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Xiong HY, Hendrix J, Schabrun S, Wyns A, Campenhout JV, Nijs J, Polli A. The Role of the Brain-Derived Neurotrophic Factor in Chronic Pain: Links to Central Sensitization and Neuroinflammation. Biomolecules 2024; 14:71. [PMID: 38254671 PMCID: PMC10813479 DOI: 10.3390/biom14010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Chronic pain is sustained, in part, through the intricate process of central sensitization (CS), marked by maladaptive neuroplasticity and neuronal hyperexcitability within central pain pathways. Accumulating evidence suggests that CS is also driven by neuroinflammation in the peripheral and central nervous system. In any chronic disease, the search for perpetuating factors is crucial in identifying therapeutic targets and developing primary preventive strategies. The brain-derived neurotrophic factor (BDNF) emerges as a critical regulator of synaptic plasticity, serving as both a neurotransmitter and neuromodulator. Mounting evidence supports BDNF's pro-nociceptive role, spanning from its pain-sensitizing capacity across multiple levels of nociceptive pathways to its intricate involvement in CS and neuroinflammation. Moreover, consistently elevated BDNF levels are observed in various chronic pain disorders. To comprehensively understand the profound impact of BDNF in chronic pain, we delve into its key characteristics, focusing on its role in underlying molecular mechanisms contributing to chronic pain. Additionally, we also explore the potential utility of BDNF as an objective biomarker for chronic pain. This discussion encompasses emerging therapeutic approaches aimed at modulating BDNF expression, offering insights into addressing the intricate complexities of chronic pain.
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Affiliation(s)
- Huan-Yu Xiong
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (H.-Y.X.); (J.H.); (A.W.); (J.V.C.); (A.P.)
| | - Jolien Hendrix
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (H.-Y.X.); (J.H.); (A.W.); (J.V.C.); (A.P.)
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, 3000 Leuven, Belgium
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
| | - Siobhan Schabrun
- The School of Physical Therapy, University of Western Ontario, London, ON N6A 3K7, Canada;
- The Gray Centre for Mobility and Activity, Parkwood Institute, London, ON N6A 4V2, Canada
| | - Arne Wyns
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (H.-Y.X.); (J.H.); (A.W.); (J.V.C.); (A.P.)
| | - Jente Van Campenhout
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (H.-Y.X.); (J.H.); (A.W.); (J.V.C.); (A.P.)
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (H.-Y.X.); (J.H.); (A.W.); (J.V.C.); (A.P.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41390 Göterbog, Sweden
| | - Andrea Polli
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (H.-Y.X.); (J.H.); (A.W.); (J.V.C.); (A.P.)
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, 3000 Leuven, Belgium
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
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de Souza VS, Medeiros LF, Stein DJ, de Oliveira CL, Medeiros HR, Dussan-Sarria JA, Caumo W, de Souza A, Torres ILS. Transcranial direct current stimulation is more effective than pregabalin in controlling nociceptive and anxiety-like behaviors in a rat fibromyalgia-like model. Scand J Pain 2024; 24:sjpain-2023-0038. [PMID: 38557595 DOI: 10.1515/sjpain-2023-0038] [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: 03/20/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Despite the fact that fibromyalgia, a widespread disease of the musculoskeletal system, has no specific treatment, patients have shown improvement after pharmacological intervention. Pregabalin has demonstrated efficacy; however, its adverse effects may reduce treatment adherence. In this context, neuromodulatory techniques such as transcranial direct current stimulation (tDCS) may be employed as a complementary pain-relieving method. Consequently, the purpose of this study was to evaluate the effect of pregabalin and tDCS treatments on the behavioral and biomarker parameters of rats submitted to a fibromyalgia-like model. METHODS Forty adult male Wistar rats were divided into two groups: control and reserpine. Five days after the end of the administration of reserpine (1 mg/kg/3 days) to induce a fibromyalgia-like model, rats were randomly assigned to receive either vehicle or pregabalin (30 mg/kg) along with sham or active- tDCS treatments. The evaluated behavioral parameters included mechanical allodynia by von Frey test and anxiety-like behaviors by elevated plus-maze test (time spent in opened and closed arms, number of entries in opened and closed arms, protected head-dipping, unprotected head-dipping [NPHD], grooming, rearing, fecal boluses). The biomarker analysis (brain-derived neurotrophic factor [BDNF] and tumor necrosis factor-α [TNF-α]) was performed in brainstem and cerebral cortex and in serum. RESULTS tDCS reversed the reduction in the mechanical nociceptive threshold and the decrease in the serum BDNF levels induced by the model of fibromyalgia; however, there was no effect of pregabalin in the mechanical threshold. There were no effects of pregabalin or tDCS found in TNF-α levels. The pain model induced an increase in grooming time and a decrease in NPHD and rearing; while tDCS reversed the increase in grooming, pregabalin reversed the decrease in NPHD. CONCLUSIONS tDCS was more effective than pregabalin in controlling nociception and anxiety-like behavior in a rat model-like fibromyalgia. Considering the translational aspect, our findings suggest that tDCS could be a potential non-pharmacological treatment for fibromyalgia.
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Affiliation(s)
- Vanessa Silva de Souza
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Liciane Fernandes Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Universidade La Salle, Canoas, RS, 92010-000, Brazil
- Post graduate program in Biological Sciences: Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Dirson João Stein
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Post graduate Program in Medicine: Medical Science, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Camila Lino de Oliveira
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Helouise Richardt Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Post graduate Program in Medicine: Medical Science, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | | | - Wolnei Caumo
- Post graduate Program in Medicine: Medical Science, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Andressa de Souza
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Iraci L S Torres
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Department of Pharmacology, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
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Crespo PC, Anderson Meira Martins L, Martins OG, Camacho Dos Reis C, Goulart RN, de Souza A, Medeiros LF, Scarabelot VL, Gamaro GD, Silva SP, de Oliveira MR, Torres ILDS, de Souza ICC. Short-term effectiveness of transcranial direct current stimulation in the nociceptive behavior of neuropathic pain rats in development. AIMS Neurosci 2023; 10:433-446. [PMID: 38188001 PMCID: PMC10767070 DOI: 10.3934/neuroscience.2023032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 01/09/2024] Open
Abstract
Neuropathic pain (NP) is caused by a lesion that triggers pain chronification and central sensitization and it can develop in a different manner, dependent of age. Recent studies have demonstrated the efficacy of transcranial direct current stimulation (tDCS) for treating NP. Then, we aimed to investigate the effects of tDCS and BDNF levels in neuropathic pain rats in development, with 30 days old in the beginning of experiments. Eight-five male Wistar rats were subjected to chronic constriction injury. After establishment of NP, bimodal tDCS was applied to the rats for eight consecutive days, for 20 minutes each session. Subsequently, nociceptive behavior was assessed at baseline, 14 days after surgery, 1 day and 7 days after the end of tDCS. The rats were sacrificed 8 days after the last session of tDCS. An increase in the nociceptive threshold was observed in rats in development 1 day after the end of tDCS (short-term effect), but this effect was not maintained 7 days after the end of tDCS (long-term effect). Furthermore, brain derived neurotrophic factor (BDNF) levels were analyzed in the frontal cortex, spinal cord and serum using ELISA assays. The neuropathic pain model showed an effect of BDNF in the spinal cord of rats in development. There were no effects of BNDF levels of pain or tDCS in the frontal cortex or serum. In conclusion, tDCS is an effective technique to relieve nociceptive behavior at a short-term effect in neuropathic pain rats in development, and BDNF levels were not altered at long-term effect.
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Affiliation(s)
- Priscila Centeno Crespo
- Postgraduate Program in Biochemistry and Bioprospection, Universidade Federal de Pelotas, Pelotas (UFPel), Pelotas, Rio Grande do Sul (RS), Brazil
- Laboratory of Cellular Neuromodulation: Basic Sciences, Institute of Biology, Department of Morphology, UFPel, Pelotas, RS, Brazil
| | - Leo Anderson Meira Martins
- Department of Physiology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Otávio Garcia Martins
- Laboratory of Cellular Neuromodulation: Basic Sciences, Institute of Biology, Department of Morphology, UFPel, Pelotas, RS, Brazil
| | - Clara Camacho Dos Reis
- Laboratory of Cellular Neuromodulation: Basic Sciences, Institute of Biology, Department of Morphology, UFPel, Pelotas, RS, Brazil
| | - Ricardo Netto Goulart
- Laboratory of Cellular Neuromodulation: Basic Sciences, Institute of Biology, Department of Morphology, UFPel, Pelotas, RS, Brazil
| | - Andressa de Souza
- Postgraduate Program in Health and Human Development, Universidade La Salle, Canoas, RS, Brazil
| | - Liciane Fernandes Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researches, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Postgraduate Program in Health and Human Development, Universidade La Salle, Canoas, RS, Brazil
| | - Vanessa Leal Scarabelot
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researches, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Postgraduate Program in Medicine Medical Sciences, Medicine School, UFRGS, Porto Alegre, RS, Brazil
| | - Giovana Duzzo Gamaro
- Postgraduate Program in Biochemistry and Bioprospection, Universidade Federal de Pelotas, Pelotas (UFPel), Pelotas, Rio Grande do Sul (RS), Brazil
| | - Sabrina Pereira Silva
- Postgraduate Program in Biochemistry and Bioprospection, Universidade Federal de Pelotas, Pelotas (UFPel), Pelotas, Rio Grande do Sul (RS), Brazil
| | | | - Iraci Lucena da Silva Torres
- Department of Physiology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researches, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Izabel Cristina Custódio de Souza
- Postgraduate Program in Biochemistry and Bioprospection, Universidade Federal de Pelotas, Pelotas (UFPel), Pelotas, Rio Grande do Sul (RS), Brazil
- Laboratory of Cellular Neuromodulation: Basic Sciences, Institute of Biology, Department of Morphology, UFPel, Pelotas, RS, Brazil
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Youssef H, Mohamed NAEH, Hamdy M. Comparison of bihemispheric and unihemispheric M1 transcranial direct current stimulations during physical therapy in subacute stroke patients: A randomized controlled trial. Neurophysiol Clin 2023; 53:102895. [PMID: 37517104 DOI: 10.1016/j.neucli.2023.102895] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Despite the central origin of stroke affecting the primary motor cortex M1, most physical and occupational rehabilitation programs focus on peripheral treatments rather than addressing the central origin of the problem. This highlights the urgent need for effective protocols to improve neurological rehabilitation and achieve better long-term functional outcomes. OBJECTIVES Our hypothesis was that the bihemispheric delivery of transcranial direct current stimulation (tDCS) is superior to unihemispheric in enhancing motor function after stroke, in both the upper and lower extremities. METHODS 35 sub-acute ischemic stroke survivors were randomly divided into three groups: bihemispheric and unihemispheric treatment groups, or sham groups. Each participant received a 20-minute session of tDCS with an intensity of 2 mA during physical therapy sessions, three days a week, for four weeks. The outcomes were measured using Fugl-Meyer assessment scale, modified Ashworth scale, Berg balance scale, and serum brain-derived neurotrophic factor (BDNF) levels. RESULTS One-way ANOVA test indicated a significant effect of both treatment protocols on the upper extremity (p = < 0.001) and lower extremity (p = .034) for motor measures, but there was no difference between the two (p = .939). Kruskal Wallis test for spasticity showed a significant improvement in both treatment groups for elbow (p = .036) and wrist flexors (p = .025), compared to the sham group. However, there was no statistically significant difference in spasticity between uni- and bihemispheric stimulation for elbow (p = .731) or wrist flexors (p = .910). CONCLUSION There is no statistically significant difference in efficacy between bihemispheric and unihemispheric tDCS in patients presenting with acute ischemic stroke. .
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Affiliation(s)
- Hussein Youssef
- Koç University Research Center for Translational Medicine (KUTTAM), Graduate School of Health Sciences, Koç University, İstanbul, Türkiye; Department of Neuroscience and Biotechnology, Faculty of Science, Alexandria University, Alexandria, Egypt; Department of Physical Therapy & Rehabilitation, Faculty of Health Sciences, Marmara University, İstanbul, Türkiye; Street Doctor, Alexandria, Egypt.
| | | | - Mohamed Hamdy
- Department of Neuropsychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Centeno Crespo P, Anderson Meira Martins L, Camacho Dos Reis C, Fernandes Medeiros L, Leal Scarabelot V, Duzzo Gamaro G, Sandrielly Pereira Soares M, Maria Spanevello R, Moro Stefanello F, Cristina Custódio De Souza I. Transcranial direct current stimulation effects in the pain threshold and in oxidative stress parameters of neuropathic pain rats. Neurosci Lett 2023; 803:137179. [PMID: 36914044 DOI: 10.1016/j.neulet.2023.137179] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023]
Abstract
Transcranial direct current stimulation (tDCS) can modulate cortical excitability and relieve neuropathic pain (NP), but the role of several biomarkers in this process is not well understood. This study aimed to analyze the effects of tDCS on biochemical parameters in rats with neuropathic pain (NP) induced by chronic constriction injury (CCI) of the right sciatic nerve. Eighty-eight male 60-day-old Wistar rats were divided into nine groups: control (C), control-electrode off (CEoff), control-tDCS (C-tDCS), sham-lesion (SL), sham-lesion electrode off (SLEoff), sham-lesion (SL-tDCS), lesion (L), lesion electrode off (LEoff), and lesion-tDCS (L-tDCS). After NP establishment, 20-minute bimodal tDCS for 8 consecutive days was applied to the rats. Fourteen days after the induction of NP, rats developed mechanical hyperalgesia with a decreased threshold, and at the end of treatment, an increase in the pain threshold was observed in NP rats. In addition, NP rats had increased levels of reactive species (RS) in the prefrontal cortex, while superoxide dismutase (SOD) activity was decreased in NP rats. In the spinal cord, nitrite levels and glutathione-S-transferase (GST) activity decreased in the L-tDCS group, and it was observed that increased levels in total sulfhydryl content for neuropathic pain rats were reversed by tDCS. In serum analyses, the neuropathic pain model increased the levels of RS and thiobarbituric acid-reactive substances (TBARS) and decreased the activity of butyrylcholinesterase (BuChE). In conclusion, bimodal tDCS increased total sulfhydryl content in the spinal cord of rats with neuropathic pain, positively modulating this parameter.
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Affiliation(s)
- Priscila Centeno Crespo
- Postgraduate Program in Bioprospecting and Biochemistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS 96010-900, Brazil; Laboratory of Cell Neuromodulation: Basic Research, Biology Institute, Department of Morphology, UFPel, Pelotas, RS 96030-000, Brazil
| | | | - Clara Camacho Dos Reis
- Laboratory of Cell Neuromodulation: Basic Research, Biology Institute, Department of Morphology, UFPel, Pelotas, RS 96030-000, Brazil
| | - Liciane Fernandes Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researches, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90050-170, Brazil; Postgraduate Program in Health and Human Development, Unilasalle, Canoas, RS 92010-000, Brazil
| | - Vanessa Leal Scarabelot
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researches, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90050-170, Brazil; Postgraduate Program in Medicine, Medical Sciences, Medicine School, Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre, RS 90035-003, Brazil
| | - Giovana Duzzo Gamaro
- Laboratory of Cell Neuromodulation: Basic Research, Biology Institute, Department of Morphology, UFPel, Pelotas, RS 96030-000, Brazil
| | - Mayara Sandrielly Pereira Soares
- Postgraduate Program in Bioprospecting and Biochemistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS 96010-900, Brazil; Laboratory of Biomarkers, Center of Chemical, Pharmaceutical and Food Sciences, UFPel, Campus Universitário Capão do Leão s/n, Pelotas, RS, Brazil
| | - Roselia Maria Spanevello
- Postgraduate Program in Bioprospecting and Biochemistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
| | - Francieli Moro Stefanello
- Postgraduate Program in Bioprospecting and Biochemistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS 96010-900, Brazil; Postgraduate Program in Medicine, Medical Sciences, Medicine School, Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre, RS 90035-003, Brazil
| | - Izabel Cristina Custódio De Souza
- Postgraduate Program in Bioprospecting and Biochemistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS 96010-900, Brazil; Laboratory of Cell Neuromodulation: Basic Research, Biology Institute, Department of Morphology, UFPel, Pelotas, RS 96030-000, Brazil.
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Development of a Clinical Prediction Rule for Treatment Success with Transcranial Direct Current Stimulation for Knee Osteoarthritis Pain: A Secondary Analysis of a Double-Blind Randomized Controlled Trial. Biomedicines 2022; 11:biomedicines11010004. [PMID: 36672512 PMCID: PMC9855334 DOI: 10.3390/biomedicines11010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
The study’s objective was to develop a clinical prediction rule that predicts a clinically significant analgesic effect on chronic knee osteoarthritis pain after transcranial direct current stimulation treatment. This is a secondary analysis from a double-blind randomized controlled trial. Data from 51 individuals with chronic knee osteoarthritis pain and an impaired descending pain inhibitory system were used. The intervention comprised a 15-session protocol of anodal primary motor cortex transcranial direct current stimulation. Treatment success was defined by the Western Ontario and McMaster Universities’ Osteoarthritis Index pain subscale. Accuracy statistics were calculated for each potential predictor and for the final model. The final logistic regression model was statistically significant (p < 0.01) and comprised five physical and psychosocial predictor variables that together yielded a positive likelihood ratio of 14.40 (95% CI: 3.66−56.69) and an 85% (95%CI: 60−96%) post-test probability of success. This is the first clinical prediction rule proposed for transcranial direct current stimulation in patients with chronic pain. The model underscores the importance of both physical and psychosocial factors as predictors of the analgesic response to transcranial direct current stimulation treatment. Validation of the proposed clinical prediction rule should be performed in other datasets.
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Matesanz-García L, Schmid AB, Cáceres-Pajuelo JE, Cuenca-Martínez F, Arribas-Romano A, González-Zamorano Y, Goicoechea-García C, Fernández-Carnero J. Effect of Physiotherapeutic Interventions on Biomarkers of Neuropathic Pain: A Systematic Review of Preclinical Literature. THE JOURNAL OF PAIN 2022; 23:1833-1855. [PMID: 35768044 PMCID: PMC7613788 DOI: 10.1016/j.jpain.2022.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 02/02/2023]
Abstract
The purpose of this systematic review was to evaluate the effects of physiotherapeutic interventions on biomarkers of neuropathic pain in preclinical models of peripheral neuropathic pain (PNP). The search was performed in Pubmed, Web of Science, EMBASE, Cochrane, Cinhal, Psycinfo, Scopus, Medline, and Science Direct. Studies evaluating any type of physiotherapy intervention for PNP (systemic or traumatic) were included. Eighty-one articles were included in this review. The most common PNP model was chronic constriction injury, and the most frequently studied biomarkers were related to neuro-immune processes. Exercise therapy and Electro-acupuncture were the 2 most frequently studied physiotherapy interventions while acupuncture and joint mobilization were less frequently examined. Most physiotherapeutic interventions modulated the expression of biomarkers related to neuropathic pain. Whereas the results seem promising; they have to be considered with caution due to the high risk of bias of included studies and high heterogeneity of the type and anatomical localization of biomarkers reported. The review protocol is registered on PROSPERO (CRD42019142878). PERSPECTIVE: This article presents the current evidence about physiotherapeutic interventions on biomarkers of neuropathic pain in preclinical models of peripheral neuropathic pain. Existing findings are reviewed, and relevant data are provided on the effectiveness of each physiotherapeutic modality, as well as its certainty of evidence and clinical applicability.
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Affiliation(s)
- Luis Matesanz-García
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Annina B Schmid
- Nuffield Department for Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Yeray González-Zamorano
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Grupo de Investigación de Neurorrehabilitación del Daño Cerebral y los Trastornos del Movimiento (GINDAT), Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | | | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain; Grupo de Investigación de Neurorrehabilitación del Daño Cerebral y los Trastornos del Movimiento (GINDAT), Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain; Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, Madrid, Spain; La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
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Callai EMM, Zin LEF, Catarina LS, Ponzoni D, Gonçalves CAS, Vizuete AFK, Cougo MC, Boff J, Puricelli E, Fernandes EK, da Silva Torres IL, Quevedo AS. Evaluation of the immediate effects of a single transcranial direct current stimulation session on astrocyte activation, inflammatory response, and pain threshold in naïve rats. Behav Brain Res 2022; 428:113880. [PMID: 35390432 DOI: 10.1016/j.bbr.2022.113880] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 02/15/2022] [Accepted: 04/01/2022] [Indexed: 11/18/2022]
Abstract
Transcranial direct current stimulation (tDCS) has demonstrated clinical benefits such as analgesia, anti-inflammatory, and neuroprotective effects. However, the mechanisms of action of a single tDCS session are poorly characterized. The present study aimed to evaluate the effects of a single tDCS session on pain sensitivity, inflammatory parameters, and astrocyte activity in naive rats. In the first experiment, sixty-day-old male Wistar rats (n=95) were tested for mechanical pain threshold (von Frey test). Afterward, animals were submitted to a single bimodal tDCS (0.5mA, 20minutes) or sham-tDCS session. According to the group, animals were re-tested at different time intervals (30, 60, 120minutes, or 24hours) after the intervention, euthanized, and the cerebral cortex collected for biochemical analysis. A second experiment (n=16) was performed using a similar protocol to test the hypotheses that S100B levels in the cerebrospinal fluid (CSF) are altered by tDCS. Elisa assay quantified the levels of tumor necrosis factor-alfa (TNF-α), interleukin-10 (IL10), S100 calcium-binding protein B (S100B), and Glial fibrillary acidic protein (GFAP). Data were analyzed using ANOVA and independent t-test (P<0.05). Results showed that tDCS decreased pain sensitivity (30 and 60min), cerebral TNF-α and S100B levels (30min). CSF S100B levels increased 30minutes after intervention. There were no differences in IL10 and GFAP levels. TCDS showed analgesic, anti-inflammatory, and neuroprotective effects in naive animals. Therefore, this non-invasive and inexpensive therapy may potentially be a preemptive alternative to reduce pain, inflammation, and neurodegeneration in situations where patients will undergo medical procedures (e.g., surgery).
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Affiliation(s)
- Etiane Micheli Meyer Callai
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | | | - Luciana Santa Catarina
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | - Deise Ponzoni
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | | | | | - Milton Cristian Cougo
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | - Jamile Boff
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | - Edela Puricelli
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | | | | | - Alexandre Silva Quevedo
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil; Neuroscience Graduate Program, UFRGS, Porto Alegre, RS, Brazil; Pharmacology Graduate Program, UFRGS, Porto Alegre, RS, Brazil.
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9
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Santos DS, Stein DJ, Medeiros HR, Dos Santos Pereira F, de Macedo IC, Fregni F, Caumo W, Torres ILS. Transcranial direct current stimulation alters anxious-like behavior and neural parameters in rats with chronic pain exposed to alcohol. J Psychiatr Res 2021; 144:369-377. [PMID: 34735841 DOI: 10.1016/j.jpsychires.2021.10.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate the effects of transcranial direct current stimulation (tDCS) on anxiety-like behavior and neural parameters in rats with chronic pain exposed to alcohol. Thirty-six adult male Wistar rats were randomly assigned to control (CT), neuropathic pain (NP), NPtDCS, NP + alcohol (NPAL), or NPALtDCS groups, subjected to sciatic nerve chronic constriction injury (CCI) and exposed to alcohol (20% v/v solution, 4 g/kg) or vehicle by gavage for 15 days. Afterward, rats were treated using bimodal tDCS (0.5 mA/20 min/8 days) and tested in the open field. Rats were killed 24 h after the last behavioral assessment, and brain and spinal cord tissue samples were collected and processed for NPY immunohistochemistry, expression of Il1a and Il1b in the spinal cord, cerebellum, and hippocampus, and levels of IL-1α and IL-1β in the same brain structures and the striatum. tDCS reverted the anxiety-like behavior induced by CCI and alcohol, and the increased expression of Il1a in the spinal cord induced by alcohol, which increased the expression of Il1b in the cerebellum. In addition, tDCS modulated the hypothalamic NPY-immunoreactivity, increased the levels of IL-1α in the hippocampus (like NP and AL), and increased the expression of Il1b in the spinal cord (like AL). Thus, this study shows that tDCS changes NP and alcohol-induced anxiety-like behavior, possibly through its central modulatory effect of NPY and spinal cord expression of Il1a and Il1b, being considered a treatment option for alcohol and NP-induced anxiety symptoms.
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Affiliation(s)
- Daniela Silva Santos
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Dirson João Stein
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Helouise Richardt Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernanda Dos Santos Pereira
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Isabel Cristina de Macedo
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil; Universidade Federal do Pampa, Uruguaiana, RS, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Wolnei Caumo
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Iraci L S Torres
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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10
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Suchting R, Teixeira AL, Ahn B, Colpo GD, Park J, Ahn H. Changes in Brain-derived Neurotrophic Factor From Active and Sham Transcranial Direct Current Stimulation in Older Adults With Knee Osteoarthritis. Clin J Pain 2021; 37:898-903. [PMID: 34757341 PMCID: PMC8589111 DOI: 10.1097/ajp.0000000000000987] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/01/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Previous work has shown effects of transcranial direct current stimulation (tDCS) on clinical pain measures, qualitative sensory testing measures, and peripheral inflammation. The present report extends this research to investigate the effect of tDCS on brain-derived neurotrophic factor (BDNF) levels. MATERIALS AND METHODS This secondary analysis examined a sample of 40 older adults (50 to 70 y old) with symptomatic knee osteoarthritis randomly assigned in a 1:1 fashion to active (n=20) or sham (n=20) tDCS for 20 minutes on 5 consecutive days. BDNF was measured before the first session and after the final treatment session. Generalized linear modeling evaluated BDNF plasma levels as a function of tDCS group, adjusted for baseline. Bayesian statistical inference was used to quantify the probability that effects of the treatment exist. RESULTS Generalized linear modeling indicated a 90.4% posterior probability that the sham condition had 49.9% higher BDNF at the end of treatment, controlling for baseline. Follow-up analyses within the active TDCS group supported an association between change in BDNF and change in clinical pain, and exploratory analyses found an effect of tDCS on irisin. DISCUSSION Results indicated that tDCS could be a potential nonpharmacological treatment to decrease BDNF levels, which may in turn decrease pain. This study adds to a growing literature suggesting that tDCS affects cortical excitability, and consequentially, the neural circuits implicated in pain modulation. In addition to a direct connection to analgesia, BDNF changes may reflect tDCS-induced changes in different cortical areas and/or neural circuits.
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Affiliation(s)
- Robert Suchting
- UTHealth McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antonio L. Teixeira
- UTHealth McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Brian Ahn
- UTHealth McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Gabriela D. Colpo
- UTHealth McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Juyoung Park
- College of Social Work & Criminal Justice, Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, FL, USA
| | - Hyochol Ahn
- College of Nursing, Florida State University, Tallahassee, FL, USA
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11
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Waye SC, Dinesh OC, Hasan SN, Conway JD, Raymond R, Nobrega JN, Blundell J, Bambico FR. Antidepressant action of transcranial direct current stimulation in olfactory bulbectomised adolescent rats. J Psychopharmacol 2021; 35:1003-1016. [PMID: 33908307 DOI: 10.1177/02698811211000765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Antidepressant drugs in adolescent depression are sometimes mired by efficacy issues and paradoxical effects. Transcranial direct current stimulation (tDCS) could represent an alternative. AIMS/METHODS We tested the antidepressant action of prefrontal tDCS and paroxetine (20 mg/kg, intraperitoneal) in olfactory bulbectomised (OBX) adolescent rats. Using enzyme-linked immunosorbent assays and in situ hybridisation, we examined treatment-induced changes in plasma brain-derived neurotrophic factor (BDNF) and brain serotonin transporter (SERT) and 5-HT-1A mRNA. RESULTS OBX-induced anhedonia-like reductions in sucrose preference (SP) correlated with open field (OF) hyperactivity. These were accompanied by decreased zif268 mRNA in the piriform/amygdalopiriform transition area, and increased zif268 mRNA in the hypothalamus. Acute paroxetine (2 days) led to a profound SP reduction, an effect blocked by combined tDCS-paroxetine administration. Chronic (14 days) tDCS attenuated hyperlocomotion and its combination with paroxetine blocked OBX-induced SP reduction. Correlations among BDNF, SP and hyperlocomotion scores were altered by OBX but were normalised by tDCS-paroxetine co-treatment. In the brain, paroxetine increased zif268 mRNA in the hippocampal CA1 subregion and decreased it in the claustrum. This effect was blocked by tDCS co-administration, which also increased zif268 in CA2. tDCS-paroxetine co-treatment had variable effects on 5-HT1A receptors and SERT mRNA. 5-HT1A receptor changes were found exclusively within depression-related parahippocampal/hippocampal subregions, and SERT changes within fear/defensive response-modulating brainstem circuits. CONCLUSION These findings point towards potential synergistic efficacies of tDCS and paroxetine in the OBX model of adolescent depression via mechanisms associated with altered expression of BDNF, 5-HT1A, SERT and zif268 in discrete corticolimbic areas.
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Affiliation(s)
- Shannon C Waye
- Department of Psychology, Memorial University of Newfoundland, St. John's, Canada
| | - O Chandani Dinesh
- Department of Psychology, Memorial University of Newfoundland, St. John's, Canada
| | - Sm Nageeb Hasan
- Department of Psychology, Memorial University of Newfoundland, St. John's, Canada
| | - Joshua D Conway
- Department of Psychology, Memorial University of Newfoundland, St. John's, Canada
| | - Roger Raymond
- Behavioural Neurobiology Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
| | - José N Nobrega
- Behavioural Neurobiology Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
| | - Jacqueline Blundell
- Department of Psychology, Memorial University of Newfoundland, St. John's, Canada
| | - Francis Rodriguez Bambico
- Department of Psychology, Memorial University of Newfoundland, St. John's, Canada.,Behavioural Neurobiology Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
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12
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Santos DS, Medeiros LF, Stein DJ, De Macedo IC, Da Silva Rios DE, De Oliveira C, Toledo RS, Fregni F, Caumo W, Torres ILS. Bimodal transcranial direct current stimulation reduces alcohol consumption and induces long-term neurochemical changes in rats with neuropathic pain. Neurosci Lett 2021; 759:136014. [PMID: 34111512 DOI: 10.1016/j.neulet.2021.136014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/17/2021] [Accepted: 06/03/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to evaluate the effects of repeated bimodal transcranial direct current stimulation (tDCS) on alcohol consumption and immunohistological and neurochemical parameters in nerve-injured rats. Forty-eight adult male Wistar rats were distributed into six groups: control, neuropathic pain (NP) + sham-tDCS, NP + alcohol + sham-tDCS, alcohol + sham-tDCS, alcohol + tDCS, and NP + alcohol + tDCS. NP is induced by chronic sciatic nerve constriction (CCI). The rats were exposed to a 10% alcohol solution by voluntary consumption for 14 days. From the 16th day after surgery, bimodal tDCS was applied for 20 min/day for 8 days. Brain structures were collected to evaluate the number of neuropeptide Y (NPY)-positive neurons, neurites, and argyrophilic grains by immunohistochemistry, and brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), interleukin (IL)-6, and IL-10 by ELISA. Nerve-injured rats showed a progressive increase in alcohol consumption compared to the non-injured rats. In addition, there was a reduction in voluntary alcohol consumption over time induced by tDCS. Alcohol exposure, chronic pain, and tDCS treatment modulated the central NPY immunoreactivity. tDCS increased the cerebellar levels of IL-6 and IL-10, and CCI and/or tDCS reduced striatal BDNF levels. The current data suggest that tDCS could be a promising non-pharmacological adjuvant to treat patients with chronic pain who use alcohol to relieve their symptoms.
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Affiliation(s)
- Daniela Silva Santos
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Liciane Fernandes Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Postgraduate Program in Health and Human Development, Universidade La Salle, Canoas, RS, Brazil
| | - Dirson João Stein
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Isabel Cristina De Macedo
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Diego Evandro Da Silva Rios
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carla De Oliveira
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Roberta Ströher Toledo
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Felipe Fregni
- Laboratoryof Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Wolnei Caumo
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Iraci L S Torres
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratoryof Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard University, Boston, MA, USA.
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13
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Longo L, de Souza VEG, Stein DJ, de Freitas JS, Uribe-Cruz C, Torres ILS, Álvares-da-Silva MR. Transcranial direct current stimulation (tDCS) has beneficial effects on liver lipid accumulation and hepatic inflammatory parameters in obese rats. Sci Rep 2021; 11:11037. [PMID: 34040131 PMCID: PMC8154948 DOI: 10.1038/s41598-021-90563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 05/04/2021] [Indexed: 02/04/2023] Open
Abstract
Obesity is key to liver steatosis development and progression. Transcranial direct current stimulation (tDCS) is a promising tool for eating disorders management but was not yet evaluated in steatosis. This study investigated tDCS' effects on liver steatosis and inflammation in an experimental obesity model. Male Wistar rats (60 days-old) were randomly allocated (n = 10/group) as follows: standard-diet/sham tDCS (SDS), standard-diet/tDCS (SDT), hypercaloric-cafeteria-diet/sham tDCS (HDS), and hypercaloric-cafeteria-diet/tDCS (HDT). After 40 days of diet, animals received active or sham tDCS for eight days and were euthanized for liver fat deposition and inflammation analysis. HDS and HDT animals showed cumulative food consumption, total liver lipid deposits, IL-1β, TNF-α levels, IL-1β/IL-10 and TNF-α/IL-10 ratios significantly higher than the SDS and SDT groups (p < 0.001 for all parameters). tDCS (SDT and HDT) reduced liver lipid deposits (0.7 times for both, p < 0.05), IL-1β (0.7 times and 0.9 times, respectively, p < 0.05) and IL-1β/IL-10 index (0.6 times and 0.8 times, respectively, p < 0.05) in relation to sham (SDS and HDS). There was an interaction effect on the accumulation of hepatic triglycerides (p < 0.05). tDCS reduced 0.8 times the average liver triglyceride concentration in the HDT vs. HDS group (p < 0.05). In this obesity model, tDCS significantly decreased liver steatosis and hepatic inflammation. These results may justify looking into tDCS utility for human steatosis.
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Affiliation(s)
- Larisse Longo
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Valessa Emanoele Gabriel de Souza
- Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Dirson João Stein
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Medicine: Medical Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
| | - Joice Soares de Freitas
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carolina Uribe-Cruz
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Iraci L S Torres
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Medicine: Medical Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
| | - Mário Reis Álvares-da-Silva
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Division of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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14
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Frontotemporal Transcranial Direct Current Stimulation Decreases Serum Mature Brain-Derived Neurotrophic Factor in Schizophrenia. Brain Sci 2021; 11:brainsci11050662. [PMID: 34069556 PMCID: PMC8160668 DOI: 10.3390/brainsci11050662] [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: 04/08/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/13/2022] Open
Abstract
Although transcranial direct current stimulation (tDCS) shows promise as a treatment for auditory verbal hallucinations in patients with schizophrenia, mechanisms through which tDCS may induce beneficial effects remain unclear. Evidence points to the involvement of neuronal plasticity mechanisms that are underpinned, amongst others, by brain-derived neurotrophic factor (BDNF) in its two main forms: pro and mature peptides. Here, we aimed to investigate whether tDCS modulates neural plasticity by measuring the acute effects of tDCS on peripheral mature BDNF levels in patients with schizophrenia. Blood samples were collected in 24 patients with schizophrenia before and after they received a single session of either active (20 min, 2 mA, n = 13) or sham (n = 11) frontotemporal tDCS with the anode over the left prefrontal cortex and the cathode over the left temporoparietal junction. We compared the tDCS-induced changes in serum mature BDNF (mBDNF) levels adjusted for baseline values between the two groups. The results showed that active tDCS was associated with a significantly larger decrease in mBDNF levels (mean −20% ± standard deviation 14) than sham tDCS (−8% ± 21) (F = 5.387; p = 0.030; η2 = 0.205). Thus, mature BDNF may be involved in the beneficial effects of frontotemporal tDCS observed in patients with schizophrenia.
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15
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Chan MMY, Yau SSY, Han YMY. The neurobiology of prefrontal transcranial direct current stimulation (tDCS) in promoting brain plasticity: A systematic review and meta-analyses of human and rodent studies. Neurosci Biobehav Rev 2021; 125:392-416. [PMID: 33662444 DOI: 10.1016/j.neubiorev.2021.02.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/05/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022]
Abstract
The neurobiological mechanisms underlying prefrontal transcranial direct current stimulation (tDCS) remain elusive. Randomized, sham-controlled trials in humans and rodents applying in vivo prefrontal tDCS were included to explore whether prefrontal tDCS modulates resting-state and event-related functional connectivity, neural oscillation and synaptic plasticity. Fifty studies were included in the systematic review and 32 in the meta-analyses. Neuroimaging meta-analysis indicated anodal prefrontal tDCS significantly enhanced bilateral median cingulate activity [familywise error (FWE)-corrected p < .005]; meta-regression revealed a positive relationship between changes in median cingulate activity after tDCS and current density (FWE-corrected p < .005) as well as electric current strength (FWE-corrected p < .05). Meta-analyses of electroencephalography and magnetoencephalography data revealed nonsignificant changes (ps > .1) in both resting-state and event-related oscillatory power across all frequency bands. Applying anodal tDCS over the rodent hippocampus/prefrontal cortex enhanced long-term potentiation and brain-derived neurotrophic factor expression in the stimulated brain regions (ps <.005). Evidence supporting prefrontal tDCS administration is preliminary; more methodologically consistent studies evaluating its effects on cognitive function that include brain activity measurements are needed.
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Affiliation(s)
- Melody M Y Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Sonata S Y Yau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yvonne M Y Han
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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16
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Lopes BC, Medeiros LF, Stein DJ, Cioato SG, de Souza VS, Medeiros HR, Sanches PRS, Fregni F, Caumo W, Torres ILS. tDCS and exercise improve anxiety-like behavior and locomotion in chronic pain rats via modulation of neurotrophins and inflammatory mediators. Behav Brain Res 2021; 404:113173. [PMID: 33577881 DOI: 10.1016/j.bbr.2021.113173] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/16/2022]
Abstract
Anxiety disorders cause distress and are commonly found to be comorbid with chronic pain. Both are difficult-to-treat conditions for which alternative treatment options are being pursued. This study aimed to evaluate the effects of transcranial direct current stimulation (tDCS), treadmill exercise, or both, on anxiety-like behavior and associated growth factors and inflammatory markers in the hippocampus and sciatic nerve of rats with neuropathic pain. Male Wistar rats (n = 216) were subjected to sham-surgery or sciatic nerve constriction for pain induction. Fourteen days following neuropathic pain establishment, either bimodal tDCS, treadmill exercise, or a combination of both was used for 20 min a day for 8 consecutive days. The elevated plus-maze test was used to assess anxiety-like behavior and locomotor activity during the early (24 h) or late (7 days) phase after the end of treatment. BDNF, TNF-ɑ, and IL-10 levels in the hippocampus, and BDNF, NGF, and IL-10 levels in the sciatic nerve were assessed 48 h or 7 days after the end of treatment. Rats from the pain groups developed an anxiety-like state. Both tDCS and treadmill exercise provided ethological and neurochemical alterations induced by pain in the early and/or late phase, and a modest synergic effect between tDCS and exercise was observed. These results indicate that non-invasive neuromodulatory approaches can attenuate both anxiety-like status and locomotor activity and alter the biochemical profile in the hippocampus and sciatic nerve of rats with neuropathic pain and that combined interventions may be considered as a treatment option.
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Affiliation(s)
- Bettega Costa Lopes
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), 90050-170 Porto Alegre, Brazil
| | - Liciane Fernandes Medeiros
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal Rio Grande do Sul, 90050-170 Porto Alegre, Brazil; Programa de Pós-Graduação em Saúde e Desenvolvimento Humano, Universidade La Salle, 92010-000 Canoas, Brazil.
| | - Dirson João Stein
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Brazil
| | - Stefania Giotti Cioato
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil
| | - Vanessa Silva de Souza
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal Rio Grande do Sul, 90050-170 Porto Alegre, Brazil
| | - Helouise Richardt Medeiros
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Brazil
| | - Paulo Roberto Stefani Sanches
- Laboratório de Engenharia Biomédica, Grupo de Pesquisa e Pós-Graduação, Hospital de Clínicas de Porto Alegre, 90035-003 Porto Alegre, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital & Massachusetts General Hospital. Harvard Medical School and Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 02215 Boston, USA
| | - Wolnei Caumo
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Brazil
| | - Iraci L S Torres
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, 90035-007 Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), 90050-170 Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal Rio Grande do Sul, 90050-170 Porto Alegre, Brazil.
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Chronic pain impact on rodents’ behavioral repertoire. Neurosci Biobehav Rev 2020; 119:101-127. [DOI: 10.1016/j.neubiorev.2020.09.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/14/2020] [Accepted: 09/21/2020] [Indexed: 12/20/2022]
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Fonseca-Rodrigues D, Amorim D, Almeida A, Pinto-Ribeiro F. Emotional and cognitive impairments in the peripheral nerve chronic constriction injury model (CCI) of neuropathic pain: A systematic review. Behav Brain Res 2020; 399:113008. [PMID: 33171146 DOI: 10.1016/j.bbr.2020.113008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/29/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Emotional and cognitive impairments are common comorbidities of chronic neuropathic pain that significantly impact the quality of life of patients. While the nociceptive components of the peripheral nerve chronic constriction injury (CCI) animal model have been extensively analyzed, data related to the development of mood and cognitive disorders, and especially its impact on female rats remains fragmented. We systematically reviewed the literature analyzing the methods used to induce and evaluate the development of emotional- and cognitive-like impairments and sex-specific differences in the CCI model. DATABASES AND DATA TREATMENT We searched PubMed, Google Scholar and Web of Science from inception to September 30th, 2019, and a total of 44 papers were considered eligible for inclusion. We included animal studies assessing nociception, locomotion, anxious-like, depressive-like and cognitive behaviours after the CCI induction. RESULTS The overall quality of the studies was considered moderate to high. Overall, the induction of CCI leads to the development of emotional impairments, namely anxiety- and depressive-like behaviours, as well as cognitive impairments. With the majority of the studies using male subjects, the lack of evidence on female animals prevents the evaluation of sex-specific differences. CONCLUSIONS This review supports the development of an anxiodepressive-like phenotype, associated with cognitive impairments, in CCI-induced animals. These results support the use of this animal model for the study of the mechanisms underlying these comorbidities, as well as a screening tool for the development/repurposing of drugs that tackle both the neuropathy-induced nociceptive and emotional impairments, such as tricyclic antidepressants. Importantly, our review also highlights the need for studies performed in female rodents as these are almost non-existent.
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Affiliation(s)
- Diana Fonseca-Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus of Gualtar, University of Minho, 4710-057, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Diana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus of Gualtar, University of Minho, 4710-057, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus of Gualtar, University of Minho, 4710-057, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus of Gualtar, University of Minho, 4710-057, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal.
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Madrid J, Benninger DH. Non-invasive brain stimulation for Parkinson's disease: Clinical evidence, latest concepts and future goals: A systematic review. J Neurosci Methods 2020; 347:108957. [PMID: 33017643 DOI: 10.1016/j.jneumeth.2020.108957] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/27/2020] [Accepted: 09/18/2020] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is becoming a major public-health issue in an aging population. Available approaches to treat advanced PD still have limitations; new therapies are needed. The non-invasive brain stimulation (NIBS) may offer a complementary approach to treat advanced PD by personalized stimulation. Although NIBS is not as effective as the gold-standard levodopa, recent randomized controlled trials show promising outcomes in the treatment of PD symptoms. Nevertheless, only a few NIBS-stimulation paradigms have shown to improve PD's symptoms. Current clinical recommendations based on the level of evidence are reported in Table 1 through Table 3. Furthermore, novel technological advances hold promise and may soon enable the non-invasive stimulation of deeper brain structures for longer periods.
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Affiliation(s)
- Julian Madrid
- Service of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | - David H Benninger
- Service of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
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Castelo-Branco L, Fregni F. Home-Based Transcranial Direct Current Stimulation (tDCS) to Prevent and Treat Symptoms Related to Stress: A Potential Tool to Remediate the Behavioral Consequences of the COVID-19 Isolation Measures? Front Integr Neurosci 2020; 14:46. [PMID: 33071764 PMCID: PMC7530274 DOI: 10.3389/fnint.2020.00046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/22/2020] [Indexed: 01/15/2023] Open
Affiliation(s)
- Luis Castelo-Branco
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, United States
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, United States
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Pacheco-Barrios K, Cardenas-Rojas A, Thibaut A, Costa B, Ferreira I, Caumo W, Fregni F. Methods and strategies of tDCS for the treatment of pain: current status and future directions. Expert Rev Med Devices 2020; 17:879-898. [PMID: 32845195 PMCID: PMC7674241 DOI: 10.1080/17434440.2020.1816168] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 08/25/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique that has been widely studied for the treatment of chronic pain. It is considered a promising and safe alternative pain therapy. Different targets have been tested, each having their own particular mechanisms for modulating pain perception. AREAS COVERED We discuss the current state of the art of tDCS to manage pain and future strategies to optimize tDCS' effects. Current strategies include primary motor cortex tDCS, prefrontal tDCS and tDCS combined with behavioral interventions while future strategies, on the other hand, include high-intensity tDCS, transcutaneous spinal direct current stimulation, cerebellar tDCS, home-based tDCS, and tDCS with extended number of sessions. EXPERT COMMENTARY It has been shown that the stimulation of the prefrontal and primary motor cortex is efficient for pain reduction while a few other new strategies, such as high-intensity tDCS and network-based tDCS, are believed to induce strong neuroplastic effects, although the underlying neural mechanisms still need to be fully uncovered. Hence, conventional tDCS approaches demonstrated promising effects to manage pain and new strategies are under development to enhance tDCS effects and make this approach more easily available by using, for instance, home-based devices.
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Affiliation(s)
- Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud. Lima, Peru
| | - Alejandra Cardenas-Rojas
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Aurore Thibaut
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
- Coma Science Group, GIGA Consciousness, University of Liege, Liège, Belgium
| | - Beatriz Costa
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Isadora Ferreira
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Wolnei Caumo
- Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA), Laboratory of Pain and Neuromodulation at UFRGS, Porto Alegre, Brazil
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
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Transcranial Direct Current Stimulation (tDCS) Induces Analgesia in Rats with Neuropathic Pain and Alcohol Abstinence. Neurochem Res 2020; 45:2653-2663. [DOI: 10.1007/s11064-020-03116-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/31/2020] [Accepted: 08/15/2020] [Indexed: 02/07/2023]
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Lopes BC, Medeiros LF, Silva de Souza V, Cioato SG, Medeiros HR, Regner GG, Lino de Oliveira C, Fregni F, Caumo W, Torres IL. Transcranial direct current stimulation combined with exercise modulates the inflammatory profile and hyperalgesic response in rats subjected to a neuropathic pain model: Long-term effects. Brain Stimul 2020; 13:774-782. [DOI: 10.1016/j.brs.2020.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 12/12/2022] Open
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Memory and Cognition-Related Neuroplasticity Enhancement by Transcranial Direct Current Stimulation in Rodents: A Systematic Review. Neural Plast 2020; 2020:4795267. [PMID: 32211039 PMCID: PMC7061127 DOI: 10.1155/2020/4795267] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 12/19/2022] Open
Abstract
Brain stimulation techniques, including transcranial direct current stimulation (tDCS), were identified as promising therapeutic tools to modulate synaptic plasticity abnormalities and minimize memory and learning deficits in many neuropsychiatric diseases. Here, we revised the effect of tDCS on the modulation of neuroplasticity and cognition in several animal disease models of brain diseases affecting plasticity and cognition. Studies included in this review were searched following the terms (“transcranial direct current stimulation”) AND (mice OR mouse OR animal) and according to the PRISMA statement requirements. Overall, the studies collected suggest that tDCS was able to modulate brain plasticity due to synaptic modifications within the stimulated area. Changes in plasticity-related mechanisms were achieved through induction of long-term potentiation (LTP) and upregulation of neuroplasticity-related proteins, such as c-fos, brain-derived neurotrophic factor (BDNF), or N-methyl-D-aspartate receptors (NMDARs). Taken into account all revised studies, tDCS is a safe, easy, and noninvasive brain stimulation technique, therapeutically reliable, and with promising potential to promote cognitive enhancement and neuroplasticity. Since the use of tDCS has increased as a novel therapeutic approach in humans, animal studies are important to better understand its mechanisms as well as to help improve the stimulation protocols and their potential role in different neuropathologies.
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de Oliveira C, de Freitas JS, Macedo IC, Scarabelot VL, Ströher R, Santos DS, Souza A, Fregni F, Caumo W, Torres ILS. Transcranial direct current stimulation (tDCS) modulates biometric and inflammatory parameters and anxiety-like behavior in obese rats. Neuropeptides 2019; 73:1-10. [PMID: 30446297 DOI: 10.1016/j.npep.2018.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/14/2018] [Accepted: 09/19/2018] [Indexed: 12/16/2022]
Abstract
Obesity is a multifactorial disease associated with metabolic dysfunction and the prevention and treatment of obesity are often unsatisfactory. Transcranial direct-current stimulation (tDCS) is a non-invasive brain stimulation technique that has proven promising in the treatment of eating disorders such as obesity. We investigate the effects of tDCS on locomotor and exploratory activities, anxiety-like and feeding behavior, and levels of brain-derived neurotrophic factor (BDNF), IL (interleukin)-10, IL-1β, and tumor necrosis factor-alpha (TNF-α) in the cerebral cortex of obese rats. A total of 40 adult male Wistar rats were used in our study. Animals were divided into groups of three or four animals per cage and allocated to four treatment groups: standard diet plus sham tDCS treatment (SDS), standard diet plus tDCS treatment (SDT), hypercaloric diet plus sham tDCS treatment (HDS), hypercaloric diet plus tDCS treatment (HDT). After 40 days on a hypercaloric diet and/or standard diet were to assessed the locomotor and exploratory activity and anxiety-like behavior to by the open field (OF) and elevated plus maze (EPM) tests respectively before and after exposure to tDCS treatment. The experimental groups were submitted to active or sham treatment tDCS during eight days. Palatable food consumption test (PFT) was performed 24 h after the last tDCS session under fasting and feeding conditions. Obese animals submitted to tDCS treatment showed a reduction in the Lee index, visceral adipose tissue weight, and food craving. In addition, bicephalic tDCS decreased the cerebral cortex levels of IL-1β and TNF-α in these animals. Exposure to a hypercaloric diet produced an anxiolytic effect, which was reversed by bicephalic tDCS treatment. These results suggest that, in accordance with studies in humans, bicephalic tDCS could modulate biometric and inflammatory parameters, as well as anxiety-like and feeding behavior, of rats subjected to the consumption of a hypercaloric diet.
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Affiliation(s)
- Carla de Oliveira
- Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil; Post-Graduate Program in Medicine: Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Joice Soares de Freitas
- Post-Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil
| | - Isabel Cristina Macedo
- Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil
| | - Vanessa Leal Scarabelot
- Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil
| | - Roberta Ströher
- Post-Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil
| | - Daniela Silva Santos
- Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil; Post-Graduate Program in Medicine: Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andressa Souza
- Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil
| | - Felipe Fregni
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Wolnei Caumo
- Post-Graduate Program in Medicine: Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Iraci L S Torres
- Post-Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Pre clinical studies, Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-003, Brazil; Post-Graduate Program in Medicine: Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Boonzaier J, van Tilborg GAF, Neggers SFW, Dijkhuizen RM. Noninvasive Brain Stimulation to Enhance Functional Recovery After Stroke: Studies in Animal Models. Neurorehabil Neural Repair 2018; 32:927-940. [PMID: 30352528 PMCID: PMC6238175 DOI: 10.1177/1545968318804425] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Stroke is the leading cause of adult disability, but treatment options remain limited, leaving most patients with incomplete recovery. Patient and animal studies have shown potential of noninvasive brain stimulation (NIBS) strategies to improve function after stroke. However, mechanisms underlying therapeutic effects of NIBS are unclear and there is no consensus on which NIBS protocols are most effective. Objective. Provide a review of articles that assessed effects and mechanisms of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in animal stroke models. Methods. Articles were searched in PubMed, including cross-references. Results. Nineteen eligible studies reporting effects of rTMS or tDCS after stroke in small rodents were identified. Seventeen of those described improved functional recovery or neuroprotection compared with untreated control or sham-stimulated groups. The effects of rTMS could be related to molecular mechanisms associated with ischemic tolerance, neuroprotection, anti-apoptosis, neurogenesis, angiogenesis, or neuroplasticity. Favorable outcome appeared most effectively when using high-frequency (>5 Hz) rTMS or intermittent theta burst stimulation of the ipsilesional hemisphere. tDCS effects were strongly dependent on stimulation polarity and onset time. Although these findings are promising, most studies did not meet Good Laboratory Practice assessment criteria. Conclusions. Despite limited data availability, animal stroke model studies demonstrate potential of NIBS to promote stroke recovery through different working mechanisms. Future studies in animal stroke models should adhere to Good Laboratory Practice guidelines and aim to further develop clinically applicable treatment protocols by identifying most favorable stimulation parameters, treatment onset, adjuvant therapies, and underlying modes of action.
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Affiliation(s)
- Julia Boonzaier
- 1 Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Geralda A F van Tilborg
- 1 Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Sebastiaan F W Neggers
- 2 Brain Center Rudolf Magnus, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Rick M Dijkhuizen
- 1 Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
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The Alteration of Hippocampal BDNF Expression Is Associated with Anxiety-Like Behavior Following the Injury to the Sciatic Nerve. ARCHIVES OF NEUROSCIENCE 2018. [DOI: 10.5812/ans.74029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Seno MDJ, Assis DV, Gouveia F, Antunes GF, Kuroki M, Oliveira CC, Santos LCT, Pagano RL, Martinez RCR. The critical role of amygdala subnuclei in nociceptive and depressive-like behaviors in peripheral neuropathy. Sci Rep 2018; 8:13608. [PMID: 30206257 PMCID: PMC6134132 DOI: 10.1038/s41598-018-31962-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/30/2018] [Indexed: 01/05/2023] Open
Abstract
The amygdala is an important component of the limbic system that participates in the control of the pain response and modulates the affective-motivational aspect of pain. Neuropathic pain is a serious public health problem and has a strong affective-motivational component that makes it difficult to treat. The central (CeA), basolateral (BLA) and lateral (LA) nuclei of the amygdala are involved in the processing and regulation of chronic pain. However, the roles of these nuclei in the maintenance of neuropathic pain, anxiety and depression remain unclear. Thus, the main objective of this study was to investigate the role of amygdala subnuclei in the modulation of neuropathic pain, including the affective-motivational axis, in an experimental model of peripheral neuropathy. The specific goals were as follows: (1) To evaluate the nociceptive responses and the patterns of activation of the CeA, BLA and LA in neuropathic rats; and (2) To evaluate the effect of inactivating the amygdala nuclei on the nociceptive response, anxiety and depressive behaviors, motor activity, and plasma stress hormones in animals with neuropathic pain. Thus, mechanical hyperalgesia and allodynia, and the pattern of c-Fos staining in the amygdala subnuclei were evaluated in rats with chronic constriction of the sciatic nerve, as well as sham-operated and naïve rats. Once the amygdala subnuclei involved in neuropathic pain response were defined, those subnuclei were pharmacological inactivated. The effect of muscimol inactivation on the nociceptive response (hyperalgesia and allodynia), anxiety (elevated plus-maze), depressive-like behavior (forced swim test), motor activity (open field), and plasma stress hormone levels (corticosterone and adrenocorticotropic hormone) were evaluated in sham-operated and neuropathic animals. The results showed that the anterior and posterior portions of the BLA and the central portion of the CeA are involved in controlling neuropathic pain. The inactivation of these nuclei reversed hyperalgesia, allodynia and depressive-like behavior in animals with peripheral neuropathy. Taken together, our findings improve our understanding of the neurocircuitry involved in persistent pain and the roles of specific amygdala subnuclei in the modulation of neuropathic pain, including the neurocircuitry that processes the affective-motivational component of pain.
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Affiliation(s)
- Midiã D J Seno
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
| | - Danielle V Assis
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
| | - Flávia Gouveia
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
| | - Geiza F Antunes
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
| | - Mayra Kuroki
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
| | | | - Lennon C T Santos
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
| | - Rosana L Pagano
- Laboratory of Neuroscience, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil
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Sánchez-Kuhn A, Pérez-Fernández C, Moreno M, Flores P, Sánchez-Santed F. Differential Effects of Transcranial Direct Current Stimulation (tDCS) Depending on Previous Musical Training. Front Psychol 2018; 9:1465. [PMID: 30250439 PMCID: PMC6139306 DOI: 10.3389/fpsyg.2018.01465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/25/2018] [Indexed: 12/23/2022] Open
Abstract
Previous studies have shown that transcranial direct current stimulation (tDCS) facilitates motor performance, but individual differences such as baseline performance seem to influence this effect. Accordingly, musicians offer an inter-individual differences model due to anatomical and functional variances displayed among the motor cortex regions. The aim of the present work was to study if the baseline motor skill predicts whether tDCS can enhance motor learning. For that objective, we administered anodal (n = 20) or sham (n = 20) tDCS on the right primary motor cortex region of 40 right-handed healthy participants, who were divided into four groups: musicians (tDCS/sham) and non-musicians (tDCS/sham). We measured the skill index (SI) presented in the sequential finger-tapping task (SEQTAP) at baseline, during three 20 min/2 mA stimulation sessions, and in follow-up tests after 20 min and 8 days. Depending on the normality of the data distribution, statistical differences were estimated by ANOVA and Bonferroni post hoc test or Kruskal-Wallis and U Mann-Whitney. Results showed that musicians scored higher in baseline performance than non-musicians. The non-musicians who received tDCS scored higher than the sham group in the first and second stimulation session. This effect was extended to the 20 min and 8 days follow-up test. In musicians, there was no effect of tDCS. The present method seems to be suitable for the achievement of positive and consolidated tDCS effects on motor learning in inexperienced participants, but not in musicians. These data may have an implication for the rehabilitation of motor impairments, contributing to more individualized stimulation protocols.
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Affiliation(s)
- Ana Sánchez-Kuhn
- Department of Psychology and CIAIMBITAL, CeiA3, University of Almería, Almería, Spain
| | | | - Margarita Moreno
- Department of Psychology and CIAIMBITAL, CeiA3, University of Almería, Almería, Spain
| | - Pilar Flores
- Department of Psychology and CIAIMBITAL, CeiA3, University of Almería, Almería, Spain
- Instituto de Neurorehabilitación Infantil InPaula, Almería, Spain
| | - Fernando Sánchez-Santed
- Department of Psychology and CIAIMBITAL, CeiA3, University of Almería, Almería, Spain
- Instituto de Neurorehabilitación Infantil InPaula, Almería, Spain
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30
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Leffa DT, Bellaver B, Salvi AA, de Oliveira C, Caumo W, Grevet EH, Fregni F, Quincozes-Santos A, Rohde LA, Torres IL. Transcranial direct current stimulation improves long-term memory deficits in an animal model of attention-deficit/hyperactivity disorder and modulates oxidative and inflammatory parameters. Brain Stimul 2018; 11:743-751. [DOI: 10.1016/j.brs.2018.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 02/07/2023] Open
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Sánchez-León CA, Ammann C, Medina JF, Márquez-Ruiz J. Using animal models to improve the design and application of transcranial electrical stimulation in humans. Curr Behav Neurosci Rep 2018; 5:125-135. [PMID: 30013890 DOI: 10.1007/s40473-018-0149-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Purpose of Review Transcranial electrical stimulation (tES) is a non-invasive stimulation technique used for modulating brain function in humans. To help tES reach its full therapeutic potential, it is necessary to address a number of critical gaps in our knowledge. Here, we review studies that have taken advantage of animal models to provide invaluable insight about the basic science behind tES. Recent Findings Animal studies are playing a key role in elucidating the mechanisms implicated in tES, defining safety limits, validating computational models, inspiring new stimulation protocols, enhancing brain function and exploring new therapeutic applications. Summary Animal models provide a wealth of information that can facilitate the successful utilization of tES for clinical interventions in human subjects. To this end, tES experiments in animals should be carefully designed to maximize opportunities for applying discoveries to the treatment of human disease.
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Affiliation(s)
| | - Claudia Ammann
- CINAC, University Hospital HM Puerta del Sur, CEU - San Pablo University, 28938-Móstoles, Madrid, Spain
| | - Javier F Medina
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | - Javier Márquez-Ruiz
- Division of Neurosciences, Pablo de Olavide University, 41013-Seville, Spain
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32
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Spezia Adachi LN, Vercelino R, de Oliveira C, Scarabelot VL, de Souza A, Medeiros LF, Cioato SG, Caumo W, Torres ILS. Isoflurane and the Analgesic Effect of Acupuncture and Electroacupuncture in an Animal Model of Neuropathic Pain. J Acupunct Meridian Stud 2018; 11:97-106. [PMID: 29436370 DOI: 10.1016/j.jams.2018.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 01/30/2018] [Accepted: 01/31/2018] [Indexed: 12/17/2022] Open
Abstract
The present study aimed to determine whether isoflurane interferes with the analgesic effects of acupuncture (Ac) and electroacupuncture (EA), using a neuropathic pain (NP) rat model. In total, 140 male Wistar rats were used; isoflurane-induced nociceptive response was evaluated using the von Frey test, serum calcium-binding protein β (S100β) levels and nerve growth factor (NGF) levels in the left sciatic nerve. The NP model was induced by chronic constriction injury of the sciatic nerve at 14 days after surgery. Treatment was initiated after NP induction with or without isoflurane anesthesia (20 min/day/8 days). The von Frey test was performed at baseline, 14 days postoperatively, and immediately, 24 h, and 48 h after the last treatment. Results of the nociceptive test and three-way analysis of variance were analyzed by generalized estimating equations, the Bonferroni test, followed by Student-Newman-Keuls or Fisher's least significant difference tests for comparing biochemical parameters (significance defined as p ≤ 0.05). At baseline, no difference was noted in the nociceptive response threshold among all groups. Fourteen days after surgery, compared with other groups, NP groups showed a decreased pain threshold, confirming establishment of NP. Ac and EA enhanced the mechanical pain threshold immediately after the last session in the NP groups, without anesthesia. Isoflurane administration caused increased nociceptive threshold in all groups, and this effect persisted for 48 h after the last treatment. There was an interaction between the independent variables: pain, treatments, and anesthesia in serum S100β levels and NGF levels in the left sciatic nerve. Isoflurane enhanced the analgesic effects of Ac and EA and altered serum S100β and left sciatic nerve NGF levels in rats with NP.
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Affiliation(s)
- Lauren N Spezia Adachi
- Graduate Program in Medicine, Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Rafael Vercelino
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Centro Universitário FADERGS, Health and Wellness School Laureate International Universities, Porto Alegre, RS, Brazil
| | - Carla de Oliveira
- Graduate Program in Medicine, Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Vanessa L Scarabelot
- Graduate Program in Biological Sciences, Physiology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Andressa de Souza
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Liciane F Medeiros
- Graduate Program in Biological Sciences, Physiology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Stefania G Cioato
- Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Wolnei Caumo
- Graduate Program in Medicine, Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Iraci L S Torres
- Graduate Program in Medicine, Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Graduate Program in Biological Sciences, Physiology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil; Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Researchs, Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil; Animal Experimentation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
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Lopes TDS, Silva WDS, Ribeiro SB, Figueiredo CA, Campbell FQ, Daltro GDC, Valenzuela A, Montoya P, Lucena RDCS, Baptista AF. Does Transcranial Direct Current Stimulation Combined with Peripheral Electrical Stimulation Have an Additive Effect in the Control of Hip Joint Osteonecrosis Pain Associated with Sickle Cell Disease? A Protocol for a One-Session Double Blind, Block-Randomized Clinical Trial. Front Hum Neurosci 2017; 11:633. [PMID: 29326577 PMCID: PMC5742338 DOI: 10.3389/fnhum.2017.00633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/11/2017] [Indexed: 12/29/2022] Open
Abstract
Chronic pain in Sickle Cell Disease (SCD) is probably related to maladaptive plasticity of brain areas involved in nociceptive processing. Transcranial Direct Current Stimulation (tDCS) and Peripheral Electrical Stimulation (PES) can modulate cortical excitability and help to control chronic pain. Studies have shown that combined use of tDCS and PES has additive effects. However, to date, no study investigated additive effects of these neuromodulatory techniques on chronic pain in patients with SCD. This protocol describes a study aiming to assess whether combined use of tDCS and PES more effectively alleviate pain in patients with SCD compared to single use of each technique. The study consists of a one-session double blind, block-randomized clinical trial (NCT02813629) in which 128 participants with SCD and femoral osteonecrosis will be enrolled. Stepwise procedures will occur on two independent days. On day 1, participants will be screened for eligibility criteria. On day 2, data collection will occur in four stages: sample characterization, baseline assessment, intervention, and post-intervention assessment. These procedures will last ~5 h. Participants will be divided into two groups according to homozygous for S allele (HbSS) (n = 64) and heterozygous for S and C alleles (HbSC) (n = 64) genotypes. Participants in each group will be randomly assigned, equally, to one of the following interventions: (1) active tDCS + active PES; (2) active tDCS + sham PES; (3) sham tDCS + active PES; and (4) sham tDCS + sham PES. Active tDCS intervention will consist of 20 min 2 mA anodic stimulation over the primary motor cortex contralateral to the most painful hip. Active PES intervention will consist of 30 min sensory electrical stimulation at 100 Hz over the most painful hip. The main study outcome will be pain intensity, measured by a Visual Analogue Scale. In addition, electroencephalographic power density, cortical maps of the gluteus maximus muscle elicited by Transcranial Magnetic Stimulation (TMS), serum levels of Brain-derived Neurotrophic Factor (BDNF), and Tumor Necrosis Factor (TNF) will be assessed as secondary outcomes. Data will be analyzed using ANOVA of repeated measures, controlling for confounding variables.
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Affiliation(s)
- Tiago da Silva Lopes
- Health and Functionality Study Group, Federal University of Bahia, Salvador, Brazil.,Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | - Wellington Dos Santos Silva
- Health and Functionality Study Group, Federal University of Bahia, Salvador, Brazil.,Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil.,Health Section, Adventist Faculty of Bahia, Cachoeira, Brazil
| | - Sânzia B Ribeiro
- Health and Functionality Study Group, Federal University of Bahia, Salvador, Brazil.,Health Section, Adventist Faculty of Bahia, Cachoeira, Brazil
| | | | - Fernanda Q Campbell
- Health and Functionality Study Group, Federal University of Bahia, Salvador, Brazil
| | | | | | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
| | - Rita de C S Lucena
- Health and Functionality Study Group, Federal University of Bahia, Salvador, Brazil.,Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | - Abrahão F Baptista
- Health and Functionality Study Group, Federal University of Bahia, Salvador, Brazil.,Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil.,Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
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Ribeiro H, Sesterhenn RB, de Souza A, de Souza AC, Alves M, Machado JC, Burger NB, Torres ILDS, Stefani LC, Fregni F, Caumo W. Preoperative transcranial direct current stimulation: Exploration of a novel strategy to enhance neuroplasticity before surgery to control postoperative pain. A randomized sham-controlled study. PLoS One 2017; 12:e0187013. [PMID: 29190741 PMCID: PMC5708693 DOI: 10.1371/journal.pone.0187013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 09/25/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An imbalance in the excitatory/inhibitory systems in the pain networks may explain the persistent chronic pain after hallux valgus surgery. Thus, to contra-regulate this dysfunction, the use of transcranial direct current stimulation (tDCS) becomes attractive. OBJECTIVE We tested the hypothesis that two preoperative active(a)-tDCS sessions compared with sham(s)-tDCS could improve the postoperative pain [as indexed by Visual Analogue Scale (VAS) at rest and during walking (primary outcomes)]. To assess their effect on the change in the Numerical Pain Scale (NPS0-10) during Conditioned Pain Modulation (CPM-task), disability related to pain (DRP) and analgesic consumption (secondary outcomes). Also, we assessed if the brain derived neurotrophic factor (BDNF) in the cerebral spinal fluid (CSF) after tDCS could predict the intervention's effect on the DRP. METHODS It is a prospective, double blind, sham-controlled, randomized single center, 40 women (18-70 years-old) who had undergone hallux valgus surgery were randomized to receive two sessions (20 minutes each) of anodal a-tDCS or s-tDCS on the primary motor cortex at night and in the morning before the surgery. To assess the DRP was used the Brazilian Profile of Chronic Pain: Screen (B-PCP:S). RESULTS A-tDCS group showed lower scores on VAS at rest and during walking (P<0.001). At rest, the difference between groups was 2.13cm (95%CI = 1.59 to 2.68) while during walking was 1.67cm (95%CI = 1.05 to 2.28). A-tDCS, when compared to s-tDCS reduced analgesic doses in 73.25% (P<0.001), produced a greater reduction in B-PCP:S (mean difference of 9.41 points, 95%CI = 0.63 to 18.21) and higher function of descending pain modulatory system (DPMS) during CPM-task. CONCLUSION A-tDCS improves postoperative pain, the DRP and the function of DPMS. Also, the CSF BDNF after a-tDCS predicted the improvement in the DRP. In overall, these findings suggest that a-tDCS effects may be mediated by top-down regulatory mechanisms associated with the inhibitory cortical control. TRIAL REGISTRATION ClinicalTrials.gov NCT02360462.
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Affiliation(s)
- Hugo Ribeiro
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Surgery Department, Hospital Independência, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Andressa de Souza
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Claudia de Souza
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Monique Alves
- Surgery Department, Hospital Independência, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jessica Catarina Machado
- Postgraduate Program in Health and Human Development, La Salle University Center, Canoas, Rio Grande do Sul, Brazil
| | | | - Iraci Lucena da Silva Torres
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Pharmacology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciana Cadore Stefani
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Surgery Department, Anesthesia and Perioperative Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Felipe Fregni
- Physical Medicine & Rehabilitation Department, Center of Neuromodulation & Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Wolnei Caumo
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Surgery Department, Anesthesia and Perioperative Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Pain and Palliative Care Service, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
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Transcranial direct current stimulation as a motor neurorehabilitation tool: an empirical review. Biomed Eng Online 2017; 16:76. [PMID: 28830433 PMCID: PMC5568608 DOI: 10.1186/s12938-017-0361-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The present review collects the most relevant empirical evidence available in the literature until date regarding the effects of transcranial direct current stimulation (tDCS) on the human motor function. tDCS in a non-invasive neurostimulation technique that delivers a weak current through the brain scalp altering the cortical excitability on the target brain area. The electrical current modulates the resting membrane potential of a variety of neuronal population (as pyramidal and gabaergic neurons); raising or dropping the firing rate up or down, depending on the nature of the electrode and the applied intensity. These local changes additionally have shown long-lasting effects, evidenced by its promotion of the brain-derived neurotrophic factor. Due to its easy and safe application and its neuromodulatory effects, tDCS has attracted a big attention in the motor neurorehabilitation field among the last years. Therefore, the present manuscript updates the knowledge available about the main concept of tDCS, its practical use, safety considerations, and its underlying mechanisms of action. Moreover, we will focus on the empirical data obtained by studies regarding the application of tDCS on the motor function of healthy and clinical population, comprising motor deficiencies of a variety of pathologies as Parkinson's disease, stroke, multiple sclerosis and cerebral palsy, among others. Finally, we will discuss the main current issues and future directions of tDCS as a motor neurorehabilitation tool.
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Wen HZ, Gao SH, Zhao YD, He WJ, Tian XL, Ruan HZ. Parameter Optimization Analysis of Prolonged Analgesia Effect of tDCS on Neuropathic Pain Rats. Front Behav Neurosci 2017; 11:115. [PMID: 28659772 PMCID: PMC5468406 DOI: 10.3389/fnbeh.2017.00115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/26/2017] [Indexed: 01/27/2023] Open
Abstract
Background: Transcranial direct current stimulation (tDCS) is widely used to treat human nerve disorders and neuropathic pain by modulating the excitability of cortex. The effectiveness of tDCS is influenced by its stimulation parameters, but there have been no systematic studies to help guide the selection of different parameters. Objective: This study aims to assess the effects of tDCS of primary motor cortex (M1) on chronic neuropathic pain in rats and to test for the optimal parameter combinations for analgesia. Methods: Using the chronic neuropathic pain models of chronic constriction injury (CCI), we measured pain thresholds before and after anodal-tDCS (A-tDCS) using different parameter conditions, including stimulation intensity, stimulation time, intervention time and electrode located (ipsilateral or contralateral M1 of the ligated paw on male/female CCI models). Results: Following the application of A-tDCS over M1, we observed that the antinociceptive effects were depended on different parameters. First, we found that repetitive A-tDCS had a longer analgesic effect than single stimulus, and both ipsilateral-tDCS (ip-tDCS) and contralateral-tDCS (con-tDCS) produce a long-lasting analgesic effect on neuropathic pain. Second, the antinociceptive effects were intensity-dependent and time-dependent, high intensities worked better than low intensities and long stimulus durations worked better than short stimulus durations. Third, timing of the intervention after injury affected the stimulation outcome, early use of tDCS was an effective method to prevent the development of pain, and more frequent intervention induced more analgesia in CCI rats, finally, similar antinociceptive effects of con- and ip-tDCS were observed in both sexes of CCI rats. Conclusion: Optimized protocols of tDCS for treating antinociceptive effects were developed. These findings should be taken into consideration when using tDCS to produce analgesic effects in clinical applications.
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Affiliation(s)
- Hui-Zhong Wen
- Department of Neurobiology, College of Basic Medical Science, Chongqing Key Laboratory of Neurobiology, Third Military Medical UniversityChongqing, China
| | - Shi-Hao Gao
- Department of Neurobiology, College of Basic Medical Science, Chongqing Key Laboratory of Neurobiology, Third Military Medical UniversityChongqing, China
| | - Yan-Dong Zhao
- Department of Neurobiology, College of Basic Medical Science, Chongqing Key Laboratory of Neurobiology, Third Military Medical UniversityChongqing, China
| | - Wen-Juan He
- Department of Pathophysiology and High Altitudepathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China
| | - Xue-Long Tian
- Bioengineering College, Chongqing UniversityChongqing, China
| | - Huai-Zhen Ruan
- Department of Neurobiology, College of Basic Medical Science, Chongqing Key Laboratory of Neurobiology, Third Military Medical UniversityChongqing, China
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Schunck RVA, Macedo IC, Laste G, de Souza A, Valle MTC, Salomón JLO, Nunes EA, Campos ACW, Gnoatto SCB, Bergold AM, Konrath EL, Dallegrave E, Arbo MD, Torres ILS, Leal MB. Standardized Passiflora incarnata L. Extract Reverts the Analgesia Induced by Alcohol Withdrawal in Rats. Phytother Res 2017; 31:1199-1208. [PMID: 28568647 DOI: 10.1002/ptr.5839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 04/14/2017] [Accepted: 05/03/2017] [Indexed: 12/13/2022]
Abstract
Passiflora incarnata L. (Passifloraceae) has been traditionally used for treatment of anxiety, insomnia, drug addiction, mild infections, and pain. The aim of this study was to investigate the effect of a commercial extract of P. incarnata in the analgesia induced by alcohol withdrawal syndrome in rats. In addition, brain-derived neurotrophic factor and interleukin-10 levels were evaluated in prefrontal cortex, brainstem, and hippocampus. Male adult rats received by oral gavage: (1: water group) water for 19 days, 1 day interval and water (8 days); (2: P. incarnata group) water for 19 days, 1 day interval and P. incarnata 200 mg/kg (8 days); (3: alcohol withdrawal group) alcohol for 19 days, 1 day interval and water (8 days); and (4: P. incarnata in alcohol withdrawal) alcohol for 19 days, 1 day interval and P. incarnata 200 mg/kg (8 days). The tail-flick and hot plate tests were used as nociceptive response measures. Confirming previous study of our group, it was showed that alcohol-treated groups presented an increase in the nociceptive thresholds after alcohol withdrawal, which was reverted by P. incarnata, measured by the hot plate test. Besides, alcohol treatment increased brain-derived neurotrophic factor and interleukin-10 levels in prefrontal cortex, which was not reverted by P. incarnata. Considering these results, the P. incarnata treatment might be a potential therapy in the alcohol withdrawal syndrome. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Rebeca Vargas Antunes Schunck
- Programa de Pós-Graduação em Ciências Biológicas - Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/107, 90050-170, Porto Alegre, RS, Brazil.,Laboratório de Farmacologia e Toxicologia de Produtos Naturais, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/202, 90050-170, Porto Alegre, RS, Brazil
| | - Isabel Cristina Macedo
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-clínicas, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170, Porto Alegre, RS, Brazil
| | - Gabriela Laste
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-clínicas, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170, Porto Alegre, RS, Brazil
| | - Andressa de Souza
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-clínicas, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170, Porto Alegre, RS, Brazil
| | - Marina Tuerlinckx Costa Valle
- Programa de Pós-Graduação em Ciências Biológicas - Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/107, 90050-170, Porto Alegre, RS, Brazil.,Laboratório de Farmacologia e Toxicologia de Produtos Naturais, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/202, 90050-170, Porto Alegre, RS, Brazil
| | - Janaína L O Salomón
- Laboratório de Farmacologia e Toxicologia de Produtos Naturais, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/202, 90050-170, Porto Alegre, RS, Brazil
| | - Ellen Almeida Nunes
- Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-clínicas, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170, Porto Alegre, RS, Brazil
| | - Andreia Cristina Wildner Campos
- Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Simone Cristina Baggio Gnoatto
- Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Ana Maria Bergold
- Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Eduardo L Konrath
- Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Eliane Dallegrave
- Departamento de Farmacociências, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
| | - Marcelo Dutra Arbo
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90050-000, Porto Alegre, RS, Brazil
| | - Iraci L S Torres
- Programa de Pós-Graduação em Ciências Biológicas - Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/107, 90050-170, Porto Alegre, RS, Brazil.,Laboratório de Farmacologia da Dor e Neuromodulação: Investigações Pré-clínicas, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170, Porto Alegre, RS, Brazil
| | - Mirna Bainy Leal
- Programa de Pós-Graduação em Ciências Biológicas - Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/107, 90050-170, Porto Alegre, RS, Brazil.,Laboratório de Farmacologia e Toxicologia de Produtos Naturais, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500/202, 90050-170, Porto Alegre, RS, Brazil
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Scarabelot VL, Medeiros LF, de Oliveira C, Adachi LNS, de Macedo IC, Cioato SG, de Freitas JS, de Souza A, Quevedo A, Caumo W, Torres ILDS. Melatonin Alters the Mechanical and Thermal Hyperalgesia Induced by Orofacial Pain Model in Rats. Inflammation 2017; 39:1649-59. [PMID: 27378529 DOI: 10.1007/s10753-016-0399-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Melatonin is a neuroendocrine hormone that presents a wide range of physiological functions including regulating circadian rhythms and sleep, enhancing immune function, sleep improvement, and antioxidant effects. In addition, melatonin has received special attention in pain treatment since it is effective and presents few adverse effects. In this study, we evaluated the effect of acute dose of melatonin upon hyperalgesia induced by complete Freund's adjuvant in a chronic orofacial pain model in Sprague-Dawley rats. Nociceptive behavior was assessed by facial Von Frey and the hot plate tests at baseline and thereafter 30, 60, and 120 min, 24 h, and 7 days after melatonin treatment. We demonstrated that acute melatonin administration alters mechanical and thermal hyperalgesia induced by an orofacial pain model (TMD), highlighting that the melatonin effect upon mechanical hyperalgesia remained until 7 days after its administration. Besides, we observed specific tissue profiles of neuroimmunomodulators linked to pain conditions and/or melatonin effect (brain-derived neurotrophic factor, nerve growth factor, and interleukins 6 and 10) in the brainstem levels, and its effects were state-dependent of the baseline of these animals.
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Affiliation(s)
- Vanessa Leal Scarabelot
- Postgraduate Program in Biological Sciences: Physiology, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
| | - Liciane Fernandes Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
| | - Carla de Oliveira
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lauren Naomi Spezia Adachi
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isabel Cristina de Macedo
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
| | - Stefania Giotti Cioato
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
| | - Joice S de Freitas
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil
| | - Andressa de Souza
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
| | - Alexandre Quevedo
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil
| | - Wolnei Caumo
- Department of Surgery in Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, 90035-003, RS, Brazil
| | - Iraci Lucena da Silva Torres
- Postgraduate Program in Biological Sciences: Physiology, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, 90050-170, Brazil.
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Research, Pharmacology Department, Health Basic Sciences Institute, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500 sala 305, Porto Alegre, 90050-170, RS, Brazil.
- Animal Experimentation Unit and Graduate Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, 90035-003, RS, Brazil.
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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da Silva FTG, Browne RAV, Pinto CB, Saleh Velez FG, do Egito EST, do Rêgo JTP, da Silva MR, Dantas PMS, Fregni F. Transcranial direct current stimulation in individuals with spinal cord injury: Assessment of autonomic nervous system activity. Restor Neurol Neurosci 2017; 35:159-169. [PMID: 28282844 DOI: 10.3233/rnn-160685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We hypothesized in this study that transcranial direct current stimulation (tDCS) of primary motor cortex could exert top-down modulation over subcortical systems associated with autonomic control and thus be useful to revert some of the dysfunctional changes found in the autonomic nervous system (ANS) of subjects with spinal cord injuries (SCI). OBJECTIVE To explore the acute effect of tDCS on ANS indexed by Heart Rate Variability (HRV) in individuals with SCI and analyze whether this effect depends on the gender, degree, level and time of injury. METHODS In this randomized, placebo-controlled, crossover, double-blinded study, 18 adults with SCI (32.9±7.9 years old) were included; the intervention consisted of a single 12-minute session of active tDCS (anodal, 2 mA) and a control session of sham tDCS applied over Cz (bihemispheric motor cortex). HRV was calculated using spectral analysis. Low-frequency (LF), high-frequency (HF), and LF/HF ratio variables were evaluated before, during, and post tDCS. RESULTS A two-way repeated measures ANOVA showed that after active (anodal) stimulation, LF/HF ratio was significantly increased (P = 0.013). There was a trend for an interaction between time and stimulation for both LF and HF (P = 0.052). Paired exploratory t-tests reported effects on the difference of time [post-pre] between stimulation conditions for LF (P = 0.052), HF (P = 0.052) and LF/HF (P = 0.003). CONCLUSION Anodal tDCS of the motor cortex modulated ANS activity in individuals with SCI independent of gender, type and time of lesion. These changes were in the direction of normalization of ANS parameters, thus confirming our initial hypothesis that an enhancement of cortical excitability by tDCS could at least partially restore some of the dysfunctional activity in the ANS system of subjects with SCI.
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Affiliation(s)
- Fabiana Tenório Gomes da Silva
- Laboratory of Neuromodulation, Center of Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,Psychology institute, Department of Neurosciences and behavior, University of São Paulo (USP), São Paulo, Brazil.,Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Rodrigo Alberto Vieira Browne
- Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Camila Bonin Pinto
- Laboratory of Neuromodulation, Center of Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Faddi Ghassan Saleh Velez
- Laboratory of Neuromodulation, Center of Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Eryvaldo Sócrates Tabosa do Egito
- Department of Pharmacy, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Jeferson Tafarel Pereira do Rêgo
- Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Marília Rodrigues da Silva
- Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Paulo Moreira Silva Dantas
- Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Center of Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
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Ljubisavljevic M, Maxood K, Bjekic J, Oommen J, Nagelkerke N. Long-Term Effects of Repeated Prefrontal Cortex Transcranial Direct Current Stimulation (tDCS) on Food Craving in Normal and Overweight Young Adults. Brain Stimul 2016; 9:826-833. [PMID: 27498606 DOI: 10.1016/j.brs.2016.07.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 06/28/2016] [Accepted: 07/09/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The dorsolateral prefrontal cortex (DLPFC) plays an important role in the regulation of food intake. Several previous studies demonstrated that a single session of transcranial direct current stimulation (tDCS) of the DLPFC reduces food craving and caloric intake. OBJECTIVES We hypothesized that repeated tDCS of the right DLPFC cortex may exert long-term changes in food craving in young, healthy adults and that these changes may differ between normal and overweight subjects. METHODS Thirty healthy individuals who reported frequent food cravings without a prior history of eating disorders were initially recruited. Subjects were randomized into an ACTIVE group who received 5 days of real tDCS (20 minutes, anode right-cathode left montage, 2 mA with current density kept at 0.06 mA/cm2, 1 min ramp-up/ramp-down), and a SHAM group, who received one day of real tDCS, on the first day (same parameters), followed by 4 days of sham tDCS. Food craving intensity was examined by Food Craving Questionnaires State and Trait and Food Craving Inventory before, during, (5-days) and one month (30-days) after tDCS. RESULTS Single session of tDCS significantly reduced the intensity of current food craving (FCQ-S). Five days of active tDCS significantly reduced habitual experiences of food craving (FCQ-T), when compared to baseline pre-stimulation levels. Furthermore, both current (FCQ-S) and habitual craving (FCQ-T) were significantly reduced 30 days after active tDCS, while sham tDCS, i.e. a single tDCS session did not have significant effects. Also, active tDCS significantly decreased craving for fast food and sweets, and to a lesser degree for fat, while it did not have significant effects on craving for carbohydrates (FCI). There were no significant differences between individual FCQ-T subscales (craving dimensions) after 5 or 30 days of either sham or active tDCS. Changes in craving were not significantly associated with the initial weight, or with weight changes 30 days after the stimulation in the subjects. CONCLUSIONS The results confirm earlier findings that single session of tDCS has immediate effects in reducing food craving. They also show that repeated tDCS over the right DLPFC may increase the duration of its effects, which may be present 30 days after the stimulation. These results support further investigation of the use of tDCS in obesity.
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Affiliation(s)
- M Ljubisavljevic
- Department of Physiology, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates.
| | - K Maxood
- Department of Physiology, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
| | - J Bjekic
- Department of Neurophysiology, Institute for Medical Research, University of Belgrade, PO Box 124, Belgrade, Serbia
| | - J Oommen
- Department of Physiology, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
| | - N Nagelkerke
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Queen Elizabeth Central Hospital, Malawi; Institute of Public Health, College of Medicine and Health Sciences, PO Box 17666, UAE University, Al Ain, United Arab Emirates
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41
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Dimov LF, Franciosi AC, Campos ACP, Brunoni AR, Pagano RL. Top-Down Effect of Direct Current Stimulation on the Nociceptive Response of Rats. PLoS One 2016; 11:e0153506. [PMID: 27071073 PMCID: PMC4829148 DOI: 10.1371/journal.pone.0153506] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/30/2016] [Indexed: 01/06/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is an emerging, noninvasive technique of neurostimulation for treating pain. However, the mechanisms and pathways involved in its analgesic effects are poorly understood. Therefore, we investigated the effects of direct current stimulation (DCS) on thermal and mechanical nociceptive thresholds and on the activation of the midbrain periaqueductal gray (PAG) and the dorsal horn of the spinal cord (DHSC) in rats; these central nervous system areas are associated with pain processing. Male Wistar rats underwent cathodal DCS of the motor cortex and, while still under stimulation, were evaluated using tail-flick and paw pressure nociceptive tests. Sham stimulation and naive rats were used as controls. We used a randomized design; the assays were not blinded to the experimenter. Immunoreactivity of the early growth response gene 1 (Egr-1), which is a marker of neuronal activation, was evaluated in the PAG and DHSC, and enkephalin immunoreactivity was evaluated in the DHSC. DCS did not change the thermal nociceptive threshold; however, it increased the mechanical nociceptive threshold of both hind paws compared with that of controls, characterizing a topographical effect. DCS decreased the Egr-1 labeling in the PAG and DHSC as well as the immunoreactivity of spinal enkephalin. Altogether, the data suggest that DCS disinhibits the midbrain descending analgesic pathway, consequently inhibiting spinal nociceptive neurons and causing an increase in the nociceptive threshold. This study reinforces the idea that the motor cortex participates in the neurocircuitry that is involved in analgesia and further clarifies the mechanisms of action of tDCS in pain treatment.
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Affiliation(s)
- Luiz Fabio Dimov
- Laboratory of Neuromodulation and Experimental Pain, Hospital Sírio Libanês, Rua Prof Daher Cutait, 69, Sao Paulo, SP, 01308-060, Brazil
| | - Adriano Cardozo Franciosi
- Laboratory of Neuromodulation and Experimental Pain, Hospital Sírio Libanês, Rua Prof Daher Cutait, 69, Sao Paulo, SP, 01308-060, Brazil
| | - Ana Carolina Pinheiro Campos
- Laboratory of Neuromodulation and Experimental Pain, Hospital Sírio Libanês, Rua Prof Daher Cutait, 69, Sao Paulo, SP, 01308-060, Brazil
| | - André Russowsky Brunoni
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculty of Medicine of University of São Paulo, Laboratory of Neuroscience (LIM27), Department and Institute of Psychiatry, University of São Paulo, Rua Doutor Ovidio Pires de Campos, 785, Sao Paulo, SP, 05403-000, Brazil.,Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation (CINA), University Hospital, University of São Paulo, São Paulo, Avenida Professor Lineu Prestes 2565, ext. 3, Sao Paulo, SP, 05508-000, Brazil
| | - Rosana Lima Pagano
- Laboratory of Neuromodulation and Experimental Pain, Hospital Sírio Libanês, Rua Prof Daher Cutait, 69, Sao Paulo, SP, 01308-060, Brazil
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