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Lopes TS, Santana JE, Silva WS, Fraga FJ, Montoya P, Sá KN, Lopes LC, Lucena R, Zana Y, Baptista AF. Increased Delta and Theta Power Density in Sickle Cell Disease Individuals with Chronic Pain Secondary to Hip Osteonecrosis: A Resting-State Eeg Study. Brain Topogr 2024; 37:859-873. [PMID: 38060074 DOI: 10.1007/s10548-023-01027-x] [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: 10/02/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE Identify the presence of a dysfunctional electroencephalographic (EEG) pattern in individuals with sickle cell disease (SCD) and hip osteonecrosis, and assess its potential associations with depression, anxiety, pain severity, and serum levels of brain-derived neurotrophic factor (BDNF). METHODS In this cross-sectional investigation, 24 SCD patients with hip osteonecrosis and chronic pain were matched by age and sex with 19 healthy controls. Resting-state EEG data were recorded using 32 electrodes for both groups. Power spectral density (PSD) and peak alpha frequency (PAF) were computed for each electrode across Delta, Theta, Alpha, and Beta frequency bands. Current Source Density (CSD) measures were performed utilizing the built-in Statistical nonparametric Mapping Method of the LORETA-KEY software. RESULTS Our findings demonstrated that SCD individuals exhibited higher PSD in delta and theta frequency bands when compared to healthy controls. Moreover, SCD individuals displayed increased CSD in delta and theta frequencies, coupled with decreased CSD in the alpha frequency within brain regions linked to pain processing, motor function, emotion, and attention. In comparison to the control group, depression symptoms, and pain intensity during hip abduction were positively correlated with PSD and CSD in the delta frequency within the parietal region. Depression symptoms also exhibited a positive association with PSD and CSD in the theta frequency within the same region, while serum BDNF levels showed a negative correlation with CSD in the alpha frequency within the left insula. CONCLUSION This study indicates that individuals with SCD experiencing hip osteonecrosis and chronic pain manifest a dysfunctional EEG pattern characterized by the persistence of low-frequency PSD during a resting state. This dysfunctional EEG pattern may be linked to clinical and biochemical outcomes, including depression symptoms, pain severity during movement, and serum BDNF levels.
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Affiliation(s)
- Tiago S Lopes
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, Santo Andre, Brazil.
- NAPEN network (Nucleus of Assistance, Research, and Teaching in Neuromodulation), São Paulo, Brazil.
- Bahia Adventist College, Cachoeira, Brazil.
| | - Jamille E Santana
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, Santo Andre, Brazil
- NAPEN network (Nucleus of Assistance, Research, and Teaching in Neuromodulation), São Paulo, Brazil
| | | | - Francisco J Fraga
- Engineering, Modelling, and Applied Social Sciences Center, Federal University of ABC, Santo André, SP, Brazil
| | - Pedro Montoya
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, Santo Andre, Brazil
- Research Institute of Health Sciences, University of Balearic Islands, Palma de Mallorca, Spain
| | - Katia N Sá
- NAPEN network (Nucleus of Assistance, Research, and Teaching in Neuromodulation), São Paulo, Brazil
- Postgraduate and Research, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Larissa C Lopes
- Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | - Rita Lucena
- Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | - Yossi Zana
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, Santo Andre, Brazil
| | - Abrahão F Baptista
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, Santo Andre, Brazil
- NAPEN network (Nucleus of Assistance, Research, and Teaching in Neuromodulation), São Paulo, Brazil
- Laboratory of Medical Investigations 54, Clinics Hospital, São Paulo State University, São Paulo, Brazil
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Martorella G, Miao H, Wang D, Park L, Mathis K, Park J, Sheffler J, Granville L, Teixeira AL, Schulz PE, Ahn H. Feasibility, Acceptability, and Efficacy of Home-Based Transcranial Direct Current Stimulation on Pain in Older Adults with Alzheimer's Disease and Related Dementias: A Randomized Sham-Controlled Pilot Clinical Trial. J Clin Med 2023; 12:401. [PMID: 36675330 PMCID: PMC9860690 DOI: 10.3390/jcm12020401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023] Open
Abstract
Although transcranial direct current stimulation (tDCS) is emerging as a convenient pain relief modality for several chronic pain conditions, its feasibility, acceptability, and preliminary efficacy on pain in patients with Alzheimer's disease and related dementias (ADRD) have not been investigated. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary efficacy of 5, 20-min home-based tDCS sessions on chronic pain in older adults with ADRD. We randomly assigned 40 participants to active (n = 20) or sham (n = 20) tDCS. Clinical pain intensity was assessed using a numeric rating scale (NRS) with patients and a proxy measure (MOBID-2) with caregivers. We observed significant reductions of pain intensity for patients in the active tDCS group as reflected by both pain measures (NRS: Cohen's d = 0.69, p-value = 0.02); MOBID-2: Cohen's d = 1.12, p-value = 0.001). Moreover, we found home-based tDCS was feasible and acceptable intervention approach for pain in ADRD. These findings suggest the need for large-scale randomized controlled studies with larger samples and extended versions of tDCS to relieve chronic pain on the long-term for individuals with ADRD.
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Affiliation(s)
| | - Hongyu Miao
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA
| | - Duo Wang
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA
| | - Lindsey Park
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Kenneth Mathis
- The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX 77030, USA
| | - JuYoung Park
- Phyllis & Harvey Sandler School of Social Work, Florida Atlantic University College of Social Work and Criminal Justice, Boca Raton, FL 33431, USA
| | - Julia Sheffler
- College of Medicine, Florida State University, Tallahassee, FL 32306, USA
| | - Lisa Granville
- College of Medicine, Florida State University, Tallahassee, FL 32306, USA
| | - Antonio L. Teixeira
- The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX 77030, USA
| | - Paul E. Schulz
- The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX 77030, USA
| | - Hyochol Ahn
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
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Rasche T, Emmert D, Seidel H, Sellin J, Conrad R, Mücke M. [Pain management in sickle cell disease]. Schmerz 2020; 34:285-296. [PMID: 32367470 DOI: 10.1007/s00482-020-00465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sickle cell disease is associated with numerous symptoms and complications. Acute painful crisis is the most characteristic manifestation of the disease. In addition, many patients report chronic pain. As both acute and chronic pain severely diminish quality of life, adequate pain management is crucial. Recommendations for the treatment of acute painful crises are based on the World Health Organization analgesic ladder, which has been developed for cancer-related pain. Chronic pain can be treated with basic long-acting opioids and on-demand short-acting opioids. If patients show signs of neuropathic pain, administration of anticonvulsants, antidepressants or possibly ketamine should be considered.
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Affiliation(s)
- T Rasche
- Zentrum für seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland
| | - D Emmert
- Zentrum für seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland
| | - H Seidel
- Centrum für Blutgerinnungsstörungen und Transfusionsmedizin (CBT), Bonn, Deutschland
| | - J Sellin
- Zentrum für seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland
| | - R Conrad
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Mücke
- Zentrum für seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland.
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