1,721,092 research outputs found
The CPM Effect: Functional Assessment of the Diffuse Noxious Inhibitory Control in Humans
No full textThe 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
A systematic review and meta-analysis of the prevalence of small fibre impairment in patients with fibromyalgia
Full text linkConverging evidence shows that patients with fibromyalgia syndrome have signs of small fibre impairment, possibly leading to pain and autonomic symptoms, with a frequency that has not yet been systematically evaluated. To fill this gap, our review aims to define the frequency of somatic and autonomic small fibre damage in patients with fibromyalgia syndrome, as assessed by objective small fibre-related testing. We found 360 articles on somatic and autonomic small fibre assessment in patients with fibromyalgia. Out of the 88 articles assessed for eligibility, 20 were included in the meta-analysis, involving 903 patients with fibromyalgia. The estimated prevalence of somatic small fibre impairment, as assessed with skin biopsy, corneal confocal microscopy, and microneurography, was 49% (95% confidence interval (CI): 39–60%, I2 = 89%), whereas the estimated prevalence of autonomic small fibre impairment, as assessed with heart rate variability, sympathetic skin response, skin conductance, and tilt testing, was 45% (95% CI: 25–65%, I2 = 91%). Our study shows that a considerable proportion of patients with fibromyalgia have somatic and autonomic small fibre impairment, as assessed by extensive small fibre-related testing. Nevertheless, the heterogeneity and inconsistencies across studies challenge the exact role of small fibre impairment in fibromyalgia symptoms
Trigeminal Neuralgia
No full textTrigeminal neuralgia, traditionally called tic douloureux, is a chronic neuropathic pain disorder characterized by spontaneous and elicited
paroxysms of electric shock–like or stabbing pain in a region of the face. A poor quality of life and suicide in severe cases have been attributed to the disorder. A classification of trigeminal neuralgia has been adopted by several professional societies and forms the basis of its description in the International Classification of Diseases, 11th Revision (ICD-11
Prognostic and predictive relevance of circulating tumor cells in patients with non-small-cell lung cancer
No full textEarly nociceptive evoked potentials (NEPs) recorded from the scalp
No full textObjective: Neurophysiological investigation of nociceptive pathway has so far been limited to late cortical responses. We sought to detect early components of the cortical evoked potentials possibly reflecting primary sensory activity. Methods: The 150 IDE micropatterned electrode was used to selectively activate Aδ intraepidermic fibres of the right hand dorsum in 25 healthy subjects and 3 patients suffering from trigeminal neuralgia. Neurographic recordings were performed to assess type of stimulated fibres and check selectivity. Cortical evoked potentials were recorded from C3′-Fz and Cz-Au1. Results: Neurographic recordings confirmed selective activation of Aδ fibres. Early components were detected after repetitive stimulation (0.83/s rate and 250–500 averages); the first negative component occured at 40 ms (N40) on the contralateral scalp. Conclusions: The provided data support the hypothesis that N40 could be the cortical primary response conducted by fast Aδ fibres. Significance: This is the first report of early, possibly primary, cortical responses in humans by nociceptive peripheral stimulation. Although not perfected yet to allow widespread diagnostic use, this is probably the only method to allow fully objective evaluation of the nociceptive system, with important future implications in experimental and clinical neurophysiology
A mechanism-based classification of pain in multiple sclerosis. J Neurol. 2013 Feb;260(2):351-67. doi: 10.1007/s00415-012-6579-2. Epub 2012 Jul 4. Review.
No full textAffidabilità medico-legale del riflesso inibitore del massetere per la valutazione delle lesioni iatrogene del nervo mandibolare.
No full textOttenere una stima medico-legale precisa della frequenza e della gravità del danno a carico della terza branca del trigemino è difficile in assenza di una standardizzazione e di un metodo di indagine obiettivo. Il presente studio si pone il fine di verificare la sensibilità e la specificità del test del riflesso inibitore del massetere (MIR) atto ad obiettivare le lesioni iatrogene a carico del nervo alveolare inferiore e del nervo linguale allo scopo di valutarne l'applicabilità a fini medico-legali
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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