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Saravagi D, Agrawal S, Saravagi M, Rahman MH. Diagnosis of Lumbar Spondylolisthesis Using a Pruned CNN Model. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2722315. [PMID: 35592683 PMCID: PMC9113885 DOI: 10.1155/2022/2722315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/15/2022] [Indexed: 11/17/2022]
Abstract
Convolutional neural network (CNN) models have made tremendous progress in the medical domain in recent years. The application of the CNN model is restricted due to a huge number of redundant and unnecessary parameters. In this paper, the weight and unit pruning strategy are used to reduce the complexity of the CNN model so that it can be used on small devices for the diagnosis of lumbar spondylolisthesis. Experimental results reveal that by removing 90% of network load, the unit pruning strategy outperforms weight pruning while achieving 94.12% accuracy. Thus, only 30% (around 850532 out of 3955102) and 10% (around 251512 out of 3955102) of the parameters from each layer contribute to the outcome during weight and neuron pruning, respectively. The proposed pruned model had achieved higher accuracy as compared to the prior model suggested for lumbar spondylolisthesis diagnosis.
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Affiliation(s)
- Deepika Saravagi
- Department of Computer Application, SAGE University, Indore 452012, India
| | | | - Manisha Saravagi
- Physiotherapy Department, Railway Hospital, Kota, Rajasthan 324002, India
| | - Md Habibur Rahman
- Department of Computer Science and Engineering, Islamic University, Kushtia-7003, Bangladesh
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Pathan EMI, Inman RD. Pain in Axial Spondyloarthritis: Insights from Immunology and Brain Imaging. Rheum Dis Clin North Am 2021; 47:197-213. [PMID: 33781490 DOI: 10.1016/j.rdc.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Inflammatory back pain is characteristic of spondyloarthritis (SpA); however, this pain may not respond to treatment with NSAIDs or biologics. Pain is multifactorial and a combination of mechanical and inflammatory factors. A growing body of literature examines the impact of emotions on pain in SpA; many patients with this condition suffer from depression and fibromyalgia. Advanced imaging techniques can investigate the interplay of various brain networks in pain perception. Animal models have helped understand the interplay between the immune and nervous systems in pain generation and have highlighted differences in pain perception between the sexes.
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Affiliation(s)
- Ejaz M I Pathan
- Rheumatology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
| | - Robert D Inman
- Spondylitis Program, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada; Schroeder Arthritis Institute, University Health Network; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Immunology, University of Toronto, Toronto, Ontario, Canada
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Littlejohn G, Guymer E. Key Milestones Contributing to the Understanding of the Mechanisms Underlying Fibromyalgia. Biomedicines 2020; 8:biomedicines8070223. [PMID: 32709082 PMCID: PMC7400313 DOI: 10.3390/biomedicines8070223] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/11/2020] [Accepted: 07/12/2020] [Indexed: 02/07/2023] Open
Abstract
The promulgation of the American College of Rheumatology (ACR) 1990 criteria for fibromyalgia (FM) classification has significantly contributed to an era of increased research into mechanisms that underlie the disorder. The previous emphasis on putative peripheral nociceptive mechanisms has advanced to identifying of changes in central neural networks that modulate pain and other sensory processes. The influences of psychosocial factors on the dynamic and complex neurobiological mechanisms involved in the fibromyalgia clinical phenotype are now better defined. This review highlights key milestones that have directed knowledge concerning the fundamental mechanisms contributing to fibromyalgia.
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Affiliation(s)
- Geoffrey Littlejohn
- Departments of Medicine, Monash University, Melbourne 3168, Australia;
- Departments of Rheumatology, Monash Health, Melbourne 3168, Australia
- Correspondence: ; Tel.: +61-3-95942575
| | - Emma Guymer
- Departments of Medicine, Monash University, Melbourne 3168, Australia;
- Departments of Rheumatology, Monash Health, Melbourne 3168, Australia
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Abstract
In this article, I review the concept of personalized pain management and consider how brain imaging and quantitative sensory testing can be used to derive biomarkers of chronic pain treatment outcome. I review how different modalities of brain imaging can be used to acquire information about brain structure and function and how this information can be linked to individual measures of pain.
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Volkers R, Giesen E, van der Heiden M, Kerperien M, Lange S, Kurt E, van Dongen R, Schutter D, Vissers KCP, Henssen D. Invasive Motor Cortex Stimulation Influences Intracerebral Structures in Patients With Neuropathic Pain: An Activation Likelihood Estimation Meta-Analysis of Imaging Data. Neuromodulation 2020; 23:436-443. [PMID: 32030854 PMCID: PMC7317964 DOI: 10.1111/ner.13119] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 11/30/2022]
Abstract
Objective Invasive motor cortex stimulation (iMCS) has been proposed as a treatment for intractable neuropathic pain syndromes. Although the mechanisms underlying the analgesic effect of iMCS remain largely elusive, several studies found iMCS‐related changes in regional cerebral blood flow (rCBF) in neuropathic pain patients. The aim of this study was to meta‐analyze the findings of neuroimaging studies on rCBF changes to iMCS. Methods PubMed, Embase, MEDLINE, Google Scholar, and the Cochrane Library were systematically searched for retrieval of relevant scientific papers. After initial assessment of relevancy by screening title and abstract by two investigators, independently, predefined inclusion and exclusion criteria were used for final inclusion of papers. Descriptive results were statistically assessed, whereas coordinates were pooled and meta‐analyzed in accordance with the activation likelihood estimation (ALE) methodology. Results Six studies were included in the systematic narrative analysis, suggesting rCBF increases in the cingulate gyrus, thalamus, insula, and putamen after switching the MCS device “ON” as compared to the “OFF” situation. Decreases in rCBF were found in for example the precentral gyrus and different occipital regions. Two studies did not report stereotactic coordinates and were excluded from further analysis. ALE meta‐analysis showed that, after switching the iMCS electrode “ON,” increased rCBF occurred in the (1) anterior cingulate gyrus; (2) putamen; (3) cerebral peduncle; (4) precentral gyrus; (5) superior frontal gyrus; (6) red nucleus; (7) internal part of the globus pallidus; (8) ventral lateral nucleus of the thalamus; (9) medial frontal gyrus; (10) inferior frontal gyrus; and (11) claustrum, as compared to the “OFF” situation. Reductions in rCBF were found in the posterior cingulate gyrus when the iMCS electrode was turned “OFF.” Conclusions These findings suggested that iMCS induces changes in principal components of the default mode‐, the salience‐, and sensorimotor network.
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Affiliation(s)
- Ruben Volkers
- Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Anesthesiology, Pain, and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esmay Giesen
- Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maudy van der Heiden
- Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mijke Kerperien
- Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sibylle Lange
- Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erkan Kurt
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert van Dongen
- Department of Anesthesiology, Pain, and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dennis Schutter
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,Helmholtz Institute, Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Kris C P Vissers
- Department of Anesthesiology, Pain, and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dylan Henssen
- Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Inami C, Tanihira H, Kikuta S, Ogasawara O, Sobue K, Kume K, Osanai M, Ohsawa M. Visualization of Brain Activity in a Neuropathic Pain Model Using Quantitative Activity-Dependent Manganese Magnetic Resonance Imaging. Front Neural Circuits 2019; 13:74. [PMID: 31849617 PMCID: PMC6889800 DOI: 10.3389/fncir.2019.00074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 10/31/2019] [Indexed: 11/13/2022] Open
Abstract
Human brain imaging studies have revealed several regions that are activated in patients with chronic pain. In rodent brains, functional changes due to chronic pain have not been fully elucidated, as brain imaging techniques such as functional magnetic resonance imaging and positron emission tomography (PET) require the use of anesthesia to suppress movement. Consequently, conclusions derived from existing imaging studies in rodents may not accurately reflect brain activity under awake conditions. In this study, we used quantitative activation-induced manganese-enhanced magnetic resonance imaging to directly capture the previous brain activity of awake mice. We also observed and quantified the brain activity of the spared nerve injury (SNI) neuropathic pain model during awake conditions. SNI-operated mice exhibited a robust decrease of mechanical nociceptive threshold 14 days after nerve injury. Imaging on SNI-operated mice revealed increased neural activity in the limbic system and secondary somatosensory, sensory-motor, piriform, and insular cortex. We present the first study demonstrating a direct measurement of awake neural activity in a neuropathic pain mouse model.
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Affiliation(s)
- Chihiro Inami
- Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Hiroki Tanihira
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Satomi Kikuta
- Graduate School of Medicine, Tohoku University, Sendai, Japan.,Systems Neuroscience Section, Primate Research Institute, Kyoto University, Inuyama, Japan
| | - Osamu Ogasawara
- Department of Anesthesiology, Graduate School of Medicine, Nagoya City University, Nagoya, Japan
| | - Kazuya Sobue
- Department of Anesthesiology, Graduate School of Medicine, Nagoya City University, Nagoya, Japan
| | - Kazuhiko Kume
- Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Makoto Osanai
- Graduate School of Medicine, Tohoku University, Sendai, Japan.,Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.,Division of Health Sciences, Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Masahiro Ohsawa
- Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
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Osborne NR, Anastakis DJ, Davis KD. Peripheral nerve injuries, pain, and neuroplasticity. J Hand Ther 2019; 31:184-194. [PMID: 29706196 DOI: 10.1016/j.jht.2018.01.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/15/2018] [Accepted: 01/20/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Peripheral nerve injuries (PNIs) cause both structural and functional brain changes that may be associated with significant sensorimotor abnormalities and pain. PURPOSE OF THE STUDY The aim of this narrative review is to provide hand therapists an overview of PNI-induced neuroplasticity and to explain how the brain changes following PNI, repair, and during rehabilitation. METHODS Toward this goal, we review key aspects of neuroplasticity and neuroimaging and discuss sensory testing techniques used to study neuroplasticity in PNI patients. RESULTS We describe the specific brain changes that occur during the repair and recovery process of both traumatic (eg, transection) and nontraumatic (eg, compression) nerve injuries. We also explain how these changes contribute to common symptoms including hypoesthesia, hyperalgesia, cold sensitivity, and chronic neurogenic pain. In addition, we describe how maladaptive neuroplasticity as well as psychological and personality characteristics impacts treatment outcome. DISCUSSION AND CONCLUSION Greater understanding of the brain's contribution to symptoms in recovering PNI patients could help guide rehabilitation strategies and inform the development of novel techniques to counteract these maladaptive brain changes and ultimately improve outcomes.
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Affiliation(s)
- Natalie R Osborne
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Dimitri J Anastakis
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Karen D Davis
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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Strunce J, Spoonemore S, Golding J, Randall T, Krok M, Lee S, Bordt D, Walker-Ferrell W, Cordel D. Physical rehabilitation therapists' perspective of the opioid crisis with evidence-based recommendations. Pain Manag 2019; 9:483-495. [PMID: 31452447 DOI: 10.2217/pmt-2019-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In 2017, the Secretary of Health and Human Services and Office of the Surgeon General declared the opioid crisis of our nation to be a public health emergency. In response to the Office of the Assistant Secretary of Health and Office of the Surgeon General's 'Call to Action', the Therapist category of the US Public Health Service commissioned a nine-member task force consisting of pain science subject matter experts to study the Therapists' role in effectively reducing chronic pain and opioid abuse. This article addresses the opioid epidemic, how patients with chronic pain have been managed inappropriately, and five key, evidence-based recommendations from this task force.
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Affiliation(s)
- Joseph Strunce
- Rehabilitation Department, Four Corners Regional Health Center, Red Mesa, AZ 86514, USA
| | - Stephen Spoonemore
- Rehabilitation Department, Physical Therapy & Exercise Southcentral Foundation, Anchorage, AK 99508, USA
| | - Joseph Golding
- Rehabilitation Department, Parker Indian Health Center, Parker, AZ 85344, USA
| | - Tarri Randall
- Rehabilitation Department, Whiteriver Indian Hospital, Whiteriver, AZ 85941, USA
| | - Michael Krok
- Rehabilitation Department, Womack Army Medical Center, Fort Bragg, NC 28310, USA
| | - Steven Lee
- Rehabilitation Department, Valley Native Primary Care Center, Wasilla, AK 99654, USA
| | - Daniel Bordt
- Rehabilitation Department, Federal Medical Center Rochester, Rochester, MN 55904, USA
| | - Wendy Walker-Ferrell
- Rehabilitation Department, Chinle Comprehensive Health Care Facility, Chinle, AZ 86503, USA
| | - Douglas Cordel
- Rehabilitation Department, Four Corners Regional Health Center, Red Mesa, AZ 86514, USA
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Pathan EM, Inman RD. Pain in spondyloarthritis: A neuro–immune interaction. Best Pract Res Clin Rheumatol 2017; 31:830-845. [DOI: 10.1016/j.berh.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/01/2018] [Indexed: 01/07/2023]
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