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Chianese D, Bonora M, Sambataro M, Sambato L, Paola LD, Tremoli E, Cappucci IP, Scatto M, Pinton P, Picari M, Ferroni L, Zavan B. Exploring Mitochondrial Interactions with Pulsed Electromagnetic Fields: An Insightful Inquiry into Strategies for Addressing Neuroinflammation and Oxidative Stress in Diabetic Neuropathy. Int J Mol Sci 2024; 25:7783. [PMID: 39063025 PMCID: PMC11277522 DOI: 10.3390/ijms25147783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/26/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Pulsed electromagnetic fields (PEMFs) are recognized for their potential in regenerative medicine, offering a non-invasive avenue for tissue rejuvenation. While prior research has mainly focused on their effects on bone and dermo-epidermal tissues, the impact of PEMFs on nervous tissue, particularly in the context of neuropathy associated with the diabetic foot, remains relatively unexplored. Addressing this gap, our preliminary in vitro study investigates the effects of complex magnetic fields (CMFs) on glial-like cells derived from mesenchymal cell differentiation, serving as a model for neuropathy of the diabetic foot. Through assessments of cellular proliferation, hemocompatibility, mutagenicity, and mitochondrial membrane potential, we have established the safety profile of the system. Furthermore, the analysis of microRNAs (miRNAs) suggests that CMFs may exert beneficial effects on cell cycle regulation, as evidenced by the upregulation of the miRNAs within the 121, 127, and 142 families, which are known to be associated with mitochondrial function and cell cycle control. This exploration holds promise for potential applications in mitigating neuropathic complications in diabetic foot conditions.
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Affiliation(s)
- Diego Chianese
- Medical Sciences Department, University of Ferrara, 44133 Ferrara, Italy; (D.C.); (M.B.); (P.P.)
| | - Massimo Bonora
- Medical Sciences Department, University of Ferrara, 44133 Ferrara, Italy; (D.C.); (M.B.); (P.P.)
| | - Maria Sambataro
- Endocrine, Metabolism and Nutrition Disease Unit, Ca’ Foncello Sant Mary Hospital, 30193 Treviso, Italy (L.S.)
| | - Luisa Sambato
- Endocrine, Metabolism and Nutrition Disease Unit, Ca’ Foncello Sant Mary Hospital, 30193 Treviso, Italy (L.S.)
| | - Luca Dalla Paola
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, 48033 Ravenna, Italy; (L.D.P.); (E.T.); (I.P.C.)
| | - Elena Tremoli
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, 48033 Ravenna, Italy; (L.D.P.); (E.T.); (I.P.C.)
| | - Ilenia Pia Cappucci
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, 48033 Ravenna, Italy; (L.D.P.); (E.T.); (I.P.C.)
| | - Marco Scatto
- Department of Economics, Science, Engineering and Design, San Marino University, 47890 Città di San Marino, San Marino;
| | - Paolo Pinton
- Medical Sciences Department, University of Ferrara, 44133 Ferrara, Italy; (D.C.); (M.B.); (P.P.)
| | - Massimo Picari
- Translational Medicine Department, University of Ferrara, 44133 Ferrara, Italy;
| | - Letizia Ferroni
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, 48033 Ravenna, Italy; (L.D.P.); (E.T.); (I.P.C.)
| | - Barbara Zavan
- Translational Medicine Department, University of Ferrara, 44133 Ferrara, Italy;
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Dana E, Tran C, Osokin E, Westwood D, Moayedi M, Sabhaya P, Khan JS. Peripheral magnetic stimulation for chronic peripheral neuropathic pain: A systematic review and meta-analysis. Pain Pract 2024; 24:647-658. [PMID: 38102884 DOI: 10.1111/papr.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES To provide a systematic review of the literature on the effects of peripheral magnetic stimulation (PMS) in the treatment of chronic peripheral neuropathic pain. METHODS A systematic search of MEDLINE, EMBASE, CENTRAL, CINHAL, Web of Science, and ProQuest was conducted from inception to July 2023 to identify studies of any design published in English language that enrolled adult patients (≥18 years) that received PMS for treatment of a chronic peripheral neuropathic pain disorder (pain > 3 months). RESULTS Twenty-three studies were identified which included 15 randomized controlled trials (RCTs), five case series, two case reports, and one non-randomized trial. PMS regimens varied across studies and ranged from 5 to 240 min per session over 1 day to 1 year of treatment. Results across included studies were mixed, with some studies suggesting benefits while others showing no significant differences. Of nine placebo-controlled RCTs, four reported statistically significant findings in favor of PMS use. In the meta-analysis, PMS significantly reduced pain scores compared to control within 0-1 month of use (mean difference -1.64 on a 0-10 numeric rating scale, 95% confidence interval -2.73 to -0.56, p = 0.003, I2 = 94%, 7 studies [264 participants], very low quality of evidence), but not at the 1-3 months and >3 months of PMS use (very low and low quality of evidence, respectively). Minimal to no adverse effects were reported with PMS use. DISCUSSION There is limited and low-quality evidence to make definitive recommendations on PMS usage, however, the available data is encouraging, especially for short-term applications of this novel modality. Large high-quality randomized controlled trials are required to establish definitive efficacy and safety effects of PMS.
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Affiliation(s)
- Elad Dana
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Anesthesia, Intensive Care and Pain Medicine, Meir Medical Center, Kfar Saba, affiliated to the Sackler School of Medicine, Tel Aviv, Israel
| | - Cody Tran
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Evgeny Osokin
- Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, Ontario, Canada
- Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Duncan Westwood
- University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada
| | - Massieh Moayedi
- Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, Ontario, Canada
- Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada
- University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada
| | - Priyancee Sabhaya
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - James S Khan
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
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Marsili F, Potgieter P, Birkill CF. Adaptive Autonomic and Neuroplastic Control in Diabetic Neuropathy: A Narrative Review. Curr Diabetes Rev 2024; 20:38-54. [PMID: 38018186 DOI: 10.2174/0115733998253213231031050044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/31/2023] [Accepted: 09/28/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a worldwide socioeconomic burden, and is accompanied by a variety of metabolic disorders, as well as nerve dysfunction referred to as diabetic neuropathy (DN). Despite a tremendous body of research, the pathogenesis of DN remains largely elusive. Currently, two schools of thought exist regarding the pathogenesis of diabetic neuropathy: a) mitochondrial-induced toxicity, and b) microvascular damage. Both mechanisms signify DN as an intractable disease and, as a consequence, therapeutic approaches treat symptoms with limited efficacy and risk of side effects. OBJECTIVE Here, we propose that the human body exclusively employs mechanisms of adaptation to protect itself during an adverse event. For this purpose, two control systems are defined, namely the autonomic and the neural control systems. The autonomic control system responds via inflammatory and immune responses, while the neural control system regulates neural signaling, via plastic adaptation. Both systems are proposed to regulate a network of temporal and causative connections which unravel the complex nature of diabetic complications. RESULTS A significant result of this approach infers that both systems make DN reversible, thus opening the door to novel therapeutic applications.
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Affiliation(s)
| | - Paul Potgieter
- Research Department, Algiamed Technologies, Burnaby, Canada
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Rao VP, Kim YK, Ghazi A, Park JY, Munir KM. Efficacy of recurrent transcutaneous magnetic stimulation in the treatment of diabetic peripheral neuropathy: Multicenter randomized trial. Pain Pract 2023; 23:914-921. [PMID: 37395169 PMCID: PMC10761591 DOI: 10.1111/papr.13269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/15/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
AIMS Transcutaneous magnetic stimulation (TCMS) is successful in decreasing pain in several neurologic conditions. This multicenter parallel double-blind phase II clinical trial is a follow-up to a pilot study that demonstrated pain relief in patients with diabetic peripheral neuropathy (DPN) treated with TCMS. METHODS Thirty-four participants with confirmed DPN and baseline pain score ≥ 5 were randomized to treatment at two sites. Participants were treated with either TCMS (n = 18) or sham (n = 16) applied to each foot once a week for four weeks. Pain scores using the Numeric Pain Rating Scale after 10 steps on a hard floor surface and answers to Patient-Reported Outcomes Measurement Information System pain questions were recorded by participants daily for 28 days. RESULTS Thirty-one participants completed the study and were analyzed. Average pain scores decreased from baseline in both the groups. The difference in pain scores between TCMS and sham treatments was -0.55 for morning, -0.13 for evening, and -0.34 overall, below the pre-determined clinically relevant difference of -2. Moderate adverse events that resolved spontaneously were experienced in both treatment arms. CONCLUSION In this two-arm trial, TCMS failed to demonstrate a significant benefit over sham in patient reported pain suggesting a substantial placebo effect in our previous pilot study. TRIAL REGISTRATION TCMS for the Treatment of Foot Pain Caused By Diabetic Neuropathy, https://clinicaltrials.gov/ct2/show/NCT03596203, ID-NCT03596203.
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Affiliation(s)
- Vishnu P. Rao
- University of Maryland, School of Medicine, 800 Linden Avenue, altimore, MD, 21201, 443-682-6800
| | - Yoon Kook Kim
- University of Maryland, School of Medicine, 800 Linden Avenue, Baltimore, MD 21201, 443-682-6800
| | - Anahita Ghazi
- Rosalind Franklin University of Medicine and Science Medical Sciences, 3333 Green Bay Road, North Chicago, IL 60064, 847-578-3000
| | - Jean Y. Park
- MedStar Medical Group, 5601 Loch Raven Blvd., Floor 3, Baltimore, MD, 21239, 443-444-5663
| | - Kashif M. Munir
- Division of Endocrinology, Diabetes and Nutrition, Address: 800 Linden Avenue, 8 floor, Division of Endocrinology, Baltimore, Maryland, 21201
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5
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Finsterer J, Scorza FA. Small fiber neuropathy. Acta Neurol Scand 2022; 145:493-503. [PMID: 35130356 DOI: 10.1111/ane.13591] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/01/2022]
Abstract
Small fiber neuropathy (SFN) is a peripheral nervous system disease due to affection of A-delta or C-fibers in a proximal, distal, or diffuse distribution. Selective SFN (without large fiber affection) manifests with pain, sensory disturbances, or autonomic dysfunction. Though uniform diagnostic criteria are unavailable, most of them request typical clinical features and reduced intra-epidermal nerve fiber density on proximal or distal skin biopsy. Little consensus has been reached about the treatment of SFN, why this narrative review aims at summarizing and discussing treatment options for SFN. Treatment of SFN can be classified as symptomatic, pathophysiologic, or causal. Prerequisites for treating SFN are an established diagnosis, knowledge about the symptoms and signs, and the etiology. Pain usually responds to oral/intravenous pain killers, antidepressants, anti-seizure drugs, or topical, transdermal specifications. Some of the autonomic disturbances respond favorably to symptomatic treatment. SFN related to Fabry disease or hATTR are accessible to pathogenesis-related therapy. Immune-mediated SFN responds to immunosuppression or immune-modulation. Several of the secondary SFNs respond to causal treatment of the underlying disorder. In conclusion, treatment of SFN relies on a multimodal concept and includes causative, pathophysiologic, and symptomatic measures. It strongly depends on the clinical presentation, diagnosis, and etiology, why it is crucial before initiation of treatment to fix the diagnosis and etiology. Due to the heterogeneous clinical presentation and multi-causality, treatment of SFN should be individualized with the goal of controlling the underlying cause, alleviating pain, and optimizing functionality.
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Affiliation(s)
- Josef Finsterer
- Neurology & Neurophysiology Center Vienna Austria
- Disciplina de Neurociência Escola Paulista de Medicina/Universidade Federal de São Paulo/. (EPM/UNIFESP) São Paulo Brasil
| | - Fulvio A. Scorza
- Disciplina de Neurociência Escola Paulista de Medicina/Universidade Federal de São Paulo/. (EPM/UNIFESP) São Paulo Brasil
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Staudt MD, Prabhala T, Sheldon BL, Quaranta N, Zakher M, Bhullar R, Pilitsis JG, Argoff CE. Current Strategies for the Management of Painful Diabetic Neuropathy. J Diabetes Sci Technol 2022; 16:341-352. [PMID: 32856490 PMCID: PMC8861791 DOI: 10.1177/1932296820951829] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The development of painful diabetic neuropathy (PDN) is a common complication of chronic diabetes that can be associated with significant disability and healthcare costs. Prompt symptom identification and aggressive glycemic control is essential in controlling the development of neuropathic complications; however, adequate pain relief remains challenging and there are considerable unmet needs in this patient population. Although guidelines have been established regarding the pharmacological management of PDN, pain control is inadequate or refractory in a high proportion of patients. Pharmacotherapy with anticonvulsants (pregabalin, gabapentin) and antidepressants (duloxetine) are common first-line agents. The use of oral opioids is associated with considerable morbidity and mortality and can also lead to opioid-induced hyperalgesia. Their use is therefore discouraged. There is an emerging role for neuromodulation treatment modalities including intrathecal drug delivery, spinal cord stimulation, and dorsal root ganglion stimulation. Furthermore, consideration of holistic alternative therapies such as yoga and acupuncture may augment a multidisciplinary treatment approach. This aim of this review is to focus on the current management strategies for the treatment of PDN, with a discussion of treatment rationale and practical considerations for their implementation.
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Affiliation(s)
- Michael D Staudt
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
| | - Tarun Prabhala
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany NY, USA
| | - Breanna L Sheldon
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany NY, USA
| | - Nicholas Quaranta
- Department of Anesthesiology, Albany Medical College, Albany, New York, USA
| | - Michael Zakher
- Department of Anesthesiology, Albany Medical College, Albany, New York, USA
| | - Ravneet Bhullar
- Department of Anesthesiology, Albany Medical College, Albany, New York, USA
| | - Julie G Pilitsis
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany NY, USA
| | - Charles E Argoff
- Department of Neurology, Albany Medical College, Albany, New York, USA
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7
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Rao VP, Satyarengga M, Lamos EM, Munir KM. The Use of Transcutaneous Magnetic Stimulation to Treat Painful Diabetic Neuropathy. J Diabetes Sci Technol 2021; 15:1406-1407. [PMID: 34218718 PMCID: PMC8655299 DOI: 10.1177/19322968211026943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Vishnu P. Rao
- Department of Medicine, Division of
Endocrinology, Diabetes and Nutrition, School of Medicine, University of Maryland,
Baltimore, MD, USA
| | - Medha Satyarengga
- Department of Medicine, Division of
Endocrinology, Diabetes and Nutrition, School of Medicine, University of Maryland,
Baltimore, MD, USA
| | - Elizabeth M. Lamos
- Department of Medicine, Division of
Endocrinology, Diabetes and Nutrition, School of Medicine, University of Maryland,
Baltimore, MD, USA
| | - Kashif M. Munir
- Department of Medicine, Division of
Endocrinology, Diabetes and Nutrition, School of Medicine, University of Maryland,
Baltimore, MD, USA
- Kashif M. Munir, MD, Department of Medicine,
Division of Endocrinology, Diabetes and Nutrition, School of Medicine, University of
Maryland, 827 Linden Avenue, 2nd floor, Baltimore, MD 21201, USA.
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8
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The efficacy and safety of a combined multipolar radiofrequency with pulsed electromagnetic field technology for the treatment of vaginal laxity: a double-blinded, randomized, sham-controlled trial. Lasers Med Sci 2021; 37:1829-1842. [PMID: 34647191 PMCID: PMC8971182 DOI: 10.1007/s10103-021-03438-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Non-invasive vaginal rejuvenation with radiofrequency (RF) and lasers devices have gained popularity, but well-designed studies confirming their effectiveness are lacking. The aim of this study was to compare the efficacy and safety of a multipolar RF and pulsed electromagnetic field-based device (PEMF) versus sham for vaginal laxity. Thirty-two premenopausal females with ≥ 1 vaginal delivery and self-reported vaginal laxity were randomized into 2 groups: active (RF + PEMF) and sham. Both groups received 3 vaginal treatments at 3-week interval. The Vaginal Laxity Questionnaire (VLQ), perineometer measurements, and Brink score were conducted at baseline, 4, and 12 weeks after treatments. Pre and post-treatment vaginal histology, Female Sexual Function Index (FSFI), subjects’ satisfaction, pain, and adverse events were assessed. The active group VLQ scores increased and were significantly better than the sham group (p < 0.001). At the final follow-up, 50% of the active group reported no vaginal laxity (VLQ > 4) versus 12% in the sham group (p = 0.054). In the active group, all domains of perineometer measurements and Brink scores (p < 0.001), FSFI scores (p < 0.05), and patients’ satisfaction (p < 0.001) were significantly increased and higher in the active group. Mild adverse effects including pain and burning sensation were not different between groups except for itch which was significantly higher in the sham arm (p = 0.014). Histology after RF + PEMF treatments demonstrated neocollagenesis, neoelastogenesis, and neoangiogenesis. In conclusion, combination RF + PEMF therapy was safe, improved vaginal laxity, strengthened pelvic floor muscles, and improved female sexual function for at least 12-week post-procedures with confirmed histological improvements. This study was registered on the Thai Clinical Trials Registry, TCTR20200803002 on 2020–07-30 “retrospectively registered.”
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Gupta M, Knezevic NN, Abd-Elsayed A, Ray M, Patel K, Chowdhury B. Treatment of Painful Diabetic Neuropathy-A Narrative Review of Pharmacological and Interventional Approaches. Biomedicines 2021; 9:biomedicines9050573. [PMID: 34069494 PMCID: PMC8161066 DOI: 10.3390/biomedicines9050573] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/01/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022] Open
Abstract
Painful diabetic neuropathy (PDN) is a common complication of diabetes mellitus that is associated with a significant decline in quality of life. Like other painful neuropathic conditions, PDN is difficult to manage clinically, and a variety of pharmacological and non-pharmacological options are available for this condition. Recommended pharmacotherapies include anticonvulsive agents, antidepressant drugs, and topical capsaicin; and tapentadol, which combines opioid agonism and norepinephrine reuptake inhibition, has also recently been approved for use. Additionally, several neuromodulation therapies have been successfully used for pain relief in PDN, including intrathecal therapy, transcutaneous electrical nerve stimulation (TENS), and spinal cord stimulation (SCS). Recently, 10 kHz SCS has been shown to provide clinically meaningful pain relief for patients refractory to conventional medical management, with a subset of patients demonstrating improvement in neurological function. This literature review is intended to discuss the dosage and prospective data associated with pain management therapies for PDN.
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Affiliation(s)
- Mayank Gupta
- Kansas Pain Management & Neuroscience Research Center, Overland Park, KS 66201, USA;
- Correspondence:
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA;
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53715, USA;
| | - Mahoua Ray
- Kansas Pain Management & Neuroscience Research Center, Overland Park, KS 66201, USA;
| | - Kiran Patel
- Department of Pain Management, Spine and Pain Institute of New York, New York, NY 10065, USA;
| | - Bhavika Chowdhury
- Department of Endocrinology, Saint Luke’s South Hospital, Overland Park, KS 66213, USA;
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10
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Qi Y, Zhang S, Zhang M, Zhou Z, Zhang X, Li W, Cai H, Zhao BC, Lee ES, Jiang HB. Effects of Physical Stimulation in the Field of Oral Health. SCANNING 2021; 2021:5517567. [PMID: 33927791 PMCID: PMC8049832 DOI: 10.1155/2021/5517567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 05/27/2023]
Abstract
Physical stimulation has been widely used in clinical medicine and healthcare due to its noninvasiveness. The main applications of physical stimulation in the oral cavity include laser, ultrasound, magnetic field, and vibration, which have photothermal, cavitation, magnetocaloric, and mechanical effects, respectively. In addition, the above four stimulations with their unique biological effects, which can play a role at the gene, protein, and cell levels, can provide new methods for the treatment and prevention of common oral diseases. These four physical stimulations have been used as important auxiliary treatment methods in the field of orthodontics, implants, periodontal, dental pulp, maxillofacial surgery, and oral mucosa. This paper systematically describes the application of physical stimulation as a therapeutic method in the field of stomatology to provide guidance for clinicians. In addition, some applications of physical stimulation in specific directions are still at the research stage, and the specific mechanism has not been fully elucidated. To encourage further research on the oral applications of physical stimulation, we elaborate the research results and development history of various physical stimuli in the field of oral health.
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Affiliation(s)
- Yanxin Qi
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - ShuXin Zhang
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Mi Zhang
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Zili Zhou
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xinyi Zhang
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Wenhui Li
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - HongXin Cai
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Bing Cheng Zhao
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Korea University, Seoul 08308, Republic of Korea
| | - Heng Bo Jiang
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
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Jafarnezhadgero A, Mamashli E, Granacher U. An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy. Front Physiol 2021; 12:654755. [PMID: 33868023 PMCID: PMC8044992 DOI: 10.3389/fphys.2021.654755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/23/2021] [Indexed: 11/21/2022] Open
Abstract
Background The prevalence of diabetes worldwide is predicted to increase from 2.8% in 2000 to 4.4% in 2030. Diabetic neuropathy (DN) is associated with damage to nerve glial cells, their axons, and endothelial cells leading to impaired function and mobility. Objective We aimed to examine the effects of an endurance-dominated exercise program on maximum oxygen consumption (VO2max), ground reaction forces, and muscle activities during walking in patients with moderate DN. Methods Sixty male and female individuals aged 45–65 years with DN were randomly assigned to an intervention (IG, n = 30) or a waiting control (CON, n = 30) group. The research protocol of this study was registered with the Local Clinical Trial Organization (IRCT20200201046326N1). IG conducted an endurance-dominated exercise program including exercises on a bike ergometer and gait therapy. The progressive intervention program lasted 12 weeks with three sessions per week, each 40–55 min. CON received the same treatment as IG after the post-tests. Pre- and post-training, VO2max was tested during a graded exercise test using spiroergometry. In addition, ground reaction forces and lower limbs muscle activities were recorded while walking at a constant speed of ∼1 m/s. Results No statistically significant baseline between group differences was observed for all analyzed variables. Significant group-by-time interactions were found for VO2max (p < 0.001; d = 1.22). The post-hoc test revealed a significant increase in IG (p < 0.001; d = 1.88) but not CON. Significant group-by-time interactions were observed for peak lateral and vertical ground reaction forces during heel contact and peak vertical ground reaction force during push-off (p = 0.001–0.037; d = 0.56–1.53). For IG, post-hoc analyses showed decreases in peak lateral (p < 0.001; d = 1.33) and vertical (p = 0.004; d = 0.55) ground reaction forces during heel contact and increases in peak vertical ground reaction force during push-off (p < 0.001; d = 0.92). In terms of muscle activity, significant group-by-time interactions were found for vastus lateralis and gluteus medius during the loading phase and for vastus medialis during the mid-stance phase, and gastrocnemius medialis during the push-off phase (p = 0.001–0.044; d = 0.54–0.81). Post-hoc tests indicated significant intervention-related increases in vastus lateralis (p = 0.001; d = 1.08) and gluteus medius (p = 0.008; d = 0.67) during the loading phase and vastus medialis activity during mid-stance (p = 0.001; d = 0.86). In addition, post-hoc tests showed decreases in gastrocnemius medialis during the push-off phase in IG only (p < 0.001; d = 1.28). Conclusions This study demonstrated that an endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with DN. The observed decreases in peak vertical ground reaction force during the heel contact of walking could be due to increased vastus lateralis and gluteus medius activities during the loading phase. Accordingly, we recommend to implement endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe and effective by improving aerobic capacity and gait characteristics.
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Affiliation(s)
- AmirAli Jafarnezhadgero
- Department of Sport Management and Biomechanics, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Elahe Mamashli
- Department of Sport Management and Biomechanics, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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12
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A Systematic Review of Pharmacologic and Rehabilitative Treatment of Small Fiber Neuropathies. Diagnostics (Basel) 2020; 10:diagnostics10121022. [PMID: 33260566 PMCID: PMC7761307 DOI: 10.3390/diagnostics10121022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/08/2020] [Accepted: 11/25/2020] [Indexed: 01/16/2023] Open
Abstract
The aim of this systematic review is to guide the physician in defining the pharmacologic and rehabilitative therapeutic approaches for adopting the best strategies described in the current literature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Science to identify the treatment of small fiber neuropathies. Two reviewers independently reviewed and came to a consensus on which articles met inclusion/exclusion criteria. The authors excluded the duplicates, animal studies and included the English articles in which the treatment of patients with small fiber neuropathies was described. The search identified a total of 975 articles with the keywords “small fiber neuropathy” AND “rehabilitation” OR “therapy” OR “treatment”. Seventy-eight selected full-text were analyzed by the reviewers. Forty-two publications met the inclusion criteria and were included in the systematic review to describe the rehabilitative and pharmacologic treatment of small fiber neuropathies. Despite the range of different protocols of treatment for small fiber neuropathy, other robust trials are needed. In addition, always different therapeutic approaches are used; a unique protocol could be important for the clinicians. More research is needed to build evidence for the best strategy and to delineate a definitive therapeutic protocol.
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13
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Zeng H, Pacheco-Barrios K, Cao Y, Li Y, Zhang J, Yang C, Fregni F. Non-invasive neuromodulation effects on painful diabetic peripheral neuropathy: a systematic review and meta-analysis. Sci Rep 2020; 10:19184. [PMID: 33154432 PMCID: PMC7645738 DOI: 10.1038/s41598-020-75922-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 10/06/2020] [Indexed: 12/30/2022] Open
Abstract
Diabetic Peripheral Neuropathy (DPN) typically is accompanied by painful symptoms. Several therapeutic agents have been tried for symptomatic relief, but with varying results. The use of non-invasive neuromodulation (NINM) is a potential treatment option for DPN. The objective of our study is to evaluate NINM effects on pain rating and nerve conduction velocity in DPN patients. The search was carried out in seven databases until Aug 30th, 2019. Finally, twenty studies met the inclusion criteria. We found a significant reduction of pain scores by central NINMs (effect size [ES] = - 0.75, 95% CI = - 1.35 to - 0.14), but not by the overall peripheral techniques (electrical and electromagnetic) (ES = - 0.58, 95% CI = - 1.23 to 0.07). However, the subgroup of peripheral electrical NINMs reported a significant higher effect (ES = - 0.84, 95% CI = - 1.57 to - 0.11) compared to electromagnetic techniques (ES = 0.21; 95% CI = - 1.00 to 1.42, I2 = 95.3%) . Other subgroup analysis results show that NINMs effects are higher with intensive protocols and in populations with resistant symptoms or intolerance to analgesic medications. Besides, NINMs can increase motor nerves velocity (ES = 1.82; 95% CI = 1.47 to 2.17), and there were no effects on sensory nerves velocity (ES = 0.01, 95% CI = - 0.79 to 0.80). The results suggest that central and peripheral electrical NINMs could reduce neuropathic pain among DPN patients, without reported adverse events. Well-powered studies are needed to confirm that NINM techniques as an alternative effective and safe treatment option.
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Affiliation(s)
- Huiyan Zeng
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 261 Datong Road, Er Sha Island, Guangzhou, 510105, China
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 96 13th Street, Charlestown, Boston, MA, USA
- Unidad de Investigación Para La Generación Y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Ying Cao
- Department of Endocrinology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Li
- Department of Endocrinology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinming Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 261 Datong Road, Er Sha Island, Guangzhou, 510105, China
| | - Caifeng Yang
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 261 Datong Road, Er Sha Island, Guangzhou, 510105, China.
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 96 13th Street, Charlestown, Boston, MA, USA.
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14
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Non-Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review. Adv Ther 2020; 37:4096-4106. [PMID: 32809209 DOI: 10.1007/s12325-020-01462-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Peripheral neuropathic pain (PNP) is defined as the neuropathic pain that arises either acutely or in the chronic phase of a lesion or disease affecting the peripheral nervous system. PNP is associated with a remarkable disease burden, and there is an increasing demand for new therapies to be used in isolation or combination with currently available treatments. The aim of this systematic review was to evaluate the current evidence, derived from randomized controlled trials (RCTs) that assess non-pharmacological interventions for the treatment of PNP. METHODS After a systematic Medline search, we identified 18 papers eligible to be included. RESULTS The currently best available evidence (level II of evidence) exist for painful diabetic peripheral neuropathy. In particular, spinal cord stimulation as adjuvant to conventional medical treatment can be effectively used for the management of patients with refractory pain. Similarly, adjuvant repetitive transcranial magnetic stimulation of the motor cortex is effective in reducing the overall pain intensity, whereas adjuvant static magnetic field therapy can lead to a significant decrease in exercise-induced pain. Weaker evidence (level III of evidence) exists for the use of acupuncture as a monotherapy and neurofeedback, either as an add-on or a monotherapy approach, for treatment of painful chemotherapy-induced peripheral neuropathy CONCLUSIONS: Future RCTs should be conducted to shed more light in the use of non-pharmacological approaches in patients with PNP.
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15
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Chiaramonte R, Romano M, Vecchio M. A Systematic Review of the Diagnostic Methods of Small Fiber Neuropathies in Rehabilitation. Diagnostics (Basel) 2020; 10:E613. [PMID: 32825514 PMCID: PMC7554909 DOI: 10.3390/diagnostics10090613] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
This systematic review describes the several methods to diagnose and measure the severity of small fiber neuropathies and aims to guide the physician to define all the diagnostic approaches for adopting the best strategies described in the current literature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Science. Two reviewers independently reviewed and came to consensus on which articles met inclusion/exclusion criteria. The authors excluded all the duplicates, animals' studies, and included the English articles in which the diagnostic measures were finalized to assess the effectiveness of rehabilitation and pharmacologic treatment of patients with small fiber neuropathies. The search identified a total of 975 articles with the keywords "small fiber neuropathy" AND "rehabilitation" OR "therapy" OR "treatment". Seventy-eight selected full-text were analyzed by the reviewers. Forty-one publications met the inclusion criteria and were included in the systematic review. Despite the range of diagnostic tools for the assessment of small fiber neuropathy, other robust trials are needed. In addition, always different diagnostic approaches are used, a unique protocol could be important for the clinicians. More research is needed to build evidence for the best diagnostic methodologies and to delineate a definitive diagnostic protocol.
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Affiliation(s)
- Rita Chiaramonte
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95125 Catania, Italy
| | - Marcello Romano
- Neurology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, 90100 Palermo, Italy;
| | - Michele Vecchio
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95125 Catania, Italy
- Rehabilitation Unit, AOU Policlinico Vittorio Emanuele, University of Catania, 95125 Catania, Italy
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16
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Moisset X, Bouhassira D, Avez Couturier J, Alchaar H, Conradi S, Delmotte MH, Lanteri-Minet M, Lefaucheur JP, Mick G, Piano V, Pickering G, Piquet E, Regis C, Salvat E, Attal N. Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations. Rev Neurol (Paris) 2020; 176:325-352. [PMID: 32276788 DOI: 10.1016/j.neurol.2020.01.361] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/07/2020] [Indexed: 02/08/2023]
Abstract
Neuropathic pain remains a significant unmet medical need. Several recommendations have recently been proposed concerning pharmacotherapy, neurostimulation techniques and interventional management, but no comprehensive guideline encompassing all these treatments has yet been issued. We performed a systematic review of pharmacotherapy, neurostimulation, surgery, psychotherapies and other types of therapy for peripheral or central neuropathic pain, based on studies published in peer-reviewed journals before January 2018. The main inclusion criteria were chronic neuropathic pain for at least three months, a randomized controlled methodology, at least three weeks of follow-up, at least 10 patients per group, and a double-blind design for drug therapy. Based on the GRADE system, we provide weak-to-strong recommendations for use and proposal as a first-line treatment for SNRIs (duloxetine and venlafaxine), gabapentin and tricyclic antidepressants and, for topical lidocaine and transcutaneous electrical nerve stimulation specifically for peripheral neuropathic pain; a weak recommendation for use and proposal as a second-line treatment for pregabalin, tramadol, combination therapy (antidepressant combined with gabapentinoids), and for high-concentration capsaicin patches and botulinum toxin A specifically for peripheral neuropathic pain; a weak recommendation for use and proposal as a third-line treatment for high-frequency rTMS of the motor cortex, spinal cord stimulation (failed back surgery syndrome and painful diabetic polyneuropathy) and strong opioids (in the absence of an alternative). Psychotherapy (cognitive behavioral therapy and mindfulness) is recommended as a second-line therapy, as an add-on to other therapies. An algorithm encompassing all the recommended treatments is proposed.
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Affiliation(s)
- X Moisset
- Université Clermont Auvergne, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France; CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - D Bouhassira
- INSERM U987, CETD, Ambroise-Paré Hospital, AP-HP, Boulogne-Billancourt, France; Université Versailles - Saint-Quentin-en-Yvelines, Versailles, France
| | - J Avez Couturier
- Service de Neuropédiatrie, Consultation Douleur Enfant, CIC-IT 1403, CHU de Lille, Lille, France
| | - H Alchaar
- 73, boulevard de Cimiez, Nice, France
| | - S Conradi
- CETD, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - M H Delmotte
- GHU, Paris site Ste-Anne, Structure Douleurs, 1, rue Cabanis, Paris 14, France
| | - M Lanteri-Minet
- Université Clermont Auvergne, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France; Département d'Évaluation et Traitement de la Douleur, Centre Hospitalier Universitaire (CHU) de Nice, Fédération Hospitalo-Universitaire InovPain, Université Côte d'Azur, Nice, France
| | - J P Lefaucheur
- EA 4391, Faculté de Médecine, Université Paris Est Créteil, Créteil, France; Service de Physiologie, Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance publique-Hôpitaux de Paris, Créteil, France
| | - G Mick
- Centre d'Évaluation et Traitement de la Douleur du Voironnais, Centre Hospitalier de Voiron, Laboratoire P2S, Université de Lyon, Lyon, France
| | - V Piano
- Centre Hospitalier de Draguignan, Service Algologie 4(e), route de Montferrat, 83007 Draguignan cedex, France
| | - G Pickering
- Université Clermont Auvergne, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France; Clinical Pharmacology Department, CPC/CIC Inserm 1405, University Hospital CHU, Clermont-Ferrand, France
| | - E Piquet
- Département d'Évaluation et Traitement de la Douleur, Centre Hospitalier Universitaire (CHU) de Nice, Fédération Hospitalo-Universitaire InovPain, Université Côte d'Azur, Nice, France
| | - C Regis
- CETD, CHU Montpellier, Montpellier, France
| | - E Salvat
- Centre d'Évaluation et de Traitement de la Douleur, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique, Strasbourg, France
| | - N Attal
- INSERM U987, CETD, Ambroise-Paré Hospital, AP-HP, Boulogne-Billancourt, France; Université Versailles - Saint-Quentin-en-Yvelines, Versailles, France
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17
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Shanb AA, Youssef EF, Al Baker WI, Al-Khamis FA, Hassan A, Jatoi NA. The Efficacy of Adding Electromagnetic Therapy or Laser Therapy to Medications in Patients With Diabetic Peripheral Neuropathy. J Lasers Med Sci 2020; 11:20-28. [PMID: 32099623 DOI: 10.15171/jlms.2020.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Introduction: Diabetes mellitus (DM) is a common disease with a highly significant burden among the Saudi population. This study aimed to investigate the effects of adding either magnetic or laser therapy to medications in patients with diabetic peripheral neuropathy (DPN). Methods: Seventy-one medically controlled diabetic patients were randomly assigned to 1) Magnetic group: 26 patients were exposed to magnetic therapy for 20 minutes/session, 2 sessions/week, for 3 months 2) Laser group: 25 patients were exposed to laser therapy with intensity 5.7 J/cm2 for 30 minutes/session, 2 times/week, for 3 months. 3) Drug group: 20 patients received only the regular medications for diabetic control and pain analgesia. Pain and neuropathy were assessed by the visual analog scale (VAS) and the Toronto Clinical Neuropath Scoring System (TRCNSS). Conduction velocities and amplitudes of peroneal and sural nerves were measured by electromyography. Results: The results showed significant increases in conduction velocities and amplitudes in both magnetic and laser groups in parallel with significant reductions in TRCNSS. Non-significant changes were obtained only after using only medications (P >0.05). The mean values of VAS reduced significantly in the three groups. The least significant differences showed significant changes among the three groups, whereas non-significant differences were obtained between both magnetic and laser groups. Conclusion: There were non-significant differences between both magnetic and laser therapy groups. Addition of either magnetic or laser therapy to medications could bring extra positive benefits to patients with DPN. Both magnetic and laser therapy can be applied with medications for the treatment of patients with DPN.
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Affiliation(s)
- Alsayed A Shanb
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Enas F Youssef
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Waleed I Al Baker
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA 3
| | - Fahd A Al-Khamis
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA 4
| | - Ali Hassan
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA 4
| | - Noor-Ahmad Jatoi
- Department of Internal Medicine, King Fahd University Hospital and College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
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18
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Melese H, Alamer A, Hailu Temesgen M, Kahsay G. Effectiveness of Exercise Therapy on Gait Function in Diabetic Peripheral Neuropathy Patients: A Systematic Review of Randomized Controlled Trials. Diabetes Metab Syndr Obes 2020; 13:2753-2764. [PMID: 32848436 PMCID: PMC7425100 DOI: 10.2147/dmso.s261175] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/02/2020] [Indexed: 01/20/2023] Open
Abstract
The purpose of this study was to review the current evidence on the effectiveness of exercise therapy on gait function in patients with diabetic peripheral neuropathy. A comprehensive search of literature published between October 2010 and May 2020 was conducted using the following electronic databases; PubMed, AMED, CINAHL, ScienceDirect, Cochrane Library, PEDro and Google Scholar. Randomized control trials conducted to determine the effectiveness of exercise therapy on gait function in patients with diabetic neuropathy were included in this review. Non-English language published papers were excluded. This review was done in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data extraction and risk of bias assessment of the studies were carried out independently by two authors. The methodological quality of the studies was evaluated using the PEDro scale and GRADE approach. The overall methodological quality of studies rated from moderate to high. Meta-analysis was not carried out due to the heterogeneity of included trials. The primary outcome measures of gait functions were the six-minute walk test, 10-meter walk test and Tinetti scale. Nine randomized controlled trials with 370 participants were analyzed. Out of them, eight studies proved its effectiveness on gait function on individuals with diabetic peripheral neuropathy. The finding of this study suggested that multi-component exercise therapy consisted of strength, ROM exercise, balance, flexibility and stretching exercises, circuit exercise training, and gait training found to enhance gait function for individuals suffering with diabetic peripheral neuropathy compared to control groups.
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Affiliation(s)
- Haimanot Melese
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
- Correspondence: Haimanot Melese Tel +2510927608383Fax +2510344416681/91 Email
| | - Abayneh Alamer
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Melaku Hailu Temesgen
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Gebresilassie Kahsay
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
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19
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Sofra X, Lampe N. A Randomized Longitudinal Double-Blind Clinical Trial on Long-Term Neuropathic Symptomatology Relief & Pain Analgesia. Health (London) 2020. [DOI: 10.4236/health.2020.127054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Gessi S, Merighi S, Bencivenni S, Battistello E, Vincenzi F, Setti S, Cadossi M, Borea PA, Cadossi R, Varani K. Pulsed electromagnetic field and relief of hypoxia-induced neuronal cell death: The signaling pathway. J Cell Physiol 2019; 234:15089-15097. [PMID: 30656694 DOI: 10.1002/jcp.28149] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 01/02/2019] [Indexed: 01/24/2023]
Abstract
Low-energy low-frequency pulsed electromagnetic fields (PEMFs) exert several protective effects, such as the regulation of kinases, transcription factors as well as cell viability in both central and peripheral biological systems. However, it is not clear on which bases they affect neuroprotection and the mechanism responsible is yet unknown. In this study, we have characterized in nerve growth factor-differentiated pheochromocytoma PC12 cells injured with hypoxia: (i) the effects of PEMF exposure on cell vitality; (ii) the protective pathways activated by PEMFs to relief neuronal cell death, including adenylyl cyclase, phospholipase C, protein kinase C epsilon and delta, p38, ERK1/2, JNK1/2 mitogen-activated protein kinases, Akt and caspase-3; (iii) the regulation by PEMFs of prosurvival heat-shock proteins of 70 (HSP70), cAMP response element-binding protein (CREB), brain-derived neurotrophic factor (BDNF), and Bcl-2 family proteins. The results obtained in this study show a protective effect of PEMFs that are able to reduce neuronal cell death induced by hypoxia by modulating p38, HSP70, CREB, BDNF, and Bcl-2 family proteins. Specifically, we found a rapid activation (30 min) of p38 kinase cascade, which in turns enrolles HSP70 survival chaperone molecule, resulting in a significant CREB phosphorylation increase (24 hr). In this cascade, later (48 hr), BDNF and the antiapoptotic pathway regulated by the Bcl-2 family of proteins are recruited by PEMFs to enhance neuronal survival. This study paves the way to elucidate the mechanisms triggered by PEMFs to act as a new neuroprotective approach to treat cerebral ischemia by reducing neuronal cell death.
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Affiliation(s)
- Stefania Gessi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Stefania Merighi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Serena Bencivenni
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | | | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
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21
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Raghav A, Singh P, Ahmad J. New insights into bioelectronic medicines: A new approach to tackle diabetic peripheral neuropathy pain in clinics. Diabetes Metab Syndr 2019; 13:1011-1014. [PMID: 31336436 DOI: 10.1016/j.dsx.2019.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/17/2019] [Indexed: 11/20/2022]
Abstract
Bioelectronic medicines are a newer way to treat and diagnose the diseases associated with biological systems. All vital organs of the body are innervated, commanding brain to regulate the homeostasis functions. Bioelectronic medicines rely on implications of electrical stimulations or signals associated with the nervous system for real-time treatment. Diabetic peripheral neuropathy (DPN) is a most prevalent micro-vascular complication associated with diabetes mellitus. Complex plexus of nerves were affected in this complication with impaired function. Bioelectronic medicines are future hope for effective treatment of DPN.
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Affiliation(s)
- Alok Raghav
- Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, 202002, India.
| | - Prerna Singh
- Department of Biochemistry, Banaras Hindu University, Varanasi, 221005, India
| | - Jamal Ahmad
- Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, 202002, India
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22
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Amato Nesbit S, Sharma R, Waldfogel JM, Zhang A, Bennett WL, Yeh HC, Chelladurai Y, Feldman D, Robinson KA, Dy SM. Non-pharmacologic treatments for symptoms of diabetic peripheral neuropathy: a systematic review. Curr Med Res Opin 2019; 35:15-25. [PMID: 30114983 DOI: 10.1080/03007995.2018.1497958] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: To systematically assess benefits and harm of non-pharmacologic interventions for diabetic peripheral neuropathy (DPN) symptoms.Methods: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from 1966 to May 24, 2016 for randomized controlled trials. Two reviewers evaluated studies for eligibility, serially abstracted data, evaluated risk of bias, and graded strength of evidence (SOE) for critical outcomes (pain and quality-of-life).Results: Twenty-three trials were included. For pain, alpha-lipoic acid was more effective than placebo (moderate SOE) and frequency-modulated electromagnetic stimulation was more effective than sham (low SOE) in the short-term but not the long-term. Electrical stimulation (including transcutaneous) was not effective for pain (low SOE). Spinal cord stimulation was more effective than usual care for pain (low SOE), but had serious complications, and studies had no sham arm. Evidence for cognitive behavioral therapy and acupuncture was insufficient; no exercise or physical therapy trials met inclusion criteria. No interventions reported sufficient evidence on quality-of-life. Most studies were short-term with unclear risk of bias.Conclusions: Alpha-lipoic acid and spinal cord stimulation were effective for pain; studies were short-term with quality deficits. Spinal cord stimulation had serious adverse events. Further research should address long-term outcomes and other non-pharmacologic treatments.
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Affiliation(s)
| | - Ritu Sharma
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julie M Waldfogel
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Allen Zhang
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wendy L Bennett
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hsin-Chieh Yeh
- Departments of Medicine, Epidemiology and Oncology, Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Dorianne Feldman
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen A Robinson
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sydney M Dy
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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23
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Zhang PX, Han N, Kou YH, Zhu QT, Liu XL, Quan DP, Chen JG, Jiang BG. Tissue engineering for the repair of peripheral nerve injury. Neural Regen Res 2019; 14:51-58. [PMID: 30531070 PMCID: PMC6263012 DOI: 10.4103/1673-5374.243701] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Peripheral nerve injury is a common clinical problem and affects the quality of life of patients. Traditional restoration methods are not satisfactory. Researchers increasingly focus on the field of tissue engineering. The three key points in establishing a tissue engineering material are the biological scaffold material, the seed cells and various growth factors. Understanding the type of nerve injury, the construction of scaffold and the process of repair are necessary to solve peripheral nerve injury and promote its regeneration. This review describes the categories of peripheral nerve injury, fundamental research of peripheral nervous tissue engineering and clinical research on peripheral nerve scaffold material, and paves a way for related research and the use of conduits in clinical practice.
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Affiliation(s)
| | - Na Han
- Peking University People's Hospital, Beijing, China
| | - Yu-Hui Kou
- Peking University People's Hospital, Beijing, China
| | - Qing-Tang Zhu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xiao-Lin Liu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Da-Ping Quan
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jian-Guo Chen
- School of Life Science, Peking University, Beijing, China
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Kim YM, Lim HM, Ro HS, Ki GE, Seo YK. Pulsed Electromagnetic Fields Increase Pigmentation through the p-ERK/p-p38 Pathway in Zebrafish ( Danio rerio). Int J Mol Sci 2018; 19:E3211. [PMID: 30336610 PMCID: PMC6214121 DOI: 10.3390/ijms19103211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022] Open
Abstract
Melanogenesis is a biological process resulting in the production of melanin pigment, which plays an important role in the prevention of sun-induced skin injury, and determines hair and skin color. So, a wide variety of approaches have been proposed to increase the synthesis of melanin. This study evaluated the effects of pulsed electromagnetic fields (PEMFs) on the pigmentation of zebrafish (Danio rerio) in vivo. We stimulated pigmentation in zebrafish by using specific frequencies and intensities of PEMFs. This study focuses on pigmentation using PEMFs, and finds that PEMFs, at an optimal intensity and frequency, upregulate pigmentation by the stimulated expression of tyrosinase-related protein 1 (TRP1), dopachrome tautomerase (DCT) through extracellular signal-regulated kinase(ERK) phosphorylation, and p38 phosphorylation signaling pathways in zebrafish. These results suggest that PEMFs, at an optimal intensity and frequency, are a useful tool in treating gray hair, with reduced melanin synthesis in the hair shaft or hypopigmentation-related skin disorders.
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Affiliation(s)
- Yu-Mi Kim
- Department of Medical Biotechnology (BK21 Plus Team), Dongguk University, Goyang-si 10326, Korea.
| | - Han-Moi Lim
- Department of Medical Biotechnology (BK21 Plus Team), Dongguk University, Goyang-si 10326, Korea.
| | | | - Ga-Eun Ki
- Department of Medical Biotechnology (BK21 Plus Team), Dongguk University, Goyang-si 10326, Korea.
| | - Young-Kwon Seo
- Department of Medical Biotechnology (BK21 Plus Team), Dongguk University, Goyang-si 10326, Korea.
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Vilar S, Castillo JM, Munuera Martínez PV, Reina M, Pabón M. Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials. Korean J Pain 2018; 31:253-260. [PMID: 30310550 PMCID: PMC6177536 DOI: 10.3344/kjp.2018.31.4.253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/22/2018] [Accepted: 06/22/2018] [Indexed: 12/22/2022] Open
Abstract
Background One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.
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Affiliation(s)
- Samuel Vilar
- Pain Clinic, University Hospital Virgen del Rocío, Seville, Spain
| | - Jose Manuel Castillo
- Department of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | | | - María Reina
- Department of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Manuel Pabón
- Department of Nursing, Physiotherapy and Podiatry, University Hospital Cruz Roja, Seville, Spain
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Structural, functional, and symptom relations in painful distal symmetric polyneuropathies: a systematic review. Pain 2018; 160:286-297. [DOI: 10.1097/j.pain.0000000000001381] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Pulsed magnetic field treatment as antineuropathic pain therapy. Rev Neurosci 2017; 28:751-758. [DOI: 10.1515/revneuro-2017-0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/08/2017] [Indexed: 01/08/2023]
Abstract
AbstractNo satisfactory effective therapy is still available to treat trauma- or disease-induced neuropathic pain, and current available treatment options have several side effects. Pulsed magnetic field (PMF) treatments are receiving growing interest as a therapeutic approach for several neuronal diseases. Although the exact mechanism of action of PMF treatments is unknown, reported findings represent a promising alternative therapeutic choice for the management of neuropathic pain. PMF treatments can supply new strategies for the therapy of life-threatening neuropathic pain due to its antihyperglycemic, anti-inflammatory, antihyperalgesic, antiallodynic, and neuroimmunomodulatory actions. In this review, I summarized the several recent findings about antineuropathic actions of PMF treatment in experimental animals with neuropathic pain induced by disease and/or damage.
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Cichoń N, Olejnik AK, Miller E, Saluk J. The multipotent action of electromagnetic field. Biologia (Bratisl) 2016. [DOI: 10.1515/biolog-2016-0142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Novel protective effects of pulsed electromagnetic field ischemia/reperfusion injury rats. Biosci Rep 2016; 36:BSR20160082. [PMID: 27780890 PMCID: PMC5137536 DOI: 10.1042/bsr20160082] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 10/11/2016] [Accepted: 10/17/2016] [Indexed: 01/02/2023] Open
Abstract
Pulsed electromagnetic field (PEMF) treatment protected ischaemia/reperfusion (I/R) injury from apoptosis via B-cell lymphoma 2 (Bcl-2), Bax and nitric oxide (NO) releasing. Extracorporeal pulsed electromagnetic field (PEMF) has shown the ability to regenerate tissue by promoting cell proliferation. In the present study, we investigated for the first time whether PEMF treatment could improve the myocardial ischaemia/reperfusion (I/R) injury and uncovered its underlying mechanisms. In our study, we demonstrated for the first time that extracorporeal PEMF has a novel effect on myocardial I/R injury. The number and function of circulating endothelial progenitor cells (EPCs) were increased in PEMF treating rats. The in vivo results showed that per-treatment of PEMF could significantly improve the cardiac function in I/R injury group. In addition, PEMF treatment also reduced the apoptosis of myocardial cells by up-regulating the expression of anti-apoptosis protein B-cell lymphoma 2 (Bcl-2) and down-regulating the expression of pro-apoptosis protein (Bax). In vitro, the results showed that PEMF treatment could significantly reduce the apoptosis and reactive oxygen species (ROS) levels in primary neonatal rat cardiac ventricular myocytes (NRCMs) induced by hypoxia/reoxygenation (H/R). In particular, PEMF increased the phosphorylation of protein kinase B (Akt) and endothelial nitric oxide synthase (eNOS), which might be closely related to attenuated cell apoptosis by increasing the releasing of nitric oxide (NO). Therefore, our data indicated that PEMF could be a potential candidate for I/R injury.
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Watterson PA, Nicholson GM. Nerve-muscle activation by rotating permanent magnet configurations. J Physiol 2016; 594:1799-819. [PMID: 26661902 DOI: 10.1113/jp271743] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/05/2015] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS The standard method of magnetic nerve activation using pulses of high current in coils has drawbacks of high cost, high electrical power (of order 1 kW), and limited repetition rate without liquid cooling. Here we report a new technique for nerve activation using high speed rotation of permanent magnet configurations, generating a sustained sinusoidal electric field using very low power (of order 10 W). A high ratio of the electric field gradient divided by frequency is shown to be the key indicator for nerve activation at high frequencies. Activation of the cane toad sciatic nerve and attached gastrocnemius muscle was observed at frequencies as low as 180 Hz for activation of the muscle directly and 230 Hz for curved nerves, but probably not in straight sections of nerve. These results, employing the first prototype device, suggest the opportunity for a new class of small low-cost magnetic nerve and/or muscle stimulators. ABSTRACT Conventional pulsed current systems for magnetic neurostimulation are large and expensive and have limited repetition rate because of overheating. Here we report a new technique for nerve activation, namely high-speed rotation of a configuration of permanent magnets. Analytical solutions of the cable equation are derived for the oscillating electric field generated, which has amplitude proportional to the rotation speed. The prototype device built comprised a configuration of two cylindrical magnets with antiparallel magnetisations, made to rotate by interaction between the magnets' own magnetic field and three-phase currents in coils mounted on one side of the device. The electric field in a rectangular bath placed on top of the device was both numerically evaluated and measured. The ratio of the electric field gradient on frequency was approximately 1 V m(-2) Hz(-1) near the device. An exploratory series of physiological tests was conducted on the sciatic nerve and attached gastrocnemius muscle of the cane toad (Bufo marinus). Activation was readily observed of the muscle directly, at frequencies as low as 180 Hz, and of nerves bent around insulators, at frequencies as low as 230 Hz. Nerve-muscles, with the muscle elevated to avoid its direct activation, were occasionally activated, possibly in the straight section of the nerve, but more likely in the nerve where it curved up to the muscle, at radius of curvature 10 mm or more, or at the nerve end. These positive first results suggest the opportunity for a new class of small, low-cost devices for magnetic stimulation of nerves and/or muscles.
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Affiliation(s)
- Peter A Watterson
- Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, Australia
| | - Graham M Nicholson
- Faculty of Science, University of Technology Sydney, Broadway, Australia
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Beaulieu K, Beland P, Pinard M, Handfield G, Handfield N, Goffaux P, Corriveau H, Léonard G. Effect of pulsed electromagnetic field therapy on experimental pain: A double-blind, randomized study in healthy young adults. Electromagn Biol Med 2016; 35:237-44. [PMID: 27014804 DOI: 10.3109/15368378.2015.1075409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Previous studies suggested that pulsed electromagnetic field (PEMF) therapy can decrease pain. To date, however, it remains difficult to determine whether the analgesic effect observed in patients are attributable to a direct effect of PEMF on pain or to an indirect effect of PEMF on inflammation and healing. In the present study, we used an experimental pain paradigm to evaluate the direct effect of PEMF on pain intensity, pain unpleasantness, and temporal summation of pain. Twenty-four healthy subjects (mean age 22 ± 2 years; 9 males) participated in the experiment. Both real and sham PEMF were administered to every participant using a randomized, double-blind, cross-over design. For each visit, PEMF was applied for 10 minutes on the right forearm using a portable device. Experimental pain was evoked before (baseline) and after PEMF with a 9 cm(2) Pelletier-type thermode, applied on the right forearm (120 s stimulation; temperature individually adjusted to produce moderate baseline pain). Pain intensity and unpleasantness were evaluated using a 0-100 numerical pain rating scale. Temporal summation was evaluated by comparing pain intensity ratings obtained at the end of tonic nociceptive stimulation (120 s) with pain intensity ratings obtained after 60 s of stimulation. When compared to baseline, there was no change in pain intensity and unpleasantness following the application of real or sham PEMF. PEMF did not affect temporal summation. The present observations suggest that PEMF does not directly influence heat pain perception in healthy individuals.
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Affiliation(s)
- Karen Beaulieu
- a École de réadaptation de l'Université de Sherbrooke , Sherbrooke , Canada.,b Clinique de physiothérapie Physio Atlas , Sherbrooke , Canada
| | - Patricia Beland
- a École de réadaptation de l'Université de Sherbrooke , Sherbrooke , Canada
| | - Marilee Pinard
- a École de réadaptation de l'Université de Sherbrooke , Sherbrooke , Canada
| | - Guilène Handfield
- c Centre et services de conditionnement cellulaires , Beloeil , Canada
| | - Nicole Handfield
- c Centre et services de conditionnement cellulaires , Beloeil , Canada
| | - Philippe Goffaux
- a École de réadaptation de l'Université de Sherbrooke , Sherbrooke , Canada.,d Centre de recherche du Centre hospitalier universitaire de Sherbrooke , Sherbrooke , Canada
| | - Hélène Corriveau
- a École de réadaptation de l'Université de Sherbrooke , Sherbrooke , Canada.,e Centre de recherche sur le vieillissement , Centre de santé et de services sociaux - Institut universitaire de gériatrie de Sherbrooke , Sherbrooke , Canada
| | - Guillaume Léonard
- a École de réadaptation de l'Université de Sherbrooke , Sherbrooke , Canada.,b Clinique de physiothérapie Physio Atlas , Sherbrooke , Canada.,e Centre de recherche sur le vieillissement , Centre de santé et de services sociaux - Institut universitaire de gériatrie de Sherbrooke , Sherbrooke , Canada
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Grbovic V, Jurisic-Skevin A, Djukic S, Stefanović S, Nurkovic J. Comparative analysis of the effects combined physical procedures and alpha-lipoic acid on the electroneurographic parameters of patients with distal sensorimotor diabetic polyneuropathy. J Phys Ther Sci 2016; 28:432-7. [PMID: 27065527 PMCID: PMC4792985 DOI: 10.1589/jpts.28.432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/30/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Painful diabetic polyneuropathy occurs as a complication in 16% of all patients
with diabetes mellitus. [Subjects and Methods] A clinical, prospective open-label
randomized intervention study was conducted of 60 adult patients, with distal sensorimotor
diabetic neuropathy two groups of 30 patients, with diabetes mellitus type 2 with distal
sensorimotor diabetic neuropathy. Patients in group A were treated with combined physical
procedures, and patients in group B were treated with alpha lipoic acid. [Results] There
where a statistically significant improvements in terminal latency and the amplitude of
the action potential in group A patients, while group B patients showed a statistically
significant improvements in conduction velocity and terminal latency of n. peroneus. Group
A patients showed a statistically significant improvements in conduction velocity and
terminal latency, while group B patients also showed a statistically significant
improvements in conduction velocity and terminal latency. This was reflected in a
significant improvements in electrophysiological parameters (conduction velocity,
amplitude and latency) of the motor and sensory nerves (n. peroneus, n. suralis).
[Conclusion] These results present further evidence justifying of the use of physical
agents in the treatment of diabetic sensorimotor polyneuropathy.
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Affiliation(s)
- Vesna Grbovic
- Center for Physical Medicine and Rehabilitation, Clinical Center Kragujevac, Serbia
| | - Aleksandra Jurisic-Skevin
- Center for Physical Medicine and Rehabilitation, Clinical Center Kragujevac, Serbia; Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Svetlana Djukic
- Faculty of Medical Sciences, University of Kragujevac, Serbia
| | | | - Jasmin Nurkovic
- Center for Physical Medicine and Rehabilitation, Clinical Center Kragujevac, Serbia; Department of Biomedical Sciences, State University of Novi Pazar, Serbia
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Controversies related to electromagnetic field exposure on peripheral nerves. J Chem Neuroanat 2016; 75:70-6. [PMID: 26718608 DOI: 10.1016/j.jchemneu.2015.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 11/23/2022]
Abstract
Electromagnetic field (EMF) is a pervasive environmental presence in modern society. In recent years, mobile phone usage has increased rapidly throughout the world. As mobile phones are generally held close to the head while talking, studies have mostly focused on the central and peripheral nervous system. There is a need for further research to ascertain the real effect of EMF exposure on the nervous system. Several studies have clearly demonstrated that EMF emitted by cell phones could affect the systems of the body as well as functions. However, the adverse effects of EMF emitted by mobile phones on the peripheral nerves are still controversial. Therefore, this review summarizes current knowledge on the possible positive or negative effects of electromagnetic field on peripheral nerves.
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Pulsed electromagnetic field (PEMF) promotes collagen fibre deposition associated with increased myofibroblast population in the early healing phase of diabetic wound. Arch Dermatol Res 2015; 308:21-9. [DOI: 10.1007/s00403-015-1604-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 12/31/2022]
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35
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Zhao F, He W, Zhang G, Liu S, Yu K, Bai J, Zhang H, Tian D. Comparison of Shoulder Management Strategies after Stage I of Fingertip Skin Defect Repair with a Random-Pattern Abdominal Skin Flap. Med Sci Monit 2015; 21:3042-7. [PMID: 26449682 PMCID: PMC4603602 DOI: 10.12659/msm.894458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In the absence of scientific evidence regarding the effectiveness of shoulder management strategies after stage I of fingertip reconstruction, the purpose of this study was to compare the clinical outcomes of various rehabilitation procedures. MATERIAL AND METHODS Patients who underwent fingertip reconstruction with a random-pattern abdominal skin flap between March 2007 and February 2013 were enrolled in the study (n=95). Thirty performed only active exercise (group A), 29 performed only passive exercise (group B), and 32 received a combination of active exercise and pulsed electromagnetic field (PEMF) (group C). The mean age at the time of treatment was 30.2 years in group A, 29.6 years in group B, and 31.8 years in group C. RESULTS At the final follow-up, there were significant differences between group A and B in terms of Constant score (P=.001), VAS (P=.047), forward flexion of the shoulder (P=0.049), and muscle strength with forward flexion and external rotation (P=0.049 and P=0.042, respectively). A higher Constant score was observed in group C compared to group A, and although there were no differences in the other evaluations between groups A and C, a trend toward better function of the shoulder was demonstrated in group C. CONCLUSIONS The most important findings in our study are that a combination of active exercise and PEME produces superior patient-reported outcomes regarding relief of shoulder signs and symptoms. Given the limitations of this study, better-designed studies with large sample sizes and long-term follow-up are required.
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Affiliation(s)
- Feng Zhao
- Department of Orthopedics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Wei He
- Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Guoping Zhang
- Department of Orthopedics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Shaojun Liu
- Department of Orthopedics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Kunlun Yu
- Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Jiangbo Bai
- Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Hongjuan Zhang
- Department of Hand Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, China (mainland)
| | - Dehu Tian
- Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
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Mert T, Gisi G, Celik A, Baran F, Uremis MM, Gunay I. Frequency-dependent effects of sequenced pulsed magnetic field on experimental diabetic neuropathy. Int J Radiat Biol 2015; 91:833-42. [DOI: 10.3109/09553002.2015.1068460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Cook JJ, Summers NJ, Cook EA. Healing in the new millennium: bone stimulators: an overview of where we've been and where we may be heading. Clin Podiatr Med Surg 2015; 32:45-59. [PMID: 25440417 DOI: 10.1016/j.cpm.2014.09.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Electromagnetic fields and their uses in bone healing have been fairly well studied, with most results showing improvement in healing of both bone and cartilage. Most supportive data are found in relation to the spine, femur, and tibia, but there is increasing evidence for its use in the foot and ankle for treatment of nonunions and as an adjunctive device in arthrodeses, particularly in high-risk populations. There are varying data and a significant variety of quality in the current research and publications concerning the use of electrical bone stimulation in the treatment of the foot and ankle. Thus, there is a definite need for further investigation and high-quality study designs to determine the most effective treatment modalities and pathologies best used with bone stimulation. Bone stimulation should be viewed as an adjunctive procedure in which the surgeon optimizes the high-risk patient both medically or surgically whenever possible. But when used appropriately, bone stimulation has the potential to influence outcomes and aid in bone healing when complications arise and in high-risk populations.
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Affiliation(s)
- Jeremy J Cook
- Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Harvard Medical School, 330 Mount Auburn Street, Cambridge, MA 02138, USA
| | - N Jake Summers
- Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Harvard Medical School, 330 Mount Auburn Street, Cambridge, MA 02138, USA.
| | - Emily A Cook
- Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Harvard Medical School, 330 Mount Auburn Street, Cambridge, MA 02138, USA
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Swanenburg J, Gruber C, Brunner F, Wirth B. Patients' and therapists' perception of change following physiotherapy in an orthopedic hospital's outpatient clinic. Physiother Theory Pract 2014; 31:293-8. [PMID: 25539095 DOI: 10.3109/09593985.2014.994152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aims of this observational, prospective cohort study were to: assess the patients' and therapists' perception of change after physiotherapy in an orthopedic hospital's outpatient clinic; relate these retrospective assessments to a serial assessment of pain; and study the influence of patient characteristics on the perceived change. METHODS 161 patients of the outpatient clinic participated. The main outcome measures were the patient global impression of change (PGIC) and the clinical global impression of change (CGIC) after physiotherapy. The visual analogue scale was used as serial assessment. RESULTS The PGIC indicated improvement in 128 patients (80%) and the CGIC in 117 patients (73%). The correlation between PGIC and CGIC was good (rS = 0.71, p < 0.001). The perceived change correlated little to baseline pain (PGIC: rS = 0.24, p = 0.004; CGIC: rS = 0.18, p = 0.024) and change in pain due to physiotherapy (PGIC: rS = -0.22, p = 0.004; CGIC: rS = -0.31, p < 0.001). The logistic regression model revealed a significant influence of the patients' education level and the number of problems on the PGIC and the CGIC. CONCLUSIONS The addition of at least one GPC scale might be valuable in evaluating the outcome in physical therapy, which requires little time and thus may be ideal for a clinical setting. Patients' and therapists' perception of change is significantly influenced by the patients' education level and the number of problems, which might be of relevance when choosing adequate treatment strategies.
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Affiliation(s)
- Jaap Swanenburg
- Department of Physiotherapy, Balgrist University Hospital , Zürich , Switzerland
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The pain quality response profile of a corticosteroid injections and heated lidocaine/tetracaine patch in the treatment of shoulder impingement syndrome. Clin J Pain 2014; 31:342-8. [PMID: 25329142 DOI: 10.1097/ajp.0000000000000130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the effects of 2 pain treatments for shoulder impingement syndrome (SIS), and illustrate how investigators can use pain quality information to understand treatment response differences. MATERIALS AND METHODS This study presents pain quality data from a randomized open-label study comparing the effects of an injection of triamcinolone and up to twice daily application of a heated lidocaine/tetracaine (Trilexis) patch in individuals with SIS. Study participants completed a measure of pain quality at baseline and again on study days 14, 28, and 42 following initiation of 2 treatments for SIS. Baseline and posttreatment pain quality scores were graphed to provide a visual representation of treatment-associated changes. Analyses of variance were used to examine the differences between treatment conditions in changes in pain quality with treatment. RESULTS Both treatments resulted in substantial (and similar) pretreatment to posttreatment improvements in many pain qualities. However, differences in the time course of treatment effects were observed for itchy and heavy qualities. DISCUSSION Although 2 different pain treatments appear to have the same effects when only pretreatment to posttreatment changes are examined, treatment differences emerged when the time course of treatment is examined. The findings support the importance of assessing both pain qualities and time course of treatment as outcome domains. The results illustrate how investigators can use data from clinical trials to provide a more fine-tuned description of treatment effects, providing knowledge that could be helpful in selecting treatment options at the individual patient level. SUMMARY Examination of the effects of pain treatments on pain qualities over time will help researchers and clinicians understand if certain pain quality domains respond faster to one treatment versus another, and may identify differences between treatments that would not be observed by measures of global pain intensity alone.
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Galace de Freitas D, Marcondes FB, Monteiro RL, Rosa SG, Maria de Moraes Barros Fucs P, Fukuda TY. Pulsed Electromagnetic Field and Exercises in Patients With Shoulder Impingement Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Arch Phys Med Rehabil 2014; 95:345-52. [DOI: 10.1016/j.apmr.2013.09.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/31/2013] [Accepted: 09/23/2013] [Indexed: 10/26/2022]
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Thakral G, Kim PJ, LaFontaine J, Menzies R, Najafi B, Lavery LA. Electrical stimulation as an adjunctive treatment of painful and sensory diabetic neuropathy. J Diabetes Sci Technol 2013; 7:1202-9. [PMID: 24124947 PMCID: PMC3876364 DOI: 10.1177/193229681300700510] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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 The objective of this review is to evaluate the use of electrical stimulation to treat diabetic neuropathy. Application of electrical stimulation may provide a novel treatment option for large and small fiber neuropathy in persons with diabetes. Large and small nerve neuropathy alters pain, proprioception, touch perception, and motor function, which cause burning foot pain and serve as protective mechanisms from ulcerations. METHODS A content search for clinical trials involving electrical stimulation, neuropathy, and diabetes was conducted through PubMed. Randomized clinical trials and prospective studies with outcome measures affecting the lower extremity function were selected for review. RESULTS We identified eight studies in which electrical stimulation was used to treat diabetic neuropathy. Six studies evaluated small fiber neuropathy. Two studies evaluated patients with both small and large fiber neuropathy and reported significant improvement in vibration and monofilament testing and reduction in symptoms in the electrical stimulation treatment group. Six of the eight painful neuropathy studies identified significant improvement in symptoms. There were no studies that evaluated electrical stimulation to treated diabetic motor neuropathy, fall prevention or postural instability. CONCLUSIONS Electrical stimulation may be an effective alternative and adjunctive therapy to current interventions for diabetic peripheral neuropathy.
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Affiliation(s)
- Gaurav Thakral
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Paul J. Kim
- Department of Plastic Surgery, Georgetown University, Washington DC
| | - Javier LaFontaine
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert Menzies
- Diabetic Foot and Wound Center, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Bijan Najafi
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - Lawrence A. Lavery
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas
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Galvanic zinc–copper microparticles inhibit melanogenesis via multiple pigmentary pathways. Arch Dermatol Res 2013; 306:27-35. [DOI: 10.1007/s00403-013-1369-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/29/2013] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
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Abstract
Diabetes is the most common cause of neuropathy in United States and neuropathies are the most common complication of diabetes mellitus, affecting up to 50% of patients with type 1 and type 2 diabetes mellitus. Symptoms usually include numbness, tingling, pain, and weakness. Dizziness with postural changes can be seen with autonomic neuropathy. Metabolic, vascular, and immune theories have been proposed for the pathogenesis of diabetic neuropathy. Axonal damage and segmental demyelination can be seen with diabetic neuropathies. Management of diabetic neuropathy should begin at the initial diagnosis of diabetes and mainly requires tight and stable glycemic control.
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Kiss B, Gyires K, Kellermayer M, László JF. Lateral gradients significantly enhance static magnetic field-induced inhibition of pain responses in mice--a double blind experimental study. Bioelectromagnetics 2013; 34:385-96. [PMID: 23737187 DOI: 10.1002/bem.21781] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 01/04/2013] [Indexed: 11/10/2022]
Abstract
Recent research demonstrated that exposure of mice to both inhomogeneous (3-477 mT) and homogeneous (145 mT) static magnetic fields (SMF) generated an analgesic effect toward visceral pain elicited by the intraperitoneal injection of 0.6% acetic acid. In the present work, we investigated behavioral responses such as writhing, entry avoidance, and site preference with the help of a specially designed cage that partially protruded into either the homogeneous (ho) or inhomogeneous (inh) SMF. Aversive effects, cognitive recognition of analgesia, and social behavior governed mice in their free locomotion between SMF and sham sides. The inhibition of pain response (I) for the 0-5, 6-20, and 21-30 min periods following the challenge was calculated by the formula I = 100 (1 - x/y) in %, where x and y represent the number of writhings in the SMF and sham sides, respectively. In accordance with previous measurements, an analgesic effect was induced in exposed mice (Iho = 64%, P < 0.0002 and Iinh = 62%, P < 0.002). No significant difference was found in the site preference (SMFho, inh vs. sham) indicating that SMF is neither aversive nor favorable. Comparison of writhings observed in the sham versus SMF side of the cage revealed that SMF exposure resulted in significantly fewer writhings than sham (Iho = 64%, P < 0.004 and Iinh = 81%, P < 0.03). Deeper statistical analysis clarified that the lateral SMF gradient between SMF and sham sides could be responsible for most of the analgesic effect (Iho = 91%, P < 0.02 and Iinh = 54%, P < 0.02).
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Affiliation(s)
- Balázs Kiss
- Department of Biophysics and Radiation Biology, Semmelweis University and MTA-SE Molecular Biophysics Research Group, Budapest, Hungary.
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Gabriel A, Sobota R, Gialich S, Maxwell GP. The use of Targeted MicroCurrent Therapy in postoperative pain management. Plast Surg Nurs 2013; 33:6-10. [PMID: 23446501 DOI: 10.1097/psn.0b013e3182844219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Effective postoperative analgesia is a prerequisite to enhance the recovery process and reduce morbidity. The use of local anesthetic techniques is well documented to be effective, but single-dose techniques (infiltration, peripheral blocks, neuraxial blocks) have been of limited value in major operations because of their short duration of analgesia. Recent advances in technology have led to the development of a noninvasive device, targeted MicroCurrent Therapy, which enhances postsurgical recovery by stimulating the body's natural healing process. This therapy transmits gentle, short bursts of electrical current targeted to the tissue cells at the surgical site. This article reviews recent clinical experience and evidence of this device in plastic and reconstructive surgery.
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Affiliation(s)
- Allen Gabriel
- Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, California, USA
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Lee YB, Eun YS, Lee JH, Cheon MS, Cho BK, Park HJ. Effects of multi-polar radiofrequency and pulsed electromagnetic field treatment in Koreans: case series and survey study. J DERMATOL TREAT 2012; 25:310-3. [PMID: 22812649 DOI: 10.3109/09546634.2012.714454] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recently, a novel combined multi-polar radiofrequency and pulsed electromagnetic field device was developed for non-ablative skin tightening. However, little is known about the clinical effects of this device. OBJECTIVES The present study evaluated the clinical efficacy and safety of the multi-polar radiofrequency and pulsed electromagnetic field device. MATERIALS AND METHODS Ten Korean patients underwent eight treatment sessions over 6 weeks. Clinical photographs of the skin were taken before and after the treatment at each week of treatment. Satisfaction score (0; dissatisfied, 5; neutral, 10; very satisfied) and pain score (0; no pain, 10; too painful) was determined using weekly questionnaires. A dermatologist evaluated the improvement of facial skin aging, including laxity, nasolabial fold, facial contour, skin texture, and skin color tone. RESULTS The mean satisfaction score was high (>8) and the mean pain score was low (1.5). Improved skin laxity, nasolabial fold, and facial contour were observed in four, one, and three patients, respectively. Skin texture and skin color tone improved in 90% and 70% of the patients, respectively. CONCLUSION The novel combined multi-polar radiofrequency and pulsed electromagnetic field device is safe and effective for rejuvenating aged skin in Korean subjects.
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Affiliation(s)
- Young Bok Lee
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea
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Sherafat MA, Heibatollahi M, Mongabadi S, Moradi F, Javan M, Ahmadiani A. Electromagnetic field stimulation potentiates endogenous myelin repair by recruiting subventricular neural stem cells in an experimental model of white matter demyelination. J Mol Neurosci 2012; 48:144-53. [PMID: 22588976 DOI: 10.1007/s12031-012-9791-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 04/26/2012] [Indexed: 04/28/2023]
Abstract
Electromagnetic fields (EMFs) may affect the endogenous neural stem cells within the brain. The aim of this study was to assess the effects of EMFs on the process of toxin-induced demyelination and subsequent remyelination. Demyelination was induced using local injection of lysophosphatidylcholine within the corpus callosum of adult female Sprague-Dawley rats. EMFs (60 Hz; 0.7 mT) were applied for 2 h twice a day for 7, 14, or 28 days postlesion. BrdU labeling and immunostaining against nestin, myelin basic protein (MBP), and BrdU were used for assessing the amount of neural stem cells within the tissue, remyelination patterns, and tracing of proliferating cells, respectively. EMFs significantly reduced the extent of demyelinated area and increased the level of MBP staining within the lesion area on days 14 and 28 postlesion. EMFs also increased the number of BrdU- and nestin-positive cells within the area between SVZ and lesion as observed on days 7 and 14 postlesion. It seems that EMF potentiates proliferation and migration of neural stem cells and enhances the repair of myelin in the context of demyelinating conditions.
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Affiliation(s)
- Mohammad Amin Sherafat
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bril V, England J, Franklin GM, Backonja M, Cohen J, Del Toro D, Feldman E, Iverson DJ, Perkins B, Russell JW, Zochodne D. Evidence-based guideline: Treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. PM R 2011; 3:345-52, 352.e1-21. [PMID: 21497321 DOI: 10.1016/j.pmrj.2011.03.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN). METHODS We performed a systematic review of the literature from 1960 to August 2008 and classified the studies according to the American Academy of Neurology classification of evidence scheme for a therapeutic article, and recommendations were linked to the strength of the evidence. The basic question asked was: "What is the efficacy of a given treatment (pharmacological: anticonvulsants, antidepressants, opioids, others; and non-pharmacological: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?" RESULTS AND RECOMMENDATIONS Pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulphate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL.
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Abstract
BACKGROUND Magnetic and electromagnetic fields have been accepted as real physical entities in medicine and are believed to achieve pain relief. Magnetic field therapy has been acknowledged as a non-invasive, safe and simple method for treatment of the site of injury, source of pain or inflammation, or other types of illnesses and pathologies. However, a consensus regarding the statistical relevance of the effects has not been established. MATERIALS AND METHODS A detailed literature research was performed and the results were evaluated. Inclusion criteria were that the studies had to be randomized, double-blind and placebo-controlled, and no additional forms of treatment other than magnetic effects were allowed to be used. RESULTS The evaluation of 17 studies with static magnetic fields showed on average no significant difference in pain relief between the group treated with magnetic fields and the placebo group. All studies using magnetic fields showed that forms of treatment conducted over a period of 30 min and at intervals of 1 week have no effects. In 10 studies with dynamic magnetic fields different effects were registered, which ranged from no effect to significant differences regarding pain relief between the treated and the control groups. CONCLUSIONS Static magnetic fields are ineffective with respect to pain therapy. Dynamic magnetic fields show diverse effects. Hence, this therapy should be researched in depth.
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Effect of Pulsed Electromagnetic Field on Healing of Mandibular Fracture: A Preliminary Clinical Study. J Oral Maxillofac Surg 2011; 69:1708-17. [DOI: 10.1016/j.joms.2010.10.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 08/11/2010] [Accepted: 10/07/2010] [Indexed: 11/23/2022]
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