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https://www.readbyqxmd.com/read/29331287/characterizing-the-effects-of-deep-brain-stimulation-with-magnetoencephalography-a-review
#1
REVIEW
Irene E Harmsen, Nathan C Rowland, Richard A Wennberg, Andres M Lozano
BACKGROUND: Deep brain stimulation (DBS) is an important form of neuromodulation that is being applied to patients with motor, mood, or cognitive circuit disorders. Despite the efficacy and widespread use of DBS, the precise mechanisms by which it works remain unknown. Over the last decade, magnetoencephalography (MEG) has become an important functional neuroimaging technique used to study DBS. OBJECTIVE: This review summarizes the literature related to the use of MEG to characterize the effects of DBS...
January 4, 2018: Brain Stimulation
https://www.readbyqxmd.com/read/29284534/perineural-local-anaesthetic-catheter-after-major-lower-limb-amputation-trial-placement-study-protocol-for-a-randomised-controlled-pilot-study
#2
David C Bosanquet, Graeme K Ambler, Cherry-Ann Waldron, Emma Thomas-Jones, Lucy Brookes-Howell, Mark Kelson, Tim Pickles, Debbie Harris, Deborah Fitzsimmons, Neeraj Saxena, Christopher P Twine
BACKGROUND: Pain after major lower limb amputation for peripheral arterial disease (PAD) is a significant problem. A perineural catheter (PNC) can be placed adjacent to the major nerve at the time of amputation with a continuous local anaesthetic infusion given postoperatively to try and reduce pain. Although low-quality observational data suggest that PNC usage reduces postoperative opioid requirements, there are limited data regarding its effect on pain. The aim of PLACEMENT is to explore the feasibility of running an effectiveness trial to assess the impact of a PNC with continuous local anaesthetic infusion, inserted at the time of amputation, on short and medium-term postoperative outcomes...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29221844/gabapentin-as-an-adjuvant-therapy-for-prevention-of-acute-phantom-limb-pain-in-pediatric-patients-undergoing-amputation-for-malignant-bone-tumors-a-prospective-double-blind-randomized-controlled-trial
#3
Xiandi Wang, Ying Yi, Dingbo Tang, Yi Chen, Yanhua Jiang, Jun Peng, Jiwei Xiao
CONTEXT: Gabapentin is reported to have an analgesic effect of reducing phantom-limb pain(PLP) in adult patients. There's no study on preoperative use of gabapentin in pediatric population in term of PLP prevention. OBJECTIVE: To determine whether gabapentin could be used as an adjuvant agent of opioid-based pain control to lower the rate of phantom-limb pain in pediatric patients undergoing amputation for malignant bone tumors in observation period of 60 days post-operatively...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29217448/perioperative-outcomes-after-regional-versus-general-anesthesia-for-above-the-knee-amputations
#4
Andrew J B Pisansky, Ethan Y Brovman, Christine Kuo, Alan D Kaye, Richard D Urman
BACKGROUND: Nontraumatic lower extremity amputation (LEA) remains a common procedure among patients who frequently have significant comorbidities. Patients undergoing above knee amputation (AKA) have the highest rates of mortality in this cohort, yet there is little evidence to support selection between peripheral nerve block or neuraxial regional anesthesia (RA) versus general anesthesia (GA) techniques. The objective of this study was to determine whether RA (neuraxial or peripheral nerve block) techniques were associated with more favorable outcomes versus general anesthesia among patients undergoing AKA...
December 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29186620/the-feeling-prosthesis-somatosensory-feedback-from-the-prosthesis-foot-reduces-phantom-limb-pain-dramatically
#5
Sandra Preißler, Caroline Dietrich, Sandra Seifert, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
No abstract text is available yet for this article.
November 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29178940/restoration-of-motor-control-and-proprioceptive-and-cutaneous-sensation-in-humans-with-prior-upper-limb-amputation-via-multiple-utah-slanted-electrode-arrays-useas-implanted-in-residual-peripheral-arm-nerves
#6
Suzanne Wendelken, David M Page, Tyler Davis, Heather A C Wark, David T Kluger, Christopher Duncan, David J Warren, Douglas T Hutchinson, Gregory A Clark
BACKGROUND: Despite advances in sophisticated robotic hands, intuitive control of and sensory feedback from these prostheses has been limited to only 3-degrees-of-freedom (DOF) with 2 sensory percepts in closed-loop control. A Utah Slanted Electrode Array (USEA) has been used in the past to provide up to 81 sensory percepts for human amputees. Here, we report on the advanced capabilities of multiple USEAs implanted in the residual peripheral arm nerves of human amputees for restoring control of 5 DOF and sensation of up to 131 proprioceptive and cutaneous hand sensory percepts...
November 25, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29158692/pulsed-radiofrequency-of-brachial-plexus-under-ultrasound-guidance-for-refractory-stump-pain-a-case-report
#7
Bixin Zheng, Li Song, Hui Liu
The post-amputation (pain) syndrome, including stump pain, phantom limb sensation, and phantom limb pain is common but difficult to treat. Refractory stump pain in the syndrome is an extremely challenging and troublesome clinical condition. Patients respond poorly to drugs, nerve blocks, and other effective treatments like spinal cord stimulation and surgery. Pulsed radiofrequency (PRF) technique has been shown to be effective in reducing neuropathic pain. This report describes a patient with persistent and refractory upper limb stump pain being successfully relieved with PRF of brachial plexus under ultrasound guidance after a 6-month follow-up period, suggesting that PRF may be considered as an alternative treatment for refractory stump-neuroma pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29155276/cortical-plasticity-as-a-basis-of-phantom-limb-pain-fact-or-fiction
#8
J Andoh, C Milde, J W Tsao, H Flor
Cortical reorganization has been proposed as a major factor involved in phantom pain with prior nociceptive input to the deafferented region and input from the non-deafferented cortex creating neuronal activity that is perceived as phantom pain. There is substantial evidence that these processes play a role in neuropathic pain, although causal evidence is lacking. Recently it has been suggested that a maintenance of the cortical representation of the former hand area is related to phantom pain. Although interesting, evidence for this process is so far scarce...
November 16, 2017: Neuroscience
https://www.readbyqxmd.com/read/29153043/effectiveness-of-mirror-therapy-motor-imagery-and-virtual-feedback-on-phantom-limb-pain-following-amputation-a-systematic-review
#9
Laura Herrador Colmenero, Jose Manuel Perez Marmol, Celia Martí-García, María de Los Ángeles Querol Zaldivar, Rosa María Tapia Haro, Adelaida María Castro Sánchez, María Encarnación Aguilar-Ferrándiz
BACKGROUND: Phantom limb pain is reported in 50%-85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain. OBJECTIVES: To provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients. STUDY DESIGN: Systematic review. METHODS: A computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus...
November 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29145179/phantom-sensations-supernumerary-phantom-limbs-and-apotemnophilia-three-body-representation-disorders
#10
Laurent Tatu, Julien Bogousslavsky
Body representation disorders continue to be mysterious and involve the anatomical substrate that underlies the mental representation of the body. These disorders sit on the boundaries of neurological and psychiatric diseases. We present the main characteristics of 3 examples of body representation disorders: phantom sensations, supernumerary phantom limb, and apotemnophilia. The dysfunction of anatomical circuits that regulate body representation can sometimes have paradoxical features. In the case of phantom sensations, the patient feels the painful subjective sensation of the existence of the lost part of the body after amputation, surgery or trauma...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29144105/motor-imagery-ability-of-patients-with-lower-limb-amputation-exploring-the-course-of-rehabilitation-effects
#11
Elodie Saruco, Aymeric Guillot, Arnaud Saimpont, Franck DI Rienzo, Anne Durand, Catherine Mercier, Francine Malouin, Philip Jackson
BACKGROUND: Amputation of a lower-limb results in a severe decrease of functional mobility that deeply alters independent living. Motor imagery (MI) refers to the mental representation of an action without engaging its actual execution. The repetitive use of MI has been shown to contribute to promote motor recovery and phantom-limb pain alleviation. AIM: Given the importance of invoking accurate images to benefit from MI practice, and considering the link between motor capacities and MI, the present study investigated the effect of a rehabilitation program on MI ability in patients with lower-limb amputation...
November 16, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29126783/two-case-reports-using-simulated-reattachment-to-treat-persistent-complex-bereavement-disorder-and-ptsd
#12
Mark Rider
These case reports focus on a rapid treatment for persistent complex bereavement disorder and posttraumatic stress disorder (PTSD), which appears to activate the mirror neuron network. Simulated reattachment is a technique which has been found to repair phantom limb pain in just a few sessions. The same neuroplasticity that accomplishes phantom pain relief has been found to occur in the treatment of complicated grief and PTSD using similar methods. The simulated reattachment for the client in Case one was found to significantly reduce the symptoms of both complicated grief and obsessive-compulsive disorder (OCD) within one session...
October 6, 2017: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/29125416/gamma-oscillations-in-the-somatosensory-thalamus-of-a-patient-with-a-phantom-limb-case-report
#13
Diellor Basha, Jonathan O Dostrovsky, Suneil K Kalia, Mojgan Hodaie, Andres M Lozano, William D Hutchison
The amputation of an extremity is commonly followed by phantom sensations that are perceived to originate from the missing limb. The mechanism underlying the generation of these sensations is still not clear although the development of abnormal oscillatory bursting in thalamic neurons may be involved. The theory of thalamocortical dysrhythmia implicates gamma oscillations in phantom pathophysiology although this rhythm has not been previously observed in the phantom limb thalamus. In this study, the authors report the novel observation of widespread 38-Hz gamma oscillatory activity in spike and local field potential recordings obtained from the ventral caudal somatosensory nucleus of the thalamus (Vc) of a phantom limb patient undergoing deep brain stimulation (DBS) surgery...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29121078/indocyanine-green-fluorescence-in-second-near-infrared-nir-ii-window
#14
Zbigniew Starosolski, Rohan Bhavane, Ketan B Ghaghada, Sanjeev A Vasudevan, Alexander Kaay, Ananth Annapragada
Indocyanine green (ICG), a FDA approved near infrared (NIR) fluorescent agent, is used in the clinic for a variety of applications including lymphangiography, intra-operative lymph node identification, tumor imaging, superficial vascular imaging, and marking ischemic tissues. These applications operate in the so-called "NIR-I" window (700-900 nm). Recently, imaging in the "NIR-II" window (1000-1700 nm) has attracted attention since, at longer wavelengths, photon absorption, and scattering effects by tissue components are reduced, making it possible to image deeper into the underlying tissue...
2017: PloS One
https://www.readbyqxmd.com/read/29120935/neuropathic-pain-experiences-of-spinal-cord-injury-patients
#15
Chin-Ching Li, Hung-Ru Lin, Ming-Dar Tsai, Shiow-Luan Tsay
BACKGROUND: Neuropathic pain (NP) is a common, severe problem that affects spinal cord injury (SCI) patients. Only SCI patients truly understand the impact and extent of this type of pain. PURPOSE: The aim of this study was to understand the NP experienced by SCI patients and the influence of this type of pain on their daily life. METHOD: A qualitative design was used. An interview guide including a semistructured questionnaire and in-depth interviews was conducted with SCI patients with NP in a neurorehabilitation department at a medical center in northern Taiwan...
November 9, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29105971/home-based-tactile-discrimination-training-tdt-reduces-phantom-limb-pain
#16
Robert Wakolbinger, Martin Diers, Laura A Hruby, Agnes Sturma, Oskar C Aszmann
BACKGROUND: Phantom limb pain (PLP) affects a high percentage of amputees. Since treatment options are limited, low quality of life and addiction to pain medication is frequent. New attempts, such as mirror therapy or electrical sensory discrimination training, make use of the brain's plasticity to alleviate this centrally derived pain. AIM: This pilot study assessed the question, whether home-based tactile discrimination training (TDT) leads to a stronger decrease in phantom limb pain levels, compared to a standard massage treatment...
November 6, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29046630/agency-over-phantom-limb-enhanced-by-short-term-mirror-therapy
#17
Shu Imaizumi, Tomohisa Asai, Shinichi Koyama
Most amputees experience phantom limb, whereby they feel that the amputated limb is still present. In some cases, these experiences include pain that can be alleviated by "mirror therapy." Mirror therapy consists of superimposing a mirrored image of the moving intact limb onto the phantom limb. This therapy provides a closed loop between the motor command to the amputated limb and its predicted visual feedback. This loop is also involved in the sense of agency, a feeling of controlling one's own body. However, it is unclear how mirror therapy is related to the sense of agency over a phantom limb...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29025106/intense-focused-ultrasound-preferentially-stimulates-transected-nerves-within-residual-limbs-pilot-study
#18
Pierre D Mourad, Janna L Friedly, Abbi M McClintic, Tessa A Olmstead, John D Loeser
Objective: Identifying pain generators in tissue deep in the skin can require uncomfortable, complicated, and invasive tests. We describe pilot studies testing the hypothesis that ultrasound image-guided, intense focused ultrasound (ig-iFU) can noninvasively and differentially stimulate the end of transected nerves in the residual limbs of amputee patients. Design: We applied iFU to the transected nerve ending as individual pulses with a length of 0.1 seconds using a carrier frequency of 2...
September 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29025089/oral-ketamine-for-acute-pain-management-after-amputation-surgery
#19
Asokumar Buvanendran, Jeffrey S Kroin, Arvind Rajagopal, Sherry J Robison, Mario Moric, Kenneth J Tuman
Objective: Intravenous ketamine has been shown to provide postoperative analgesia in many clinical trials, in particular to reduce opioid consumption. The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery. Methods: Three consented subjects (age 57-60 years) undergoing elective amputation of the lower extremity were included in the study (Institutional Review Board and Food and Drug Administration Investigational New Drug approved)...
September 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29024959/limb-laterality-recognition-score-a-reliable-clinical-measure-related-to-phantom-limb-pain
#20
Christopher Kevin Wong, Caitlin Kimberly Wong
Objective: To explore the usefulness of the limb laterality recognition score as a clinical measure of phantom limb pain, regarding test-retest reliability and association of limb laterality recognition scores with phantom limb pain measures. Design: Retrospective cohort. Setting: Community support group. Subjects: Eleven adults who averaged 4.8 years since lower limb amputation due to vascular pathologies (N = 9), trauma (N = 1), and cancer (N = 1)...
August 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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