Resting-state EEG as Biomarker of Maladaptive Motor Function and Depressive Profile in Stroke Patients.

Objective: Investigate the relationship between resting-state EEG-measured brain oscillations and clinical and demographic measures in Stroke patients. Methods: We performed a cross-sectional analysis of a cohort study (DEFINE cohort), Stroke arm, with 85 patients, considering demographic, clinical, and stroke characteristics. Resting-state EEG relative power from delta, theta, alpha, and beta oscillations were measured from the central region. Multivariate regression models were used for both affected and non-affected hemispheres. Results: Motor function was negatively associated with Delta and Theta oscillations, while positively associated with Alpha oscillations (both hemispheres). Similarly, cognition levels measured were negatively associated with Delta activity. Depression levels were negatively associated with Alpha activity specifically in the affected hemisphere, while positively associated with Beta activity in both hemispheres. Regarding pain measures, no significant association was observed, while CPM measure showed a positive association with Alpha activity in the non-affected hemisphere. Finally, we found that theta/alpha ratio was negatively associated with motor function and CPM scores. Conclusion: The results lead us to propose a framework for brain oscillations in stroke, whereas Delta and Beta would represent disrupted mal-adaptive brain plasticity and Theta and Alpha would represent compensatory and functional brain oscillations for motor and sensory deficits in stroke, respectively.

Effects of Hypnotic Analgesia and Transcranial Direct Current Stimulation on Pain Tolerance and Corticospinal Excitability in Individuals with Fibromyalgia: A Cross-Over Randomized Clinical Trial.

Objective: We compare the effect of HAS, a-tDCS on the left dorsolateral prefrontal cortex (l-DLPFC), and rest-testing on pain measures [(cold pressor test (CPT) (primary outcome) and heat pain threshold]. We also compare their effects on the motor evoked potential (MEP) (primary outcome), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Methods: This randomized, blind, crossover trial included 18 women with fibromyalgia, aged from 18 to 65 years old. They received at random and in a crossover order a-tDCS over the l-DLPFC (2mA), HAS, or a rest-testing. Results: HAS compared to a-tDCS increased the pain tolerance with a moderate effect size (ES) [Cohen's f=-0.78; (CI 95%; -1.48 to -0.12)]. While compared to rest-testing, HAS increased the CPT with a large ES [Cohen's f=-0.87; (CI 95%; -1.84 to -0.09)]. The a-tDCS compared to HAS increased the MEP amplitude with large ES [Cohen's f=-1.73 (CI 95%; -2.17 to -0.17)]. Likewise, its ES compared to rest-testing in the MEP size was large [Cohen's f=-1.03; (CI 95%; -2.06 to -0.08)]. Conclusion: These findings revealed that HAS affects contra-regulating mechanisms involved in perception and pain tolerance, while the a-tDCS increased the excitability of the corticospinal pathways. They give a subsidy to investigate their effect as approaches to counter regulate the maladaptive neuroplasticity involved in fibromyalgia. Clinical Trial Registration: www.ClinicalTrials.gov, identifier - NCT05066568.

Differences in Psychosocial Factors and Experimental Pain Sensitivity Between Hispanics and Non-Hispanic Whites from the U.S.-Mexico Border.

PURPOSE: Research suggests that ethnicity is a predictor of pain-related outcomes; however, studies comparing the differences in experimental pain sensitivity between Hispanics and non-Hispanic Whites (NHW) are scarce. This study investigated these differences between Hispanics and NHW from the U.S.- Mexico border. METHODS: Fifty-eight healthy participants completed the survey packet, which included a demographic and a psychosocial factors questionnaire. Participants underwent quantitative sensory testing, which included heat pain threshold, heat pain tolerance, Suprathreshold Heat Pain Response (SHPR), and Conditioned Pain Modulation (CPM). SHPR was induced by repeated thermal stimuli in both thenar eminences. CPM was assessed using SHPR as the experimental stimulus and cold pressor task as the conditioning stimulus. RESULTS: Analyses showed significant differences in experimental pain measures believed to be representative of facilitatory pain processing including SHPR and heat pain threshold, where Hispanics reported significantly higher pain ratings than NHW. Hispanics also reported higher levels of ethnic identity and acculturation. However, these factors were not significantly associated with experimental pain sensitivity. CONCLUSION: The experimental pain sensitivity and psychosocial factors included in this study differed by ethnic group, where Hispanics reported significantly higher pain ratings, when compared with NHW. However, ethnic identity and acculturation were not associated with these pain-related outcomes. Overall, enhanced understanding by clinicians of pain sensitivity and disparities in the pain experience between ethnic groups allows for increased cultural sensitivity and can be used to optimize pain treatment on an individual-by-individual basis.

Differential Neuroplastic Changes in Fibromyalgia and Depression Indexed by Up-Regulation of Motor Cortex Inhibition and Disinhibition of the Descending Pain System: An Exploratory Study.

Background: Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption of neuroplastic processes that mediate the equilibrium in the inhibitory systems stands out as a possible mechanism. Thus, the purpose of this cross-sectional exploratory study was: (i) to compare the motor cortex inhibition indexed by transcranial magnetic stimulation (TMS) measures [short intracortical inhibition (SICI) and intracortical facilitation (ICF)], as well as the function of descending pain modulatory systems (DPMS) among FM, MDD, and healthy subjects (HS); (ii) to compare SICI, ICF, and the role of DPMS evaluated by the change on Numerical Pain Scale (NPS) during the conditioned pain modulation test (CPM-test) between FM and MDD considering the BDNF-adjusted index; (iii) to assess the relationship between the role of DPMS and the BDNF-adjusted index, despite clinical diagnosis. Patients and Methods: A cohort of 63 women, aged 18 to 75 years [FM (n = 18), MDD (n = 19), and HC (n = 29)]. Results: The MANCOVA analysis revealed that the mean of SICI was 53.40% larger in FM compared to MDD [1.03 (0.50) vs. 0.55 (0.43)] and 66.99% larger compared to HC [1.03 (0.50) vs. 0.34 (0.19)], respectively. The inhibitory potency of the DPMS assessed by the change on the NPS during CPM-test was 112.29 % lower in the FM compared to MDD [0.22 (1.37) vs. -0.87 (1.49)]. The mean of BDNF from FM compared to MDD was 35.70% higher [49.82 (16.31) vs. 14.12 (8.86)]. In FM, the Spearman's coefficient between the change in the NPS during CPM-test with the SICI was Rho = -0.49, [confidence interval (CI) 95%; -0.78 to -0.03]. The BDNF-adjusted index was positively correlated with the disinhibition of the DPMS. Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM.

Effects of Transcranial Direct Current Stimulation Block Remifentanil-Induced Hyperalgesia: A Randomized, Double-Blind Clinical Trial.

Background: Remifentanil-induced hyperalgesia (r-IH) involves an imbalance in the inhibitory and excitatory systems. As the transcranial Direct Current Stimulation (tDCS) modulates the thalamocortical synapses in a top-down manner, we hypothesized that the active (a)-t-DCS would be more effective than sham(s)-tDCS to prevent r-IH. We used an experimental paradigm to induce temporal summation of pain utilizing a repetitive cold test (rCOLDT) assessed by the Numerical Pain Score (NPS 0-10) and we evaluated the function of the descending pain modulatory system (DPMS) by the change on the NPS (0-10) during the conditioned pain modulation (CPM)-task (primary outcomes). We tested whether a-tDCS would be more effective than s-tDCS to improve pain perception assessed by the heat pain threshold (HPT) and the reaction time during the ice-water pain test (IPT) (secondary outcomes). Methods: This double-blinded, factorial randomized trial included 48 healthy males, ages ranging 19-40 years. They were randomized into four equal groups: a-tDCS/saline, s-tDCS/saline, a-tDCS/remifentanil and s-tDCS/remifentanil. tDCS was applied over the primary motor cortex, during 20 min at 2 mA, which was introduced 10 min after starting remifentanil infusion at 0.06 µg⋅kg-1⋅min-1 or saline. Results: An ANCOVA mixed model revealed that during the rCOLDT, there was a significant main effect on the NPS scores (F = 3.81; P = 0.01). The s-tDCS/remifentanil group presented larger pain scores during rCOLDT, [mean (SD) 5.49 (1.04)] and a-tDCS/remifentanil group had relative lower pain scores [4.15 (1.62)]; showing its blocking effect on r-IH. a-tDCS/saline and s-tDCS/saline groups showed lowest pain scores during rCOLDT, [3.11 (1.2)] and [3.15 (1.62)], respectively. The effect of sedation induced by remifentanil during the rCOLDT was not significant (F = 0.76; P = 0.38). Remifentanil groups showed positive scores in the NPS (0-10) during the CPM-task, that is, it produced a disengagement of the DPMS. Also, s-tDCS/Remifentanil compared to a-tDCS showed lower HPT and larger reaction-time during the IPT. Conclusion: These findings suggest that effects of a-tDCS prevent the summation response induced by r-IH during rCOLDT and the a-tDCS blocked the disengagement of DPMS. Thereby, tDCS could be considered as a new approach to contra-regulate paradoxical mechanisms involved in the r-IH. Clinical trials identification: NCT02432677. URL:https://clinicaltrials.gov/.

Effect of fish oil and vitamin E on sperm lipid peroxidation in dogs.

The objective was to evaluate the effects of dietary fish oil (FO) and vitamin E (VE) supplementation on sperm sensitivity to lipid peroxidation (LP) in dogs. Using an incomplete replicate 3 × 3 Latin square design, five dogs were allocated into three groups. One of the squares was incomplete and had two dogs that were used with three treatments. The dogs were assigned to three different treatments, fed a control diet of balanced commercial food (control group; CG), control diet supplemented with 54 mg FO/kg body weight0·75 per d (FO group; FG) and FO plus 400 mg VE per d (FO and VE group; FEG) for 60 d. Semen samples were collected on days 0 and 60 and divided into two halves, peroxidised and control, with or without ascorbate-Fe2+, respectively. LP was measured in both halves by chemiluminescence as counts per min/mg protein. Fatty acid profile was determined by GC. Data were analysed using the mixed procedure (SAS). On day 0, LP increased in all groups in the peroxidised samples (P < 0·05). However, on day 60 LP decreased in peroxidised samples of both the FG and FEG (P < 0·05), but there were no differences between the FG and FEG (P > 0·1). Additionally, on day 60 total n-3 was higher in the FG and FEG compared with the CG (P < 0·05). Supplementation with FO alone or together with VE decreased LP in peroxidised samples. These results could indicate a protective effect of n-3 on sperm. More studies are needed to understand the mechanism whereby FO and/or FO plus VE decrease LP in dogs' sperm.

Combined neuromodulatory interventions in acute experimental pain: assessment of melatonin and non-invasive brain stimulation.

Transcranial direct current stimulation (tDCS) and melatonin can effectively treat pain. Given their potentially complementary mechanisms of action, their combination could have a synergistic effect. Thus, we tested the hypothesis that compared to the control condition and melatonin alone, tDCS combined with melatonin would have a greater effect on pain modulatory effect, as assessed by quantitative sensory testing (QST) and by the pain level during the Conditioned Pain Modulation (CPM)-task. Furthermore, the combined treatment would have a greater cortical excitability effect as indicated by the transcranial magnetic stimulation (TMS) and on the serum BDNF level. Healthy males (n = 20), (aged 18-40 years), in a blinded, placebo-controlled, crossover, clinical trial, were randomized into three groups: sublingual melatonin (0.25 mg/kg) + a-tDCS, melatonin (0.25 mg/kg) + sham-(s)-tDCS, or sublingual placebo+sham-(s)-tDCS. Anodal stimulation (2 mA, 20 min) was applied over the primary motor cortex. There was a significant difference in the heat pain threshold (°C) for melatonin+a-tDCS vs. placebo+s-tDCS (mean difference: 4.86, 95% confidence interval [CI]: 0.9 to 8.63) and melatonin+s-tDCS vs. placebo+s-tDCS (mean: 5.16, 95% CI: 0.84 to 8.36). There was no difference between melatonin+s-tDCS and melatonin+a-tDCS (mean difference: 0.29, 95% CI: -3.72 to 4.23). The mean change from the baseline on amplitude of motor evocate potential (MEP) was significantly higher in the melatonin+a-tDCS (-19.96% ± 5.2) compared with melatonin+s-tDCS group (-1.36% ± 5.35) and with placebo+s-tDCS group (3.61% ± 10.48), respectively (p < 0.05 for both comparisons). While melatonin alone or combined with a-tDCS did not significantly affect CPM task result, and serum BDNF level. The melatonin effectively reduced pain; however, its association with a-tDCS did not present an additional modulatory effect on acute induced pain.

Correlates of physical activity in 2-year-old toddlers: the generation R study.

OBJECTIVE: To describe and identify correlates of objectively measured physical activity and sedentary behavior in 2-year-old toddlers. STUDY DESIGN: A total of 347 children participating in a birth cohort study wore a unaxial ActiGraph accelerometer during 1 weekday and 1 weekend day. Information on potential correlates was assessed by parent-reported questionnaires, delivery reports, and regular visits to child health centers. Univariate and multivariable linear regression analyses were conducted to examine the associations between potential correlates and the following physical activity outcomes: percentage of time spent in sedentary behavior, percentage of time spent in moderate-to-vigorous physical activity, and mean counts per minute. RESULTS: A high percentage of monitored time was spent in sedentary behavior; 85.6% on weekdays and 84.5% on weekend days. Four correlates were significantly associated with at least 1 physical activity outcome in the multivariable regression models: child's sex, child's age, number of siblings, and season of measurement. The associations of gross motor development with moderate-to-vigorous physical activity and mean counts per minute approached significance. Associations of socioeconomic variables and child's body mass index z-score with physical activity outcomes were not significant. CONCLUSION: Two-year-old toddlers spend most of their time in sedentary behavior. No modifiable correlates were identified. Further research on physical activity and associated health benefits among very young children is warranted.

Evaluación de la citotoxicidad de distintos cementos selladores endodónticos en cultivos de fibroblastos gingivales / Citotoxicity assessment of different endodontic-use sealing cements in gingival fibroblast cultures

El objetivo de esta investigación fue evaluar in vitro la respuesta de fibroblastos gingivales contra diferentes selladores endodónticos mediante cultivos celulares, en un lapso de 96 horas. Los resultados obtenidos a intervalos de tiempo de 0, 1, 2, 3, 6, 24, 48, 72 y 96 horas fueron utilizados para determinar la citotoxicidad de los selladores. Cultivos de fibroblastos gingivales sin ningún sellador y con Sealapex fueron utilizados como controles positivos y negativos respectivamente. Los resultados fueron comparados con los controles negativos y analizados estadísticamente por medio de la prueba t Dunnett (p ≤ 0.05). Los cementos selladores investigados fueron: ProRoot MTA gris y blanco CPM, MTA Angelus, Sealapex y GuttaFlow. Los resultados demostraron que a pesar de que el ProRoot MTA (gris y blanco) MTA Angelus, CPM y GuttaFlow demostraron tener un potencial citotóxico menor que el Sealapex, no se encontraron diferencias estadísticas significativas.

The aim of the present study was the in vitro evaluation of the response, within 96 hours, of gingival fibroblast cultures with respect to different endodontic sealers. Results obtained at time intervals of 0, 1, 2, 3, 6, 24, 48, 72 and 96 hours were used to determine sealers' cytotoxicity. Gingival fibroblasts cultures without root canal sealer and with Sealapex were used as negative and positive controls respectively. Results were compared with negative controls and statistically analyzed with t Dunnett test (p ≤ 0.05). Assessed sealing cements were: ProRoot MTA, grey and white, CPM, MTA Angelus, Sealapex and GuttaFlow. Results showed that even though ProRoot MTA (grey and white) MTA Angelus, CPM and GuttaFlow exhibited lower cytotoxic potential than Sealapex, no statistical significant differences were established.

Aplicação da Movimentação Passiva Contínua (CPM) na reabilitação do cotovelo: uma revisão da literatura / Aplicación de Movimiento Pasivo Continuo (CPM - MPC) en la rehabilitación del codo: una revisión de la literatura / Application of Continuous Passive Motion (CPM) in elbow rehabilitation: a literature survey

A Movimentação Passiva Contínua (CPM) é utilizada na reabilitação após trauma ou cirurgia articular, e sua aplicação pode gerar resultados positivos na reabilitação dos membros. Este estudo teve como objetivo analisar e discutir a utilização de equipamentos de CPM na reabilitação do cotovelo a partir de uma revisão bibliográfica de estudos publicados nos últimos 10 anos. Esta pesquisa bibliográfica foi realizada em banco de dados informatizado da Biblioteca Virtual em Saúde, EBSCO HOST, PeDRO, Biblioteca Cochrane e Science Direct. Para localizar os estudos, foram utilizadas palavras-chave: movimento passivo contínuo, cotovelo e CPM cotovelo, em Português e Inglês. Foram selecionados artigos completos em português, inglês e espanhol. A estratégia de pesquisa estava focalizada em estudos do tratamento de patologias do cotovelo utilizando a CPM como método isolado ou associado a outras técnicas fisioterapêuticas. A amostra foi composta de 16 publicações de periódicos. Em 11 dos artigos, a aplicação da CPM associada ou não a outros métodos fisioterapêuticos gerou resultados benéficos; um não apresentou diferença quando comparada a utilização ou não da CPM; dois demonstraram resultados positivos, ressaltando cuidados específicos; e dois afirmam ser necessário mais estudos para comprovação de resultados. Portanto, foi possível evidenciar que pesquisas estão explorando a utilização da CPM na reabilitação do cotovelo, porém os parâmetros utilizados e os modos de aplicação do equipamento não estão bem especificados. Além disso, foi possível perceber que a CPM está sendo utilizada como adjuvante aos métodos de reabilitação fisioterápica e prevalecemos resultados positivos.

Continuous Passive Motion (CPM) is used in post-trauma or articulations surgery rehabilitation to articulate, and its application may produce positive results in members` rehabilitation. This study aimed to analyze and to discuss the use of CPM equipment in elbow rehabilitation through a bibliographical survey of studies published in the last 10 years. This bibliographical survey was done in a computerized databank of Virtual Library in Health, EBSCO HOST, PeDRO, Cochrane Library and Science Direct. For locating studies, we used the keywords continuous passive movement, elbow and elbow MPC/CPM in English, Portuguese and Spanish. Complete articles in Portuguese, English and Spanish were selected. The research strategy focused on studies of the treatment of elbow pathologies using CPM as an isolated method and associated to other physiotherapeutic techniques. The sample was composed by 16 newspaper articles. In 11 articles, CPM application associated or not to other physiotherapeutic methods, has produced beneficial results; 1 did not present differences in the comparison between the use of (CPM) and the use of other techniques; 2 presented positive results, emphasizing specific cares, and 2 called for more studies for result verification. Therefore, it was possible to shoe that researchs are now exploring the use of CPM in elbow rehabilitation, but parameters used and application methods are not well explained. In addition, it was possible to perceive that today CPM is used as an adjuvant method of physiotherapeutic rehabilitation, with the prevalence of positive results.

El Movimiento Pasivo Continuo (MPC) es utilizado en la rehabilitación post-trauma o cirugía articular y su aplicación puede generar resultados positivos en la rehabilitación de los miembros. Este estudio tuvo como objetivo analizar y discutir la utilización de equipamientos de MPC en la rehabilitación del codo a través de una revisión bibliográfica de estudios publicados en los últimos 10 años. Esta investigación bibliográfica fue realizada en un banco de datos informatizado de la Biblioteca Virtual en Salud, EBSCO HOST, PeDRO, Biblioteca Cochrane y Science Direct. Para localizar los estudios, fueron utilizadas las palabras-llave movimiento pasivo continuo, codo y CPM codo en Portugués y Inglés. Se seleccionaran artículos completos en portugués, inglés y español. La estrategia de investigación focalizó estudios del tratamiento de patologías del codo que utilizaban el CPM como método aislado o asociado a otras técnicas fisioterapéuticas. La muestra se compuso de 16 artículos de periódicos. En 11 de los artículos, la aplicación del CPM, asociada o no a otros métodos fisioterapéuticos, ha producido resultados benéficos; 1 no presentó diferencia en la comparación entre la utilización o no del CPM; 2 han demostrado resultados positivos, resaltando cuidados específicos, y 2 afirman se necesitar de más estudios para la comprobación de resultados. Por consiguiente, fue posible evidenciar que investigaciones exploran en la actualidad la utilización de la CPM en la rehabilitación del codo, mas los parámetros utilizados y los modos de aplicación del equipamiento non están bien especificados. Además, fue posible percibir que la CPM es hoy utilizado como adyuvante de los métodos de rehabilitación fisioterápica, prevaleciendo los resultados positivos.

Sealing ability of grar MTA AngelusTM, CPM TM and MBPc used as apical plugs

This study evaluated the sealing ability of apical plugs fabricated with gray MTA AngelusTM sealer, CPM TM sealer and MBPc sealer. The root canals of 98 extracted single-rooted human teeth were instrumented with #5 to #1 Gates Glidden drills according to the crown-down technique until the #1 drill could pass through the apical foramen. The specimens were then prepared with K-files, starting with an ISO 50 until an ISO 90 could be visualized 1 mm beyond the apex. After root canal preparation, the external surface of each root was rendered impermeable and roots were assigned to 3 experimental groups (n = 30), which received a 5-mm thick apical plug of gray MTA AngelusTM, CPM TM and MBPc, and two control groups (n=4). The remaining portion of the canal in the experimental groups was filled by the lateral condensation technique. The teeth of each group, properly identified, were fixed on utility wax by their crowns and were placed in plastic flasks, leaving the apex free and facing upward. The flasks were filled with 0.2 percent Rhodamine B solution, pH 7.0, so as to completely cover the root apex of all teeth. The sealing ability was analyzed by measuring 0.2 percent Rhodamine B leakage after all groups had been maintained in this solution for 48 hours. Data were analyzed statistically by Kruskal-Wallis test and Dunn test with a=5 percent. The results showed that, among the tested materials used for fabrication of apical plugs, MBPc sealer had the least amount of leakage with statistically significant difference (p<0.05).