Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.311
Filtrar
1.
Mayo Clin Proc ; 96(4): 943-951, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33722397

RESUMO

OBJECTIVES: To determine the prevalence and breakdown of pain symptoms among patients with coronavirus disease 2019 (COVID-19) infection admitted for nonpain symptoms and the association between the presence of pain and intensive care unit (ICU) admission and death. PATIENTS AND METHODS: In this multicenter prospective study, data on the intensity and type of pain were collected on 169 patients with active severe acute respiratory syndrome coronavirus 2 infection at 2 teaching hospitals in the United States and Korea and on 8 patients with acute pain at another large teaching hospital between February 1, 2020, and June 15, 2020. RESULTS: Sixty-five of 169 patients (38.5%) reported an active pain condition. Among the 73 patients with pain, the most common pain symptoms were headache (n=22; 30.1%), chest pain (n=17; 23.3%), spinal pain (n=18; 24.7%), myalgia (n=13; 17.8%), abdominal or pelvic pain (n=13; 17.8%), arthralgia (n=11; 15.1%), and generalized pain (n=9; 12.3%). Those reporting headache as their main symptom were less likely to require ICU admission (P=.003). Acetaminophen or nonsteroidal anti-inflammatory drugs were prescribed to 80.8% (n=59), opioids to 17.8% (n=13), adjuvants to 8.2% (n=6), and ketamine to 5.5% (n=4) of patients with pain. When age 65 years and older and sex were controlled for in multivariable analysis, the absence of pain was associated with ICU admission (odds ratio, 2.92; 95% CI, 1.42 to 6.28; P=.004) and death (odds ratio, 3.49; 95% CI, 1.40 to 9.76; P=.01). CONCLUSION: Acute pain is common during active COVID-19 infection with the most common manifestations being headache, chest pain and spine pain. Individuals without pain were more likely to require intensive care and expire than those with pain. Reasons why pain may be associated with reduced mortality include that an intense systemic stimulus (eg, respiratory distress) might distract pain perception or that the catecholamine surge associated with severe respiratory distress might attenuate nociceptive signaling.


Assuntos
Dor Aguda , Manejo da Dor/métodos , Medição da Dor/métodos , Percepção da Dor/fisiologia , Dor Aguda/diagnóstico , Dor Aguda/etiologia , Dor Aguda/fisiopatologia , Fatores Etários , /fisiopatologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , República da Coreia/epidemiologia , Fatores Sexuais , Estados Unidos/epidemiologia
2.
Rev. int. med. cienc. act. fis. deporte ; 20(80): 623-640, dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-198577

RESUMO

Se analizó el efecto de la técnica de estiramiento HOLD RELAX sin (HR) y con electroestimulación (HR+EE) sobre la mejora y retención del rango de movimiento (ROM) activo (AROM) y pasivo (PROM) de cadera en flexión, y la percepción del dolor durante su aplicación. 42 deportistas fueron asignados a tres grupos: control, HR y HR+EE. El ROM fue medido con el test Straight-Leg-Raise antes, al finalizar el entrenamiento y trascurridas 2 semanas de su finalización. La valoración del dolor se realizó con la escala EVA. El ANOVA mostró un aumento significativo del PROM (p < 0,001) en HR y HR+EE, no así del AROM. No se observaron pérdidas significativas del PROM en la retención de sendos grupos. En cuanto al dolor, no existieron diferencias significativas en los valores de EVA al aplicar ambas técnicas. Tanto HR como HR+EE fueron bien toleradas en cuanto a la percepción del dolor


The objective of this study was to analyze the effect of the Hold-Relax stretching technique without (HR) and with electrostimulation (HR+EE) on the improvement and retention of active movement range (AROM) and passive (PROM) of hip in flexion, and the perception of pain during its application. 42 athletes were assigned to three groups: control, HR+EE and HR. The range of motion of the hip flexion was measured by test straight-leg-rise before, once completed and after 2 weeks of completion the training. Pain assessment was performed in all sessions with the EVA scale. The ANOVA showed a very significant increase in PROM (p < 0.001) in HR and HR+EE, but not in AROM. No significant PROM losses were observed in the retention of both groups. Regarding pain, there were no significant differences in EVA values when applying both techniques. Both HR and HR+EE were well tolerated in terms of pain perception


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Percepção da Dor/fisiologia , Exercícios de Alongamento Muscular/métodos , Estimulação Elétrica Nervosa Transcutânea/métodos , Reflexo de Estiramento/fisiologia , Medição da Dor , Análise de Variância , Esportes/fisiologia , Análise Fatorial
3.
Sci Rep ; 10(1): 22319, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33339884

RESUMO

Brief thermo-nociceptive stimuli elicit low-frequency phase-locked local field potentials (LFPs) and high-frequency gamma-band oscillations (GBOs) in the human insula. Although neither of these responses constitute a direct correlate of pain perception, previous findings suggest that insular GBOs may be strongly related to the activation of the spinothalamic system and/or to the processing of thermal information. To disentangle these different features of the stimulation, we compared the insular responses to brief painful thermonociceptive stimuli, non-painful cool stimuli, mechano-nociceptive stimuli, and innocuous vibrotactile stimuli, recorded using intracerebral electroencephalograpic activity in 7 epileptic patients (9 depth electrodes, 58 insular contacts). All four types of stimuli elicited consistent low-frequency phase-locked LFPs throughout the insula, possibly reflecting supramodal activity. The latencies of thermo-nociceptive and cool low-frequency phase-locked LFPs were shorter in the posterior insula compared to the anterior insula, suggesting a similar processing of thermal input initiating in the posterior insula, regardless of whether the input produces pain and regardless of thermal modality. In contrast, only thermo-nociceptive stimuli elicited an enhancement of insular GBOs, suggesting that these activities are not simply related to the activation of the spinothalamic system or to the conveyance of thermal information.


Assuntos
Córtex Cerebral/fisiologia , Epilepsia/fisiopatologia , Nociceptividade/fisiologia , Dor/fisiopatologia , Percepção/fisiologia , Adulto , Mapeamento Encefálico , Córtex Cerebral/diagnóstico por imagem , Eletroencefalografia , Epilepsia/diagnóstico por imagem , Potenciais Somatossensoriais Evocados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurociências , Nociceptores/fisiologia , Dor/diagnóstico por imagem , Percepção da Dor/fisiologia , Percepção do Tato/fisiologia , Vibração
4.
Rev. cuba. invest. bioméd ; 39(4): e781, oct.-dic. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1156449

RESUMO

Introducción: El dolor inducido por los aparatos de ortodoncia es una de las principales razones que desalientan a los pacientes a buscar tratamiento ortodóntico y puede afectar negativamente su cooperación. Objetivo: Determinar la relación de la percepción del dolor, rasgos de personalidad y la actitud del paciente hacia el tratamiento ortodóntico. Métodos: Estudio transversal y observacional. La muestra estuvo conformada por dos grupos: I) 200 sujetos no tratados (78 varones y 122 mujeres; edad promedio 20,02 ± 2,67 años) y II) 200 sujetos tratados (64 varones y 136 mujeres; edad promedio 20,29 ± 3,88 años). El instrumento para la recolección de datos fue un cuestionario que incluía la evaluación de la expectativa del dolor para sujetos no tratados, experiencia de dolor para sujetos tratados, los perfiles de personalidad de los pacientes y actitudes hacia el tratamiento de ortodoncia. Resultados: No se encontró relación entre la percepción del dolor, los rasgos de personalidad y actitud del paciente hacia el tratamiento ortodóntico (p > 0,05). El estado de tratamiento (presentar ortodoncia) afectó la percepción del dolor hacia el tratamiento ortodóntico (p < 0,05), el género no afectó la percepción del dolor. El estado de tratamiento y el género masculino afectaron la actitud del paciente hacia el tratamiento ortodóntico (p < 0,05). Conclusiones: Los pacientes con mejor actitud mostraron menos dolor y los pacientes con mayor percepción del dolor mostraron una actitud negativa. Los niveles bajos de amabilidad tienen efecto sobre la percepción del dolor del paciente hacia el tratamiento ortodóntico(AU)


Introduction: The pain induced by orthodontic appliances is one of the main reasonswhy patients are reluctant to seek orthodontic treatment, and may negatively affect their cooperation. Objective: Determine the relationship between pain perception, personality traits and patient attitude toward orthodontic treatment. Methods: A cross-sectional observational study was conducted of a study sample composed of two groups: I) 200 untreated subjects (78 male and 122 female; mean age 20.02 ± 2.67 years) and II) 200 treated subjects (64 male and 136 female; mean age 20.29 ± 3.88 years). The data collection tool was a questionnaire including an evaluation of pain expectation for untreated subjects, pain experience for treated subjects, patients' personality profiles and attitudes toward orthodontic treatment. Results: No relationship was found between pain perception, personality traits and patient attitude toward orthodontic treatment (p > 0.05). Treatment status (untreated or treated) affected pain perception and the attitude toward orthodontic treatment (p < 0.05); gender did not affect pain perception. Treatment status and male gender affected patient attitude toward orthodontic treatment (p < 0.05). Conclusions: Patients with a better attitude experienced less pain, whereas patients with a greater pain perception showed a negative attitude. Low levels of kindness have an effect on pain perception and patient attitude toward orthodontic treatment(AU)


Assuntos
Ortodontia/métodos , Aparelhos Ortodônticos/efeitos adversos , Personalidade , Estudos Transversais , Percepção da Dor/fisiologia
5.
PLoS One ; 15(12): e0244321, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33338075

RESUMO

BACKGROUND: Women involved in repetitive, fatiguing, jobs develop more neck and/or shoulder musculoskeletal disorders than men. Sex differences in the pain response to exercise could contribute to the higher prevalence of neck/shoulder musculoskeletal disorders in women. The objective of this study was to assess sex differences in pain sensitivity following a fatiguing upper limb task. Relationships between measures of fatigue and of the sensitivity to nociceptive and to non-nociceptive stimulations were also explored. METHODS: Thirty healthy adults (15 women) performed a fatiguing repetitive pointing task with their dominant arm. Upper limb electromyography was recorded from the dominant upper trapezius, anterior deltoid and bicep brachii and from the contralateral tibialis anterior. Before and immediately after the repetitive pointing task, pressure pain and light touch sensitivity thresholds were measured over the same muscles. RESULTS: Electromyographic signs of fatigue were observed only in the anterior deltoid and biceps brachii muscles. Pressure pain thresholds over both muscles increased slightly (effect size ≤ 0.34), but no changes occurred over the upper trapezius and the tibialis anterior. Light touch thresholds increased moderately to importantly after the repetitive pointing task over all four muscles (effect sizes = 0.58 to 0.87). No sex differences were observed in any sensory variable. Moreover, no or weak correlations (r = -0.27 to 0.39) were observed between electromyographical signs of fatigue, light touch threshold and pressure pain threshold variables. CONCLUSIONS: We observed sex-independent effects of a repetitive upper limb task on the sensitivity to painful and to nonpainful stimuli. Moreover, the hypoalgesia induced by the repetitive pointing task was weak and localized, and did not directly correlate with the induced muscle fatigue. Results suggest that fatigue-related changes in the sensitivity to noxious and innocuous stimuli could not explain women's greater prevalence of neck/shoulder musculoskeletal disorders.


Assuntos
Transtornos Traumáticos Cumulativos/fisiopatologia , Percepção da Dor/fisiologia , Limiar da Dor/fisiologia , Adulto , Braço/fisiologia , Transtornos Traumáticos Cumulativos/metabolismo , Eletromiografia/métodos , Fadiga/fisiopatologia , Feminino , Humanos , Masculino , Movimento/fisiologia , Contração Muscular/fisiologia , Fadiga Muscular/fisiologia , Pescoço/fisiologia , Caracteres Sexuais , Fatores Sexuais , Ombro/fisiologia , Tato/fisiologia , Extremidade Superior/fisiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-33348763

RESUMO

BACKGROUND: The aim of the research was to analyse the impact of gender on pain perception during and directly after tattooing, with the following predictors as covariates: the body area chosen for a tattoo, the character of the pain, the time it takes to complete the tattoo, bleeding, the level of stress, analgesics taken before the tattooing procedure, and the cycle phase. METHODS: A total of 1092 participants took part in this study (F: 863, M: 229). A proprietary survey was used in the research, including patient characteristics and questions relating to the above-mentioned variables. Multiple regression analyses were used for continuous outcomes and multiple logistic regression analyses for binary outcomes. RESULTS: Factors increasing pain during tattooing include: time B: 0.35; 95% CIs: 0.27-0.43; p = 0.001; bleeding B: 0.36; 95% CIs: 0.00-0.72; p = 0.052; level of stress B: 0.45; 95% CIs: 0.31-0.60; p = 0.001; pain medications taken before tattooing B: 1.42; 95% CIs: 0.60-2.23; p = 0.001. Factors increasing pain after tattooing include: time B: 0.21; 95% CIs: 0.15-0.27; p = 0.001; bleeding B: 0.47; 95% CIs: 0.20-0.72; p = 0.001; level of stress B: 0.15; 95% CIs: 0.04-0.26; p = 0.001. CONCLUSIONS: There was no difference between females and males in pain intensity during tattooing. Directly after the procedure, however, pain intensity was higher in women when compared to men. The most important factors increasing pain were time, bleeding, and the level of stress.


Assuntos
Percepção da Dor , Dor , Tatuagem , Feminino , Humanos , Masculino , Dor/epidemiologia , Dor/etiologia , Percepção da Dor/fisiologia , Fatores Sexuais , Inquéritos e Questionários , Tatuagem/efeitos adversos
7.
Pediatrics ; 146(Suppl 1): S70-S74, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32737236

RESUMO

The alleviation of suffering has always been central to the care of the sick. Yet as medical technology has advanced and life-sustaining treatments multiplied, medicine's capacity to both prevent and create suffering has grown exponentially. In pediatric medicine, the ability to stave off death with life-sustaining treatments allows children to survive but also to suffer in ways that are diverse and unprecedented. However, although parents and pediatric clinicians broadly agree that all children can suffer, there is little published literature in which researchers analyze or clarify the concept of pediatric suffering. This gap is worrisome, especially in light of growing concerns that the label of suffering is used to justify end-of-life decision-making and mask quality-of-life determinations for pediatric patients with profound neurologic impairment. Moreover, the awareness that some children can experience suffering but cannot communicate whether and how they are suffering creates a problem. Does the determination of suffering in a nonverbal child lie in the judgement of clinicians or parents? In this article, I will address several important questions related to the suffering of children through an analysis of two prevalent conceptualizations of pediatric suffering and suggest a possible avenue forward for future scholarship.


Assuntos
Temas Bioéticos , Tomada de Decisão Clínica/ética , Percepção da Dor/fisiologia , Angústia Psicológica , Terminologia como Assunto , Bibliometria , Criança , Pré-Escolar , Dissidências e Disputas , Humanos , Lactente , Futilidade Médica/ética , Comunicação não Verbal/fisiologia , Percepção da Dor/ética , Qualidade de Vida , Suspensão de Tratamento/ética
8.
PLoS One ; 15(6): e0234160, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559202

RESUMO

Pain is evolutionarily hardwired to signal potential danger and threat. It has been proposed that altered pain-related associative learning processes, i.e., emotional or fear conditioning, might contribute to the development and maintenance of chronic pain. Pain in or near the face plays a special role in pain perception and processing, especially with regard to increased pain-related fear and unpleasantness. However, differences in pain-related learning mechanisms between the face and other body parts have not yet been investigated. Here, we examined body-site specific differences in associative emotional conditioning using electrical stimuli applied to the face and the hand. Acquisition, extinction, and reinstatement of cue-pain associations were assessed in a 2-day emotional conditioning paradigm using a within-subject design. Data of 34 healthy subjects revealed higher fear of face pain as compared to hand pain. During acquisition, face pain (as compared to hand pain) led to a steeper increase in pain-related negative emotions in response to conditioned stimuli (CS) as assessed using valence ratings. While no significant differences between both conditions were observed during the extinction phase, a reinstatement effect for face but not for hand pain was revealed on the descriptive level and contingency awareness was higher for face pain compared to hand pain. Our results indicate a stronger propensity to acquire cue-pain-associations for face compared to hand pain, which might also be reinstated more easily. These differences in learning and resultant pain-related emotions might play an important role in the chronification and high prevalence of chronic facial pain and stress the evolutionary significance of pain in the head and face.


Assuntos
Condicionamento Clássico , Face , Mãos , Dor/psicologia , Adulto , Sinais (Psicologia) , Estimulação Elétrica , Extinção Psicológica , Medo/psicologia , Feminino , Humanos , Masculino , Rememoração Mental , Percepção da Dor/fisiologia , Limiar da Dor
9.
Rev. cuba. hematol. inmunol. hemoter ; 36(2): e1042, abr.-jun. 2020.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1149893

RESUMO

Introducción: El dolor como experiencia subjetiva desagradable es un síntoma frecuente en los pacientes atendidos en el servicio de Hematología. Este afecta al individuo a nivel psicológico y provoca la aparición de dificultades en las áreas laboral, educacional, familiar y en las relaciones interpersonales. La percepción del dolor puede verse distorsionada como resultado de esta alteración provocada en el paciente. Objetivo: Analizar los factores psicológicos que median la percepción del dolor de los pacientes. Métodos: Se realizó una revisión de la literatura, a través del sitio web PubMed y el motor de búsqueda Google Académico. Se emplearon las palabras clave: dolor, manejo del dolor, evaluación del dolor, psicología del dolor, dolor en hematología, dolor en drepanocitosis, dolor en hemofilia, dolor en leucemia. Análisis y síntesis de la información: Se evidencia el carácter multifacético de esta experiencia subjetiva. Los determinantes y mecanismos del dolor son diversos, lo cual implica que su enfrentamiento requiera un enfoque integral que ayude a los pacientes a desarrollar conciencia acerca de los efectos de la enfermedad que padece y los síntomas del dolor. También es necesario guiarlos en la comprensión de los factores que contribuyen a su magnificación, crear estrategias que les ayuden a minimizar la exposición a estos, y orientarlos para que desarrollen métodos personales que les permitan lidiar con el dolor con un mínimo estrés psicológico. Conclusiones: El dolor es un fenómeno complejo que involucra diversas variables y factores en su funcionamiento. Su manejo requiere un enfoque integral para la atención de los pacientes en su enfrentamiento al dolor(AU)


Introduction: Pain as an unpleasant subjective experience is a frequent symptom in patients treated by the Hematology service. This affects the individual on a psychological level and causes the onset of difficulties in the work, educational, family and interpersonal relationships. The perception of pain can be distorted as a result of this alteration caused in the patient. Objective: To analyze the psychological factors that mediate patients' perception of pain. Methods: A literature review was carried out through the PubMed website and the search engine of Google Scholar. The following keywords were used: dolor [pain], manejo del dolor [pain management], evaluación del dolor [pain assessment], psicología del dolor [pain psychology], dolor en hematología [pain in hematology], dolor en drepanocitosis [pain in sickle cell disease], dolor en hemofilia [pain in hemophilia], dolor en leucemia [pain in leukemia]. Information analysis and synthesis: The multifaceted nature of this subjective experience is evidenced. Pain determinants and mechanisms are diverse, which implies that their coping requires a comprehensive approach that helps patients develop awareness about the disease effects and the pain symptoms. It is also necessary to guide them in understanding the factors that contribute to pain magnification, create strategies that help them minimize pain exposure, and guide them to develop personal methods that allow them to deal with pain with minimal psychological stress. Conclusions: Pain is a complex phenomenon involving several variables and factors in its operation. Its management requires a comprehensive approach to patient care regarding coping with pain(AU)


Assuntos
Humanos , Medição da Dor/métodos , Medição da Dor/psicologia , Percepção da Dor/fisiologia , Manejo da Dor/psicologia , Doenças Hematológicas/psicologia , Hematologia
10.
Nat Neurosci ; 23(7): 854-868, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32424286

RESUMO

General anesthesia (GA) can produce analgesia (loss of pain) independent of inducing loss of consciousness, but the underlying mechanisms remain unclear. We hypothesized that GA suppresses pain in part by activating supraspinal analgesic circuits. We discovered a distinct population of GABAergic neurons activated by GA in the mouse central amygdala (CeAGA neurons). In vivo calcium imaging revealed that different GA drugs activate a shared ensemble of CeAGA neurons. CeAGA neurons also possess basal activity that mostly reflects animals' internal state rather than external stimuli. Optogenetic activation of CeAGA potently suppressed both pain-elicited reflexive and self-recuperating behaviors across sensory modalities and abolished neuropathic pain-induced mechanical (hyper-)sensitivity. Conversely, inhibition of CeAGA activity exacerbated pain, produced strong aversion and canceled the analgesic effect of low-dose ketamine. CeAGA neurons have widespread inhibitory projections to many affective pain-processing centers. Our study points to CeAGA as a potential powerful therapeutic target for alleviating chronic pain.


Assuntos
Anestésicos Gerais/farmacologia , Núcleo Central da Amígdala/efeitos dos fármacos , Neurônios GABAérgicos/efeitos dos fármacos , Dor/fisiopatologia , Animais , Feminino , Masculino , Camundongos , Vias Neurais/efeitos dos fármacos , Percepção da Dor/efeitos dos fármacos , Percepção da Dor/fisiologia
11.
Int J Sports Med ; 41(9): 596-602, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32396966

RESUMO

This study aimed at determining the effect of kinesio-taping (KT) on muscle performance and delayed onset muscle soreness (DOMS) after exercise induced muscle damaged. Sixty-six healthy men volunteered to participate (age:18-25 y/o), who performed 200 isokinetic lengthening contractions of the dominant quadriceps. Then subjects were randomized to either control (no treatment), sham (no tape tension), or KT (10% tape tension) groups. Muscle performance was assessed by peak torque and muscular work during maximal isometric and concentric isokinetic contractions. DOMS intensity was assessed using a visual analog scale. Measurements were taken pre-exercise (Pre), 48 h and 96 h post-exercise. Repeated measures ANOVA was used for comparisons within group, and ANCOVA for comparisons among groups. Muscle damage was confirmed in all participants by an increase in CK activity level (p<0.01). Decrease in isometric and isokinetic peak torque was detected at 48 h in the control and sham groups (p<0.01). Muscular work decreased in all groups at 48 h (p<0.01). No differences between groups were detected in muscular performance variables. Increase in DOMS intensity was determined in all groups at 48 h. Comparisons between groups showed lower DOMS intensity in the KT group at 48 h. KT decreased DOMS intensity perception after exercise-induced muscle damage; however, it did not impact muscular performance.


Assuntos
Desempenho Atlético/fisiologia , Fita Atlética , Mialgia/prevenção & controle , Músculo Quadríceps/fisiologia , Adolescente , Adulto , Creatina Quinase/sangue , Exercício Físico/fisiologia , Humanos , Contração Isométrica/fisiologia , Masculino , Contração Muscular/fisiologia , Percepção da Dor/fisiologia , Músculo Quadríceps/lesões , Músculo Quadríceps/metabolismo , Fatores de Tempo , Torque , Adulto Jovem
12.
PLoS Biol ; 18(4): e3000491, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32282798

RESUMO

Nervous systems exploit regularities in the sensory environment to predict sensory input, adjust behavior, and thereby maximize fitness. Entrainment of neural oscillations allows retaining temporal regularities of sensory information, a prerequisite for prediction. Entrainment has been extensively described at the frequencies of periodic inputs most commonly present in visual and auditory landscapes (e.g., >0.5 Hz). An open question is whether neural entrainment also occurs for regularities at much longer timescales. Here, we exploited the fact that the temporal dynamics of thermal stimuli in natural environment can unfold very slowly. We show that ultralow-frequency neural oscillations preserved a long-lasting trace of sensory information through neural entrainment to periodic thermo-nociceptive input as low as 0.1 Hz. Importantly, revealing the functional significance of this phenomenon, both power and phase of the entrainment predicted individual pain sensitivity. In contrast, periodic auditory input at the same ultralow frequency did not entrain ultralow-frequency oscillations. These results demonstrate that a functionally significant neural entrainment can occur at temporal scales far longer than those commonly explored. The non-supramodal nature of our results suggests that ultralow-frequency entrainment might be tuned to the temporal scale of the statistical regularities characteristic of different sensory modalities.


Assuntos
Encéfalo/fisiologia , Percepção da Dor/fisiologia , Dor/fisiopatologia , Estimulação Acústica , Adulto , Eletroencefalografia , Feminino , Humanos , Lasers , Masculino , Dor/psicologia , Medição da Dor , Processamento de Sinais Assistido por Computador
13.
Pain Pract ; 20(6): 676-694, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32255268

RESUMO

BACKGROUND: Exercise, a cornerstone in current treatments for people with musculoskeletal pain, elicits a phenomenon called exercise-induced hypoalgesia (EIH), which may result in reduced pain intensity and/or increased pain thresholds. However, EIH can be impaired in patients with musculoskeletal pain, and psychosocial factors may play a mediating role in EIH. OBJECTIVE: The aim of this study was to systematically review the scientific literature regarding the association between psychosocial factors and EIH in healthy people and people with musculoskeletal pain. METHODS: An extensive search in databases including Medline Ovid, Embase, Web of Science, PsycINFO Ovid, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCOhost was carried out. Two reviewers independently carried out study selection, data extraction, and critical appraisal. Included studies analyzed the association or effect of psychosocial factors on EIH in adults with or without musculoskeletal pain. RESULTS: Nine cross-sectional studies were included, 6 involving healthy people and 4 involving people with musculoskeletal pain; 1 study included both. Overall risk of bias was high. Different types of exercise bouts, psychosocial factors, and/or outcome measures were used across studies. In healthy people and people with musculoskeletal pain, most studies did not find an association between psychosocial factors and EIH. However, 1 study involving musculoskeletal pain and 2 studies with healthy people did find a significant association. CONCLUSION: Due to poor quality and heterogeneity between studies, no conclusions can be drawn regarding whether psychosocial factors are associated with EIH or not. This review includes recommendations and directions for further research to investigate the role of psychosocial factors on EIH.


Assuntos
Exercício Físico/psicologia , Dor Musculoesquelética/psicologia , Dor Musculoesquelética/reabilitação , Limiar da Dor/fisiologia , Limiar da Dor/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Dor Musculoesquelética/fisiopatologia , Percepção da Dor/fisiologia , Adulto Jovem
14.
J Neurosci ; 40(17): 3478-3490, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32241836

RESUMO

Gamma-band oscillations (GBOs) elicited by transient nociceptive stimuli are one of the most promising biomarkers of pain across species. Still, whether these GBOs reflect stimulus encoding in the primary somatosensory cortex (S1) or nocifensive behavior in the primary motor cortex (M1) is debated. Here we recorded neural activity simultaneously from the brain surface as well as at different depths of the bilateral S1/M1 in freely-moving male rats receiving nociceptive stimulation. GBOs measured from superficial layers of S1 contralateral to the stimulated paw not only had the largest magnitude, but also showed the strongest temporal and phase coupling with epidural GBOs. Also, spiking of superficial S1 interneurons had the strongest phase coherence with epidural GBOs. These results provide the first direct demonstration that scalp GBOs, one of the most promising pain biomarkers, reflect neural activity strongly coupled with the fast spiking of interneurons in the superficial layers of the S1 contralateral to the stimulated side.SIGNIFICANCE STATEMENT Nociceptive-induced gamma-band oscillations (GBOs) measured at population level are one of the most promising biomarkers of pain perception. Our results provide the direct demonstration that these GBOs reflect neural activity coupled with the spike firing of interneurons in the superficial layers of the primary somatosensory cortex (S1) contralateral to the side of nociceptive stimulation. These results address the ongoing debate about whether nociceptive-induced GBOs recorded with scalp EEG or epidurally reflect stimulus encoding in the S1 or nocifensive behavior in the primary motor cortex (M1), and will therefore influence how experiments in pain neuroscience will be designed and interpreted.


Assuntos
Ritmo Gama/fisiologia , Córtex Motor/fisiopatologia , Nociceptividade/fisiologia , Dor/fisiopatologia , Córtex Somatossensorial/fisiopatologia , Potenciais de Ação/fisiologia , Animais , Potenciais Somatossensoriais Evocados/fisiologia , Interneurônios/fisiologia , Masculino , Percepção da Dor/fisiologia , Ratos
15.
Arch Gynecol Obstet ; 301(4): 885-894, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32140807

RESUMO

PURPOSE: The aim of this review is to provide an overview of the literature about the perception and management of anxiety and pain in women undergoing an office hysteroscopic procedure. METHODS: We performed a systematic literature search in Embase, PubMed/MEDLINE, Cochrane Library and Web of Science for original studies written in English (registered in PROSPERO 2019-CRD42019132341), using the terms 'hysteroscopy' AND 'pain' AND 'anxiety' published up to January 2019. Only original articles (randomized, observational and retrospective studies) about management of anxiety and pain related to the hysteroscopic procedure were considered eligible. RESULTS: Our literature search produced 84 records. After exclusions, 11 studies including 2222 patients showed the following results: (a) pain experienced during hysteroscopy is negatively affected by preprocedural anxiety; (b) pharmacological interventions seem to be help in reducing pain during hysteroscopy; (c) waiting time before the procedure is a significant factor affecting patients' anxiety; (d) music during the procedure may be helpful in reducing anxiety. CONCLUSIONS: The utilization of office hysteroscopy is hampered by varying levels of anxiety and pain perceived by women who are candidates for the procedure. For these reasons, it is essential to identify effective pharmacological and non-pharmacological strategies to alleviate these factors. We recommend further studies especially focusing on non-pharmacological interventions to facilitate the dissemination of good clinical practices among hysteroscopists.


Assuntos
Ansiedade/terapia , Histeroscopia/efeitos adversos , Manejo da Dor/métodos , Percepção da Dor/fisiologia , Dor/tratamento farmacológico , Feminino , Humanos , Histeroscopia/métodos , Estudos Retrospectivos
16.
J Neurol Surg A Cent Eur Neurosurg ; 81(4): 368-371, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32176923

RESUMO

OBJECTIVE: Headache disorders are frequently associated with epilepsy. Some neuromodulation techniques for refractory epilepsy have been reported to positively influence the associated chronic headache. However, the exact mechanism of action of vagus nerve stimulation (VNS) and anterior thalamic nuclei-deep brain stimulation (ANT-DBS) on pain perception is unclear. METHOD: We report a structured assessment of pain perception in a patient who experienced headache relief after ANT-DBS for refractory focal epilepsy and compare it with pain perception of epilepsy patients with chronic headache who were treated with and without VNS. RESULTS: The pain-associated symptoms in the ANT-DBS case were on the Pain Anxiety Symptoms Scale (PASS-40) subscore "physiological anxiety" closer to the control collective, whereas in patients with VNS, this was more likely for the PASS-40 subscores "cognitive anxiety" or "escape and avoidance." CONCLUSION: ANT-DBS and VNS may influence epilepsy-associated chronic headache in different ways.


Assuntos
Núcleos Anteriores do Tálamo/fisiopatologia , Estimulação Encefálica Profunda/métodos , Epilepsia/terapia , Cefaleia/terapia , Percepção da Dor/fisiologia , Epilepsia/complicações , Epilepsia/fisiopatologia , Feminino , Cefaleia/etiologia , Cefaleia/fisiopatologia , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
17.
PLoS One ; 15(3): e0229692, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32191722

RESUMO

It has been demonstrated that secretion of several hormones can be classically conditioned, however, the underlying brain responses of such conditioning have never been investigated before. In this study we aimed to investigate how oxytocin administration and classically conditioned oxytocin influence brain responses. In total, 88 females were allocated to one of three groups: oxytocin administration, conditioned oxytocin, or placebo, and underwent an experiment consisting of three acquisition and three evocation days. Participants in the conditioned group received 24 IU of oxytocin together with a conditioned stimulus (CS) during three acquisition days and placebo with the CS on three evocation days. The oxytocin administration group received 24 IU of oxytocin and the placebo group received placebo during all days. On the last evocation day, fMRI scanning was performed for all participants during three tasks previously shown to be affected by oxytocin: presentation of emotional faces, crying baby sounds and heat pain. Region of interest analysis revealed that there was significantly lower activation in the right amygdala and in two clusters in the left superior temporal gyrus in the oxytocin administration group compared to the placebo group in response to observing fearful faces. The activation in the conditioned oxytocin group was in between the other two groups for these clusters but did not significantly differ from either group. No group differences were found in the other tasks. Preliminary evidence was found for brain activation of a conditioned oxytocin response; however, despite this trend in the expected direction, the conditioned group did not significantly differ from other groups. Future research should, therefore, investigate the optimal timing of conditioned endocrine responses and study whether the findings generalize to other hormones as well.


Assuntos
Encéfalo/efeitos dos fármacos , Encéfalo/fisiologia , Condicionamento Clássico/efeitos dos fármacos , Condicionamento Clássico/fisiologia , Ocitocina/administração & dosagem , Ocitocina/fisiologia , Estimulação Acústica , Choro , Expressão Facial , Feminino , Neuroimagem Funcional , Humanos , Imagem por Ressonância Magnética , Sprays Nasais , Percepção da Dor/efeitos dos fármacos , Percepção da Dor/fisiologia , Estimulação Luminosa , Saliva/metabolismo , Método Simples-Cego , Adulto Jovem
18.
J Neurosci ; 40(17): 3424-3442, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32217613

RESUMO

The parabrachial (PB) complex mediates both ascending nociceptive signaling and descending pain modulatory information in the affective/emotional pain pathway. We have recently reported that chronic pain is associated with amplified activity of PB neurons in a rat model of neuropathic pain. Here we demonstrate that similar activity amplification occurs in mice, and that this is related to suppressed inhibition to lateral parabrachial (LPB) neurons from the CeA in animals of either sex. Animals with pain after chronic constriction injury of the infraorbital nerve (CCI-Pain) displayed higher spontaneous and evoked activity in PB neurons, and a dramatic increase in after-discharges, responses that far outlast the stimulus, compared with controls. LPB neurons in CCI-Pain animals showed a reduction in inhibitory, GABAergic inputs. We show that, in both rats and mice, LPB contains few GABAergic neurons, and that most of its GABAergic inputs arise from CeA. These CeA GABA neurons express dynorphin, somatostatin, and/or corticotropin releasing hormone. We find that the efficacy of this CeA-LPB pathway is suppressed in chronic pain. Further, optogenetically stimulating this pathway suppresses acute pain, and inhibiting it, in naive animals, evokes pain behaviors. These findings demonstrate that the CeA-LPB pathway is critically involved in pain regulation, and in the pathogenesis of chronic pain.SIGNIFICANCE STATEMENT We describe a novel pathway, consisting of inhibition by dynorphin, somatostatin, and corticotropin-releasing hormone-expressing neurons in the CeA that project to the parabrachial nucleus. We show that this pathway regulates the activity of pain-related neurons in parabrachial nucleus, and that, in chronic pain, this inhibitory pathway is suppressed, and that this suppression is causally related to pain perception. We propose that this amygdalo-parabrachial pathway is a key regulator of both chronic and acute pain, and a novel target for pain relief.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Dor Crônica/fisiopatologia , Neuralgia/fisiopatologia , Percepção da Dor/fisiologia , Núcleos Parabraquiais/fisiopatologia , Potenciais de Ação/fisiologia , Animais , Modelos Animais de Doenças , Feminino , Masculino , Camundongos , Vias Neurais/fisiopatologia , Neurônios/fisiologia , Medição da Dor , Limiar da Dor/fisiologia
19.
Nat Hum Behav ; 4(5): 517-530, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32015488

RESUMO

Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities.


Assuntos
Grupos de Populações Continentais/psicologia , Cultura , Percepção da Dor/fisiologia , Dor/etnologia , Adulto , Afro-Americanos/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Neuroimagem Funcional , Hispano-Americanos/psicologia , Humanos , Imagem por Ressonância Magnética , Masculino , Dor/diagnóstico por imagem , Dor/fisiopatologia , Medição da Dor , Psicologia , Racismo/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...