Reduction of intra-abdominal pain through transcranial direct current stimulation: A systematic review

[Holistic treatment of endometriosis]

BACKGROUND

The pain phenomena caused by endometriosis are manifold. In addition to nociceptive pain there is also a nociplastic reaction with central sensitization. Atypical symptoms, such as acyclic lower abdominal pain, radiating pain, nonspecific bladder and intestinal complaints or even depression increasingly occur in addition to the classical cyclic complaints, such as severe dysmenorrhea, cyclic lower abdominal pain, dyspareunia, dysuria and dyschezia. Due to the diffuse range of symptoms, affected patients often consult not just gynecologists but also specialists from other disciplines (internal medicine, gastroenterology, orthopedics, pain therapy, psychology etc.).

OBJECTIVE

The complexity of endometriosis is presented. The resulting approaches to multimodal interdisciplinary holistic treatment are described.

RESULTS

Interdisciplinary concepts should be involved in the optimal treatment of endometriosis patients along with hormonal and surgical treatment, mostly under the supervision of a gynecologist and pain management, dietary changes, psychological support and physiotherapeutic management should also be included. This article provides an overview of possible treatment strategies for chronic symptomatic endometriosis.

CONCLUSION

Based on multimodal treatment strategies and regarding the complex pathophysiological alterations of this disease, the complex complaints that significantly impair the quality of life of endometriosis patients can be greatly improved.

Neural Stimulation of Brain Organoids with Dynamic Patterns: A Sentiomics Approach Directed to Regenerative Neuromedicine

The new science called Sentiomics aims to identify the dynamic patterns that endow living systems with the capacity to feel and become conscious. One of the most promising fields of investigation in Sentiomics is the development and ‘education’ of human brain organoids to become sentient and useful for the promotion of human health in the (also new) field of Regenerative Neuromedicine. Here, we discuss the type of informational-rich input necessary to make a brain organoid sentient in experimental settings. Combining this research with the ecological preoccupation of preserving ways of sentience in the Amazon Rainforest, we also envisage the development of a new generation of biosensors to capture dynamic patterns from the forest, and use them in the ‘education’ of brain organoids to afford them a ‘mental health’ quality that is likely to be important in future advances in ‘post-humanist’ procedures in regenerative medicine. This study is closely related to the psychophysical approach to human mental health therapy, in which we have proposed the use of dynamic patterns in electric and magnetic brain stimulation protocols, addressing electrochemical waves in neuro-astroglial networks.

Advances in Non-Invasive Neuromodulation

PURPOSE OF REVIEW

Pain medicine is rapidly expanding. The gap in treatment for patients with chronic pain in between traditional conservative therapy and major invasive surgery is closing. Neuromodulation is one therapeutic area that has continued to show promise for treatment of chronic pain. Our aim is to review updates in non-invasive neuromodulation (NIN) techniques as an adjunct for various chronic pain conditions.

RECENT FINDINGS

Overall, the literature suggests that NIN techniques such as tCDS, TMS, TENS, tVNS, and HIFUS/LIFUS have utility in treating various types of chronic pain and have a promising future. There is a better understanding of the mechanistic basis for pain relief from NIN, as well as refinement in technology improving NIN therapy success. Future studies will need to focus on continuing to refine protocols for optimal benefit from NIN as well as implementing larger RCTs to improve the quality of data being generated in the field.

Brain stimulation: a therapeutic approach for the treatment of neurological disorders

Brain stimulation has become one of the most acceptable therapeutic approaches in recent years and a powerful tool in the remedy against neurological diseases. Brain stimulation is achieved through the application of electric currents using non-invasive as well as invasive techniques. Recent technological advancements have evolved into the development of precise devices with capacity to produce well-controlled and effective brain stimulation. Currently, most used non-invasive techniques are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), whereas the most common invasive technique is deep brain stimulation (DBS). In last decade, application of these brain stimulation techniques has not only exploded but also expanded to wide variety of neurological disorders. Therefore, in the current review, we will provide an overview of the potential of both non-invasive (rTMS and tDCS) and invasive (DBS) brain stimulation techniques in the treatment of such brain diseases.

[The effectiveness of the transcranial electrical stimulation method in obstetrics and gynecology]

The review examines the use of protective (endorphinergic and serotonergic) mechanisms of the brain in obstetrics and gynecology. To review the current state of the problem an analysis of the eLIBRARU, PubMed, Embase, MEDLINE, Cochrane databases was carried out, and works for 2015-2020 were selected. It has been shown that the method of non - invasive non - drug effects on the human body - transcranial electrical stimulation (TES) - activates and accelerates reparative processes, normalizes psychophysiological status, has anti-inflammatory and immune-stimulating effects, has an onco-protective effect, stabilizes the autonomic nervous system, provides drug - free disturbance homeostasis in general. This makes it possible to successfully use TES in obstetrics and gynecology in such pathological conditions as the threat of pregnancy termination at different times, nausea and vomiting of pregnant women, preeclampsia, pathological prelaminar period, menstrual dysfunction, climacteric syndrome, leiomyoma and endometriosis of the uterus, endometrial hyperplastic processes, chronic inflammatory diseases of the pelvic organs with pain syndrome, surgery and obstetrics care. TES is characterized by high efficiency, safety, ease of use, availability and economic profitability. TES reduces the number of prescribed drugs and shortens the recovery time. This method is used both as monotherapy and as a component of a complex action including medication and non-medication. The results of the TES studies presented in the review complement each other and demonstrate the importance of modern alternative methods of treatment, and the authors of these studies are unanimous in their opinion on the fruitfulness of the use of transcranial electrical stimulation as a type of non-drug therapy in various fields of obstetrics and gynecology.

No efficacy of transcranial direct current stimulation on chronic migraine with medication overuse: A double blind, randomised clinical trial

Background

Transcranial direct current stimulation was suggested to provide beneficial effects in chronic migraine, a condition often associated with medication overuse for which no long-term therapy is available.

Methods

We conducted a randomised controlled trial to assess long-term efficacy of transcranial direct current stimulation. Adults diagnosed with chronic migraine and medication overuse were assigned to receive in a 1:1:1 ratio anodal, cathodal, or sham transcranial direct current stimulation daily for five consecutive days, along with standardised drug withdrawal protocol. Primary outcome was 50% reduction of days of headache per month at 12 months. Co-secondary outcomes were 50% reduction of days of headache per month at 6 months, reduction of analgesic intake per month, and change in disability and quality of life, catastrophising, depression, state and trait anxiety, dependence attitude and allodynia intensity. Patients were not allowed to take any migraine prophylaxis drug for the entire study period.

Results

We randomly allocated 135 patients to anodal (44), cathodal (45), and sham (46) transcranial direct current stimulation. At 6 and 12 months, the percentage of reduction of days of headache and number of analgesics per month ranged between 48.5% and 64.7%, without differences between transcranial direct current stimulation (cathodal, anodal, or the results obtained from the two arms of treatment, anodal plus cathodal) and sham. Catastrophising attitude significantly reduced at 12 months in all groups. There was no difference for the other secondary outcomes.

Conclusions

Transcranial direct current stimulation did not influence the short and long-term course of chronic migraine with medication overuse after acute drug withdrawal. Behavioral and educational measures and support for patients’ pain management could provide long-term improvement and low relapse rate. Trial registration number NCT04228809