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pain neurophysiology

Tuija Teerijoki-Oksa, Heli Forssell, Satu K Jääskeläinen
INTRODUCTION: We evaluated diagnostic value of sensory tests during recovery from iatrogenic sensory neuropathy using intraoperatively verified nerve injury with subjective symptoms as gold standard. METHODS: Inferior alveolar nerves were monitored neurophysiologically throughout mandibular osteotomy in 19 patients. Sensory disturbance was registered and sensation tested using clinical and quantitative sensory (QST) and neurophysiologic tests postoperatively at 1, 3, 6, 12 months...
December 14, 2018: Muscle & Nerve
Reda Badry, Rania M Gamal, Manal M Hassanien, Mohamed Abd El Hamed, Nevin Hammam, Bastawy M El Fawal
Background: Sympathetic skin response (SSR) is a technique to assess the sympathetic cholinergic pathways. Sympathetic dysfunction may participate in the development of pain, which is the major complaint in patients with systemic sclerosis (SSc) and rheumatoid arthritis (RA). Objectives: In this study, we aimed to assess the autonomic dysfunction in patients with (SSc) and (RA) using SSR as a simple neurophysiologic test. Methods: Palmar SSR to median nerve electrical stimulation was recorded in 21 patients with SSc, 39 patients with RA, and in 60 healthy age and sex-matched control subjects...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
Zhi Chai, Cungen Ma, Xiaoming Jin
Hyperexcitability of neural network is a key neurophysiological mechanism in several neurological disorders including epilepsy, neuropathic pain, and tinnitus. Although standard paradigm of pharmacological management of them is to suppress this hyperexcitability, such as having been exemplified by the use of certain antiepileptic drugs, their frequent refractoriness to drug treatment suggests likely different pathophysiological mechanism. Because the pathogenesis in these disorders exhibits a transition from an initial activity loss after injury or sensory deprivation to subsequent hyperexcitability and paroxysmal discharges, this process can be regarded as a process of functional compensation similar to homeostatic plasticity regulation, in which a set level of activity in neural network is maintained after injury-induced activity loss through enhanced network excitability...
January 2019: Neural Regeneration Research
Intan Low, Po-Chih Kuo, Cheng-Lin Tsai, Yu-Hsiang Liu, Ming-Wei Lin, Hsiang-Tai Chao, Yong-Sheng Chen, Jen-Chuen Hsieh, Li-Fen Chen
The irregularity and uncertainty of neurophysiologic signals across different time scales can be regarded as neural complexity, which is related to the adaptability of the nervous system and the information processing between neurons. We recently reported general loss of brain complexity, as measured by multiscale sample entropy (MSE), at pain-related regions in females with primary dysmenorrhea (PDM). However, it is unclear whether this loss of brain complexity is associated with inter-subject genetic variations...
2018: Frontiers in Neuroscience
Clara Monteiro, Helder Cardoso-Cruz, Vasco Galhardo
Over the last 20 years a large number of transgenic mouse models have been produced showing different degrees of congenital hypoalgesia; some of these models mimic known human conditions while others seemingly have no human counterpart. However, very little significant contributions to our understanding of pain neurobiology were obtained from this multitude of animal models; in most cases the study of these animals was limited to the characterization of its pain perception without addressing the long term consequences of their hypoalgesic condition...
November 29, 2018: Neuroscience Letters
Dante Duarte, Luis Eduardo Coutinho Castelo-Branco, Elif Uygur Kucukseymen, Felipe Fregni
Fibromyalgia affects more than 5 million people in the United States and has a detrimental impact on individuals' quality of life. Current pharmacological treatments provide limited benefits to relieve the pain of fibromyalgia, along with a risk of adverse effects; a scenario that explains the increasing interest for multimodal approaches. A tailored strategy to focus on this dysfunctional endogenous pain inhibitory system is transcranial direct current stimulation (tDCS) of the primary motor cortex. By combining tDCS with aerobic exercise, the effects can be optimized...
December 3, 2018: Expert Review of Medical Devices
Carol A Courtney, Pranoti Atre, Kharma C Foucher, Ali M Alsouhibani
BACKGROUND: While surgical reconstruction restores mechanical stability following anterior cruciate ligament (ACL) rupture, many experience early-onset osteoarthritis despite surgery. Neurophysiological changes are hypothesized to contribute to knee osteoarthritis progression. Proprioceptive deficits have been reported following ACL injury/reconstruction; however, vibration perception threshold (VPT) has been less studied. This study explored relationships between pain, VPT, proprioception, function, and strength following ACL-reconstruction...
November 26, 2018: Knee
Johannes M Nicolaas Enslin, Nelleke Gertrude Langerak, Anthony Graham Fieggen
Selective dorsal rhizotomy is a key technique in the surgical management of spasticity in patients with cerebral palsy. The technique evolved from the late 1800s when pioneers like Dana and Abbe performed dorsal rhizotomy in their treatment of refractory pain. These surgeons noted a reduction in muscle tone associated with the operation. When Sherrington then published his Nobel prize-winning work on the corticospinal tract and its role in the neuromuscular system in the 1890s, the course was set for modifying spasticity by aiming surgery at the dorsal roots...
November 20, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Jan Vesper, Philipp Slotty, Stefan Schu, Katja Poeggel-Kraemer, Heike Littges, Pieter Van Looy, Filippo Agnesi, Lalit Venkatesan, Tony Van Havenbergh
INTRODUCTION: The burst waveform, a recent innovation in spinal cord stimulation (SCS), can achieve better outcomes than conventional tonic SCS, both for de novo implants and as a salvage therapy. Burst stimulation delivers more energy per second than tonic stimulation, which is a consideration for battery consumption. The clinical effectiveness of an energy-conserving strategy was investigated. METHODS: Subjects were experienced users of BurstDR SCS for back and leg pain...
November 19, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Joshua W Pate, Stephanie Veage, Susan Lee, Mark J Hancock, Julia M Hush, Verity Pacey
BACKGROUND: Pain education is an important part of multidisciplinary management of chronic pain. The characteristics of people likely to have the most improvement in pain biology knowledge following pain education are unknown. OBJECTIVE: To identify baseline factors predicting changes in pain biology knowledge in adults with chronic pain following a 2-hour multidisciplinary pain education session. METHODS: Fifty-five adults with chronic pain attended a 2-hour pain education session prior to a multidisciplinary assessment at a pain clinic...
November 18, 2018: Pain Practice: the Official Journal of World Institute of Pain
Kylie Fitzgerald, Michael Fleischmann, Brett Vaughan, Kevin de Waal, Sarah Slater, John Harbis
Background: Chronic pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic pain. Knowledge of the neurophysiology and multidimensional aspects of pain is imperative to ensure health professionals apply a biopsychosocial approach to pain. Questionnaires may be used to assess learner changes in neurophysiology knowledge and beliefs and attitudes towards pain after education interventions.The aim of this study was to evaluate changes in pain neurophysiology knowledge, beliefs and attitudes following a 12 week clinically-focused pain module in year 3 osteopathy students as measured by the Neurophysiology of Pain (NPQ) Questionnaire and Health Care Providers Pain and Impairment Relationship scale (HC-PAIRS)...
2018: Chiropractic & Manual Therapies
Elizabeth Lane, Julie M Fritz, Tom Greene, Daniel Maddox
BACKGROUND: Chronic spinal pain affects many in the United States and is associated with rising healthcare costs - but not improved outcomes. Education and self-care promotion are hallmarks of the recommended approach for this condition. Pain Neuroscience Education (PNE) is a method of educating patients about the neurophysiology of pain that aims to reconceptualize pain from an indicator of damage to an interpretation of input signals by the brain and nervous system. PNE has shown efficacy in controlled situations when delivered by experts, but its effectiveness has not been investigated among trained clinicians in a pragmatic setting...
October 25, 2018: BMC Musculoskeletal Disorders
Lluch E, D Pecos-Martín, V Domenech-García, P Herrero, T Gallego-Izquierdo
BACKGROUND: Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations. OBJECTIVES: To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead athletes with chronic shoulder pain. DESIGN: Double-blind, controlled, within-subject, repeated-measures design...
December 2018: Musculoskeletal Science & Practice
Alisson R Teles, Don Daniel Ocay, Abdulaziz Bin Shebreen, Andrew Tice, Neil Saran, Jean A Ouellet, Catherine E Ferland
BACKGROUND CONTEXT: Although 40% of adolescent idiopathic scoliosis (AIS) patients present with chronic back pain, the pathophysiology and underlying pain mechanisms remain poorly understood. We hypothesized that development of chronic pain syndrome in AIS is associated with alterations in pain modulatory mechanisms. PURPOSE: To identify the presence of sensitization in nociceptive pathways and to assess the efficacy of the diffuse noxious inhibitory control in patients with AIS presenting with chronic back pain...
October 18, 2018: Spine Journal: Official Journal of the North American Spine Society
Kharma C Foucher, Samuel J Chmell, Carol A Courtney
Impaired descending pain inhibition has been linked to chronic pain and poorer patient outcomes. Vibration perception threshold (VPT) has also been observed and linked to radiographic stage of OA. However, it is not known how duration of symptoms may influence these neurophysiological measures. Our purpose was to evaluate the relationship between duration of symptoms and conditioned pain modulation (CPM), a measure of descending pain inhibition, and VPT, and to determine whether these relationships differed in men and women seeking orthopedic care...
October 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Jon J Ford, Sarah L Slater, Matthew C Richards, Luke D Surkitt, Alexander Y P Chan, Nicholas F Taylor, Andrew J Hahne
OBJECTIVES: To determine whether individualised manual therapy plus guideline-based advice results in superior outcomes to advice alone in participants with clinical features potentially indicative of lumbar zygapophyseal joint pain. DESIGN: Multi centre parallel group randomised controlled trial. SETTING: 14 physiotherapy clinics in Melbourne, Australia. PARTICIPANTS: Sixty-four participants with clinical features potentially indicative of lumbar zygapophyseal joint pain...
August 3, 2018: Physiotherapy
Daivik B Vyas, Allen L Ho, David Y Dadey, Arjun V Pendharkar, Eric S Sussman, Robert Cowan, Casey H Halpern
OBJECTIVES: Cluster headaches are a set of episodic and chronic pain syndromes that are sources of significant morbidity for patients. The standard of care for cluster headaches remains medication therapy, however a minority of patients will remain refractory to treatment despite changes to dosage and therapeutic combinations. In these patients, functional neuromodulation using Deep Brain Stimulation (DBS) presents the opportunity to alleviate the significant pain that is experienced by targeting the neurophysiological substrates that mediate pain...
October 10, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Loredana Cavalli, Lucia Briscese, Tiziana Cavalli, Paolo Andre, Maria Chiara Carboncini
Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF-1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Faris Alodaibi, Ahmed Alhowimel, Hana Alsobayel
BACKGROUND: Pain is a leading cause of disability and accounts for many hospital and physical therapy visits. Current pain science understanding has evolved and changed substantially in the past 20 years; however, university health science curricula may not have progressed at the same rate. This study aimed to examine knowledge about pain neurophysiology among physical therapy students in Saudi Arabia, and to compare their knowledge across different education levels and by gender. METHODS: A cross-sectional study conducted to examine the pain neurophysiology knowledge among college physical therapy students in Saudi Arabia...
October 3, 2018: BMC Medical Education
Luana Colloca, Nicole Corsi, Mirta Fiorio
Over the last few decades, placebo, and nocebo effects in general, have been investigated at rest. This proposed study explores whether they could work even when the experience of pain occurs during a movement. Exercise itself can have a hypoalgesic effect, suggesting that placebo- and exercise-induced hypoalgesia could foster pain reduction. In the present study, we investigated the interplay of exercise, placebo and nocebo effects on pain. To this aim, we developed a machine-controlled isotonic motor task to standardize the exercise across participants and used a well-validated model of placebo and nocebo manipulations with reinforced expectations via a conditioning procedure including visual cues paired with heat painful stimulations...
October 3, 2018: Scientific Reports
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