the nominal plan and V95% ≥ 98% for worst-case scenarios were fulfilled for all treatment plans and the 46 recalculated plans on control CTs. Kidney V17Gy was 0-6% and mean kidney dose 0-6 Gy across all plans. Bowel bag V15Gy was 194-698 cm3. All other OAR showed low doses. Four patients had replans (1-2 per patient). The median time for our image guidance (IG) strategy was 14:07 min across all patients with two CBCTs. We have established a robust setup for treatment planning, IG strategy, treatment delivery and adequate response to replanning. Therefore, we suggest considering IMPT for testicular seminoma whenever available.

Abstract Thermal perception is determined not only by sensitivity but also by precision, yet the latter is often overlooked in thermosensation and pain research. This study examined how ageing and diabetic polyneuropathy (DPN) affect the sensitivity and precision of thermal perception and whether combining these parameters can aid in distinguishing patients from healthy controls. Using a Bayesian hierarchical modelling approach, we estimated psychometric function thresholds (sensitivity) and slopes (precision) for cold detection, warm detection, cold pain, and heat pain in 86 healthy adults (aged 21–80) and 34 patients with DPN. We assessed age- and neuropathy-related effects on these parameters. Using simulated classification analyses, we also tested their utility in discriminating patients from controls. Ageing was associated with elevated detection and cold pain thresholds and reduced precision of cold detection. Patients with DPN showed similar patterns: higher detection thresholds and lower cold detection slopes while pain-related parameters were largely unaffected. These findings indicate that ageing and neuropathy produce qualitatively similar changes in thermosensory function, particularly affecting cold detection sensitivity and precision. Classification based on detection thresholds and cold detection slope successfully discriminated patients from controls, with cold detection slope offering the best performance. Combining threshold and slope parameters did not significantly improve classification accuracy. Accurate classification was not possible based on pain thresholds and slopes. Modelling both thresholds and slopes provides a more comprehensive view of sensory decline and may enhance the detection of early or subtle sensory dysfunction.

Interoception, the perception and integration of physiological signals, is a fundamental aspect of self-awareness and homeostasis. While previous work has explored interoceptive processing in the cardiac system, research in the respiratory domain, particularly in relation to brain structure and function, is limited. To address this gap, we utilized a Bayesian psychophysical model to quantify perceptual, metacognitive, and affective dimensions of respiratory interoception in a sample of over 200 healthy participants of both genders. Hierarchical modeling revealed that respiratory metacognition was associated with higher somatic and lower cognitive anxiety, respectively. Whole-brain microstructural indices of myelin content and cortical iron were measured using quantitative brain imaging. Whole-brain voxel-based quantification revealed distinct microstructural patterns in the insular, cingulate, and primary sensory cortices that underlie interoceptive sensitivity and precision. Myelination in the cingulate cortex and periaqueductal gray was associated with confidence bias, while metacognitive sensitivity correlated with myelination in the midline prefrontal cortex. Our findings highlight key brain pathways involved in respiratory interoception and its perceptual, metacognitive, and emotional dimensions.