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1.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(10): 1160-1165, 2019 Oct 30.
Artículo en Chino | MEDLINE | ID: mdl-31801715

RESUMEN

OBJECTIVE: To observe the effect of occlusal interference on the afferent pathway of the trigeminal nerve and neuronal excitability in the trigeminal subnucleus caudalis (SPVC) of rats by electrical stimulation of the trigeminal ganglion (TG) and extracellular recordings of SPVC activities. METHODS: Twenty male Wistar rats were randomly divided into control group and model group (n=10). In the model group, occlusal interference for 30 consecutive days was induced using light-cured flowable resin on the right maxillary molars. During occlusal interference, the pain sensitivity was scored with von Frey Fibers in the masseter. Simultaneous recordings of electrical activities from the SPVC, electrocardiogram, body temperature and electromyogram of the breath muscles of the anesthetized rats were performed, and the responses evoked by electrical stimulation of the TG were analyzed. RESULTS: Compared with the control rats, the rats in the model group showed significantly increased pain sensitivity scores (P < 0.05) and increased spontaneous discharge frequency of the SPVC (P < 0.05). The amplitude of the SPVC responses induced by electrical stimulation of the TG showed stimulus intensity-dependent changes (P < 0.05), and the amplitude evoked by 4 mA and 8 mA stimulation was similar between the model group and the control group (P>0.05). Train stimulation (0.2 ms, 1 mA, 30 s, 100 Hz) of the TG significantly increased the discharge frequency of the SPVC only in the rats in the model group (P < 0.05). CONCLUSIONS: The functional activities of the pain afferent pathway of the trigeminal nerve can be electrophysiologically monitored by electrical stimulation of the TG and extracellular recordings of SPVC activities in rats. Occlusal interference can increase the excitability of the neurons in the SPVC and enhance their sensitivities to TG afferent activation, suggesting the neural plasticity of the pain afferent pathway.


Asunto(s)
Vías Aferentes , Dimensión del Dolor , Umbral del Dolor , Dolor/fisiopatología , Nervio Trigémino/fisiología , Animales , Masculino , Distribución Aleatoria , Ratas , Ratas Wistar , Núcleos del Trigémino
2.
J Clin Neurophysiol ; 36(6): 430-436, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31688326

RESUMEN

The diffuse noxious inhibitory control, which has been investigated extensively in animals, consists of the inhibitory modulation of pain pathways after heterotopic noxious stimulation. The subnucleus reticularis dorsalis, which lies in the caudal part of the medulla, together with its descending projections to the wide-dynamic-range neurones, is responsible for the diffuse noxious inhibitory control. Many studies have investigated the diffuse noxious inhibitory control phenomenon in humans. However, owing to the complexity of the effect of descending modulation on human pain perception, expert opinion has recommended the term "conditioned pain modulation" to describe the psychophysical paradigm in which a heterotopic noxious stimulus is used to affect pain pathways in humans. In this narrative review, we present the current knowledge on the mechanisms underlying the diffuse noxious inhibitory control in animals and show how this phenomenon can be investigated in humans by using the conditioned pain modulation paradigm. We also demonstrate the relevance of conditioned pain modulation to the pathophysiology of pain.


Asunto(s)
Control Inhibidor Nocivo Difuso/fisiología , Percepción del Dolor/fisiología , Dolor/fisiopatología , Animales , Humanos
3.
Nat Commun ; 10(1): 4096, 2019 09 10.
Artículo en Inglés | MEDLINE | ID: mdl-31506426

RESUMEN

Information about others' experiences can strongly influence our own feelings and decisions. But how does such social information affect the neural generation of affective experience, and are the brain mechanisms involved distinct from those that mediate other types of expectation effects? Here, we used fMRI to dissociate the brain mediators of social influence and associative learning effects on pain. Participants viewed symbolic depictions of other participants' pain ratings (social information) and classically conditioned pain-predictive cues before experiencing painful heat. Social information and conditioned stimuli each had significant effects on pain ratings, and both effects were mediated by self-reported expectations. Yet, these effects were mediated by largely separable brain activity patterns, involving different large-scale functional networks. These results show that learned versus socially instructed expectations modulate pain via partially different mechanisms-a distinction that should be accounted for by theories of predictive coding and related top-down influences.


Asunto(s)
Encéfalo/fisiopatología , Condicionamiento Clásico , Red Nerviosa/fisiopatología , Dolor/fisiopatología , Conducta Social , Adolescente , Adulto , Señales (Psicología) , Femenino , Respuesta Galvánica de la Piel , Humanos , Aprendizaje , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Análisis Multivariante , Adulto Joven
4.
Muscle Nerve ; 60(6): 724-731, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31531865

RESUMEN

INTRODUCTION: There is currently little evidence regarding oculopharyngeal muscular dystrophy (OPMD) disease burden reported by patients. In this study we aim to elicit direct patient input regarding OPMD disease burden. METHODS: We conducted semistructured interviews with 25 participants with genetically confirmed OPMD and a wide range of disease duration (15 ± 8 years). Using the Framework Technique, themes and categories were then extracted. RESULTS: Analyses revealed 7 themes (physical impact, mental impact, social impact, perception of progression, treatment perceptions, coping strategies, and access to disease information), encompassing 27 categories of OPMD disease burden. The most frequent categories were related to dysphagia, coping strategies for dysphagia, and impaired mobility. DISCUSSION: This study demonstrates the importance of considering, when providing clinical care, the broad range of coping strategies patients use to deal with OPMD symptoms, especially dysphagia, to properly assess limitations and monitor real disease progression.


Asunto(s)
Distrofia Muscular Oculofaríngea/fisiopatología , Distrofia Muscular Oculofaríngea/psicología , Acceso a la Información , Adaptación Psicológica , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Trastorno Dismórfico Corporal , Niño , Costo de Enfermedad , Trastornos de Deglución/etiología , Trastornos de Deglución/fisiopatología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Limitación de la Movilidad , Debilidad Muscular/etiología , Debilidad Muscular/fisiopatología , Distrofia Muscular Oculofaríngea/complicaciones , Distrofia Muscular Oculofaríngea/terapia , Dolor/etiología , Dolor/fisiopatología , Medición de Resultados Informados por el Paciente , Investigación Cualitativa , Participación Social , Trastornos de la Voz/etiología , Trastornos de la Voz/fisiopatología , Rendimiento Laboral , Adulto Joven
5.
Nat Commun ; 10(1): 4253, 2019 09 18.
Artículo en Inglés | MEDLINE | ID: mdl-31534133

RESUMEN

Medication-overuse headaches (MOH) occur with both over-the-counter and pain-relief medicines, including paracetamol, opioids and combination analgesics. The mechanisms that lead to MOH are still uncertain. Here, we show that abnormal activation of Nav1.9 channels by Nitric Oxide (NO) is responsible for MOH induced by triptan migraine medicine. Deletion of the Scn11a gene in MOH mice abrogates NO-mediated symptoms, including cephalic and extracephalic allodynia, photophobia and phonophobia. NO strongly activates Nav1.9 in dural afferent neurons from MOH but not normal mice. Abnormal activation of Nav1.9 triggers CGRP secretion, causing artery dilatation and degranulation of mast cells. In turn, released mast cell mediators potentiates Nav1.9 in meningeal nociceptors, exacerbating inflammation and pain signal. Analysis of signaling networks indicates that PKA is downregulated in trigeminal neurons from MOH mice, relieving its inhibitory action on NO-Nav1.9 coupling. Thus, anomalous activation of Nav1.9 channels by NO, as a result of chronic medication, promotes MOH.


Asunto(s)
Cefaleas Secundarias/patología , Trastornos Migrañosos/patología , Canal de Sodio Activado por Voltaje NAV1.9/metabolismo , Neuronas Aferentes/metabolismo , Óxido Nítrico/metabolismo , Triptaminas/efectos adversos , Animales , Péptido Relacionado con Gen de Calcitonina/metabolismo , Degranulación de la Célula/fisiología , Células Cultivadas , Femenino , Cefaleas Secundarias/inducido químicamente , Hiperalgesia/fisiopatología , Masculino , Mastocitos/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Canal de Sodio Activado por Voltaje NAV1.9/genética , Neuronas Aferentes/efectos de los fármacos , Nociceptores/fisiología , Dolor/fisiopatología , Uso Excesivo de Medicamentos Recetados/efectos adversos
6.
Phys Ther Sport ; 40: 107-116, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31518777

RESUMEN

OBJECTIVES: To examine the feasibility of recommended education and exercise supplemented by a hopping intervention implemented based on self-reported pain over 12 weeks for recreational runners with Achilles tendinopathy. DESIGN: Single cohort feasibility study. SETTING: One private physiotherapy clinic in Melbourne, Australia. PARTICIPANTS: Fifteen male recreational runners with midportion Achilles tendinopathy. MAIN OUTCOME MEASURES: Recruitment and adherence measures, adverse events, intervention acceptability and treatment effect trends were measured at baseline, 4 and 12 weeks. RESULTS: Recruitment (100%), retention (87%) and follow-up (93%) rates were high. Exercise adherence was 70% (SD = 12.7) but fidelity was 50% (SD = 13.9). Three participants suffered adverse events (undertaking activities contrary to advice). Participants reported the education package, perceived benefit, and feedback frequency as intervention enablers; while the onerous time commitment was regarded a barrier. At 12 weeks, five participants were satisfied and eight very satisfied, while VISA-A had improved 24 ±â€¯20.65 points (µ2 = 0.740). CONCLUSIONS: A randomised control trial including recommended education and exercise with a pain-guided hopping intervention as treatment for recreational runners with midportion Achilles tendinopathy may be warranted, once strategies to improve adherence and reduce adverse events are addressed.


Asunto(s)
Tendón Calcáneo/fisiopatología , Terapia por Ejercicio , Manejo del Dolor/métodos , Carrera , Tendinopatía/terapia , Adulto , Australia , Estudios de Cohortes , Estudios de Factibilidad , Humanos , Masculino , Persona de Mediana Edad , Dolor/fisiopatología , Educación del Paciente como Asunto , Resultado del Tratamiento
7.
Phys Ther Sport ; 40: 85-90, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31499400

RESUMEN

OBJECTIVE: To (i) compare objective function in a range of tasks between people with and without patellofemoral pain (PFP); and (ii) evaluate the relationship of objective function with hip muscle capacity and self-reported function in people with PFP. DESIGN: Cross-sectional. SETTINGS: Laboratory. PARTICIPANTS: Thirty-two physically active people (16 with PFP and 16 controls). MAIN OUTCOME MEASURES: Functional assessments included stair climbing (time), single-legged chair stand (repetitions), step down (repetitions), forward hop for distance and side hop (repetitions). Hip abductor and extensor capacity assessments included power, endurance, isometric and dynamic strength. Self-reported function included the Kujala scale and Patellofemoral sub-scale of the Knee injury and Osteoarthritis Outcome Score (KOOS-PF). RESULTS: The PFP group was 15% slower climbing stairs (effect size [ES] = 0.90), performed 12% fewer chair stands (ES = 0.62) and forward hopped 20% shorter (ES = 0.79) compared to controls. Lower hip muscle strength and power correlated with lower objective function (r = 0.52-0.78). Lower Kujala scores correlated with longer stair climbing time (r = -0.53). CONCLUSION: People with PFP have objective functional impairments, that are associated with reduced hip muscle capacity, indicating progressive resistance training may be beneficial. Absence of a strong correlation between self-reported, and objective, function indicates assessment of both when treating people with PFP is warranted.


Asunto(s)
Cadera/fisiopatología , Músculo Esquelético/fisiopatología , Dolor/fisiopatología , Síndrome de Dolor Patelofemoral/fisiopatología , Rendimiento Físico Funcional , Adulto , Estudios de Casos y Controles , Estudios Transversales , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Fuerza Muscular , Medición de Resultados Informados por el Paciente , Adulto Joven
8.
Med Sci Monit ; 25: 6598-6604, 2019 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-31477682

RESUMEN

BACKGROUND The aim of this study was to evaluate the influence of distal radius fractures (DRFs) malalignment on the treatment outcomes in patients over age 65 years. MATERIAL AND METHODS We retrospectively reviewed the records on fresh DRFs treated with closed reduction from December 2014 to January 2018. After treatment, patients were evaluated for the determination of grip strength, the Visual Analog Scale (VAS) during wrist movement, the Patient-Rated Wrist Evaluation (PRWE), the Disabilities of the Arm, Shoulder and Hand (DASH) score, the appearance satisfaction, and active wrist range of motion (ROM). RESULTS A total of 96 patients with complete data were included in our study. During follow-up, there were 75 patients (78.1%) with acceptable reduction and 21 patients (21.9%) with unacceptable reduction. Compared with those having acceptable alignment in the distal radius, patients with unacceptable alignment had weak grip strength, were unsatisfied appearance, and had severe flexion as well as ulnar deviation limitation at 6-month follow-up. A significant correlation was found between ulnar positive variance and grip strength (r=-0.35, P=0.03), as well as dorsal angulation and flexion movement (r=-0.31, P=0.02). CONCLUSIONS Conservative treatment should be used differently, even in elderly patients. For low-demand patients, it is not necessary to restore all anatomic radiographic parameters, as malalignment does not increase disability or pain score. However, for patients who are still healthy and active, satisfactory reduction is the first choice, as malalignment can lead to decreased grip strength, dissatisfaction with appearance, and certain wrist limitations.


Asunto(s)
Fracturas del Radio/diagnóstico por imagen , Anciano , Evaluación de la Discapacidad , Femenino , Estudios de Seguimiento , Fuerza de la Mano , Humanos , Masculino , Dolor/fisiopatología , Fracturas del Radio/fisiopatología , Rango del Movimiento Articular
9.
Neurology ; 93(12): e1180-e1192, 2019 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-31409737

RESUMEN

OBJECTIVE: To determine the frequency and relative importance of the most meaningful symptoms in facioscapulohumeral muscular dystrophy (FSHD) and to identify the demographic and clinical features that are associated with the greatest disease burden in this population. METHODS: We performed a cross-sectional study involving 328 participants with FSHD. Collectively, participants reported the prevalence and relative importance of 274 symptoms and 15 symptomatic themes. We assessed the association between symptomatic theme prevalence and participants' age, sex, disease duration, pain level, employment status, and education. RESULTS: Participants answered >48,000 questions regarding their disease burden. The symptomatic themes with the highest prevalence in our sample were problems with shoulders or arms (96.9%), limitations with activities (94.7%), core weakness (93.8%), fatigue (93.8%), limitations with mobility and walking (93.6%), changed body image due to the disease (91.6%), and pain (87.7%). Problems with shoulders and arms and limitations with mobility and walking had the greatest effect on participants' lives. Employment status and the report of pain had the most extensive association with the prevalence of symptoms, with employment being associated with 8 of 15 of the symptomatic themes and pain being associated with 7 of 15 of the symptomatic themes. Men and women with FSHD experienced a similar prevalence of all symptomatic themes. CONCLUSIONS: Adults with FSHD experience a variety of symptoms that play an important role in their disease burden. These symptoms have a variable prevalence and importance in the FSHD population and are associated with disease duration, employment status, and pain level.


Asunto(s)
Distrofia Muscular Facioescapulohumeral/diagnóstico , Distrofia Muscular Facioescapulohumeral/fisiopatología , Medición de Resultados Informados por el Paciente , Encuestas y Cuestionarios , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Fatiga/complicaciones , Fatiga/diagnóstico , Fatiga/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Distrofia Muscular Facioescapulohumeral/complicaciones , Dolor/complicaciones , Dolor/diagnóstico , Dolor/fisiopatología , Adulto Joven
10.
Pediatr Hematol Oncol ; 36(5): 255-266, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31424297

RESUMEN

Medical marijuana (MM) is widespread in many medical fields, including oncology, with limited use in pediatric oncology where research is scarce and often shows conflicting results. This research focuses on alleviating side effects of anticancer treatment as an integral part of supportive and palliative care of children with cancer. We report our experience with MM treatment in 50 children, adolescents, and young adults with different types of cancer during 2010-2017. The main indications for prescriptions were nausea and vomiting, decreased mood, disturbed sleep, and pain. The medication was supplied to 30 patients via oil drops (60%) and 11 via smoking (22%), followed by vaporization, capsules, or combinations of various routes. Positive effects were reported by verbal children and parents in 80% of cases. MM was generally well tolerated with few patients reporting toxicity, with the most common adverse reactions being burning in the throat and anxiety attacks in subjects who chose to smoke the product. We conclude that MM may serve as a potentially useful complementary therapy to conventional supportive treatment of children suffering from cancer at the end of life. Further research is needed on the safety and efficacy and the consequences of prolonged use in pediatric populations.


Asunto(s)
Marihuana Medicinal/administración & dosificación , Náusea/tratamiento farmacológico , Neoplasias/tratamiento farmacológico , Dolor/tratamiento farmacológico , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Vómitos/tratamiento farmacológico , Adolescente , Adulto , Niño , Preescolar , Terapias Complementarias , Femenino , Humanos , Masculino , Náusea/patología , Náusea/fisiopatología , Neoplasias/patología , Neoplasias/fisiopatología , Dolor/patología , Dolor/fisiopatología , Trastornos del Sueño-Vigilia/patología , Trastornos del Sueño-Vigilia/fisiopatología , Vómitos/patología , Vómitos/fisiopatología
11.
Gait Posture ; 74: 20-26, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31442818

RESUMEN

BACKGROUND: Pain reports show at most weak to moderate relationship with structural findings of knee osteoarthritis (OA). Less is known about the relationship between measures of knee and gait function and structural findings of knee OA. RESEARCH QUESTION: To test the hypothesis that patient-reported, performance-based and three-dimensional knee and gait measures can distinguish between individuals with varying degrees of radiographic knee OA severity. METHODS: To increase the spectrum of radiographic severity baseline data of individuals included in a cohort study and in a randomized controlled trial respectively were included in this cross-sectional study. Individuals completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Single Limb Mini Squat (SLMS) test, and three-dimensional gait analysis. Radiographic severity was dichotomized into mild (Kellgren Lawrence (KL) 1-2) or severe (KL 3-4) knee OA. Proxies for medial knee joint loading were peak knee adduction moment (KAM) and KAM impulse, and summary measures of overall gait function were the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic). Area under the receiver operating characteristic curves (AUC) and logistic regressions were used to evaluate whether KOOS-scores, SLMS test, peak KAM, KAM impulse, and GDI-scores could discriminate radiographic severity of knee OA. RESULTS: The sample (n = 115) consisted of 60% women, mean age 61 years (SD 8). Good discriminating abilities (AUC > 0.7) were demonstrated for all measures of knee function and gait, except for GDI and GDI-kinetic (0.62 and 0.36, respectively). Odds ratios from logistic regressions largely supported the AUC findings. SIGNIFICANCE: With the exception of gait summary measures, discriminating abilities were demonstrated by all measures of knee and gait function. Given the interest in interpreting OA as a multi-factorial disease, this information may assist researchers in selecting the most appropriate outcomes for biomechanical studies.


Asunto(s)
Marcha/fisiología , Articulación de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/fisiopatología , Anciano , Fenómenos Biomecánicos , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/diagnóstico por imagen , Dolor/fisiopatología
12.
IEEE Int Conf Rehabil Robot ; 2019: 1159-1166, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31374786

RESUMEN

Over the last decade, the use of wearable exoskeletons for human locomotion assistance has become more feasible. The VariLeg powered lower limb robotic exoskeleton is an example of such systems, potentially enabling paraplegic users to perform upright activities of daily living. The acceptance of this type of robotic assistive technologies is often still affected by limited usability, in particular regarding the physical interface between the exoskeleton and the user (here referred to as pilot). In this study, we proposed and evaluated a novel pilot attachment system (PAS), which was designed based on user-centered design with experienced paraplegic exoskeleton users. Subjective assessments to compare usability aspects of the initial and the redesigned physical interfaces were conducted with two paraplegic and five healthy pilots. The redesigned PAS showed a 45% increase in the system usability scale (SUS), normalized to the PAS of a commercial exoskeleton assessed in the same manner. Pain rating scales assessed with healthy pilots indicated an increased comfort using the redesigned PAS while performing several activities of daily living. Overall, an improvement in usability relative to the initial PAS was achieved through intensified user evaluation and individual needs assessments. Hence, a user-centered design of physical body-machine interfaces has the potential to positively influence the usability and acceptance of lower limb exoskeletons for paraplegic users.


Asunto(s)
Dispositivo Exoesqueleto , Paraplejía/terapia , Actividades Cotidianas , Humanos , Extremidad Inferior/fisiología , Dolor/fisiopatología , Paraplejía/fisiopatología , Traumatismos de la Médula Espinal/fisiopatología
13.
Eur J Appl Physiol ; 119(9): 2053-2064, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31327028

RESUMEN

PURPOSE: To quantify how postural stability is modified during experimental pain while performing different cognitively demanding tasks. METHODS: Sixteen healthy young adults participated in the experiment. Pain was induced by intramuscular injection of hypertonic saline solution (1 mL, 6%) in both vastus medialis and vastus lateralis muscles (0.9% isotonic saline was used as control). The participants stood barefoot in tandem position for 1 min on a force plate. Center of pressure (CoP) was recorded before and immediately after injections, while performing two cognitive tasks: (i) counting forwards by adding one; (ii) counting backwards by subtracting three. CoP variables-total area of displacement, velocity in anterior-posterior (AP-velocity) and medial-lateral (ML-velocity) directions, and CoP sample entropy in anterior-posterior and medial-lateral directions were displayed as the difference between the values obtained after and before each injection and compared between tasks and injections. RESULTS: CoP total area ( - 84.5 ± 145.5 vs. 28.9 ± 78.5 cm2) and ML-velocity ( - 1.71 ± 2.61 vs. 0.98 ± 1.93 cm/s) decreased after the painful injection vs. Control injection while counting forward (P < 0.05). CoP total area (12.8 ± 53.9 vs. - 84.5 ± 145.5 cm2), ML-velocity ( - 0.34 ± 1.92 vs. - 1.71 ± 2.61 cm/s) and AP-velocity (1.07 ± 2.35 vs. - 0.39 ± 1.82 cm/s) increased while counting backwards vs. forwards after the painful injection (P < 0.05). CONCLUSION: Pain interfered with postural stability according to the type of cognitive task performed, suggesting that pain may occupy cognitive resources, potentially resulting in poorer balance performance.


Asunto(s)
Atención/fisiología , Rodilla/fisiología , Dolor/fisiopatología , Balance Postural/fisiología , Postura/fisiología , Adulto , Femenino , Humanos , Articulación de la Rodilla/fisiología , Masculino , Músculo Cuádriceps/fisiología
14.
Gait Posture ; 73: 173-179, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31344606

RESUMEN

BACKGROUND: Groin pain is one of the common problems in multidirectional sports. It seems that abnormal muscular activity and improper movement strategy led to prolongation and high rate of this injury. Therefore, the aim of this study was to Comparing the Average amplitude of Electromyography (AEMG), co-contraction ratio (CCR) of selected thigh and thoracic muscle during turning in individuals with chronic groin pain and healthy individuals. METHODS: Surface electromyography was collected from the internal oblique/transversus abdominis (IO/TrA), multifidus (MF), adductor Longus (AL) and gluteus Medius (GM) for AEMG and CCR analyzed in 16-males with LSGP and 16-controls in four motion phases during 11 cycles of gait coupled with turning. RESULTS: Results revealed that in the AEMG apart from the third phase in the muscle of the IO/ Tr. A muscle and in the second phase in the MF muscle in the trunk and in the third phase in the muscle of the AL and the fourth phase in the GM foot Left There was a significant difference in other phases. There was a significant difference in the CCR, except in the second phase of the trunk and the fourth phase of the left foot in the rest of the phases. CONCLUSIONS: It seems that in athletes with LSGP, have selective muscular activation and CCR have during turning, that may be resulting in compensatory strategies and movement control defects, which may be a useful tool to predict LSGP occurrence in players with a history of groin pain.


Asunto(s)
Ingle/fisiopatología , Contracción Muscular/fisiología , Dolor/fisiopatología , Fútbol/fisiología , Adulto , Atletas , Estudios de Casos y Controles , Estudios Transversales , Electromiografía , Humanos , Masculino , Músculo Esquelético/fisiología
15.
Biomed Res Int ; 2019: 9037510, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31346525

RESUMEN

Radiofrequency (RF) treatment is an invasive and promising procedure in the treatment of osteoarthritis (OA). A meta-analysis based on 12 RCT studies was to investigate whether invasive RF treatment is more effective in relieving knee pain and improving knee function. Relevant studies were searched on database of Pubmed, Embase, EBSCO, Cochrane library, Wanfang digital database, VIP database, and CNKI up to January 2018. A total of 841 participants from 12 publications were included. The weighted mean difference (WMD) and the corresponding 95% CIs were used to evaluate the difference in pain scores and OKS/WOMAC scores between RF treatment and control groups. The statistical analysis was performed by Stata 12.0. The pain scores (VAS) in the RF group were lower than those in the conservative treatment group after 1 week (WMD -1.77, 95% CI -2.93 to -0.61, P<0.01), 1 month (WMD -1.40, 95% CI -1.98 to -0.82, P<0.01), and 3 months (WMD -1.32, 95% CI -2.27 to -0.37, P<0.01) of treatment, while there was no significant improvement in knee function. In subgroup analyses by site of radiofrequency, RF mode showed some discrepancies in the WMD of VAS between the treatment and control groups. In addition, subgroup analysis and meta-regression showed that the efficacy of RF treatment for reducing pain is reversely related to female ratio, and we did not find any surgery-related adverse reactions. RF treatment significantly reduces the knee pain, but rarely improves the knee joint function. Radiofrequency ablation has better efficacy than pulsed radiofrequency ablation in reducing pain. Furthermore, subgroup analysis and meta-regression suggested that women are more sensitive to RF treatment than men.


Asunto(s)
Ablación por Catéter , Articulación de la Rodilla , Osteoartritis de la Rodilla , Dolor , Ondas de Radio , Humanos , Articulación de la Rodilla/fisiopatología , Articulación de la Rodilla/cirugía , Osteoartritis de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/cirugía , Dolor/fisiopatología , Dolor/cirugía , Ensayos Clínicos Controlados Aleatorios como Asunto
16.
Nat Commun ; 10(1): 3087, 2019 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-31300648

RESUMEN

The dorsal root ganglia (DRG) contain the somas of first-order sensory neurons critical for somatosensation. Due to technical difficulties, DRG neuronal activity in awake behaving animals remains unknown. Here, we develop a method for imaging DRG at cellular and subcellular resolution over weeks in awake mice. The method involves the installation of an intervertebral fusion mount to reduce spinal movement, and the implantation of a vertebral glass window without interfering animals' motor and sensory functions. In vivo two-photon calcium imaging shows that DRG neuronal activity is higher in awake than anesthetized animals. Immediately after plantar formalin injection, DRG neuronal activity increases substantially and this activity upsurge correlates with animals' phasic pain behavior. Repeated imaging of DRG over 5 weeks after formalin injection reveals persistent neuronal hyperactivity associated with ongoing pain. The method described here provides an important means for in vivo studies of DRG functions in sensory perception and disorders.


Asunto(s)
Ganglios Espinales/diagnóstico por imagen , Microscopía Intravital/métodos , Percepción del Dolor/fisiología , Células Receptoras Sensoriales/fisiología , Animales , Técnicas de Observación Conductual/instrumentación , Técnicas de Observación Conductual/métodos , Conducta Animal/fisiología , Calcio/química , Femenino , Formaldehído/administración & dosificación , Formaldehído/toxicidad , Ganglios Espinales/citología , Ganglios Espinales/fisiología , Proteínas Fluorescentes Verdes/química , Proteínas Fluorescentes Verdes/genética , Microscopía Intravital/instrumentación , Masculino , Ratones , Ratones Transgénicos , Modelos Animales , Imagen Óptica/instrumentación , Imagen Óptica/métodos , Dolor/inducido químicamente , Dolor/fisiopatología , Fotones , Vigilia
17.
PLoS Comput Biol ; 15(7): e1007106, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31295266

RESUMEN

Experimental studies show that human pain sensitivity varies across the 24-hour day, with the lowest sensitivity usually occurring during the afternoon. Patients suffering from neuropathic pain, or nerve damage, experience an inversion in the daily modulation of pain sensitivity, with the highest sensitivity usually occurring during the early afternoon. Processing of painful stimulation occurs in the dorsal horn (DH), an area of the spinal cord that receives input from peripheral tissues via several types of primary afferent nerve fibers. The DH circuit is composed of different populations of neurons, including excitatory and inhibitory interneurons, and projection neurons, which constitute the majority of the output from the DH to the brain. In this work, we develop a mathematical model of the dorsal horn neural circuit to investigate mechanisms for the daily modulation of pain sensitivity. The model describes average firing rates of excitatory and inhibitory interneuron populations and projection neurons, whose activity is directly correlated with experienced pain. Response in afferent fibers to peripheral stimulation is simulated by a Poisson process generating nerve fiber spike trains at variable firing rates. Model parameters for fiber response to stimulation and the excitability properties of neuronal populations are constrained by experimental results found in the literature, leading to qualitative agreement between modeled responses to pain and experimental observations. We validate our model by reproducing the wind-up of pain response to repeated stimulation. We apply the model to investigate daily modulatory effects on pain inhibition, in which response to painful stimuli is reduced by subsequent non-painful stimuli. Finally, we use the model to propose a mechanism for the observed inversion of the daily rhythmicity of pain sensation under neuropathic pain conditions. Underlying mechanisms for the shift in rhythmicity have not been identified experimentally, but our model results predict that experimentally-observed dysregulation of inhibition within the DH neural circuit may be responsible. The model provides an accessible, biophysical framework that will be valuable for experimental and clinical investigations of diverse physiological processes modulating pain processing in humans.


Asunto(s)
Ritmo Circadiano/fisiología , Modelos Neurológicos , Dolor/fisiopatología , Asta Dorsal de la Médula Espinal/fisiopatología , Biología Computacional , Ganglios Espinales/fisiopatología , Humanos , Interneuronas/fisiología , Red Nerviosa/fisiología , Neuralgia/fisiopatología , Nocicepción/fisiología , Dolor Nociceptivo/fisiopatología , Percepción del Dolor/fisiología
18.
Handb Clin Neurol ; 161: 121-148, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31307596

RESUMEN

Clinical neurophysiologic investigation of pain pathways in humans is based on specific techniques and approaches, since conventional methods of nerve conduction studies and somatosensory evoked potentials do not explore these pathways. The proposed techniques use various types of painful stimuli (thermal, laser, mechanical, or electrical) and various types of assessments (measurement of sensory thresholds, study of nerve fiber excitability, or recording of electromyographic reflexes or cortical potentials). The two main tests used in clinical practice are quantitative sensory testing and pain-related evoked potentials (PREPs). In particular, PREPs offer the possibility of an objective assessment of nociceptive pathways. Three types of PREPs can be distinguished depending on the type of stimulation used to evoke pain: laser-evoked potentials, contact heat evoked potentials, and intraepidermal electrical stimulation evoked potentials (IEEPs). These three techniques investigate both small-diameter peripheral nociceptive afferents (mainly Aδ nerve fibers) and spinothalamic tracts without theoretically being able to differentiate the level of lesion in the case of abnormal results. In routine clinical practice, PREP recording is a reliable method of investigation for objectifying the existence of a peripheral or central lesion or loss of function concerning the nociceptive pathways, but not the existence of pain. Other methods, such as nerve fiber excitability studies using microneurography, more directly reflect the activities of nociceptive axons in response to provoked pain, but without detecting or quantifying the presence of spontaneous pain. These methods are more often used in research or experimental study design. Thus, it should be kept in mind that most of the results of neurophysiologic investigation performed in clinical practice assess small fiber or spinothalamic tract lesions rather than the neuronal mechanisms directly at the origin of pain and they do not provide objective quantification of pain.


Asunto(s)
Dimensión del Dolor/métodos , Dolor/diagnóstico , Dolor/fisiopatología , Humanos
19.
Biol Aujourdhui ; 213(1-2): 43-49, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31274102

RESUMEN

A large body of clinical and pre-clinical evidence has shown complex interactions between bottom-up and top-down mechanisms that are essential for the discrimination of noxious information and pain perception. These endogenous systems, mainly originating from the brainstem, hypothalamus and cerebral cortex, are strongly influenced by behavioral, cognitive and emotional factors that are relevant for the survival of the individual. Under pathological conditions, however, dysfunctional engagement of these descending pathways certainly contributes to the transformation from acute into chronic pain states. In disorders such as primary headaches, dysfunctions affecting brain regulation mechanisms contribute to the generation of episodic painful states in susceptible individuals, and to the evolution from acute to chronic migraine or cluster headache. Taken together, these studies support the concept that CNS mechanisms that process trigemino-vascular pain do not consist only of a bottom-up process, whereby a painful focus modifies the inputs to the next higher level. Indeed, several CNS regions mediate subtle forms of plasticity by adjusting neural maps downstream and, consequently, altering all the modulatory mechanisms as a result of sensory, autonomic, endocrine, cognitive and emotional influences. Disturbances in normal sensory processing within these loops could lead to maladaptive changes and impaired craniofacial functions at the origin of primary headaches.


Asunto(s)
Encéfalo/fisiopatología , Cefalea/etiología , Cefalea/fisiopatología , Red Nerviosa/fisiopatología , Animales , Trastornos Cerebrovasculares/etiología , Trastornos Cerebrovasculares/fisiopatología , Cefalea/psicología , Humanos , Red Nerviosa/patología , Dolor/etiología , Dolor/fisiopatología , Percepción del Dolor/fisiología , Ratas
20.
Phys Ther Sport ; 39: 99-106, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31288214

RESUMEN

OBJECTIVES: To assess the correlation between the functional movement screen (FMS) and Y balance test (Y-BT) performance, and the self-reported hip/groin problems, and to compare healthy with hip/groin pain participants. DESIGN: a cross-sectional study. SETTING: Sports hall in a football club. PARTICIPANTS: 43 elite adolescent football (soccer) players. MAIN OUTCOME: The Copenhagen Hip and Groin Outcome Score (HAGOS), Anterior, posterolateral and posteromedial distance of Y-BT, FMS score. MEASURES: Y balance and FMS test kit, HAGOS questionnaire. RESULTS: The posterolateral, posteromedial distance and composite reach score of the Y-BT were lower in participants with hip/groin problems (p < 0.05). FMS performance was similar in healthy and hip/groin groups. There was a weak correlation (r = 0.32, p= 0.03) between the HAGOS Activities of Daily Living subscale and FMSstabil. In the Y-BT the posterolateral reach was weakly correlated with Symptoms (r = 0.35-0.44, p < 0.02) and moderately correlated with Pain (r = 0.44, p < 0.01) subscales. Posteromedial direction reach with the right leg was weakly correlated with Symptoms (r = 0.32, p = 0.04) and Pain (r = 0.39, p = 0.01). The Y-BT composite score was moderately correlated with Symptoms and Pain (r = 0.42-0.44, p < 0.01). CONCLUSIONS: The Y-BT and the FMS subtests were weakly or moderately correlated with self-reported hip/groin problems. Thus, these tests should be investigated further in adolescent footballers because they may have potential to predict hip and groin problems.


Asunto(s)
Prueba de Esfuerzo , Ingle/fisiopatología , Articulación de la Cadera/fisiopatología , Dolor/fisiopatología , Balance Postural/fisiología , Adolescente , Atletas , Estudios Transversales , Humanos , Masculino , Fútbol/fisiología , Encuestas y Cuestionarios
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