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2.
Nat Commun ; 11(1): 187, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924769

RESUMO

Individual differences in pain perception are of interest in basic and clinical research as altered pain sensitivity is both a characteristic and a risk factor for many pain conditions. It is, however, unclear how individual sensitivity to pain is reflected in the pain-free resting-state brain activity and functional connectivity. Here, we identify and validate a network pattern in the pain-free resting-state functional brain connectome that is predictive of interindividual differences in pain sensitivity. Our predictive network signature allows assessing the individual sensitivity to pain without applying any painful stimulation, as might be valuable in patients where reliable behavioural pain reports cannot be obtained. Additionally, as a direct, non-invasive readout of the supraspinal neural contribution to pain sensitivity, it may have implications for translational research and the development and assessment of analgesic treatment strategies.


Assuntos
Encéfalo/fisiologia , Percepção da Dor/fisiologia , Dor/fisiopatologia , Descanso/fisiologia , Adolescente , Adulto , Conectoma , Feminino , Humanos , Individualidade , Imagem por Ressonância Magnética , Masculino , Rede Nervosa/fisiologia , Dor/psicologia , Adulto Jovem
3.
Pain Res Manag ; 2019: 6256179, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31885756

RESUMO

Background: Tenderness of masseters and temporalis can be considered a relevant tool for diagnosis of myo-type craniofacial pain disorders, but a limit of pain score systems is that they are based on subjective pain perception. Surface electromyography (sEMG) is a noninvasive and reliable tool for recording muscle activity. Therefore, we investigated whether a correlation exists between tenderness on masseters and temporalis, assessed by subjective pain scale, and muscles activity, evaluated by sEMG, in patients with painful temporomandibular disorder (TMD) and concurrent tension-type headache (TTH). Methods: A cross-sectional study on fifty adult volunteer patients with TMD and TTH, who underwent tenderness protocol according to Diagnostic Criteria for TMD (DC/TMD) guidelines, was conducted followed by sEMG recording of temporalis and masseters. Pearson's correlation was performed to investigate the correlation between muscular activity and subjective pain scores. Results: An overall moderate correlation between muscle tenderness and sEMG values (y = 1 + 1.2 · x; r 2 = 0.62; p < 0.0001), particularly in the temporalis, was observed. Segregation of data occurred according to tenderness and sEMG values. At the highest pain score, the mean sEMG absolute value was higher at the temporalis than the masseters. Conclusions: Our study provides evidence that subjective pain perception can be objectively quantified at a magnitude proportional to pain severity. At greater tenderness scores, higher sEMG activity at the level of temporalis could help discriminate clinically prevalent TTH versus prevalent TMD. sEMG confirms to be an accurate tool to reliably objectify the subjective perception of pain. When combined with clinical evaluation and patients' symptoms, sEMG increases diagnostic sensitivity in the field of myo-type craniofacial pain disorders. This trial is registered with NCT02789085.


Assuntos
Eletromiografia/métodos , Medição da Dor/métodos , Transtornos da Articulação Temporomandibular/diagnóstico , Cefaleia do Tipo Tensional/diagnóstico , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Músculos da Mastigação/fisiopatologia , Mialgia/diagnóstico , Mialgia/fisiopatologia , Percepção da Dor/fisiologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Cefaleia do Tipo Tensional/fisiopatologia
4.
J Clin Neurophysiol ; 36(6): 430-436, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31688326

RESUMO

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.


Assuntos
Controle Inibitório Nociceptivo Difuso/fisiologia , Percepção da Dor/fisiologia , Dor/fisiopatologia , Animais , Humanos
5.
Biomed Res Int ; 2019: 9073073, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31380442

RESUMO

The study investigated touch and pain sensations and the correlation between them in diadynamic current (DD) and transcutaneous electrical nerve stimulation (TENS), electrotherapies commonly applied in musculoskeletal disorders and occupational rehabilitation medicine. Forty healthy subjects were treated with either DD (n=20) or TENS (n=20). Each treatment consisted of three sessions with one-week interval. Touch sensation was determined with the JVP Domes esthesiometer, pain sensation with pressure pain threshold (PPT), and pressure pain tolerance threshold (PPTO) by an algometer. During each session the measurements were performed before the application of the procedure (T0), immediately after it (T1), and 30 minutes after the end of the procedure (T2). Both DD and TENS increased touch sensation (p<0.01) and did not significantly alter PPT and PPTO (p>0.05). No statistically significant differences in short-term effects, i.e., 3 weeks of the trial, were noted between DD and TENS in their influence on touch and pain sensations (p>0.05). There was a high significant correlation between touch and pain sensations in DD (r=0.86). TENS and DD caused similar analgesic effects. DD, which is shorter in the duration of the treatment, may comprise a realistic alternative to TENS in clinical practice of pain management.


Assuntos
Terapia por Estimulação Elétrica , Manejo da Dor/métodos , Tato/fisiologia , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Feminino , Humanos , Masculino , Medição da Dor/métodos , Percepção da Dor/fisiologia , Adulto Jovem
6.
Biol Sex Differ ; 10(1): 39, 2019 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391124

RESUMO

BACKGROUND: The incidence and prevalence of musculoskeletal disorders (MSDs) is about twice as high in women compared to men, and those of the neck/shoulder region are particularly high among women. Fatigue and responses towards pain are known risk factor for MSDs. However, women have been shown to be less fatigable than men, but more sensitive to experimental pain. From a general standpoint, sex differences in the relationships between the fatigue and pain pathways are poorly understood. This may be due to differences in how men and women conceptually define the sensations of fatigue and pain. The objective of this study was to compare physical and verbal descriptors of fatigue and pain between men and women undergoing an experimental protocol where fatigue and pain were manipulated. METHODS: Healthy adult volunteers (14 men and 14 women) underwent experimental pain tests to identify pressure pain threshold (PPT) at biceps brachii (BIC), anterior deltoid (AD), and upper trapezius (UT) followed by the Short-form McGill Pain Questionnaire (SF-MPQ) and Pain Catastrophizing Scale (PCS) before and after a repetitive arm task performed at shoulder height until reaching a rating of neck/shoulder perceived exertion, using the Borg Category Ratio 10 (CR10), greater than 8/10. PPT and MPQ data were analyzed using repeated measures analyses of variance (ANOVA) (time × sex). Correlational analyses were used to investigate relationships between pain measures with time and fatigue. RESULTS: UT PPT was reduced following the fatiguing task (p ≤ 0.01). Men overall reported higher AD PPT levels compared to women (p ≤ 0.05). MPQ and PCS magnification scores were significantly higher after the fatiguing task (p ≤ 0.05), with no sex differences. Time to fatigue correlated with changes in AD PPT in men and with PCS scores in women. CONCLUSIONS: Findings suggest that mechanisms underlying the sensation of acute pain following a repetitive shoulder height task are closely linked with PPT changes in shoulder stabilizers (UT) irrespective of sex, and more so with physical pain responses in men and in attitudes towards pain in women. Sex differences in pain perception may contribute to a better understanding of sex-specific mechanisms underlying neck/shoulder MSDs.


Assuntos
Fadiga Muscular , Medição da Dor , Percepção da Dor/fisiologia , Limiar da Dor/fisiologia , Adulto , Feminino , Humanos , Masculino , Caracteres Sexuais , Adulto Jovem
7.
Science ; 365(6454): 695-699, 2019 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-31416963

RESUMO

An essential prerequisite for the survival of an organism is the ability to detect and respond to aversive stimuli. Current belief is that noxious stimuli directly activate nociceptive sensory nerve endings in the skin. We discovered a specialized cutaneous glial cell type with extensive processes forming a mesh-like network in the subepidermal border of the skin that conveys noxious thermal and mechanical sensitivity. We demonstrate a direct excitatory functional connection to sensory neurons and provide evidence of a previously unknown organ that has an essential physiological role in sensing noxious stimuli. Thus, these glial cells, which are intimately associated with unmyelinated nociceptive nerves, are inherently mechanosensitive and transmit nociceptive information to the nerve.


Assuntos
Percepção da Dor/fisiologia , Células de Schwann/fisiologia , Pele/inervação , Animais , Feminino , Masculino , Mecanorreceptores/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Nociceptores/fisiologia , Optogenética , Limiar da Dor , Fatores de Transcrição SOXE/genética , Fatores de Transcrição SOXE/metabolismo , Células de Schwann/metabolismo , Termorreceptores/fisiologia
8.
Acta Psychol (Amst) ; 199: 102894, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31349030

RESUMO

Human beings possess the adaptive ability to apply experiential knowledge to new situations. Although this generalization capability has been demonstrated in fear and reward learning, it remains unclear whether it extends to analgesic and hyperalgesic pain responses. Here, we conducted two experiments (total n = 104) to test the generalization effects of placebo analgesia and nocebo hyperalgesia. The first experiment, using a category-based conditioning paradigm in which two categories of images were used as acquisition stimuli, assessed whether pain perception can be generalized to never-seen pictures of the same category in the generalization phase. The second experiment adopted a single stimulus for each category as CS to further examine the generalization effects after learning a single exemplar. Pain ratings showed that participants reported higher pain or lower pain when the pain was preceded by novel stimuli that were conceptually similar to the previously conditioned stimuli, suggesting a generalization of analgesic and hyperalgesic pain modulation effects. These results provide novel evidence that analgesic and hyperalgesic effects on pain perception can be generalized to conceptually similar new items.


Assuntos
Condicionamento Clássico/fisiologia , Aprendizagem/fisiologia , Percepção da Dor/fisiologia , Estimulação Luminosa/métodos , Adulto , Medo/fisiologia , Medo/psicologia , Feminino , Humanos , Masculino , Efeito Nocebo , Medição da Dor/métodos , Medição da Dor/psicologia , Efeito Placebo , Adulto Jovem
9.
Nat Commun ; 10(1): 3087, 2019 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300648

RESUMO

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.


Assuntos
Gânglios Espinais/diagnóstico por imagem , Microscopia Intravital/métodos , Percepção da Dor/fisiologia , Células Receptoras Sensoriais/fisiologia , Animais , Técnicas de Observação do Comportamento/instrumentação , Técnicas de Observação do Comportamento/métodos , Comportamento Animal/fisiologia , Cálcio/química , Feminino , Formaldeído/administração & dosagem , Formaldeído/toxicidade , Gânglios Espinais/citologia , Gânglios Espinais/fisiologia , Proteínas de Fluorescência Verde/química , Proteínas de Fluorescência Verde/genética , Microscopia Intravital/instrumentação , Masculino , Camundongos , Camundongos Transgênicos , Modelos Animais , Imagem Óptica/instrumentação , Imagem Óptica/métodos , Dor/induzido quimicamente , Dor/fisiopatologia , Fótons , Vigília
10.
PLoS Comput Biol ; 15(7): e1007106, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31295266

RESUMO

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.


Assuntos
Ritmo Circadiano/fisiologia , Modelos Neurológicos , Dor/fisiopatologia , Corno Dorsal da Medula Espinal/fisiopatologia , Biologia Computacional , Gânglios Espinais/fisiopatologia , Humanos , Interneurônios/fisiologia , Rede Nervosa/fisiologia , Neuralgia/fisiopatologia , Nociceptividade/fisiologia , Dor Nociceptiva/fisiopatologia , Percepção da Dor/fisiologia
11.
Biol Aujourdhui ; 213(1-2): 43-49, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31274102

RESUMO

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.


Assuntos
Encéfalo/fisiopatologia , Cefaleia/etiologia , Cefaleia/fisiopatologia , Rede Nervosa/fisiopatologia , Animais , Transtornos Cerebrovasculares/etiologia , Transtornos Cerebrovasculares/fisiopatologia , Cefaleia/psicologia , Humanos , Rede Nervosa/patologia , Dor/etiologia , Dor/fisiopatologia , Percepção da Dor/fisiologia , Ratos
12.
Soc Cogn Affect Neurosci ; 14(7): 747-757, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31236566

RESUMO

Predictability has been suggested to modulate both the anticipation and perception of self-pain. Considering the overlapping neural circuits between self-pain and other-pain perceptions, the present study investigated how the predictability of forthcoming pain modulates the anticipation and perception of self-pain and other-pain. We used a balanced, within-participant experimental design in which a visual cue indicating the recipient, intensity and predictability of an upcoming painful electrical stimulation was presented before its delivery. Subjective ratings and electroencephalography activities to the anticipation and perception of self-pain and other-pain were recorded and compared between certain and uncertain conditions. Results showed that predictability affected the perception of self-pain and other-pain in a similar manner such that the differences in behavioral ratings and event-related potentials to high-intensity and low-intensity pain were significantly reduced when the intensity was uncertain. The strengths of predictability-induced modulation of self-pain and other-pain perceptions were positively correlated with each other. Furthermore, predictability also modulated the anticipation of both self-pain and other-pain such that pre-stimulus high-frequency α-oscillation power at sensorimotor electrodes contralateral to the stimulation side was maximally suppressed when anticipating certain high-intensity pain. These findings demonstrate that predictability-induced modulation on pain anticipation and perception was similarly applied to both self-pain and other-pain.


Assuntos
Percepção da Dor/fisiologia , Incerteza , Adulto , Estimulação Elétrica , Eletroencefalografia , Potenciais Evocados/fisiologia , Feminino , Humanos , Masculino , Dor , Medição da Dor
13.
Bone Joint J ; 101-B(6_Supple_B): 31-36, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31146567

RESUMO

AIMS: Whether patient-reported pain differs among surgical approaches in total hip arthroplasty (THA) remains unclear. This study's purposes were to determine differences in pain based on surgical approach (direct anterior (DA) vs posterolateral (PL)) and PL approach incision length. PATIENTS AND METHODS: This was a retrospective investigation from two centres and seven surgeons (three DA, three PL, one both) of primary THAs. PL patients were categorized for incision length (6 cm to 8 cm, 8 cm to 12 cm, 12 cm to 15 cm). All patients had cementless femoral and acetabular fixation, at least one year's follow-up, and well-fixed components. Patients completed a pain-drawing questionnaire identifying the location and intensity of pain on an anatomical diagram. Power analysis indicated 800 patients in each cohort for adequate power to detect a 4% difference in pain (alpha = 0.05, beta = 0.80). RESULTS: A total of 1848 patients (982 DA, 866 PL) were included. PL patients were younger (59.4 years, sd 12.9 vs 62.7 years, sd 9.7; p < 0.001) and had shorter follow-up (3.3 years, sd 1.3 vs 3.7 years, sd 1.3; p < 0.001). DA patients reported decreased moderate to severe trochanteric (14% vs 21%; p < 0.001) and groin pain (19% vs 24%; p = 0.004) than PL patients. There were no differences in anterior, lateral, or posterior thigh, back, or buttock pain between cohorts (p = 0.05 to 0.7). PL approach incision length did not impact the incidence or severity of pain (p = 0.3 to 0.7). CONCLUSION: A significant proportion of patients perceive persistent pain following THA regardless of approach. DA patients reported less trochanteric and groin pain versus PL patients. PL incision length did not influence the incidence or severity of patient-reported pain. Cite this article: Bone Joint J 2019;101-B(6 Supple B):31-36.


Assuntos
Artroplastia de Quadril/métodos , Percepção da Dor/fisiologia , Dor Pós-Operatória/fisiopatologia , Artroplastia de Quadril/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/fisiopatologia , Medição da Dor , Dor Pós-Operatória/etiologia , Estudos Retrospectivos , Autorrelato
14.
Exp Brain Res ; 237(9): 2205-2215, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31218369

RESUMO

Experimental pain inhibits primary motor cortex (M1) excitability. Attenuating pain-related inhibition of M1 excitability may be useful during rehabilitation in individuals with pain. One strategy to attenuate M1 excitability is to influence prefrontal and premotor cortex activity. Working memory tasks, e.g. the two-back task (TBT), engage prefrontal and premotor cortices and may influence M1 excitability. We hypothesized that performing the TBT during pain would influence pain-related changes in M1 excitability. Participants (n = 28) received rigorous training in the TBT before baseline testing. Experimental pain was induced by injecting hypertonic saline into the first dorsal interosseous (FDI) muscle. Participants rated pain intensity on a 0-10 numerical rating scale (NRS) every second min until pain-resolved (PR) during the performance of the TBT (n = 14) or during REST (n = 14). In the TBT, letters were presented pseudo-randomly, and accuracy and reaction time to identified letters corresponding to letters shown two times back were recorded. M1 excitability was assessed using transcranial magnetic stimulation. Motor-evoked potentials (MEPs) were recorded at baseline, and at PR, PR + 10, PR + 20, and PR + 30 min. Four minutes after hypertonic saline injection, the pain NRS scores were higher in the TBT group than the REST group (p = 0.009). No time × group interaction was found for MEPs (p = 0.73), but a main effect of time (p < 0.0005) revealed a reduction of MEPs at PR up until PR + 30 (p < 0.008). The TBT accuracy improved at PR + 30 in both groups (p = 0.019). In conclusion, the pain-induced reduction in corticomotor excitability was unaffected by performing a working memory task, despite greater pain in the TBT group.


Assuntos
Atenção/fisiologia , Potencial Evocado Motor/fisiologia , Memória de Curto Prazo/fisiologia , Córtex Motor/fisiologia , Plasticidade Neuronal/fisiologia , Percepção da Dor/fisiologia , Córtex Pré-Frontal/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Feminino , Humanos , Masculino , Medição da Dor , Reconhecimento Visual de Modelos/fisiologia , Estimulação Magnética Transcraniana , Adulto Jovem
15.
Biomed Res Int ; 2019: 5021914, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31119173

RESUMO

Objective: Virtual reality (VR) is an advanced technology that can be used to attenuate pain. The present study aimed to investigate which method was more effective for pain management: VR combined with exercise imagery or VR distraction. Methods: Fifty-two healthy students participated in this randomized cross-over controlled trial. One VR-based task aimed to passively use the imagery of driving a car as a distraction intervention (the driving group), whereas the other VR-based task aimed to use exercise imagery (running) to actively engage the participants in movement (the running group). The mechanical pressure pain thresholds of the quadriceps and forearm and the heat pain threshold of the hand of each subject were measured before, during, and after each VR task. The differences between the values at each time point and the differences between the groups were analyzed. Results: The pressure and heat pain thresholds were significantly greater during VR task than those before VR task in both driving and running groups. The changes in the pressure pain thresholds that occurred during VR task were significantly higher in the running group than in the driving group. The difference between groups gradually declined after VR task. Conversely, there was no significant difference in the changes in the heat pain thresholds between the groups both during VR task and after VR task. Conclusions: VR combined with exercise imagery has a greater effect on pressure pain thresholds, but not heat pain thresholds, than VR distraction.


Assuntos
Medição da Dor , Percepção da Dor/fisiologia , Dor/prevenção & controle , Realidade Virtual , Adulto , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Dor/fisiopatologia , Limiar da Dor , Análise e Desempenho de Tarefas , Interface Usuário-Computador , Adulto Jovem
16.
Neuroscience ; 410: 16-28, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31078688

RESUMO

The present study investigated how pain appraisals from other individuals modulated self-pain anticipation and perception. Appraisals of pain intensity from 10 other individuals were presented before the participants received identical electrical pain stimulation themselves. In reality, the presented other's pain appraisals, with either low or high in mean and variance, were generated by the experimenter, and were randomly paired with the subsequent electrical stimulation at either low or high intensity. Specifically, the mean and variance of others' pain appraisals were manipulated to induce participants' expectation and certainty to the upcoming pain. Subjective ratings of pain intensity and electroencephalographic (EEG) responses to the electrical stimulation, as well as anticipatory EEG activities measured prior to the onset of electrical stimulation, were compared. Results showed that the mean and variance of others' pain appraisal modulated the subjective pain ratings and the affective-motivational P2 responses elicited by the electrical stimulation, as well as anticipatory sensorimotor α-oscillation measured before the onset of pain stimulation. When the mean of others' pain appraisal was low, higher variance suppressed the sensorimotor α-oscillations and enhanced subsequent pain perception. In contrast, when the mean was high, the higher variance enhanced sensorimotor α-oscillations and suppressed subsequent pain perception. These results demonstrated that others' pain appraisals can modulate both of the anticipation and perception of first-hand pain. It also suggested that the top-down modulation of others' pain appraisals on pain perception could be partially driven by the different brain states during the anticipation stage, as captured by the prestimulus sensorimotor α-oscillations.


Assuntos
Ritmo alfa/fisiologia , Antecipação Psicológica/fisiologia , Medição da Dor/psicologia , Percepção da Dor/fisiologia , Dor/psicologia , Adolescente , Estimulação Elétrica/efeitos adversos , Eletroencefalografia/métodos , Eletroencefalografia/psicologia , Feminino , Humanos , Masculino , Dor/diagnóstico , Medição da Dor/métodos , Adulto Jovem
17.
Rev Bras Ter Intensiva ; 31(1): 57-62, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30970092

RESUMO

OBJECTIVE: To assess the Perme mobility scale score as a predictor of functional status and complications in the postoperative period in patients undergoing liver transplantation. METHODS: The sample consisted of 30 patients who underwent liver transplantation. The patients were evaluated at two time points to determine their perception of pain, degree of dyspnea, peripheral muscle strength, and functional status according to the Perme scale. The collected data were analyzed by descriptive and inferential statistics. To compare the means between the evaluations, Student's t test for paired samples was applied. In case of asymmetry, the Wilcoxon test was used. In the evaluation of the association between the quantitative variables, the Pearson or Spearman correlation tests were applied. RESULTS: A total of 30 individuals who underwent liver transplantation were included. The patients were predominantly male, and the mean age was 58.4 ± 9.9 years. The most prevalent underlying pathology was cirrhosis C virus (23.3%). Significant associations of the time on mechanical ventilation with the Perme scale score at discharge from the intensive care unit (r = -0.374; p = 0.042) and the number of physical therapy treatments (r = -0.578; p = 0.001) were recorded. When comparing the results of the initial evaluation and the evaluation at hospital discharge, there was a significant improvement in functional status (p < 0.001). CONCLUSION: Functional mobility, peripheral muscle strength, pain perception, and dyspnea are significantly improved at hospital discharge compared with those at inpatient unit admission.


Assuntos
Transplante de Fígado/métodos , Modalidades de Fisioterapia/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Recuperação de Função Fisiológica/fisiologia , Idoso , Dispneia/epidemiologia , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Força Muscular/fisiologia , Percepção da Dor/fisiologia , Alta do Paciente , Estudos Prospectivos , Respiração Artificial/estatística & dados numéricos , Fatores de Tempo
18.
Georgian Med News ; (287): 119-124, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30958302

RESUMO

The purpose of this study was to elucidate the relationship between thermal and mechanical sensation, as well as pain thresholds degrees and the dynamics of the TRPV1 level in almost healthy young males and females in the follicular and luteal phases of the OMC. We found gender differences for some pain sensation indices, taking into account OMC phases of females. Mechanical pain tolerance and heat pain thresholds were significantly higher in males compared with females in both phases of the OMC, also, mechanical pain, mechanical pressure, cold pain and heat sensation thresholds were insignificantly higher in males compared with females in follicular phase of the OMC and significantly higher - in luteal phase of the OMC. We haven't found any differences in cold sensation threshold between males and females in both phases of OMC. Moreover, we found significant gender and interphase differences in receptor protein TRPV1 level - the maximal level in females in luteal phase of the OMC, lower in males and minimal in females in follicular phase of the OMC.


Assuntos
Fase Folicular/fisiologia , Fase Luteal/fisiologia , Percepção da Dor/fisiologia , Limiar da Dor/fisiologia , Dor , Caracteres Sexuais , Canais de Cátion TRPV/metabolismo , Sensação Térmica/fisiologia , Adolescente , Adulto , Temperatura Baixa , Feminino , Temperatura Alta , Humanos , Masculino , Adulto Jovem
19.
Rev Bras Ginecol Obstet ; 41(3): 170-175, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30991431

RESUMO

OBJECTIVE: Endometriosis is a complex disease, and pain is an important component of the syndrome. One of the most used methods to assess pain is the visual analogue scale (VAS). The aim of the present research was to study the pain experienced by patients who referred to our unit for endometriosis, using the VAS to understand the variables that could influence it. METHODS: We have conducted a prospective study from February 2012 to December 2016, enrolling 388 patients who referred to a university hospital, in Florence, Italy. We have included in the present study patients during their follow-up for endometriosis; we have also included patients who underwent surgery with a histological diagnosis of endometriosis. We have collected sociodemographic and clinical information regarding age, body mass index (BMI), smoking habit, number of pregnancies, and endometriosis staging. Finally, we have administered the VAS for several symptoms. RESULTS: Dysmenorrhea was the symptom associated with the highest perception of pain (mean VAS score of 5.76). The logistic regression showed that the stage of endometriosis could influence the pain associated to constipation and to dysuria. The linear regression showed that age could influence the pain associated to constipation, to dyspareunia, and to dysmenorrhea. A positive correlation was found between dysmenorrhea and chronic pelvic pain (CPP), between dysmenorrhea and dyspareunia, and between constipation and dysuria. CONCLUSION: Using a validated method, the VAS, we have studied the pain experienced by a group of patients with a history of endometriosis and observed that smoking habit and BMI did not influence the VAS scores, and that dysmenorrhea was associated with the highest perception of pain.


Assuntos
Endometriose/complicações , Dor Pélvica/etiologia , Adolescente , Adulto , Índice de Massa Corporal , Dor Crônica , Dismenorreia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Dor , Percepção da Dor/fisiologia , Projetos Piloto , Estudos Prospectivos , Escala Visual Analógica , Adulto Jovem
20.
Exp Brain Res ; 237(7): 1735-1744, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31030281

RESUMO

BACKGROUND AND OBJECTIVES: Pain is a complex experience involving both nociceptive and affective-cognitive mechanisms. The present study evaluated whether modulation of pain perception, employing a conditioned pain modulation (CPM) paradigm, is paralleled by changes in contact heat-evoked potentials (CHEPs), a brain response to nociceptive stimuli. METHODS: Participants were 25 healthy, pain-free, college students (12 males, 13 females, mean age 19.24 ± 0.97 years). Twenty computer-controlled heat stimuli were delivered to the non-dominant forearm and CHEPs were recorded at Cz using a 32-channel EEG system. After each stimulus, participants rated the intensity of the heat pain using the 0-100 numerical rating scale. The latency and amplitude of N2, P2 components as well as single-sweep spectral analysis of individual CHEPs were measured offline. For CPM, participants had to submerge their dominant foot into a neutral (32 °C) or noxious (0 °C) water bath. CHEPs and heat pain ratings were recorded in 3 different conditions: without CPM, after neutral CPM (32 °C) and after noxious CPM (0 °C). RESULTS: The noxious CPM induced a facilitatory pain response (p = 0.001) with an increase in heat pain following noxious CPM compared to neutral CPM (p = 0.001) and no CPM (p = 0.001). Changes in CHEPs did not differ between conditions when measured as N2-P2 peak-to-peak amplitude (p = 0.33) but the CPM significantly suppressed the CHEPs-related delta power (p = 0.03). Changes in heat pain in the noxious CPM were predicted by trait catastrophizing variables (p = 0.04). CONCLUSION: The current study revealed that pain facilitatory CPM is related to suppression of CHEPs delta power which could be related to dissociation between brain responses to noxious heat and pain perception.


Assuntos
Encéfalo/fisiopatologia , Catastrofização/fisiopatologia , Medição da Dor/métodos , Percepção da Dor/fisiologia , Dor/fisiopatologia , Catastrofização/diagnóstico , Catastrofização/psicologia , Eletroencefalografia/métodos , Feminino , Temperatura Alta/efeitos adversos , Humanos , Masculino , Fibras Nervosas Mielinizadas/fisiologia , Dor/diagnóstico , Dor/psicologia , Medição da Dor/psicologia , Limiar da Dor/fisiologia , Adulto Jovem
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