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1.
Eur J Neurol ; 30(5): 1443-1452, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36773324

RESUMO

BACKGROUND: It is unknown if different etiologies or lesion topographies influence central neuropathic pain (CNP) clinical manifestation. METHODS: We explored the symptom-somatosensory profile relationships in CNP patients with different types of lesions to the central nervous system to gain insight into CNP mechanisms. We compared the CNP profile through pain descriptors, standardized bedside examination, and quantitative sensory test in two different etiologies with segregated lesion locations: the brain, central poststroke pain (CPSP, n = 39), and the spinal cord central pain due to spinal cord injury (CPSCI, n = 40) in neuromyelitis optica. RESULTS: Results are expressed as median (25th to 75th percentiles). CPSP presented higher evoked and paroxysmal pain scores compared to CPSCI (p < 0.001), and lower cold thermal limen (5.6°C [0.0-12.9]) compared to CPSCI (20.0°C [4.2-22.9]; p = 0.004). CPSCI also had higher mechanical pain thresholds (784.5 mN [255.0-1078.0]) compared to CPSP (235.2 mN [81.4-1078.0], p = 0.006) and higher mechanical detection threshold compared to control areas (2.7 [1.5-6.2] vs. 1.0 [1.0-3.3], p = 0.007). Evoked pain scores negatively correlated with mechanical pain thresholds (r = -0.38, p < 0.001) and wind-up ratio (r = -0.57, p < 0.001). CONCLUSIONS: CNP of different etiologies may present different pain descriptors and somatosensory profiles, which is likely due to injury site differences within the neuroaxis. This information may help better design phenotype mechanism correlations and impact trial designs for the main etiologies of CNP, namely stroke and spinal cord lesions. This study provides evidence that topography may influence pain symptoms and sensory profile. The findings suggest that CNP mechanisms might vary according to pain etiology or lesion topography, impacting future mechanism-based treatment choices.


Assuntos
Neuralgia , Traumatismos da Medula Espinal , Humanos , Neuralgia/etiologia , Limiar da Dor/fisiologia , Encéfalo , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/patologia , Medula Espinal/patologia
2.
J Toxicol Environ Health A ; 86(19): 697-706, 2023 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-37565658

RESUMO

Only a small number of the many medicinally important species in the genus Psidium L. have had their safety assessed. Psidium glaziovianum, a plant native to Brazil, is reported to exert antinociceptive and anti-inflammatory effects; however, there are no apparent reports of long-term safety following administering of repeated doses. The aim of this study was to examine the effects of 28-day oral of treatment at 250, 500 or 1,000 mg/kg Psidium glaziovianum essential oil (PgEO) on behavioral and physiological parameters in male and female Swiss mice. First, PgEO was chemically characterized by gas chromatography mass spectrometry (GC-MS). The following parameters were examined: motor activity, body temperature, blood glucose, urine, hematology, biochemistry, histology, and oxidative stress. Characterization of PgEO revealed 48 components which were dominated by sesquiterpenes 1,8-cineol (24.29%), α-pinene (19.73%) and ß-pinene (17.31%). Data showed that PgEO treatment in mice increased activities of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) without markedly affecting body weight, hematological or biochemical parameters, as well as water or food consumption. Administration of PgEO in repeated daily dosages over 28 days did not significantly alter exploratory or locomotor activities. Based upon our findings, PgEO administration daily for 28 days, exhibited low toxicity and absence of effects on the nervous system. Data demonstrated that PgEO produced hypoglycemic and antioxidant actions which need to be considered in safety assessment.


Assuntos
Óleos Voláteis , Psidium , Camundongos , Animais , Óleos Voláteis/toxicidade , Antioxidantes/farmacologia , Psidium/química , Extratos Vegetais/farmacologia , Folhas de Planta/química
3.
Inflammopharmacology ; 31(6): 3143-3151, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37498376

RESUMO

Myrciaria floribunda is a plant that is distributed across different Brazilian biomes such as the Amazon, Caatinga, Cerrado, and Atlantic Forest, and it possesses antioxidant, antimicrobial, and anticancer properties. The antinociceptive and anti-inflammatory properties of the essential oil from M. floribunda leaves (MfEO) were examined in this study using mouse models. Gas chromatography-mass spectrometry was employed to describe the oil, and the results revealed that δ-cadinene, bicyclogermacrene, α-cadinol, and epi-α-muurolol predominated in the chemical profile. The oil stimulated a decrease in nociception in the chemical and thermal models used to evaluate acute antinociceptive activity. Findings from the use of pain pathway blockers to study the presumed underlying mechanism indicated opioid pathway activity. The anti-edematogenic effect, decreased cell migration, and generation of pro-inflammatory cytokines provided evidence of the anti-inflammatory potential of the essential oil from M. floribunda. According to this research, the essential oil from M. floribunda can effectively alleviate acute pain and inflammation.


Assuntos
Anti-Infecciosos , Óleos Voláteis , Camundongos , Animais , Óleos Voláteis/farmacologia , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/química , Antioxidantes/farmacologia , Anti-Infecciosos/farmacologia , Extratos Vegetais/química , Analgésicos/farmacologia , Analgésicos/química , Folhas de Planta/química
4.
Trop Anim Health Prod ; 55(5): 305, 2023 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-37731138

RESUMO

The purpose of this study was to evaluate the effects of using calcium anacardate (CaA) as a source of anacardic acid and its association with citric acid (CA) in diets for breeding quails on the performance, the egg quality, incubation parameters, and progeny performance. Were used 540 quails European quails (Coturnix coturnix coturnix) that were 21 weeks old, housed in laying cages based on a completely randomized design, with nine treatments and six replications of 10 quails per parcel, with each experimental unit having eight females and two males. The following additions to the diet were evaluated: 1, no addition (control diet); 2, 0.25% CaA; 3, 0.25% CaA and 0.25% CA; 4, 0.50% CaA; 5, 0.50% CaA and 0.25% CA; 6, 0.50% CaA and 0.50% CA; 7, 0.75% CaA; 8, 0.75% CaA and 0.25% CA; and 9, 0.75% CaA and 0.50% CA. The treatments had no significant effects on the performance of the breeding quails, incubation parameters, and progeny performance. For egg quality, there was only an effect on yolk lipid oxidation, which was lower for eggs from quails fed the diets containing 0.50% CaA and 0.25% CA, 0.50% CaA and 0.50% CA, or 0.75% CaA alone, when compared with the control group. Considering that including CaA with or without CA in diets for breeding quails only affected yolk lipid oxidation, it can be recommend including 0.50% CaA and 0.25% CA or 0.75% CaA alone to mitigate oxidative damage in the yolk of fertile eggs.


Assuntos
Cálcio , Codorniz , Animais , Feminino , Masculino , Coturnix , Óvulo , Cálcio da Dieta , Dieta/veterinária , Carne , Ácido Cítrico , Lipídeos
5.
Cerebellum ; 21(5): 861-865, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34480330

RESUMO

Cerebellar symptoms remain orphan of treatment options despite being prevalent and incapacitating. Investigate whether dentate nucleus deep brain stimulation (DN DBS) is safe and leads to improvements in cerebellar symptoms when compared to sham stimulation. This randomized double-blind crossover pilot trial enrolled five patients with spinocerebellar ataxia type 3 or post-lesion ataxia. Active or sham phases were randomly performed three months apart. The primary outcome was ataxia improvement as measured by the Scale for the Assessment and Rating of Ataxia (SARA) after the active compared to the sham period. Secondary outcome measures included safety and tolerability, the Fahn-Tolosa-Marin Tremor Rating Scale (FTMRS), quality of life measurements, and patients' global impression of change. The effects on ataxia were numerically better in four out of five patients after active versus sham stimulation. The composite SARA score did not change after comparing active to sham stimulation (8.6 ± 3.6 versus 10.1 ± 4.1; p = 0.223). The FTMRS showed significant improvement after active stimulation versus sham (18.0 ± 17.2 versus 22.2 ± 19.5; p = 0.039) as did patients' global impression of change (p = 0.038). The quality of life was not modified by stimulation (p = 0.337). DN DBS was well tolerated without serious adverse events. One patient had the electrode repositioned. DN DBS is a safe and well tolerated procedure that is effective in alleviating cerebellar tremor. In this small cohort of ataxic patients, DN DBS did not achieve statistical significance for ataxia improvement.


Assuntos
Ataxia Cerebelar , Estimulação Encefálica Profunda , Ataxia/etiologia , Ataxia Cerebelar/etiologia , Ataxia Cerebelar/terapia , Núcleos Cerebelares/diagnóstico por imagem , Estimulação Encefálica Profunda/efeitos adversos , Estimulação Encefálica Profunda/métodos , Humanos , Resultado do Tratamento , Tremor/etiologia
6.
Brain ; 144(10): 2994-3004, 2021 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-34373901

RESUMO

Motor cortex stimulation via surgically implanted electrodes has been used as an off-label treatment for chronic neuropathic pain, but its efficacy has not been fully established. We aimed to objectively study the efficacy of motor cortex stimulation and characterize potential predictors of response. In this randomized, double-blind, sham-controlled, single centre trial, we recruited 18 patients with chronic neuropathic pain who did not adequately respond to conventional treatment and had a numerical pain rating scale (NRS) score ≥6. Patients were initially assigned to receive 3 months of active ('on') or sham ('off') stimulation in a double-blind cross-over phase. This was followed by a 3-month single-blind phase, and 6 months of open-label follow-up. A meaningful response in our trial was defined as a ≥30% or 2-point reduction in NRS scores during active stimulation. Using Bayesian statistics, we found a 41.4% probability of response towards on versus off motor cortex stimulation. The probability of improvement during active stimulation (double-blind, single-blind and open-label phases) compared to baseline was 47.2-68.5%. Thirty nine per cent of the patients were considered long-term responders, 71.4% of whom had facial pain, phantom limb pain or complex regional pain syndrome. In contrast, 72.7% of non-responders had either post-stroke pain or pain associated with brachial plexus avulsion. Thirty-nine per cent of patients had a substantial postoperative analgesic effect after electrode insertion in the absence of stimulation. Individuals with diagnoses associated with a good postoperative outcome or those who developed an insertional effect had a near 100% probability of response to motor cortex stimulation. In summary, we found that ∼40% of patients responded to motor cortex stimulation, particularly those who developed an insertional effect or had specific clinical conditions that seemed to predict an appropriate postoperative response.


Assuntos
Dor Crônica/terapia , Terapia por Estimulação Elétrica/métodos , Córtex Motor/fisiologia , Neuralgia/terapia , Medição da Dor/métodos , Adulto , Idoso , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Estudos Cross-Over , Método Duplo-Cego , Eletrodos Implantados , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia/diagnóstico , Neuralgia/fisiopatologia , Método Simples-Cego
7.
Chem Biodivers ; 19(9): e202200034, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35864035

RESUMO

The purpose of this study was to analyses the influence of seasonal variation on the chemical composition and antimicrobial, antioxidant and cytotoxicity activities of the essential oil (EO) extracted from the leaves of Eugenia pohliana. Chemical characterization of the samples - by gas chromatography-mass spectrometry - found 35 and 38 components for summer and winter, respectively, of the EO from E. pohliana leaves, totaling 47 different compounds. Analysis of antioxidant capacity (DPPH, ABTS and TAC) revealed that the summer EO showed greater free radical scavenging capacity than the winter. Similarly, the summer EO exhibited superior antimicrobial potential (MIC=128-512 µg/mL and MMC=128-1024 µg/mL, compared to the winter EO (128-2048 µg/mL and 256-2048 µg/mL, respectively). Results showed that both oils had a low potential to cause hemolysis. This study provides new scientific evidence on the influence of seasonality on the pharmacological properties of E. pohliana leaves and its potential for the development of herbal medicines.


Assuntos
Anti-Infecciosos , Eugenia , Óleos Voláteis , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Antioxidantes/química , Radicais Livres , Testes de Sensibilidade Microbiana , Óleos Voláteis/química , Folhas de Planta/química , Estações do Ano
8.
Trop Anim Health Prod ; 54(6): 397, 2022 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-36418520

RESUMO

The purpose of this study was to evaluate the inclusion of cardanol in the diet of quails on productive performance, egg quality, reproductive performance, and progeny performance. A total of three hundred European quail breeders of 32 weeks of age, with average body weights of 305.98 g, were housed in laying cages in groups (4 females and 1 male), following a distribution in a completely randomized design with 5 treatments and 6 replications of 10 quails, being the experimental unit constituted by the set of two cages. The treatments consisted of diets with 0, 0.25, 0.50, 0.75, and 1.00% of cardanol. There was reduction in the performance of the quail with the inclusion of 1.00% of cardanol in the diet when compared to the control treatment, while egg weight and egg mass were lower in the treatments with 0.75 and 1.00% of cardanol, respectively. It was observed that there was decrease in the specific gravity, and increase in color and TBARS value of the yolk in all treatments with cardanol. The inclusion of 0.50% of cardanol decreased the percentage of albumen, and increased the percentage of yolk, while the shell thickness decreased with 0.75%. The weight of the incubated eggs and the chick weight at hatching were lower in the treatments with 0.75 and 1.00% of cardanol. In the evaluation of the progeny performance, it was found that the weight at 7 days of age of chicks from breeders fed the diet containing 1.00% of cardanol was decreased when compared to the chicks from breeders fed the control diet. It was concluded that the inclusion of cardanol did not present benefits to the quail breeders.


Assuntos
Óvulo , Codorniz , Masculino , Animais , Feminino , Carne , Fenóis , Galinhas
10.
Oncologist ; 22(10): 1154-e105, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28652279

RESUMO

LESSONS LEARNED: Pregabalin is a medication that can decrease neuronal hyperexcitability, relieve neuropathic pain, and reach stable plasma levels after a titration period of only a few days.Its use during oxaliplatin infusions was not able to decrease the incidence of chronic, oxalipaltin-related neuropathic pain, compared with placebo. BACKGROUND: Patients with colorectal cancer (CRC) receiving oxaliplatin (OXA) develop acute and chronic painful oxaliplatin-induced peripheral neuropathy (OXAIPN). Acute and chronic OXA-related neuropathies have different pathophysiological bases, but both lead to a common phenomenon: central sensitization (CS) of nociceptive neuronal networks, leading to increased sensitivity (hyperlgesia, allodynia) in the somatosensory system, the common ground of chronic neuropathic pain. Because CS is related to increased risk of painful OXAIPN, we hypothesized that preemptive use of the anti-hyperalgesic drug pregabaline (known to decrease CS) during OXA infusions would decrease the incidence of chronic OXAIPN. METHODS: Pain-free, chemotherapy-naïve CRC patients receiving at least one cycle of modified-FLOX [5-FU(500 mg/m2)+leucovorin(20 mg/m2)/week for] 6 weeks+oxaliplatin(85 mg/m2) at weeks 1-3-5 every 8 weeks] were randomized (1:1) into the study. Patients received either pregabalin or placebo for 3 days before and 3 days after each OXA infusion and were followed for up to 6 months. Clinical assessments were performed at baseline, at the end of chemotherapy, and after the follow-up period. The main outcome was average pain at the last visit assessed by the visual analogic scale (0-10) item of the Brief Pain Inventory (BPI). Secondary endpoints were presence of neuropathic pain according to the Douleur Neuropathique-4 (DN-4), pain dimensions (short- form McGill Pain Questionnaire [MPQ]), Neuropathic Pain Symptom Inventory (NPSI), and changes in nerve conduction studies (NCS) and side effect profile. RESULTS: One hundred ninety-nine patients (57.0 ± 10.7 years old, 98 female, 101 male) were randomized. Data from 56 patients were not included in the analyses (as they did not receive at least one full cycle of modified FLOX). Data from 78 patients in the pregabalin group and 65 patients in the placebo group were retained for analyses. At the last visit, pain intensity in the pregabalin group was 1.03 (95% confidence interval [CI] = 0.79-1.26), and 0.85 (95% CI = 0.64-1.06) in the placebo group, which did not reach significance. Scores from the BPI, MPQ, DN-4, NPSI, and NCS and side-effect profiles and incidence of death did not differ between groups. Quality of life (QoL) score did not differ between groups (placebo = 76.9 ± 23.1, pregabalin group 79.4 ± 20.6). Mood scores were not significantly different between groups (placebo 9.7 [8.1-11.2]; pregabalin 6.8 [5.6-8.0]). CONCLUSION: The preemptive use of pregabalin during OXA infusions was safe, but did not decrease the incidence of chronic pain related to OXAIPN.


Assuntos
Anticonvulsivantes/uso terapêutico , Compostos Organoplatínicos/efeitos adversos , Dor/induzido quimicamente , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Pregabalina/uso terapêutico , Anticonvulsivantes/administração & dosagem , Anticonvulsivantes/farmacologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxaliplatina , Pregabalina/administração & dosagem , Pregabalina/farmacologia
12.
Rev Gaucha Enferm ; 45: e20230045, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38477747

RESUMO

OBJECTIVE: Perform a cross-cultural adaptation of the Pasero Opioid-induced Sedation Scale to the Brazilian setting. METHOD: This is a methodological study using Beaton's framework, which consists in six stages: translation, synthesis of translations, re-translation, expert committee, pre-test, and sending the adapted version of the instrument to the author of the original. The study was carried out from April to December 2021. The research was conducted in a private hospitalin the city of São Paulo, in the adult hospitalization and critical care units. It was approved by the research ethics committee. RESULTS: After translation, translation synthesis and back-translation steps, the version was evaluated by the expert committee, requiring two rounds to obtain acceptable CVI values above 0.80. In the pre-test phase, the scale was well understood, with a CVI of 0.98. CONCLUSION: The scale was adapted for the Brazilian context; however, further studies will be needed to analyze validity and reliability evidence.


Assuntos
Analgésicos Opioides , Comparação Transcultural , Adulto , Humanos , Brasil , Reprodutibilidade dos Testes , Hospitalização
13.
J Pain ; : 104527, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38599264

RESUMO

Improvements in fetal ultrasound have allowed for the diagnosis and treatment of fetal diseases in the uterus, often through surgery. However, little attention has been drawn to the assessment of fetal pain. To address this gap, a fetal pain scoring system, known as the Fetal-7 scale, was developed. The present study is a full validation of the Fetal-7 scale. The validation involved 2 steps: 1) 4 fetuses with the indication of surgery were evaluated in 3 conditions perioperatively: acute pain, rest, and under loud sound stimulation. Facial expressions were assessed by 30 raters using screenshots from 4D high-definition ultrasound films; 2) assessment of sensitivity and specificity of the Fetal-7 scale in 54 healthy fetuses and 2 fetuses undergoing acute pain after preoperative anesthetic intramuscular injection. There was high internal consistency with Cronbach's alpha (α) of .99. Intrarater reliability of the Fetal-7 scale (test-retest) calculated by intraclass correlation coefficient was .95, and inter-rater reliability was .99. The scale accurately differentiated between healthy fetuses at rest and those experiencing acute pain (sensitivity of 100% and specificity of 94.4%). The Fetal-7 scale is a valid tool for assessing acute pain-related behavior in third-trimester fetuses and may be of value in guiding analgesic procedures efficacy in these patients. Further research is warranted to explore the presence of postoperative pain in fetuses and its effects after birth. PERSPECTIVE: Recordings with 3-dimensional ultrasound of human fetuses undergoing preoperative anesthetic injections revealed complex facial expressions during acute pain, similar to those collected in newborns. This study presented the validation process and cut-off value of the Fetal-7 scale, paving the way for the study of pain before birth in humans.

14.
Chem Biol Interact ; 396: 111047, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38735454

RESUMO

Lung adenocarcinoma stands as a leading global cause of cancer-related fatalities, with current therapeutic approaches remaining unsatisfactory. Given the association between elevated oxidative markers and the aggressive nature of cancer cells (including multidrug resistance and metastatic potential) that can predict poor outcome of lung adenocarcinoma patients, any compounds that interfere with their aberrant redox biology should be rationally explored as innovative intervention strategies. This study was designed to screen potential anticancer activities within nine newly synthesized organochalcogen - compounds characterized by the presence of oxygen, sulfur, or selenium elements in their structure and exhibiting antioxidant activity - and systematically evaluated their performance against cisplatin, the cornerstone therapeutic agent for lung adenocarcinoma. Our methodology involved the establishment of optimal conditions for generating single tumor spheroids using A549 human lung adenocarcinoma cell line. The initiation interval for spheroid formation was determined to be four days in vitro (DIV), and these single spheroids demonstrated sustained growth over a period of 20 DIV. Toxic dose-response curves were subsequently performed for each compound after 24 and 48 h of incubation at the 12th DIV. Our findings reveal that at least two of the synthetic organochalcogen compounds exhibited noteworthy anticancer activity, surpassing cisplatin in key parameters such as lower LD (Lethal Dose) 50, larger drug activity area, and maximum amplitude of effect, and are promising drugs for futures studies in the treatment of lung adenocarcinomas. Physicochemical descriptors and prediction ADME (absorption, distribution, metabolism, and excretion) parameters of selected compounds were obtained using SwissADME computational tool; Molinspiration server was used to calculate a biological activity score, and possible molecule targets were evaluated by prediction with the SwissTargetPrediction server. This research not only sheds light on novel avenues for therapeutic exploration but also underscores the potential of synthetic organochalcogen compounds as agents with superior efficacy compared to established treatments.


Assuntos
Adenocarcinoma de Pulmão , Antineoplásicos , Calcogênios , Cisplatino , Neoplasias Pulmonares , Esferoides Celulares , Humanos , Esferoides Celulares/efeitos dos fármacos , Esferoides Celulares/patologia , Antineoplásicos/farmacologia , Antineoplásicos/química , Antineoplásicos/síntese química , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/metabolismo , Calcogênios/química , Calcogênios/farmacologia , Adenocarcinoma de Pulmão/tratamento farmacológico , Adenocarcinoma de Pulmão/metabolismo , Adenocarcinoma de Pulmão/patologia , Células A549 , Cisplatino/farmacologia , Ensaios de Seleção de Medicamentos Antitumorais , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/metabolismo , Sobrevivência Celular/efeitos dos fármacos
15.
JAMA Psychiatry ; 81(4): 329-337, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38170541

RESUMO

Importance: Transcranial direct current stimulation (tDCS) is moderately effective for depression when applied by trained staff. It is not known whether self-applied tDCS, combined or not with a digital psychological intervention, is also effective. Objective: To determine whether fully unsupervised home-use tDCS, combined with a digital psychological intervention or digital placebo, is effective for a major depressive episode. Design, Setting, and Participants: This was a double-blinded, sham-controlled, randomized clinical trial with 3 arms: (1) home-use tDCS plus a digital psychological intervention (double active); (2) home-use tDCS plus digital placebo (tDCS only), and (3) sham home-use tDCS plus digital placebo (double sham). The study was conducted between April 2021 and October 2022 at participants' homes and at Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. Included participants were aged 18 to 59 years with major depression and a Hamilton Depression Rating Scale, 17-item version (HDRS-17), score above 16, a minimum of 8 years of education, and access to a smartphone and internet at home. Exclusion criteria were other psychiatric disorders, except for anxiety; neurologic or clinical disorders; and tDCS contraindications. Interventions: tDCS was administered in 2-mA, 30-minute prefrontal sessions for 15 consecutive weekdays (1-mA, 90-second duration for sham) and twice-weekly sessions for 3 weeks. The digital intervention consisted of 46 sessions based on behavioral therapy. Digital placebo was internet browsing. Main Outcomes and Measures: Change in HDRS-17 score at week 6. Results: Of 837 volunteers screened, 210 participants were enrolled (180 [86%] female; mean [SD] age, 38.9 [9.3] years) and allocated to double active (n = 64), tDCS only (n = 73), or double sham (n = 73). Of the 210 participants enrolled, 199 finished the trial. Linear mixed-effects models did not reveal statistically significant group differences in treatment by time interactions for HDRS-17 scores, and the estimated effect sizes between groups were as follows: double active vs tDCS only (Cohen d, 0.05; 95% CI, -0.48 to 0.58; P = .86), double active vs double sham (Cohen d, -0.20; 95% CI, -0.73 to 0.34; P = .47), and tDCS only vs double sham (Cohen d, -0.25; 95% CI, -0.76 to 0.27; P = .35). Skin redness and heat or burning sensations were more frequent in the double active and tDCS only groups. One nonfatal suicide attempt occurred in the tDCS only group. Conclusions and Relevance: Unsupervised home-use tDCS combined with a digital psychological intervention or digital placebo was not found to be superior to sham for treatment of a major depressive episode in this trial. Trial Registration: ClinicalTrials.gov Identifier: NCT04889976.


Assuntos
Transtorno Depressivo Maior , Estimulação Transcraniana por Corrente Contínua , Humanos , Feminino , Adulto , Masculino , Transtorno Depressivo Maior/tratamento farmacológico , Resultado do Tratamento , Método Duplo-Cego , Brasil
16.
Neurophysiol Clin ; 53(3): 102845, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36822032

RESUMO

OBJECTIVES: Central neuropathic pain (CNP) is associated with altered corticomotor excitability (CE), which can potentially provide insights into its mechanisms. The objective of this study is to describe the CE changes that are specifically related to CNP. METHODS: We evaluated CNP associated with brain injury after stroke or spinal cord injury (SCI) due to neuromyelitis optica through a battery of CE measurements and comprehensive pain, neurological, functional, and quality of life assessments. CNP was compared to two groups of patients with the same disease: i. with non-neuropathic pain and ii. without chronic pain, matched by sex and lesion location. RESULTS: We included 163 patients (stroke=93; SCI=70: 74 had CNP, 43 had non-neuropathic pain, and 46 were pain-free). Stroke patients with CNP had lower motor evoked potential (MEP) in both affected and unaffected hemispheres compared to non- neuropathic pain and no-pain patients. Patients with CNP had lower amplitudes of MEPs (366 µV ±464 µV) than non-neuropathic (478 ±489) and no-pain (765 µV ± 880 µV) patients, p < 0.001. Short-interval intracortical inhibition (SICI) was defective (less inhibited) in patients with CNP (2.6±11.6) compared to no-pain (0.8±0.7), p = 0.021. MEPs negatively correlated with mechanical and cold-induced allodynia. Furthermore, classifying patients' results according to normative data revealed that at least 75% of patients had abnormalities in some CE parameters and confirmed MEP findings based on group analyses. DISCUSSION: CNP is associated with decreased MEPs and SICI compared to non-neuropathic pain and no-pain patients. Corticomotor excitability changes may be helpful as neurophysiological markers of the development and persistence of pain after CNS injury, as they are likely to provide insights into global CE plasticity changes occurring after CNS lesions associated with CNP.


Assuntos
Dor Crônica , Neuralgia , Traumatismos da Medula Espinal , Acidente Vascular Cerebral , Humanos , Qualidade de Vida , Traumatismos da Medula Espinal/complicações , Acidente Vascular Cerebral/complicações , Potencial Evocado Motor/fisiologia , Estimulação Magnética Transcraniana/métodos
17.
Neurophysiol Clin ; 53(3): 102853, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37018953

RESUMO

OBJECTIVES: It is not known whether cortical plastic changes reported in low-back pain (LBP) are present in all etiologies of LBP. Here we report on the assessment of patients with three LBP conditions: non-specific-LBP (ns-LBP), failed back surgery syndrome (FBSS), and sciatica (Sc). METHODS: Patients underwent a standardized assessment of clinical pain, conditioned pain modulation (CPM), and measures of motor evoked potential (MEPs)-based motor corticospinal excitability (CE) by transcranial magnetic stimulation, including short interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Comparisons were also made with normative data from sex- and age-matched healthy volunteers. RESULTS: 60 patients (42 women, 55.1±9.1 years old) with LBP were included (20 in each group). Pain intensity was higher in patients with neuropathic pain [FBSS (6.8±1.3), and Sc (6.4±1.4)] than in those with ns-LBP (4.7±1.0, P<0.001). The same was shown for pain interference (5.9±2.0, 5.9±1.8, 3.2±1.9, P<0.001), disability (16.4±3.3, 16.3±4.3, 10.4±4.3, P<0.001), and catastrophism (31.1±12.3, 33.0±10.4, 17.4±10.7, P<0.001) scores for FBSS, Sc, and ns-LBP groups, respectively. Patients with neuropathic pain (FBSS, Sc) had lower CPM (-14.8±1.9, -14.1±16.7, respectively) compared to ns-LBP (-25.4±16.6; P<0.02). 80.0% of the FBSS group had defective ICF compared to the other two groups (52.5% for ns-LBP, P=0.025 and 52.5% for Sc, P=0.046). MEPs (140%-rest motor threshold) were low in 50.0% of patients in the FBSS group compared to 20.0% of ns-LBP (P=0.018) and 15.0% of Sc (P=0.001) groups. Higher MEPs were correlated with mood scores (r=0.489), and with lower neuropathic pain symptom scores(r=-0.415) in FBSS. CONCLUSIONS: Different types of LBP were associated with different clinical, CPM and CE profiles, which were not uniquely related to the presence of neuropathic pain. These results highlight the need to further characterize patients with LBP in psychophysics and cortical neurophysiology studies.


Assuntos
Dor Lombar , Neuralgia , Humanos , Feminino , Pessoa de Meia-Idade , Síndrome , Medição da Dor , Neuralgia/diagnóstico , Estimulação Magnética Transcraniana/métodos , Potencial Evocado Motor/fisiologia
18.
Res Vet Sci ; 164: 105038, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37801743

RESUMO

The objective of this study was to evaluate the effects of sunflower cake inclusion and its association with crude glycerin in the diet of laying hens. A total of 320 laying hens with 39 weeks of age were distributed in a completely randomized design in a 4 × 2 factorial scheme with 5 replications of 8 birds. The studied factors were 4 inclusion levels of sunflower cake and 2 levels of crude glycerin. The inclusion of 210 g/kg of sunflower cake reduced egg mass and worsened feed conversion, and after the level 70 g/kg there was reduction in yolk coloration and specific density of eggs with or without the addition of glycerin in the diet. The addition of 70 g/kg of crude glycerin reduced the specific density of eggs in all levels of sunflower cake. There was increase in phenolic compounds, antioxidant capacity and antioxidant activity in eggs and reduction in lipid oxidation of yolks from fresh and stored eggs, with the inclusion of sunflower cake. The addition of crude glycerin increased the lipid oxidation of egg yolks. Therefore, it is possible to include up to 140 g/kg sunflower cake in the diet of laying hens, with or without crude glycerin, without impairing performance and egg quality, obtaining higher antioxidant capacity of eggs and lower lipid oxidation in yolks from fresh and stored eggs. The inclusion of 70 g/kg crude glycerin does not affect laying hens performance, however, it worsens shell quality and increases lipid oxidation in the liver and egg yolks.


Assuntos
Antioxidantes , Helianthus , Animais , Feminino , Ração Animal/análise , Antioxidantes/farmacologia , Galinhas , Dieta/veterinária , Suplementos Nutricionais , Gema de Ovo , Ovos , Glicerol/farmacologia , Lipídeos/farmacologia , Óvulo
19.
J Pain ; 24(12): 2186-2198, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37442404

RESUMO

Chronic pain is a frequent and burdensome nonmotor symptom of Parkinson's disease (PD). PD-related chronic pain can be classified as nociceptive, neuropathic, or nociplastic, the former being the most frequent subtype. However, differences in neurophysiologic profiles between these pain subtypes, and their potential prognostic and therapeutic implications have not been explored yet. This is a cross-sectional study on patients with PD (PwP)-related chronic pain (ie, started with or was aggravated by PD). Subjects were assessed for clinical and pain characteristics through questionnaires and underwent quantitative sensory tests and motor corticospinal excitability (CE) evaluations. Data were then compared between individuals with nociceptive and non-nociceptive (ie, neuropathic or nociplastic) pains. Thirty-five patients were included (51.4% male, 55.7 ± 11.0 years old), 20 of which had nociceptive pain. Patients with nociceptive PD-related pain had lower warm detection threshold (WDT, 33.34 ± 1.39 vs 34.34 ± 1.72, P = .019) and mechanical detection threshold (MDT, 2.55 ± 1.54 vs 3.86 ± .97, P = .007) compared to those with non-nociceptive pains. They also presented a higher proportion of low rest motor threshold values than the non-nociceptive pain ones (64.7% vs 26.6%, P = .048). In non-nociceptive pain patients, there was a negative correlation between WDT and non-motor symptoms scores (r = -.612, P = .045) and a positive correlation between MDT and average pain intensity (r = .629, P = .038), along with neuropathic pain symptom scores (r = .604, P = .049). It is possible to conclude that PD-related chronic pain subtypes have distinctive somatosensory and CE profiles. These preliminary data may help better frame previous contradictory findings in PwP and may have implications for future trial designs aiming at developing individually-tailored therapies. PERSPECTIVE: This work showed that PwP-related nociceptive chronic pain may have distinctive somatosensory and CE profiles than those with non-nociceptive pain subtypes. These data may help shed light on previous contradictory findings in PwP and guide future trials aiming at developing individually-tailored management strategies.


Assuntos
Dor Crônica , Dor Nociceptiva , Doença de Parkinson , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Doença de Parkinson/complicações , Estudos Transversais , Medição da Dor
20.
J Ethnopharmacol ; 312: 116443, 2023 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-37054827

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: One of the native species of the genus most often mentioned by traditional people is Psidium cattleyanum Sabine, which is used mostly to treat disorders of the respiratory, genitourinary, and digestive systems. These symptoms are mainly treated by the decoction of the leaves. Additionally, there are gaps in the in vivo and toxicity investigations of this species. AIM OF THE STUDY: The aim of this study was evaluate antinociceptive and anti-inflammatory potential of essential oil from P. cattleyanum leaves in vivo. MATERIALS AND METHODS: Gas chromatography-mass spectrometry (GC/MS) was used to examine the essential oil of P. cattleyanum. The acute toxicity test was then done with a 2000 mg/kg dosage. The oil at 50, 100, and 200 mg/kg orally, as well as the reference medications Morphine 10.0 mg/kg IP and/or Indomethacin 20.0 mg/kg IP, were tested using nociception (abdominal writhing, formalin, and tail immersion) and inflammatory models (paw edema and peritonitis). RESULTS: The phytochemical assay showed a high concentration of ß-caryophyllene (46.68%) and α-caryophyllene (10.81%). In the in vivo assays, P. cattleyanum essential oil proved to be an important antinociceptive agent, reaching 76.96% inhibition of abdominal writhing with acetic acid and 67.12% in the formalin assay. An increase in latency time in the tail test was also reported. In the test with carrageenan, the oil showed significant inhibition compared to the control. A decrease in the migration of leukocytes was also reported in the group treated with P. cattleyanum, reaching 60.49% at the dose of 200 mg/kg. CONCLUSIONS: The essential oil from the leaves of P. cattleyanum has anti-inflammatory and antinociceptive action and has potential for application in the pharmaceutical and food industry.


Assuntos
Óleos Voláteis , Psidium , Camundongos , Animais , Óleos Voláteis/uso terapêutico , Óleos Voláteis/toxicidade , Psidium/química , Extratos Vegetais/uso terapêutico , Extratos Vegetais/toxicidade , Anti-Inflamatórios/uso terapêutico , Anti-Inflamatórios/toxicidade , Analgésicos/uso terapêutico , Analgésicos/toxicidade , Formaldeído , Folhas de Planta/química , Edema/induzido quimicamente , Edema/tratamento farmacológico
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