Clinical Value of Serum Neuroplasticity Mediators in Identifying the Central Sensitivity Syndrome in Patients With Chronic Pain With and Without Structural Pathology

Deitos, Alícia; Dussán‐Sarria, Jairo Alberto; Souza, Andressa de; Medeiros, Liciane Fernandes; Tarragó, Maria da Graça Lopes; Sehn, Francislea Cristina; Chassot, Mônica; Zanette, Simone de Azevedo; Schwertner, André; Fregni, Felipe; Torres, Iraci Lucena da Silva; Caumo, Wolnei

doi:10.1097/ajp.0000000000000194

Cited by 54 publications

(83 citation statements)

References 42 publications

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“…Only the main effect observed was interaction between timepoint and orofacial pain on the BDNF levels, with the levels of this mediator returning to baseline levels 7 days after the end of tDCS treatment. Also, a study involving patients with central sensitivity syndrome showed an increase in serum BDNF levels compared to control subjects, suggesting that this neuroplasticity mediator could be a screening tool for pain clinicians …”

Section: Discussionmentioning

confidence: 99%

Transcranial direct‐current stimulation reduces nociceptive behaviour in an orofacial pain model

Scarabelot

Oliveira

Medeiros

et al. 2018

J of Oral Rehabilitation

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Background: Transcranial direct-current stimulation (tDCS) is a noninvasive method of brain stimulation suggested as a therapeutic tool for pain and is related to the reversal of maladaptive plasticity associated with chronic pain.Objectives: This study investigated the effect of tDCS, a non-pharmacological therapy, on local mechanical hyperalgesia, and remote thermal hyperalgesia in rats submitted to orofacial inflammatory pain model, by facial von Frey and hot plate tests, respectively. In addition, we evaluated levels of BDNF, NGF, IL-10 and IL-6 in the brainstem and blood serum of these animals at 24 hours and 7 days after the end of tDCS treatment. Methods:Rats were subjected to temporomandibular joint pain and treated with tDCS. The animals were divided into control, pain and pain + treatment groups.Mechanical and thermal hyperalgesia were evaluated at baseline, 7 days after administration of complete Freund's adjuvant, and immediately, 24 hours, and 7 days after the tDCS treatment. Neuroimmunomodulators levels were determined by ELISA.Statistical analyses were performed by (GEE)/Bonferroni (behavioural tests), threeway ANOVA/SNK (neurochemical tests) and Kruskal-Wallis (histological analysis).Results: Transcranial direct-current stimulation reduced mechanical and thermal hyperalgesia (P < 0.01). We observed interaction between factors (pain and treatment) increasing brainstem BDNF (P < 0.01) and NGF (P < 0.05) levels. Furthermore, we found an increase in IL-6 and IL-10 levels in the brainstem at 24 hours and 7 days after tDCS, respectively. Conclusion:We showed that tDCS reduces thermal and mechanical hyperalgesia induced by orofacial pain until 7 days after treatment. These findings demonstrate that tDCS was effective in the control of orofacial inflammatory pain. K E Y W O R D S hyperalgesia, neuromodulation, orofacial inflammatory pain, tDCS, temporomandibular joint | 41 SCARABELOT ET AL. How to cite this article: Scarabelot VL, de Oliveira C, Medeiros LF, et al. Transcranial direct-current stimulation reduces nociceptive behaviour in an orofacial pain model.

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Section: Discussionmentioning

confidence: 99%

Transcranial direct‐current stimulation reduces nociceptive behaviour in an orofacial pain model

Scarabelot

Oliveira

Medeiros

et al. 2018

J of Oral Rehabilitation

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“…Symptoms of CS include allodynia, hyperalgesia, expansion of the receptive field beyond the area of peripheral nerve supply, and prolonged pain after a stimulus has been removed (Latremoliere & Woolf, ). A number of CS‐related biological mechanisms have been identified, including dysregulation of ascending and descending tracks in the central nervous system (Ren & Dubner, ; Yunus, ; Heinricher et al., ; van Wijk & Veldhuijzen, ; Kindler, Bennett, & Jones, ); over‐activation of glial cells, resulting in the release of pro‐inflammatory cytokines (Ji, Berta, & Nedergaard, ; Loggia et al., ; Nijs et al., ); dysfunction of the stress system, including the hypothalamic–pituitary–adrenal axis (Van Houdenhove & Luyten, ); decreased production of pain‐inhibiting neurotransmitters, and increased production of pain‐augmenting neurotransmitters, including excess production of brain‐derived neurotropic factor (BDNF) (Caumo et al., ; Deitos et al., ; Nijs, Meeus et al., ; Phillips & Clauw, ; Trang, Beggs, & Salter, ).…”

Section: Central Sensitizationmentioning

confidence: 99%

“…Subjective evidence for central‐related pain hypersensitivity has been demonstrated by differences in self‐reported pain severity ratings to heat, cold, electrical, and pressure stimuli between subjects with and without pain disorders (Yunus, ). Objective measures of CS, including brain imaging (Robinson, Craggs, Price, Perlstein, & Staud, ; Walitt, Ceko, Gracely, & Gracely, ), cortical excitability parameters assessed by transcranial magnetic stimulation (TMS), and levels of brain‐derived neurotrophic factor (BDNF) (Caumo et al., ; Deitos et al., ) have demonstrated biological differences between control subjects and those with CS‐related pain disorders.…”

Section: Central Sensitizationmentioning

confidence: 99%

The central sensitization inventory: A user’s manual

Neblett

2018

J Appl Biobehavioral Res

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The Central Sensitization (CSI) Inventory was introduced in 2012. It was initially intended as a screener to help identify when presenting symptoms may be related to central sensitization or indicate the presence of a central sensitivity syndrome. It has now been translated and validated in a number of European, Asian, and South American languages. This article provides an overview of CSI rationale, development, recommended uses, and research results, including evidence of validity and reliability, in clinical and non‐clinical subject samples.

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“…Conditions where a noxious stimulus is no longer present and shares this phenomenon includes: fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, temporomandibular joint disorder, chronic whiplash, and others (Deitos et al., ; Robinson, Durham, & Newton, ). These conditions together have been described as a group called central sensitivity syndromes (CSS; Yunus, ).…”

Section: Introductionmentioning

confidence: 99%

Convergent validity and clinically relevant categories for the Dutch Central Sensitization Inventory in patients with chronic pain

Noord¹,

Paap

Wilgen

2018

J Appl Biobehavioral Res

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The Central Sensitization Inventory (CSI) is a diagnostic tool, which assists the clinicians in the identification of signs of central sensitization (CS). Psychosocial factors contribute to the development and maintenance of signs of CS. But the relationship with the CSI is unknown. The aim of this study is to investigate the convergent validity for the Dutch CSI with CSS, depression, anxiety, widespread pain, catastrophizing, and pain intensity. The second aim is to determine clinically relevant categories for the Dutch CSI. In this cross-sectional study, patients completed multiple questionnaires. Bivariate correlations were calculated and the Kruskal-Wallis one-way analysis of variance test was used. One-hundred and ninety-eighth patients were included. The CSI scores were strongly correlated with depression (r s = .67; p < .01), anxiety (r s = .65; p < .01), and CSS (r s = .51; p < .01). Moderate to strong relationships were found for the Widespread Pain Index (r s = .43; p < .01) and a low relationship with pain intensity (r s = .36; p < .01) and catastrophizing (r s = .39; p < .01). Four clinical relevant categories were identified: low 0-26 points, mild 27-39points, moderate 40-52 points, and high 53+ points. This study provides a weak to strong association between the total score of the Dutch CSI and psychosocial factors, and presents clinically relevant categories for the Dutch CSI.2 of 13 | van der nOOrd et al.

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Clinical Value of Serum Neuroplasticity Mediators in Identifying the Central Sensitivity Syndrome in Patients With Chronic Pain With and Without Structural Pathology

Abstract: Neuroplasticity mediators could play a role as screening tools for pain clinicians, and as validation of the complex and diffuse symptoms of these patients.

Cited by 54 publications

References 42 publications

Transcranial direct‐current stimulation reduces nociceptive behaviour in an orofacial pain model

Transcranial direct‐current stimulation reduces nociceptive behaviour in an orofacial pain model

The central sensitization inventory: A user’s manual

Convergent validity and clinically relevant categories for the Dutch Central Sensitization Inventory in patients with chronic pain

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