scholarly journals A Cognitive Neuropsychological and Psychophysiological Investigation of a Patient Who Exhibited an Acute Exacerbated Behavioural Response during Innocuous Somatosensory Stimulation and Movement

2004 ◽  
Vol 15 (1-2) ◽  
pp. 15-22 ◽  
Author(s):  
N. M. J. Edelstyn ◽  
S. R. Baker ◽  
S. J. Ellis ◽  
P. Jenkinson
Keyword(s):  
White Matter ◽  
Pain Intensity ◽  
Visual Processing ◽  
Behavioural Response ◽  
Pain Tolerance ◽  
Control Group ◽  
Somatosensory Stimulation ◽  
Pain Affect ◽  
Psychophysiological Investigation ◽  
Cognitive Neuropsychological

We report findings from a cognitive neuropsychological and psychophysiological investigation of a patient who displayed an exacerbated acute emotional expression during movement, innocuous, and aversive somatosensory stimulation. The condition developed in the context of non-specific white matter ischaemia along with abnormalities in the cortical white matter of the left anterior parietal lobe, and subcortical white matter of the left Sylvian cortex.Cognitive neuropsychological assessment revealed a pronounced deficiency in executive function, relative to IQ, memory, attention, language and visual processing. Compared to a normal control group, the patient [EQ] displayed a significantly elevated skin conductance level during both innocuous and aversive somatosensory stimulation. His pain tolerance was also significantly reduced. Despite this, EQ remained able to accurately describe the form of stimulation taking place, and to rate the levels of pain intensity and pain affect.These results suggest that EQ’s exaggerated behavioural response and reduced pain tolerance to somatosensory stimulation may be linked to cognitive changes, possibly related to increased apprehension and fear, rather than altered pain intensity or pain affect per se.

Pain intensity and pain affect in relation to white matter changes

Pain ◽  
2006 ◽  
Vol 125 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Joukje M. Oosterman ◽  
Barbera van Harten ◽  
Henry C. Weinstein ◽  
Philip Scheltens ◽  
Erik J.A. Scherder
Keyword(s):  
White Matter ◽  
Pain Intensity ◽  
White Matter Changes ◽  
Pain Affect

scholarly journals COPAHS Study: protocol of a randomised experimental study comparing the effects of hypnosis, mindfulness meditation, and spiritual practices on experimental pain in healthy adults

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040068
Author(s):  
Alexandra Ferreira-Valente ◽  
Filipa Pimenta ◽  
Rui M. Costa ◽  
Melissa A. Day ◽  
José Pais-Ribeiro ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Mindfulness Meditation ◽  
Pain Tolerance ◽  
Healthy Adults ◽  
Spiritual Practices ◽  
Control Group ◽  
Audio Recording ◽  
Pain Experience ◽  
Painful Stimulation ◽  
Related Stress

BackgroundThere has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of self-hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation.Methods and analysisRecruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either self-hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes.Ethics and disseminationThis study was approved by ISPA—University Institute’s internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences.Trial registration numberClinicalTrials.gov registry (NCT04491630). Stage: pre-results.

Design and Evaluation of a Modulated TENS Stimulation in Medical Pain Therapy

2019 ◽  
Vol 14 (1) ◽  
pp. 75-83
Author(s):  
L. Bouafif ◽  
N. Ellouze
Keyword(s):  
Pain Intensity ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Pain Therapy ◽  
Subjective Evaluation ◽  
Large Population ◽  
Electrical Current ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Electrical Nerve Stimulation

Background: Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive pain therapy that uses the sensory effects of an electrical current applied to the skin. Some clinical studies demonstrated that this treatment helps to reduce acute and chronic pains, while others gave sometimes contradictory or uncertain conclusions about the performances of this strategy according to pathology classification. The purpose of this study is the development and evaluation of a new modulated version of transcutaneous electrical nerve stimulation called PWM-TENS. The principle is based on an automatic variation of the stimulation parameters (frequency, amplitude, duration, shape, cyclic ratio) according to the pain evolution. Methods: The study was a controlled clinical trial involving 15 participants, divided into 2 groups. The first experimental group performed modulated PWM-TENS electro-stimulation sessions applied to the painful areas 3 to 4 times a day, for one month. The second control group did parallel treatments by Placebo. The evaluation of the pain intensity is done with the Visual Analog Scale (EVA), the DN4 and SF36 questionnaires. Results: The tests and measurements with our embedded PWM-TENS technique demonstrated that we succeeded to increase the analgesic effect after stopping the stimulation and reduced the pain sensation by about 60%. An improvement in pain intensity scores and questionnaires (EVA, DN4), as well as the quality of life score (SF36), was observed. Also, a reduction of the treatment period from 3 to 1 month was also obtained. Conclusion: The first results clinically observed in the PWM-TENS technique are encouraging. The findings of this study confirm that this noninvasive strategy is suitable and useful for acute pains coming from the nociceptive, neuropathic and musculoskeletal origin. However, its efficiency is moderated and less adapted for low back pain. The experiments make it possible to estimate whether this modulated TENS method could improve existing anti-pain therapies, taking into account objective and subjective evaluation criteria. But this study must be followed by large population samples to answer all the problems of acute and chronic pains.

scholarly journals Preliminary Evidence for a Relationship between Elevated Plasma TNFα and Smaller Subcortical White Matter Volume in HCV Infection Irrespective of HIV or AUD Comorbidity

2021 ◽  
Vol 22 (9) ◽  
pp. 4953
Author(s):  
Natalie M. Zahr ◽  
Kilian M. Pohl ◽  
Allison J. Kwong ◽  
Edith V. Sullivan ◽  
Adolf Pfefferbaum
Keyword(s):  
White Matter ◽  
Proinflammatory Cytokines ◽  
Soluble Protein ◽  
Subcortical White Matter ◽  
Control Group ◽  
White Matter Volume ◽  
Brain Volumes ◽  
Protein Levels ◽  
Matter Volume ◽  
Patient Groups

Classical inflammation in response to bacterial, parasitic, or viral infections such as HIV includes local recruitment of neutrophils and macrophages and the production of proinflammatory cytokines and chemokines. Proposed biomarkers of organ integrity in Alcohol Use Disorders (AUD) include elevations in peripheral plasma levels of proinflammatory proteins. In testing this proposal, previous work included a group of human immunodeficiency virus (HIV)-infected individuals as positive controls and identified elevations in the soluble proteins TNFα and IP10; these cytokines were only elevated in AUD individuals seropositive for hepatitis C infection (HCV). The current observational, cross-sectional study evaluated whether higher levels of these proinflammatory cytokines would be associated with compromised brain integrity. Soluble protein levels were quantified in 86 healthy controls, 132 individuals with AUD, 54 individuals seropositive for HIV, and 49 individuals with AUD and HIV. Among the patient groups, HCV was present in 24 of the individuals with AUD, 13 individuals with HIV, and 20 of the individuals in the comorbid AUD and HIV group. Soluble protein levels were correlated to regional brain volumes as quantified with structural magnetic resonance imaging (MRI). In addition to higher levels of TNFα and IP10 in the 2 HIV groups and the HCV-seropositive AUD group, this study identified lower levels of IL1β in the 3 patient groups relative to the control group. Only TNFα, however, showed a relationship with brain integrity: in HCV or HIV infection, higher peripheral levels of TNFα correlated with smaller subcortical white matter volume. These preliminary results highlight the privileged status of TNFα on brain integrity in the context of infection.

scholarly journals Bi-caudate ratio as a MRI marker of white matter atrophy in multiple sclerosis and ischemic leukocencephalopathy

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Dena Serag ◽  
Eman Ragab
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Surrogate Marker ◽  
Normal Subjects ◽  
Subjective Assessment ◽  
Linear Measurement ◽  
Control Group ◽  
Imaging Science ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Background Brain atrophy measurement is now a cornerstone in basic neuro-imaging science. While assessment of white matter atrophy by visual inspection is subjective, volumetric approaches are time-consuming and not often feasible. Bi-caudate ratio represents a linear surrogate parameter of brain volume that can be derived from standard imaging sequences. This study highlights the value of the bi-caudate ratio (BCR) as a MRI marker of white matter atrophy in patients with multiple sclerosis and ischemic leukoencephalopathy and set a cut-off value to differentiate between patients with white matter atrophy and normal subjects. Results A total of 115 patients (54 males and 61 females) diagnosed with white matter leukoencephalopathy (MS in 51 patients and ischemic leukoencephalopathy in 64 patients) were included. Another group of 60 subjects with a normal white matter signal was recruited as a control group. BCR for the patient group ranged from 0.13 to 0.27 (mean (± SD) = 0.16 ± 0.02), while for the control group, it ranged from 0.05 mm to 0.13 (mean (± SD) = 0.09 ± 0.01). The difference between the two groups was statistically significant (P value < 0.001). A cut-off value of 0.13 was used to differentiate between the BCR in both patients and control groups with sensitivity, specificity, and accuracy of 99.2%, 100%, and 99%, respectively. The difference in BCR for patients diagnosed with MS and ischemic leukoencephalopathy was also statistically significant (P value < 0.001). Conclusion The bi-caudate ratio represents a linear measurement of subcortical atrophy that can be useful as a surrogate marker of global supra-tentorial white matter atrophy instead of the usually performed visual and therefore subjective assessment. It is an easily obtained measure that can be performed without complex time-consuming volumetric studies. Our findings also revealed that the BCR is higher in patients with ischemic leukoencephalopathy than in patients with MS.

scholarly journals Football Juggling Learning Alters the Working Memory and White Matter Integrity in Early Adulthood: A Randomized Controlled Study

2021 ◽  
Vol 11 (9) ◽  
pp. 3843
Author(s):  
Yifan Shi ◽  
Kelong Cai ◽  
Hao Zhu ◽  
Xiaoxiao Dong ◽  
Xuan Xiong ◽  
...  
Keyword(s):  
Working Memory ◽  
White Matter ◽  
Motor Skill ◽  
Early Adulthood ◽  
Skill Learning ◽  
Neural Mechanisms ◽  
White Matter Integrity ◽  
Control Group ◽  
Motor Skill Learning ◽  
Experimental Group

Cross-sectional studies suggest that motor skill learning is associated with working memory (WM) and white matter integrity (WMI). However, it has not been established whether motor skill learning improves WM performance, and information on its neural mechanisms have not been clearly elucidated. Therefore, this study compared WM and WMI across time points prior to and following football juggling learning, in early adulthood (18–20 years old), relative to a control group. Study participants in the experimental group were subjected to football juggling for 10 weeks while participants in the control category went on with their routine life activities for the same period of time and were not involved in the learning-related activities. Data on cognitive measurements and that from diffusion tensor imaging (DTI) were collected before and after learning. There was a significant improvement in WM performance of the experimental group after motor learning, although no improvement was observed in the control group. Additionally, after learning, DTI data revealed a significant increase in functional anisotropy (FA) in the genu of corpus callosum (GOCC) and the right anterior corona radiata (R.ACR) in the experimental group. Moreover, the better WM associated with football juggling learning was correlated to a higher FA. Mediation analysis suggested that FA in the GOCC acts as a mediation variable between football juggling learning and WM. These findings show that motor skill learning improves the WM and remodels WMI in early adulthood. With a particular emphasis on the importance of WMI in motor skill learning and WM, this study also revealed the possible neural mechanisms mediated by WMI.

scholarly journals Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Azza B. Hammad ◽  
Rasha E. Elsharkawy ◽  
Ghada S. Abdel Azim
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Serum Level ◽  
Pain Intensity ◽  
Magnetic Stimulation ◽  
Prophylactic Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Control Group ◽  
Neurokinin A ◽  
Abortive Treatment

Abstract Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.

The Clinical Value of Periventricular White Matter Hyperintensity on MRI in Sudden Sensorineural Hearing Loss

2021 ◽  
pp. 000348942110189
Author(s):  
Jung Woo Lee ◽  
Deoksu Kim ◽  
Seokhwan Lee ◽  
Sung-Won Choi ◽  
Soo-Keun Kong ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Multivariate Analysis ◽  
White Matter ◽  
Brain Mri ◽  
Sudden Sensorineural Hearing Loss ◽  
White Matter Hyperintensity ◽  
Control Group ◽  
Periventricular White Matter ◽  
Clinical Value ◽  
Hearing Gain

Objectives: To assess the clinical value of periventricular white matter hyperintensity (PWMH) found on brain magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL). Methods: In this prospective study, 115 patients who were diagnosed with SSNHL aged between 55 and 75 years were analyzed. All subjects underwent brain MRI and were divided into a PWMH and control groups, depending on the presence of PWMH on MRI. PWMH was subdivided into 3 groups according to severity. Pure-tone average results and hearing gain were compared between the 2 groups before treatment and 2 months after treatment. Hearing improvement was assessed using Sigel’s criteria. Results: A total of 106 patients (43 in the PWMH group and 63 in the control group) finally completed the 2-month follow-up. Average hearing gain in the PWMH group was significantly higher than in the control group (34.8 ± 20.3 and 25.9 ± 20.3, respectively, P = .029). PWMH score 1 showed significantly better hearing levels and hearing gain compared to PWMH score 3 and the control group. Multivariate analysis revealed that younger age, better initial hearing level, and the presence of PVWM score 1 were associated with good recovery. Conclusions: The presence of PWMH score 1 on brain MRI in patients with SSNHL was associated with better treatment response and was a good prognostic factor in a multivariate analysis while the hearing recovery in more severe PWMH (scores 2, 3) was not different from the control group.

scholarly journals Virtual Reality Analgesia for Children With Large Severe Burn Wounds During Burn Wound Debridement

2020 ◽  
Vol 1 ◽  
Author(s):  
Hunter G. Hoffman ◽  
David R. Patterson ◽  
Robert A. Rodriguez ◽  
Raquel Peña ◽  
Wanda Beck ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pain Intensity ◽  
Wound Care ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Severe Burn ◽  
Burn Wound ◽  
Absolute Change ◽  
Wound Debridement ◽  
Pain Medications

The objective of this study was to compare the effect of adjunctive virtual reality vs. standard analgesic pain medications during burn wound cleaning/debridement. Participants were predominantly Hispanic children aged 6–17 years of age, with large severe burn injuries (TBSA = 44%) reporting moderate or higher baseline pain during burn wound care. Using a randomized between-groups design, participants were randomly assigned to one of two groups, (a) the Control Group = pain medications only or (b) the VR Group = pain medications + virtual reality. A total of 50 children (88% Hispanic) with large severe burns (mean TBSA &gt; 10%) received severe burn wound cleaning sessions. For the primary outcome measure of worst pain (intensity) on Study Day 1, using a between groups ANOVA, burn injured children in the group that received virtual reality during wound care showed significantly less pain intensity than the No VR control group, [mean worst pain ratings for the No VR group = 7.46 (SD = 2.93) vs. 5.54 (SD = 3.56), F(1,48) = 4.29, &lt; 0.05, MSE = 46.00]. Similarly, one of the secondary pain measures, “lowest pain during wound care” was significantly lower in the VR group, No VR = 4.29 (SD = 3.75) vs. 1.68 (2.04) for the VR group, F(1,47) = 9.29, &lt;0.005, MSE = 83.52 for Study Day 1. The other secondary pain measures showed the predicted pattern on Study Day 1, but were non-significant. Regarding whether VR reduced pain beyond Study Day 1, absolute change in pain intensity (analgesia = baseline pain minus the mean of the worst pain scores on Study days 1–10) was significantly greater for the VR group, F(1,48) = 4.88, p &lt; 0.05, MSE = 34.26, partial eta squared = 0.09, but contrary to predictions, absolute change scores were non-significant for all secondary measures.

EFFICACY OF PRESSURE-BIOFEEDBACK GUIDED DEEP CERVICAL FLEXOR TRAINING ON NECK PAIN AND MUSCLE PERFORMANCE IN VISUAL DISPLAY TERMINAL OPERATORS

2013 ◽  
Vol 16 (03) ◽  
pp. 1350011 ◽  
Author(s):  
Md. Nezamuddin ◽  
Shahnawaz Anwer ◽  
Sohrab Ahmad Khan ◽  
Ameed Equebal
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Exercise Program ◽  
Visual Display ◽  
Muscle Performance ◽  
Control Group ◽  
Women Patients ◽  
Flexor Muscle ◽  
Visual Display Terminal ◽  
Pressure Biofeedback

Purpose: This randomized trial study compared the efficacy of pressure-biofeedback guided deep cervical flexor training as an adjunct with conventional exercise on pain and muscle performance in visually displayed terminal operators. Methods: A total of 50 (22 men and 28 women) patients with neck pain participated in the study. Patients were randomly placed into two groups: a biofeedback group (n = 25) and a control group (n = 25). The biofeedback group received pressure-biofeedback guided deep cervical flexor training program for 5 days a week for 6 weeks, whereas the control group received an exercise program only. Results: On intergroup comparisons, the deep cervical flexor performance in biofeedback group, at the end of 6th week was significantly higher than those of control group (p < 0.01). Pain intensity was also significantly reduced in biofeedback group when compared to control group at the end of trial (p < 0.004). Conclusion: The addition of pressure-biofeedback to a 6-week conventional program appeared to increase deep cervical flexor muscle performance, compared to the exercise program alone for people with reduced muscle performance.

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