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Savignac C, Ocay DD, Mahdid Y, Blain-Moraes S, Ferland CE. Clinical use of Electroencephalography in the Assessment of Acute Thermal Pain: A Narrative Review Based on Articles From 2009 to 2019. Clin EEG Neurosci 2022; 53:124-132. [PMID: 34133245 DOI: 10.1177/15500594211026280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Nowadays, no practical system has successfully been able to decode and predict pain in clinical settings. The inability of some patients to verbally express their pain creates the need for a tool that could objectively assess pain in these individuals. Neuroimaging techniques combined with machine learning are seen as possible candidates for the identification of pain biomarkers. This review aimed to address the potential use of electroencephalographic features as predictors of acute experimental pain. Twenty-six studies using only thermal stimulations were identified using a PubMed and Scopus search. Combinations of the following terms were used: "EEG," "Electroencephalography," "Acute," "Pain," "Tonic," "Noxious," "Thermal," "Stimulation," "Brain," "Activity," "Cold," "Subjective," and "Perception." Results revealed that contact-heat-evoked potentials have been widely recorded over central areas during noxious heat stimulations. Furthermore, a decrease in alpha power over central regions was revealed, as well as increased theta and gamma powers over frontal areas. Gamma and theta rhythms were associated with connectivity between sensory and affective regions involved in pain processing. A machine learning analysis revealed that the gamma band is a predominant predictor of acute thermal pain. This review also addressed the need of supplementing current spectral features with techniques that allow the investigation of network dynamics.
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Affiliation(s)
- Chloé Savignac
- 5620McGill University, Montreal, Quebec, Canada.,70357Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Don Daniel Ocay
- 5620McGill University, Montreal, Quebec, Canada.,70357Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | | | | | - Catherine E Ferland
- 5620McGill University, Montreal, Quebec, Canada.,70357Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Research Institute-McGill University Health Centre, Montreal, Quebec, Canada
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2
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Sun L, Zhang H, Han Q, Feng Y. Electroencephalogram-derived pain index for evaluating pain during labor. PeerJ 2022; 9:e12714. [PMID: 35036175 PMCID: PMC8710049 DOI: 10.7717/peerj.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022] Open
Abstract
Background The discriminative ability of a point-of-care electroencephalogram (EEG)-derived pain index (Pi) for objectively assessing pain has been validated in chronic pain patients. The current study aimed to determine its feasibility in assessing labor pain in an obstetric setting. Methods Parturients were enrolled from the delivery room at the department of obstetrics in a tertiary hospital between February and June of 2018. Pi values and relevant numerical rating scale (NRS) scores were collected at different stages of labor in the presence or absence of epidural analgesia. The correlation between Pi values and NRS scores was analyzed using the Pearson correlation analysis. The receiver operating characteristic (ROC) curve was plotted to estimate the discriminative capability of Pi to detect labor pain in parturients. Results Eighty paturients were eligible for inclusion. The Pearson correlation analysis exhibited a positive correlation between Pi values and NRS scores in parturients (r = 0.768, P < 0.001). The ROC analysis revealed a cut-off Pi value of 18.37 to discriminate between mild and moderate-to-severe labor pain in parturients. Further analysis indicated that Pi values had the best diagnostic accuracy reflected by the highest area under the curve (AUC) of 0.857, with a sensitivity and specificity of 0.767 and 0.833, respectively, and a Youden index of 0.6. Subgroup analyses further substantiated the correlations between Pi values and NRS scores, especially in parturients with higher pain intensity. Conclusion This study indicates that Pi values derived from EEGs significantly correlate with the NRS scores, and can serve as a way to quantitatively and objectively evaluate labor pain in parturients.
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Affiliation(s)
- Liang Sun
- Department of Anesthesiology, Peking University People's Hospital, Beijing, China
| | - Hong Zhang
- Department of Anesthesiology, Peking University People's Hospital, Beijing, China
| | - Qiaoyu Han
- Department of Anesthesiology, Peking University People's Hospital, Beijing, China
| | - Yi Feng
- Department of Anesthesiology, Peking University People's Hospital, Beijing, China
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3
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Stern T, Crutcher EH, McCarthy JM, Ali MA, Issachar G, Geva AB, Peremen Z, Schaaf CP. Brain Network Analysis of EEG Recordings Can Be Used to Assess Cognitive Function in Teenagers With 15q13.3 Microdeletion Syndrome. Front Neurosci 2021; 15:622329. [PMID: 33584189 PMCID: PMC7876406 DOI: 10.3389/fnins.2021.622329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/04/2021] [Indexed: 11/26/2022] Open
Abstract
15q13.3 microdeletion syndrome causes a spectrum of cognitive disorders, including intellectual disability and autism. We assessed the ability of the EEG analysis algorithm Brain Network Analysis (BNA) to measure cognitive function in 15q13.3 deletion patients, and to differentiate between patient and control groups. EEG data was collected from 10 individuals with 15q13.3 microdeletion syndrome (14–18 years of age), as well as 30 age-matched healthy controls, as the subjects responded to Auditory Oddball (AOB) and Go/NoGo cognitive tasks. It was determined that BNA can be used to evaluate cognitive function in 15q13.3 microdeletion patients. This analysis also significantly differentiates between patient and control groups using 5 scores, all of which are produced from ERP peaks related to late cortical components that represent higher cognitive functions of attention allocation and response inhibition (P < 0.05).
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Affiliation(s)
| | - Emeline H Crutcher
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | - John M McCarthy
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | - May A Ali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | | | | | | | - Christian P Schaaf
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States.,Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
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4
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La Cesa S, Di Stefano G, Leone C, Pepe A, Galosi E, Alu F, Fasolino A, Cruccu G, Valeriani M, Truini A. Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials. Eur J Pain 2017; 22:161-169. [DOI: 10.1002/ejp.1112] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/20/2023]
Affiliation(s)
- S. La Cesa
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Di Stefano
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - C. Leone
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Pepe
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - E. Galosi
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - F. Alu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Fasolino
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Cruccu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - M. Valeriani
- Ospedale Bambino Gesù; IRCCS; Rome Italy
- Center for Sensory-Motor Interaction; Aalborg University; Denmark
| | - A. Truini
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
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5
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Biederman J, Hammerness P, Sadeh B, Peremen Z, Amit A, Or-Ly H, Stern Y, Reches A, Geva A, Faraone SV. Diagnostic utility of brain activity flow patterns analysis in attention deficit hyperactivity disorder. Psychol Med 2017; 47:1259-1270. [PMID: 28065167 DOI: 10.1017/s0033291716003329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND A previous small study suggested that Brain Network Activation (BNA), a novel ERP-based brain network analysis, may have diagnostic utility in attention deficit hyperactivity disorder (ADHD). In this study we examined the diagnostic capability of a new advanced version of the BNA methodology on a larger population of adults with and without ADHD. METHOD Subjects were unmedicated right-handed 18- to 55-year-old adults of both sexes with and without a DSM-IV diagnosis of ADHD. We collected EEG while the subjects were performing a response inhibition task (Go/NoGo) and then applied a spatio-temporal Brain Network Activation (BNA) analysis of the EEG data. This analysis produced a display of qualitative measures of brain states (BNA scores) providing information on cortical connectivity. This complex set of scores was then fed into a machine learning algorithm. RESULTS The BNA analysis of the EEG data recorded during the Go/NoGo task demonstrated a high discriminative capacity between ADHD patients and controls (AUC = 0.92, specificity = 0.95, sensitivity = 0.86 for the Go condition; AUC = 0.84, specificity = 0.91, sensitivity = 0.76 for the NoGo condition). CONCLUSIONS BNA methodology can help differentiate between ADHD and healthy controls based on functional brain connectivity. The data support the utility of the tool to augment clinical examinations by objective evaluation of electrophysiological changes associated with ADHD. Results also support a network-based approach to the study of ADHD.
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Affiliation(s)
- J Biederman
- Massachusettes General Hospital,Boston,MA,USA
| | | | | | | | - A Amit
- ElMindA Ltd,Herzliya,Israel
| | | | | | | | - A Geva
- ElMindA Ltd,Herzliya,Israel
| | - S V Faraone
- SUNY Upstate Medical University,Syracuse,NY,USA
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6
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Benromano T, Pick CG, Granovsky Y, Defrin R. Increased Evoked Potentials and Behavioral Indices in Response to Pain Among Individuals with Intellectual Disability. PAIN MEDICINE 2017; 18:1715-1730. [DOI: 10.1093/pm/pnw349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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7
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Reches A, Kutcher J, Elbin RJ, Or-Ly H, Sadeh B, Greer J, McAllister DJ, Geva A, Kontos AP. Preliminary investigation of Brain Network Activation (BNA) and its clinical utility in sport-related concussion. Brain Inj 2017; 31:237-246. [PMID: 28055228 PMCID: PMC5351793 DOI: 10.1080/02699052.2016.1231343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: The clinical diagnosis and management of patients with sport-related concussion is largely dependent on subjectively reported symptoms, clinical examinations, cognitive, balance, vestibular and oculomotor testing. Consequently, there is an unmet need for objective assessment tools that can identify the injury from a physiological perspective and add an important layer of information to the clinician’s decision-making process. Objective: The goal of the study was to evaluate the clinical utility of the EEG-based tool named Brain Network Activation (BNA) as a longitudinal assessment method of brain function in the management of young athletes with concussion. Methods: Athletes with concussion (n = 86) and age-matched controls (n = 81) were evaluated at four time points with symptom questionnaires and BNA. BNA scores were calculated by comparing functional networks to a previously defined normative reference brain network model to the same cognitive task. Results: Subjects above 16 years of age exhibited a significant decrease in BNA scores immediately following injury, as well as notable changes in functional network activity, relative to the controls. Three representative case studies of the tested population are discussed in detail, to demonstrate the clinical utility of BNA. Conclusion: The data support the utility of BNA to augment clinical examinations, symptoms and additional tests by providing an effective method for evaluating objective electrophysiological changes associated with sport-related concussions.
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Affiliation(s)
- A Reches
- a ElMindA Ltd , Herzliya , Israel
| | - J Kutcher
- b The Sports Neurology Clinic , University of Michigan , Ann Arbor , MI , USA
| | - R J Elbin
- c Department of Health, Human Performance and Recreation , University of Arkansas , Fayetteville , AR , USA
| | - H Or-Ly
- a ElMindA Ltd , Herzliya , Israel
| | - B Sadeh
- a ElMindA Ltd , Herzliya , Israel
| | - J Greer
- b The Sports Neurology Clinic , University of Michigan , Ann Arbor , MI , USA
| | - D J McAllister
- d UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery , University of Pittsburgh , Pittsburgh , PA , USA
| | - A Geva
- a ElMindA Ltd , Herzliya , Israel
| | - A P Kontos
- d UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery , University of Pittsburgh , Pittsburgh , PA , USA
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8
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Myer GD, Yuan W, Barber Foss KD, Smith D, Altaye M, Reches A, Leach J, Kiefer AW, Khoury JC, Weiss M, Thomas S, Dicesare C, Adams J, Gubanich PJ, Geva A, Clark JF, Meehan WP, Mihalik JP, Krueger D. The Effects of External Jugular Compression Applied during Head Impact Exposure on Longitudinal Changes in Brain Neuroanatomical and Neurophysiological Biomarkers: A Preliminary Investigation. Front Neurol 2016; 7:74. [PMID: 27375546 PMCID: PMC4893920 DOI: 10.3389/fneur.2016.00074] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/29/2016] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Utilize a prospective in vivo clinical trial to evaluate the potential for mild neck compression applied during head impact exposure to reduce anatomical and physiological biomarkers of brain injury. METHODS This project utilized a prospective randomized controlled trial to evaluate effects of mild jugular vein (neck) compression (collar) relative to controls (no collar) during a competitive hockey season (males; 16.3 ± 1.2 years). The collar was designed to mildly compress the jugular vein bilaterally with the goal to increase intracranial blood volume to reduce risk of brain slosh injury during head impact exposure. Helmet sensors were used to collect daily impact data in excess of 20 g (games and practices) and the primary outcome measures, which included changes in white matter (WM) microstructure, were assessed by diffusion tensor imaging (DTI). Specifically, four DTI measures: fractional anisotropy, mean diffusivity (MD), axial diffusivity, and radial diffusivity (RD) were used in the study. These metrics were analyzed using the tract-based Spatial Statistics (TBSS) approach - a voxel-based analysis. In addition, electroencephalography-derived event-related potentials were used to assess changes in brain network activation (BNA) between study groups. RESULTS For athletes not wearing the collar, DTI measures corresponding to a disruption of WM microstructure, including MD and RD, increased significantly from pre-season to mid-season (p < 0.05). Athletes wearing the collar did not show a significant change in either MD or RD despite similar accumulated linear accelerations from head impacts (p > 0.05). In addition to these anatomical findings, electrophysiological network analysis of the degree of congruence in the network electrophysiological activation pattern demonstrated concomitant changes in brain network dynamics in the non-collar group only (p < 0.05). Similar to the DTI findings, the increased change in BNA score in the non-collar relative to the collar group was statistically significant (p < 0.01). Changes in DTI outcomes were also directly correlated with altered brain network dynamics (r = 0.76; p < 0.05) as measured by BNA. CONCLUSION Group differences in the longitudinal changes in both neuroanatomical and electrophysiological measures, as well as the correlation between the measures, provide initial evidence indicating that mild jugular vein compression may have reduced alterations in the WM response to head impacts during a competitive hockey season. The data indicate sport-related alterations in WM microstructure were ameliorated by application of jugular compression during head impact exposure. These results may lead to a novel line of research inquiry to evaluate the effects of protecting the brain from sports-related head impacts via optimized intracranial fluid dynamics.
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Affiliation(s)
- Gregory D Myer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; The Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA, USA; The Micheli Center for Sports Injury Prevention, Waltham, MA, USA; Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | - Kim D Barber Foss
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; The Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Athletic Training, Division of Health Sciences, Mount St. Joseph University, Cincinnati, OH, USA
| | - David Smith
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Neurosurgery, NorthShore University Health Systems, Evanston, IL, USA
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | | | - James Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | - Adam W Kiefer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; The Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Psychology, Center for Cognition, Action and Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | | | - Staci Thomas
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; The Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Chris Dicesare
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; The Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Janet Adams
- Division of Radiology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | - Paul J Gubanich
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Amir Geva
- ElMindA, Ltd., Herzliya, Israel; Department of Electrical and Computer Engineering, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Joseph F Clark
- Department of Neurology, College of Medicine, University of Cincinnati , Cincinnati, OH , USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, MA, USA
| | - Jason P Mihalik
- Department of Exercise and Sport Science, Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina , Chapel Hill, NC , USA
| | - Darcy Krueger
- Division of Neurology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
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9
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Castillo-Saavedra L, Gebodh N, Bikson M, Diaz-Cruz C, Brandao R, Coutinho L, Truong D, Datta A, Shani-Hershkovich R, Weiss M, Laufer I, Reches A, Peremen Z, Geva A, Parra LC, Fregni F. Clinically Effective Treatment of Fibromyalgia Pain With High-Definition Transcranial Direct Current Stimulation: Phase II Open-Label Dose Optimization. THE JOURNAL OF PAIN 2016; 17:14-26. [PMID: 26456677 PMCID: PMC5777157 DOI: 10.1016/j.jpain.2015.09.009] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 12/11/2022]
Abstract
Despite promising preliminary results in treating fibromyalgia (FM) pain, no neuromodulation technique has been adopted in clinical practice because of limited efficacy, low response rate, or poor tolerability. This phase II open-label trial aims to define a methodology for a clinically effective treatment of pain in FM by establishing treatment protocols and screening procedures to maximize efficacy and response rate. High-definition transcranial direct current stimulation (HD-tDCS) provides targeted subthreshold brain stimulation, combining tolerability with specificity. We aimed to establish the number of HD-tDCS sessions required to achieve a 50% FM pain reduction, and to characterize the biometrics of the response, including brain network activation pain scores of contact heat-evoked potentials. We report a clinically significant benefit of a 50% pain reduction in half (n = 7) of the patients (N = 14), with responders and nonresponders alike benefiting from a cumulative effect of treatment, reflected in significant pain reduction (P = .035) as well as improved quality of life (P = .001) over time. We also report an aggregate 6-week response rate of 50% of patients and estimate 15 as the median number of HD-tDCS sessions to reach clinically meaningful outcomes. The methodology for a pivotal FM neuromodulation clinical trial with individualized treatment is thus supported. ONLINE REGISTRATION Registered in Clinicaltrials.gov under registry number NCT01842009. PERSPECTIVE In this article, an optimized protocol for the treatment of fibromyalgia pain with targeted subthreshold brain stimulation using high-definition transcranial direct current stimulation is outlined.
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Affiliation(s)
- Laura Castillo-Saavedra
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nigel Gebodh
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Biomedical Engineering, The City College of the City University of New York, New York, New York
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of the City University of New York, New York, New York
| | - Camilo Diaz-Cruz
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rivail Brandao
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Postgraduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Livia Coutinho
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dennis Truong
- Department of Biomedical Engineering, The City College of the City University of New York, New York, New York
| | - Abhishek Datta
- Department of Biomedical Engineering, The City College of the City University of New York, New York, New York; Soterix Medical, Inc, New York, New York
| | | | | | | | | | - Ziv Peremen
- ElMindA Ltd, Herzliya, Israel; Tel Aviv University, Tel Aviv, Israel
| | - Amir Geva
- ElMindA Ltd, Herzliya, Israel; Ben Gurion University, Beersheba, Israel
| | - Lucas C Parra
- Department of Biomedical Engineering, The City College of the City University of New York, New York, New York
| | - Felipe Fregni
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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10
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Kiefer AW, Barber Foss K, Reches A, Gadd B, Gordon M, Rushford K, Laufer I, Weiss M, Myer GD. Brain Network Activation as a Novel Biomarker for the Return-to-Play Pathway Following Sport-Related Brain Injury. Front Neurol 2015; 6:243. [PMID: 26635720 PMCID: PMC4653293 DOI: 10.3389/fneur.2015.00243] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/30/2015] [Indexed: 12/02/2022] Open
Abstract
Children and adolescent athletes are at a higher risk for concussion than adults, and also experience longer recovery times and increased associated symptoms. It has also recently been demonstrated that multiple, seemingly mild concussions may result in exacerbated and prolonged neurological deficits. Objective assessments and return-to-play criteria are needed to reduce risk and morbidity associated with concussive events in these populations. Recent research has pushed to study the use of electroencephalography as an objective measure of brain injury. In the present case study, we present a novel approach that examines event-related potentials via a brain network activation (BNA) analysis as a biomarker of concussion and recovery. Specifically, changes in BNA scores, as indexed through this approach, offer a potential indicator of neurological health as the BNA assessment qualitatively and quantitatively indexes the network dynamics associated with brain injury. Objective tools, such as these support accurate and efficient assessment of brain injury and may offer a useful step in categorizing the temporal and spatial changes in brain activity following concussive blows, as well as the functional connectivity of brain networks, associated with concussion.
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Affiliation(s)
- Adam W Kiefer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA ; Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA ; Center for Cognition Action and Perception, Department of Psychology, University of Cincinnati , Cincinnati, OH , USA
| | - Kim Barber Foss
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | | | - Brooke Gadd
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
| | | | | | | | | | - Gregory D Myer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA ; Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA ; Department of Orthopaedic Surgery, University of Cincinnati , Cincinnati, OH , USA ; The Micheli Center for Sports Injury Prevention , Waltham, MA , USA ; Sports Health and Performance Institute, The Ohio State University , Columbus, OH , USA
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