Quantitative Sensory Testing to Predict Postoperative Pain.

PURPOSE OF REVIEW: We review the relevance of quantitative sensory testing (QST) in light of acute and chronic postoperative pain and associated challenges. RECENT FINDINGS: Predicting the occurrence of acute and chronic postoperative pain with QST can help identify patients at risk and allows proactive preventive management. Generally, central QST testing, such as temporal summation of pain (TSP) and conditioned pain modulation (CPM), appear to be the most promising modalities for reliable prediction of postoperative pain by QST. Overall, QST testing has the best predictive value in patients undergoing orthopedic procedures. Current evidence underlines the potential of preoperative QST to predict postoperative pain in patients undergoing elective surgery. Implementing QST in routine preoperative screening can help advancing traditional pain therapy toward personalized perioperative pain medicine.

Dependence of the filled-space illusion on the size and location of contextual distractors.

For most observers, the part of the stimulus that is filled with some visual elements (e.g., distractors) appears larger than the unfilled part of the same size. This illusion of interrupted spatial extent is also known as the \'filled­space' or 'Oppel­Kundt' illusion. Although the continuously filled­space illusion has been systematically studied for over a century, there is still no generally accepted explanation of its origin. The present study aimed to further develop our computational model of the continuously filled­space illusion and to examine whether the model predictions successfully account for illusory effects caused by distracting line­segments of various lengths that are\r\nattached to different endpoints (i.e., terminators) of the reference spatial interval of the three­dot stimulus. Our experiments confirm that the illusion manifests itself along a distracting segment located both inside and outside of the reference interval. In the case of two distractors arranged symmetrically with respect to the lateral terminator, we found that the magnitude of the illusion is approximately equal to the sum of the relevant values obtained with separate distractors. The results of experiments using vertical shifts of distractors supported the model's assumption regarding the two­dimensional Gaussian profile of hypothetical areas of weighted spatial summation\r\nof neural activity. A good correspondence between the experimental and theoretical results supports the suggestion that perceptual positional biases associated with the context­evoked increase in neural excitation may be one of the main causes of the continuously filled­space illusion.

The relation of peripheral and central sensitization to muscle co-contraction: the MOST study.

OBJECTIVE: To examine the relation of pain sensitization to altered motor activity in knee OA as assessed by hamstrings muscle co-contraction during maximal effort knee extension. DESIGN: Medial, lateral, and overall hamstring co-contraction was assessed in the Multicenter Osteoarthritis (MOST) Study cohort using electromyography during isokinetic knee extension at 60°/second. Mechanical temporal summation of pain (TS) was assessed at the right wrist and pressure pain thresholds (PPT) were assessed at the patellae; PPTs were categorized into sex-specific tertiles. Muscle co-contraction was categorized into age- and sex-specific tertiles. We evaluated the relation of measures of sensitization to muscle co-contraction using a generalized logistic regression model. RESULTS: 1633 participants were included: mean age and BMI was 67.3 ± 7.7 years and 30.3 ± 5.6 kg/m2, respectively; 58% were female. Presence of TS was associated with higher overall (OR 1.3, 95% confidence interval (CI) (1.0-1.8)), medial (1.4 (1.0-1.9), and lateral (1.3 (1.0, 1.9)) hamstring co-contraction. The lowest PPT tertile (greater sensitivity) was associated with higher overall (1.5 (1.0, 2.3)) and medial (1.5 (1.0, 2.3)) hamstring co-contraction compared with those in the highest PPT tertile. CONCLUSION: Greater pain sensitization, as assessed by presence of TS at the wrist and low patellar PPT, was associated with greater overall and medial hamstring co-contraction during knee extension. This provides support to the possibility that peripheral and/or central nervous system alterations may not only affect pain sensitivity, but also motor function.

Assessing peripheral fibers, pain sensitivity, central sensitization, and descending inhibition in Native Americans: main findings from the Oklahoma Study of Native American Pain Risk.

Native Americans (NAs) have a higher prevalence of chronic pain than other U.S. racial/ethnic groups, but there have been few attempts to understand the mechanisms of this pain disparity. This study used a comprehensive battery of laboratory tasks to assess peripheral fiber function (cool/warm detection thresholds), pain sensitivity (eg, thresholds/tolerances), central sensitization (eg, temporal summation), and pain inhibition (conditioned pain modulation) in healthy, pain-free adults (N = 155 NAs, N = 150 non-Hispanic Whites [NHWs]). Multiple pain stimulus modalities were used (eg, cold, heat, pressure, ischemic, and electric), and subjective (eg, pain ratings and pain tolerance) and physiological (eg, nociceptive flexion reflex) outcomes were measured. There were no group differences on any measure, except that NAs had lower cold-pressor pain thresholds and tolerances, indicating greater pain sensitivity than NHWs. These findings suggest that there are no group differences between healthy NAs and NHWs on peripheral fiber function, central sensitization, or central pain inhibition, but NAs may have greater sensitivity to cold pain. Future studies are needed to examine potential within-group factors that might contribute to NA pain risk.

Experimentally induced spinal nociceptive sensitization increases with migraine frequency: a single-blind controlled study.

The nitric-oxide donor nitroglycerin (NTG) administration induces a facilitation of nociceptive pathways in episodic migraine. This study aims to test the hypothesis that induced spinal sensitization could be more pronounced in patients affected by high-frequency migraine (HF-MIG) with respect to low-frequency migraine (LF-MIG). We enrolled 28 patients with LF-MIG (1-5 migraine days/month), 19 patients with HF-MIG (6-14 migraine days/month), and 21 healthy controls (HCs). Spinal sensitization was evaluated with the neurophysiological recording of the temporal summation threshold (TST) of the nociceptive withdrawal reflex at the lower limb. Temporal summation threshold was recorded at baseline and 30, 60, and 120 minutes after NTG administration (0.9 mg sublingual). Spinal sensitization was detected in LF-MIG at 60 (P = 0.010) and 120 minutes (P = 0.001) and in HF-MIG at 30 (P = 0.008), 60 (P = 0.001), and 120 minutes (P = 0.001) after NTG administration. Temporal summation threshold did not change in HC (P = 0.899). Moreover, TST reduction was more pronounced in HF-MIG with respect to LF-MIG (P = 0.002). The percentage of patients who developed a migraine-like headache after NTG was comparable in the 2 migraine groups (LF-MIG: 53.6%, HF-MIG: 52.6%, P = 0.284), whereas no subjects in the HC group developed a delayed-specific headache. Notably, the latency of headache onset was significantly shorter in the HF-MIG group when compared with the LF-MIG group (P = 0.015). Our data demonstrate a direct relationship between migraine frequency and both neurophysiological and clinical parameters, to suggest an increasing derangement of the nociceptive system control as the disease progresses, probably as a result of the interaction of genetic and environmental factors.

Stereoscopic depth adaptation from binocularly correlated versus anti-correlated noise: Test of an efficient coding theory of stereopsis.

Stereoscopic, or "3D" vision in humans is mediated by neurons sensitive to the disparities in the positions of objects in the two eyes' views. A disparity-sensitive neuron is typically characterized by its responses to left- and right-eye monocular signals, SL and SR, respectively. However, it can alternatively be characterized by sensitivity to the sum of the two eyes' inputs, S+ = SL + SR, and the difference, S- = SL - SR. Li and Atick's theory of efficient binocular encoding proposes that the S+ and S- signals can be separately weighted to maximize the efficiency with which binocular information is encoded. This adaptation changes each neuron's sensitivity and preferred binocular disparity, resulting in predicted effects on the perceived stereoscopic depth of objects. To test these predictions, we measured the apparent depth of a random-dot stereogram with an 'in-front' target following adaptation to binocularly correlated or anti-correlated horizontally-oriented grating stimuli, which reduce sensitivity to the S+ and S- signals, respectively, but which contain no conventional stereo-depth signals. The anti-correlated noise adaptation made the target appear relatively closer to the background than the correlated noise adaptation, with differences of up to 60%. We show how this finding can be accommodated by a standard model of binocular disparity processing, modified to incorporate the binocular adaptation suggested by Li and Atick's theory.

Cul3 and insomniac are required for rapid ubiquitination of postsynaptic targets and retrograde homeostatic signaling.

At the Drosophila neuromuscular junction, inhibition of postsynaptic glutamate receptors activates retrograde signaling that precisely increases presynaptic neurotransmitter release to restore baseline synaptic strength. However, the nature of the underlying postsynaptic induction process remains enigmatic. Here, we design a forward genetic screen to discover factors in the postsynaptic compartment necessary to generate retrograde homeostatic signaling. This approach identified insomniac (inc), a putative adaptor for the Cullin-3 (Cul3) ubiquitin ligase complex, which together with Cul3 is essential for normal sleep regulation. Interestingly, we find that Inc and Cul3 rapidly accumulate at postsynaptic compartments following acute receptor inhibition and are required for a local increase in mono-ubiquitination. Finally, we show that Peflin, a Ca2+-regulated Cul3 co-adaptor, is necessary for homeostatic communication, suggesting a relationship between Ca2+ signaling and control of Cul3/Inc activity in the postsynaptic compartment. Our study suggests that Cul3/Inc-dependent mono-ubiquitination, compartmentalized at postsynaptic densities, gates retrograde signaling and provides an intriguing molecular link between the control of sleep and homeostatic plasticity at synapses.

Association Between Pain Sensitivity and Endogenous Supraspinal Pain Modulation in Patients with Orofacial Pain.

Address correspondence to: Dr. Carla S. Enriquez, Physical Therapy Program, Stockton University School of Health Sciences, 101 Vera King Farris Drive, Galloway, NJ 08205-9441, USA. Tel 609-626-3508, fax 609-652-4858. carla.enriquez@stockton.edu. PURPOSE: To investigate the association between pain sensitivity and endogenous supraspinal pain modulation activity using quantitative sensory tests (QST) in patients with orofacial pain. METHODS: Temporal summation (TS) testing and conditioned pain modulation (CPM) are QSTs used to quantify individual pain processing mechanisms. TS testing was used to assess pain sensitivity which correlates to central sensitization and CPM for endogenous pain modulation. These tests were administered to a convenience sample of patients with orofacial pain (n=40) seen for initial examination in an orofacial pain clinic. Bivariate correlation analyses were conducted on TS and CPM scores, including age and gender. RESULTS: A strong linear correlation was found between pain sensitivity and endogenous pain modulation (r=0.69, p<0.001). QST outcomes suggest that inefficient endogenous pain modulation is positively correlated with the magnitude of pain sensitivity among individuals who seek treatment for orofacial pain. A weak linear correlation was also found between TS and age (r=0.37, p=0.02). CONCLUSION: QSTs demonstrated a strong association between heightened pain sensitivity and inefficient endogenous pain modulation revealed from higher pain report on TS and CPM testing in patients with orofacial pain. Our findings provide supporting evidence on the impairments in pain-processing mechanisms that require consideration when evaluating orofacial pain etiology, where increased pain sensitivity and aberrant pain modulation appear to significantly contribute in prolonged and persistent pain experience.

Functional Specialization of ON and OFF Cortical Pathways for Global-Slow and Local-Fast Vision.

Visual information is processed in the cortex by ON and OFF pathways that respond to light and dark stimuli. Responses to darks are stronger, faster, and driven by a larger number of cortical neurons than responses to lights. Here, we demonstrate that these light-dark cortical asymmetries reflect a functional specialization of ON and OFF pathways for different stimulus properties. We show that large long-lasting stimuli drive stronger cortical responses when they are light, whereas small fast stimuli drive stronger cortical responses when they are dark. Moreover, we show that these light-dark asymmetries are preserved under a wide variety of luminance conditions that range from photopic to low mesopic light. Our results suggest that ON and OFF pathways extract different spatiotemporal information from visual scenes, making OFF local-fast signals better suited to maximize visual acuity and ON global-slow signals better suited to guide the eye movements needed for retinal image stabilization.

Peripheral and Central Sensitization of Pain in Individuals With Hand Osteoarthritis and Associations With Self-Reported Pain Severity.

OBJECTIVE: Pain sensitization, an important osteoarthritis (OA) pain mechanism, has not been substantially investigated in patients with hand OA. It is unknown how peripheral and central sensitization are related to self-reported hand pain. METHODS: Individuals with verified hand OA in the Nor-Hand study underwent quantitative sensory testing of pressure pain thresholds (PPTs) locally (painful and nonpainful finger joints) and remotely (wrist, trapezius, and tibialis anterior muscles), and testing of temporal summation (TS), a manifestation of central sensitization. We examined cross-sectional associations of PPT tertiles and TS with hand pain using the Numerical Rating Scale (NRS) (range 0-10) and the Australian/Canadian Osteoarthritis Hand Index (AUSCAN) pain subscale (range 0-20). Linear regression models were adjusted for demographics, psychosocial factors, and radiographic severity. RESULTS: This study included 282 participants (88% female) with a median age of 61 years (interquartile range [IQR] 57-66). Participants with the lowest PPTs in their finger joints and in most remote locations reported higher NRS pain values, compared to patients with the highest PPTs, with adjusted ß values ranging from 0.6 (95% confidence interval [95% CI] 0.0, 1.2) to 0.9 (95% CI 0.3, 1.5). The 118 participants (42%) with TS reported higher mean ± SD NRS pain values compared to those without TS (4.1 ± 2.4 versus 3.1 ± 1.7; adjusted ß = 0.6 [95% CI 0.2, 1.1]). Neither PPTs nor the presence of TS were associated with AUSCAN pain. CONCLUSION: Central sensitization was common in patients with hand OA. Lower local and widespread PPTs and the presence of TS were associated with higher hand pain intensity, even after adjustment for demographics, psychosocial factors, and radiographic severity. Sensitization may therefore represent a possible treatment target.

What do you expect? Catastrophizing mediates associations between expectancies and pain-facilitatory processes.

BACKGROUND: Pain expectancies are associated with altered pain sensitivity in individuals with chronic pain. However, little is known about the processes by which pain expectancies impact pain processing. This study assessed the association between pain expectancies and temporal summation (TS) of pain, and examined whether pain catastrophizing mediated this association. METHODS: In this cross-sectional study, participants (437 chronic low back pain [CLBP] patients, 115 controls) completed self-report measures of pain intensity, pain expectancies and pain catastrophizing before undergoing psychophysical pain-testing procedures designed to assess mechanical TS of mechanical pain. Pearson's correlations examined the associations between study variables in CLBP patients and controls. Bootstrapping mediation analyses assessed the mediating role of pain catastrophizing on the association between pain expectancies and TS of pain. RESULTS: Temporal summation of pain was significantly associated with pain expectancies (r = 0.113) and pain catastrophizing (r = 0.171) in CLBP patients. Results of mediation analyses revealed that pain catastrophizing mediated the relationship between pain expectancies and TS of pain in CLBP patients (ab = 0.309, 95% CI = 0.1222-0.5604), but not in healthy controls (ab = -0.125, 95% CI = -0.5864 to 0.0244). CONCLUSIONS: The findings from this study suggest that compared to controls, CLBP patients show increased sensitivity to mechanical pain procedures and enhanced pain-facilitatory processing, proving further evidence for changes in central nervous system pain processing in CLBP patients. Our results also suggest that pain catastrophizing may be the mechanism by which pain expectancies are associated with TS of pain in CLBP patients. SIGNIFICANCE: Individuals with chronic low back pain who expect higher levels of pain and catastrophize about their pain are more likely to experience altered pain sensitivity. Our results point to catastrophizing as a mechanism of action through which psychological factors may operate and lead to the development and maintenance of chronic low back pain.

Childhood Adversity and Pain Facilitation.

OBJECTIVE: This study investigated whether childhood adversity would be associated with hypersensitivity on two measures of central pain facilitation: area of secondary allodynia and temporal summation of second pain (TSSP), and whether pain facilitation would be explained by adult posttraumatic stress disorder (PTSD) symptoms. METHOD: Participants endorsing high (n = 31) and low (n = 31) childhood adversity underwent capsaicin-induced secondary allodynia and TSSP testing. The tests were conducted a week apart with test order counterbalanced. RESULTS: Larger areas of secondary allodynia were observed in the high adversity group compared with the low adversity group (F(1,60) = 4.81, p = .032). This group difference was largely (62%) explained by greater PTSD symptoms in the high adversity group. Although no overall difference was found in TSSP slopes (p = .886), this was attributed to an order by group interaction (F(1,58) = 5.07, p = .028) and low power. Subsequent analyses revealed positive TSSP slopes in the high adversity group when TSSP testing was performed first, and this order effect was associated with blunted sympathetic responses to TSSP on the first visit. The two facilitation measures were unrelated (p = .631). CONCLUSIONS: Larger areas of secondary allodynia were observed in the high adversity group, which was explained largely by PTSD symptoms. This suggests that adversity-related changes in pain facilitation may underlie the association between childhood adversity and generalized widespread pain. Although TSSP was affected by previous testing, adversity-related pain facilitation was observed when TSSP testing occurred first. Finally, adversity was not associated with a consistent pattern of hypersensitivity across the two measures of central pain facilitation.

Matched Short-Term Depression and Recovery Encodes Interspike Interval at a Central Synapse.

Reversible decreases in synaptic strength, known as short-term depression (STD), are widespread in neural circuits. Various computational roles have been attributed to STD but these tend to focus upon the initial depression rather than the subsequent recovery. We studied the role of STD and recovery at an excitatory synapse between the fast extensor tibiae (FETi) and flexor tibiae (flexor) motor neurons in the desert locust (Schistocerca gregaria) by making paired intracellular recordings in vivo. Over behaviorally relevant pre-synaptic spike frequencies, we found that this synapse undergoes matched frequency-dependent STD and recovery; higher frequency spikes that evoke stronger, faster STD also produce stronger, faster recovery. The precise matching of depression and recovery time constants at this synapse ensures that flexor excitatory post-synaptic potential (EPSP) amplitude encodes the presynaptic FETi interspike interval (ISI). Computational modelling shows that this precise matching enables the FETi-flexor synapse to linearly encode the ISI in the EPSP amplitude, a coding strategy that may be widespread in neural circuits.

[Loudness optimized registration of compound action potential in cochlear implant recipients]. / Lautheitsoptimierte Messung von Summenaktionspotentialen bei Cochlea Implantat Trägern.

Background Postoperative measurements of compound action potentials are not always possible due to the insufficient acceptance of the CI-recipients. This study investigated the impact of different parameters on the acceptance of the measurements. Methods Compound action potentials of 16 CI recipients were measured with different pulse-widths. Recipients performed a loudness rating at the potential thresholds with the different sequences. Results Compound action potentials obtained with higher pulse-widths were rated softer than those obtained with smaller pulse-widths. Conclusions Compound action potentials measured with higher pulse-widths generate a gap between loudest acceptable presentation level and potential threshold. This gap contributes to a higher acceptance of postoperative measurements.

Association Between Borderline Personality Features and Temporal Summation of Second Pain: A Cross-Sectional Study.

Individuals with greater borderline personality features may be vulnerable to chronic pain. Because pain is an unpleasant sensory and emotional experience, affect dysregulation as the core personality feature may be linked to pain hypersensitivity. Studies have found that greater borderline features are associated with increased intensity in clinical and experimental pain, and that depression mediates this increase. The current study further examined the association between borderline features and heat pain sensitivity, the contribution of affect dysregulation and the other borderline personality factors (identity problems, negative relationships, self-harming/impulsivity) to the association, and depression as a mediator. Additionally, we examined whether blunted sympathetic responses mediate the association between borderline features and temporal summation of second pain (TSSP). Thermal pain threshold, thermal TSSP and aftersensations pain were assessed in 79 healthy individuals with varying degrees of borderline features. TSSP is a proxy measure for central sensitization and refers to the gradual increase in pain to repeated nociceptive stimuli. A regression analysis showed that greater borderline features predicted greater TSSP (ß = .22, p = .050, R2 = .05). Borderline features were unrelated to pain threshold and TSSP decay. A stepwise regression showed greater TSSP in individuals with greater borderline features was accounted for by the negative relationships factor rather than the affect dysregulation factor. The results of mediational analyses showed depression and blunted sympathetic skin conductance responses mediated the positive association between TSSP and borderline features.

Measuring temporal summation in visual detection with a single-photon source.

Temporal summation is an important feature of the visual system which combines visual signals that arrive at different times. Previous research estimated complete summation to last for 100ms for stimuli judged "just detectable." We measured the full range of temporal summation for much weaker stimuli using a new paradigm and a novel light source, developed in the field of quantum optics for generating small numbers of photons with precise timing characteristics and reduced variance in photon number. Dark-adapted participants judged whether a light was presented to the left or right of their fixation in each trial. In Experiment 1, stimuli contained a stream of photons delivered at a constant rate while the duration was systematically varied. Accuracy should increase with duration as long as the later photons can be integrated with the proceeding ones into a single signal. The temporal integration window was estimated as the point that performance no longer improved, and was found to be 650ms on average. In Experiment 2, the duration of the visual stimuli was kept short (100ms or <30ms) while the number of photons was varied to explore the efficiency of summation over the integration window compared to Experiment 1. There was some indication that temporal summation remains efficient over the integration window, although there is variation between individuals. The relatively long integration window measured in this study may be relevant to studies of the absolute visual threshold, i.e., tests of single-photon vision, where "single" photons should be separated by greater than the integration window to avoid summation.

Fourth-root summation of contrast over area: No end in sight when spatially inhomogeneous sensitivity is compensated by a witch's hat.

Measurements of area summation for luminance-modulated stimuli are typically confounded by variations in sensitivity across the retina. Recently we conducted a detailed analysis of sensitivity across the visual field (Baldwin, Meese, & Baker, 2012) and found it to be well described by a bilinear "witch's hat" function: Sensitivity declines rapidly over the first eight cycles or so, but more gently thereafter. Here we multiplied luminance-modulated stimuli (4 cycles/degree gratings and "Swiss cheeses") by the inverse of the witch's hat function to compensate for the inhomogeneity. This revealed summation functions that were straight lines (on double log axes) with a slope of -1/4 extending to ≥33 cycles, demonstrating fourth-root summation of contrast over a wider area than has previously been reported for the central retina. Fourth-root summation is typically attributed to probability summation, but recent studies have rejected that interpretation in favor of a noisy energy model that performs local square-law transduction of the signal, adds noise at each location of the target, and then sums over signal area. Modeling shows our results to be consistent with a wide field application of such a contrast integrator. We reject a probability summation model, a quadratic model, and a matched template model of our results under the assumptions of signal detection theory. We also reject the high threshold theory of contrast detection under the assumption of probability summation over area.

Postsynaptic Potentiation in Mouse Motor Synapses Induced by ATP Accumulation in Synaptic Cleft.

In mouse motor synapses, a non-selective purinoceptor antagonist suramin increased the quantum content of endplate potentials (EPP) without changing the time course of synaptic potentials. An ectonucleotidase inhibitor ARL 67156 had no effect on the amplitude and quantum content of EPP and miniature endplate potentials (mEPP) evoked by single stimuli, but significantly prolonged their duration. Long-term high-frequency stimulation of the nerve in the presence of ARL 67156 persistently increased the amplitude and duration of EPP during the train of impulses, but did not change their quantum content. ATP-γ-S, a non-hydrolyzed ATP analogue, significantly increased the amplitudes and prolonged the rising and falling phases of EPP and mEPP. The ATP-induced postsynaptic potentiation in neuromuscular transmission can result from the increase in ATP content and its longer presence in the synaptic cleft.

Diferencias neurofuncionales de la onda P300 ante estimulación multisensorial en niños con trastorno por déficit de atención/hiperactividad / Neurofunctional differences in the P300 frequency for multi-sensory stimulation in kids with attention deficit hyperactivity disorder

Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) se caracteriza por falta de atención, hiperactividad motora, impulsividad o una combinación de todas. La P300 es una prueba neurofisiológica no invasiva que ha mostrado su eficacia para detectar diferencias entre sujetos con TDAH, pero los resultados todavía no son concluyentes. Objetivo. Evaluar el procesamiento cerebral de la información mediante el componente P300, en modalidad auditiva, visual y táctil, en niños con TDAH. Sujetos y métodos. Se registraron los componentes P300 auditivo, visual y táctil a 17 niños con TDAH (10 combinados y siete inatentos) y a 15 niños control de edades comprendidas entre 7 y 10 años de ambos sexos. Resultados. En los tiempos de reacción de respuesta, se halló una tendencia más acentuada en el tiempo auditivo y visual, pero no estadísticamente significativo en ninguna de las tres respuestas; en el porcentaje de errores, un incremento en los niños con TDAH respecto al grupo control. Los niños con TDAH presentaban un aumento significativo de la latencia de la onda P300 visual, mientras que existía una disminución no significativa en la P300 táctil y auditiva. Se encontró un aumento de las áreas corticales en el componente P300 en los niños con TDAH durante la prueba visual y auditiva, pero no en la táctil. Conclusiones. Los resultados apoyan la hipótesis de la existencia de aumento de áreas cerebrales funcionales durante el procesamiento sensorial auditivo y visual en el grupo con TDAH, excepto durante la estimulación táctil, en que sucede lo contrario (AU)

Introduction. Attention deficit/hyperactivity disorder (ADHD) is characterized by inattention, motor hyperactivity, impulsivity, or a combination of all. The P300 is a non-invasive neurophysiological that has shown its effectiveness to detect differences between subjects with ADHD but results are not yet conclusive. Aim. To assess brain information processing by the P300 component, auditory, visual and tactile modality in children with ADHD. Subjects and methods. The P300 components auditory, visual and tactile 17 children with ADHD (11 combined and 7 inattentive) and 15 control children aged between 7 and 10 years were recorded. Results. In response reaction times found a more pronounced trend in the auditory and visual time but not statistically significant in any of the three responses. In the error rate increased in children with ADHD compared to the control group.Children with ADHD have a significant increase in latency of visual P300 wave while there is no significant decrease in tactile and auditory P300. We found increased cortical areas in the P300 component in children with ADHD during visual and auditory test, but not touch. Conclusions. Our results support the hypothesis of the existence of increased brain areas during auditory and visual sensory processing in ADHD group, except for tactile stimulation happens otherwise (AU)