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Peier F, Mouthon M, De Pretto M, Chabwine JN. Response to experimental cold-induced pain discloses a resistant category among endurance athletes, with a distinct profile of pain-related behavior and GABAergic EEG markers: a case-control preliminary study. Front Neurosci 2024; 17:1287233. [PMID: 38287989 PMCID: PMC10822956 DOI: 10.3389/fnins.2023.1287233] [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: 09/01/2023] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
Pain is a major public health problem worldwide, with a high rate of treatment failure. Among promising non-pharmacological therapies, physical exercise is an attractive, cheap, accessible and innocuous method; beyond other health benefits. However, its highly variable therapeutic effect and incompletely understood underlying mechanisms (plausibly involving the GABAergic neurotransmission) require further research. This case-control study aimed to investigate the impact of long-lasting intensive endurance sport practice (≥7 h/week for the last 6 months at the time of the experiment) on the response to experimental cold-induced pain (as a suitable chronic pain model), assuming that highly trained individual would better resist to pain, develop advantageous pain-copying strategies and enhance their GABAergic signaling. For this purpose, clinical pain-related data, response to a cold-pressor test and high-density EEG high (Hβ) and low beta (Lβ) oscillations were documented. Among 27 athletes and 27 age-adjusted non-trained controls (right-handed males), a category of highly pain-resistant participants (mostly athletes, 48.1%) was identified, displaying lower fear of pain, compared to non-resistant non-athletes. Furthermore, they tolerated longer cold-water immersion and perceived lower maximal sensory pain. However, while having similar Hβ and Lβ powers at baseline, they exhibited a reduction between cold and pain perceptions and between pain threshold and tolerance (respectively -60% and - 6.6%; -179.5% and - 5.9%; normalized differences), in contrast to the increase noticed in non-resistant non-athletes (+21% and + 14%; +23.3% and + 13.6% respectively). Our results suggest a beneficial effect of long-lasting physical exercise on resistance to pain and pain-related behaviors, and a modification in brain GABAergic signaling. In light of the current knowledge, we propose that the GABAergic neurotransmission could display multifaceted changes to be differently interpreted, depending on the training profile and on the homeostatic setting (e.g., in pain-free versus chronic pain conditions). Despite limitations related to the sample size and to absence of direct observations under acute physical exercise, this precursory study brings into light the unique profile of resistant individuals (probably favored by training) allowing highly informative observation on physical exercise-induced analgesia and paving the way for future clinical translation. Further characterizing pain-resistant individuals would open avenues for a targeted and physiologically informed pain management.
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Affiliation(s)
- Franziska Peier
- Laboratory for Neurorehabilitation Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael Mouthon
- Laboratory for Neurorehabilitation Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael De Pretto
- Laboratory for Neurorehabilitation Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Joelle Nsimire Chabwine
- Laboratory for Neurorehabilitation Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Neurology Division, Department of Internal Medicine, Fribourg-Cantonal Hospital, Fribourg, Switzerland
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Zieliński G, Matysik-Woźniak A, Baszczowski M, Rapa M, Ginszt M, Pająk B, Szkutnik J, Rejdak R, Gawda P. Myopia & painful muscle form of temporomandibular disorders: connections between vision, masticatory and cervical muscles activity and sensitivity and sleep quality. Sci Rep 2023; 13:20231. [PMID: 37981640 PMCID: PMC10658172 DOI: 10.1038/s41598-023-47550-6] [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: 06/18/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023] Open
Abstract
The main aim of this study is to evaluate the effects of painful muscle form of temporomandibular disorders and myopia on the connections between the visual organ, the bioelectrical activity and sensitivity of the masticatory and cervical muscles, and sleep quality. Subjects were divided into 4 groups (Myopia & TMDs, Myopia (Without TMDs), Emmetropic & TMDs and Emmetropic (Without TMDs)). The study was conducted in the following order of assessment: examination for temporomandibular disorders, assessment of the muscle activity by electromyograph, pressure pain thresholds examination, ophthalmic examination and completion of the Pittsburgh Sleep Quality Index. It was observed that the Myopia & TMDs group had higher muscle tenderness, higher resting and lower functional muscle bioelectrical activity. The visual organ is clinical related to the masticatory and cervical muscles. TMDs and myopia alter masticatory and cervical muscle activity. The thickness of the choroid in people with myopia is related to muscle tenderness. TMDs and myopia impair sleep quality. It is recommended to determine the number of people with refractive error and its magnitude in the sEMG study in order to be able to replicate the research methodology.
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, Lublin, Poland.
| | - Anna Matysik-Woźniak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Michał Baszczowski
- Interdisciplinary Scientific Group of Sports Medicine, Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
| | - Maria Rapa
- Students' Scientific Association at the Department and Clinic of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland
| | - Beata Pająk
- Interdisciplinary Scientific Group of Sports Medicine, Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
| | - Jacek Szkutnik
- Department of Functional Masticatory Disorders, Medical University of Lublin, Lublin, Poland
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Piotr Gawda
- Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
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Wittkopf PG, Larsen DB, Graven-Nielsen T. Protocols for inducing homeostatic plasticity reflected in the corticospinal excitability in healthy human participants: A systematic review and meta-analysis. Eur J Neurosci 2021; 54:5444-5461. [PMID: 34251703 DOI: 10.1111/ejn.15389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
Homeostatic plasticity complements synaptic plasticity by stabilising neural activity within a physiological range. In humans, homeostatic plasticity is investigated using two blocks of non-invasive brain stimulation (NIBS) with an interval without stimulation between blocks. The aim of this systematic review and meta-analysis was to investigate the effect of homeostatic plasticity induction protocols on motor evoked potentials (MEP) in healthy participants. Four databases were searched (Medline, Scopus, Embase and Cochrane library). Studies describing the application of two blocks of NIBS of the primary motor cortex with an interval of no stimulation between blocks reporting changes in corticospinal excitability by MEP amplitude were included. Thirty-seven reports with 55 experiments (700 participants) were included. Study quality was considered poor overall, with heterogeneity in study size, sample and designs. Two blocks of excitatory stimulation at the primary motor cortex produced a homeostatic response (decreased MEP) between 0 and 30 min post-protocols, when compared with a single stimulation block. Two blocks of inhibitory stimulation at the primary motor cortex using interval duration of 10 min or less produced a homeostatic response (increased MEP) between 0 and 30 min post-protocols, when compared with a single stimulation block. There were no differences in MEPs when compared with baseline MEPs. In conclusion, homeostatic plasticity induction using two blocks of NIBS with an interval of 10 min or less without stimulation between blocks produces a homeostatic response up to 30 min post-protocol. Improvements in participant selection, sample sizes and protocols of NIBS techniques are needed.
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Affiliation(s)
- Priscilla G Wittkopf
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Dennis B Larsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Suchting R, Kapoor S, Mathis KB, Ahn H. Changes in Experimental Pain Sensitivity from Using Home-Based Remotely Supervised Transcranial Direct Current Stimulation in Older Adults with Knee Osteoarthritis. PAIN MEDICINE 2020; 21:2676-2683. [PMID: 32869092 DOI: 10.1093/pm/pnaa268] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The present study examined the effects of home-based remotely supervised transcranial direct current stimulation on quantitative sensory testing measurements in older adults with knee osteoarthritis. Participants were hypothesized to experience improved pain measurements over time. DESIGN Open-label, single-arm trial. SETTING Southeast Texas between March and November 2018 at a nursing school and participant homes. SUBJECTS Older adults (aged 50-85 years) with self-reported unilateral or bilateral knee osteoarthritis pain who met eligibility criteria set by the American College of Rheumatology. METHODS The intervention was applied with a constant current intensity for 20 minutes every weekday for two weeks (10 total sessions). Quantitative measures of pain were collected three times over 10 days (days 1, 5, and 10) and included heat threshold and tolerance, pressure pain threshold, punctate mechanical pain, pain, and conditioned pain modulation. Analyses used nonparametric tests to evaluate differences between day 1 and day 10. Generalized linear mixed models were then used to evaluate change across all three time points for each measure. Bayesian inference was used to provide the posterior probability of longitudinal effects. RESULTS Nonparametric tests found improvements in seven measures, and longitudinal models supported improvements in 10 measures, with some nonlinear effects. CONCLUSIONS The home-based, remotely supervised intervention improved quantitative measurements of pain in older adults with knee osteoarthritis. This study contributes to the growing body of literature supporting home-based noninvasive stimulation interventions.
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Affiliation(s)
- Robert Suchting
- Faillace Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Shweta Kapoor
- Faillace Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Kenneth B Mathis
- Department of Orthopedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Hyochol Ahn
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Cheng I, Scarlett H, Zhang M, Hamdy S. Preconditioning human pharyngeal motor cortex enhances directional metaplasticity induced by repetitive transcranial magnetic stimulation. J Physiol 2020; 598:5213-5230. [DOI: 10.1113/jp279977] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/11/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ivy Cheng
- Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - Honor Scarlett
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - Mengqing Zhang
- Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
- Department of Rehabilitation Medicine, The Third Affiliated Hospital Sun Yat‐sen University Guangzhou China
| | - Shaheen Hamdy
- Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
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Motor corticospinal excitability: a novel facet of pain modulation? Pain Rep 2019; 4:e725. [PMID: 31041424 PMCID: PMC6455687 DOI: 10.1097/pr9.0000000000000725] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 01/20/2019] [Accepted: 01/30/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction Increase in excitability of the primary motor cortex (M1) is associated with pain inhibition by analgesics, which is, in turn, associated with the psychophysical antinociceptive pain modulation profile. However, the relationship between neurophysiological M1 excitability and psychophysical pain modulation has not yet been explored. Objectives We aim to study these relationships in healthy subjects. Methods Forty-one young healthy subjects (22 women) underwent a wide battery of psychophysical testing that included conditioned pain modulation (CPM) and pain temporal summation, and a transcranial magnetic stimulation neurophysiological assessment of the motor corticospinal excitability, including resting motor threshold, motor-evoked potentials (MEPs), and cortical silent period. Results Increased motor corticospinal excitability in 2 parameters was associated with more efficient CPM: (1) higher MEP amplitude (r = -0.574; P _Bonferroni = 0.02) and (2) longer MEP duration (r = -0.543; P _Bonferroni = 0.02). The latter also correlated with the lower temporal summation magnitude (r = -0.421; P = 0.007); however, on multiplicity adjustment, significance was lost. Conclusions Increased corticospinal excitability of the primary motor cortex is associated with more efficient inhibitory pain modulation as assessed by CPM, in healthy subjects. Motor-evoked potential amplitude and duration may be considered as an additional, objective and easy to measure parameter to allow for better individual assessment of pain modulation profile.
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Ahn H, Suchting R, Woods AJ, Miao H, Green C, Cho RY, Choi E, Fillingim RB. Bayesian analysis of the effect of transcranial direct current stimulation on experimental pain sensitivity in older adults with knee osteoarthritis: randomized sham-controlled pilot clinical study. J Pain Res 2018; 11:2071-2082. [PMID: 30310309 PMCID: PMC6166765 DOI: 10.2147/jpr.s173080] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Previous studies have indicated that transcranial direct current stimulation (tDCS) with the anode over the motor cortex and the cathode over the contralateral supraorbital region is effective in reducing clinical pain in patients with chronic pain, but these studies have not focused on experimental pain sensitivity. Therefore, the aim of this study was to examine the effect of tDCS on experimental pain sensitivity in older adults with knee osteoarthritis (OA). Patients and methods Forty community-dwelling participants aged 50–70 years with knee OA pain were randomly assigned to receive five daily sessions of 2 mA tDCS for 20 minutes (n = 20) or sham tDCS (n = 20) using a parallel group design. A multimodal quantitative sensory testing battery was completed, including heat pain, pressure pain threshold (PPT), punctate mechanical pain, and conditioned pain modulation (CPM). Results The active tDCS group showed greater increases in heat pain thresholds and tolerances, PPTs, and CPM, and reductions in punctate pain. In addition, beneficial changes in experimental pain measures were associated with reductions in clinical pain. Future studies are needed to extend these findings to better understand the underlying mechanisms of tDCS as well as to optimize treatment parameters including number and duration of stimulation sessions. Conclusion Our findings demonstrate that tDCS reduces experimental pain sensitivity, and these beneficial changes in experimental pain measures were associated with reductions in clinical pain.
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Affiliation(s)
- Hyochol Ahn
- Department of Nursing Research, University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, USA,
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX; USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, University of Florida Center for Cognitive Aging and Memory, McKnight Brain Institute, Gainesville, FL, USA
| | - Hongyu Miao
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Charles Green
- Department of Pediatrics, University of Texas Health Science Center at Houston, Center for Clinical Research and Evidence-Based Medicine, Houston, TX, USA
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eunyoung Choi
- Department of Patient Care, Epic Health Services, Houston, TX, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida Pain Research and Intervention Center of Excellence, Gainesville, FL, USA
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How different priming stimulations affect the corticospinal excitability induced by noninvasive brain stimulation techniques: a systematic review and meta-analysis. Rev Neurosci 2018; 29:883-899. [DOI: 10.1515/revneuro-2017-0111] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 01/12/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Noninvasive brain stimulation (NIBS) techniques could induce changes in corticospinal excitability (CSE) and neuroplasticity. These changes could be affected by different factors, including having a session of stimulation called the ‘priming’ protocol before the main stimulation session called the ‘test’ protocol. Literature indicates that a priming protocol could affect the activity of postsynaptic neurons, form a neuronal history, and then modify the expected effects of the test protocol on CSE indicated by the amplitude of transcranial magnetic stimulation-induced motor-evoked potentials. This prior history affects a threshold to activate the necessary mechanism stabilizing the neuronal activity within a useful dynamic range. For studying the effects of this history and related metaplasticity mechanisms in the human primary motor cortex (M1), priming-test protocols are successfully employed. Thirty-two studies were included in this review to investigate how different priming protocols could affect the induced effects of a test protocol on CSE in healthy individuals. The results showed that if the history of synaptic activity were high or low enough to displace the threshold, the expected effects of the test protocol would be the reverse. This effect reversal is regulated by homeostatic mechanisms. On the contrary, the effects of the test protocol would not be the reverse, and at most we experience a prolongation of the lasting effects if the aforementioned history is not enough to displace the threshold. This effect prolongation is mediated by nonhomeostatic mechanisms. Therefore, based on the characteristics of priming-test protocols and the interval between them, the expected results of priming-test protocols would be different. Moreover, these findings could shed light on the different mechanisms of metaplasticity involved in NIBS. It helps us understand how we can improve the expected outcomes of these techniques in clinical approaches.
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Vaseghi B, Zoghi M, Jaberzadeh S. The effects of anodal-tDCS on corticospinal excitability enhancement and its after-effects: conventional vs. unihemispheric concurrent dual-site stimulation. Front Hum Neurosci 2015; 9:533. [PMID: 27242498 PMCID: PMC4871166 DOI: 10.3389/fnhum.2015.00533] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/14/2015] [Indexed: 12/13/2022] Open
Abstract
Previous researchers have approved the ability of anodal transcranial direct current stimulation (a-tDCS) of the primary motor cortex (M1) to enhance corticospinal excitability (CSE). The primary aim of the current study was to investigate the effect of concurrent stimulation of M1 and a functionally connected cortical site of M1 on CSE modulation. This new technique is called unihemispheric concurrent dual-site a-tDCS (a-tDCSUHCDS). The secondary aim was to investigate the mechanisms underlying the efficacy of this new approach in healthy individuals. In a randomized crossover study, 12 healthy right-handed volunteers received a-tDCS under five conditions: a-tDCS of M1, a-tDCSUHCDS of M1-dorsolateral prefrontal cortex (DLPFC), a-tDCSUHCDS of M1-primary sensory cortex (S1), a-tDCSUHCDS of M1-primary visual cortex (V1), and sham a-tDCSUHCDS. Peak-to-peak amplitude of transcranial magnetic stimulation (TMS) induced MEPs, short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were assessed before and four times after each condition. A-tDCSUHCDS conditions induced larger MEPs than conventional a-tDCS. The level of M1 CSE was significantly higher following a-tDCSUHCDS of M1-DLPFC than other a-tDCSUHCDS conditions (p < 0.001), and lasted for over 24 h. The paired-pulse TMS results after a-tDCS of M1-DLPFC showed significant facilitatory increase and inhibitory change. A-tDCSUHCDS of M1-DLPFC increases M1 CSE twofold that of conventional a-tDCS. A-tDCSUHCDS of M1-DLPFC enhances the activity of glutamergic mechanisms for at least 24 h. Such long-lasting M1 CSE enhancement induced by a-tDCSUHCDS of M1-DLPFC could be a valuable finding in clinical scenarios such as learning, motor performance, or pain management. The present study has been registered on the Australian New Zealand Clinical Trial at http://www.anzctr.org.au/ with registry number of ACTRN12614000817640.
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Affiliation(s)
- Bita Vaseghi
- Faculty of Medicine, Department of Physiotherapy, School of Primary Health Care, Nursing and Health Sciences, Monash University Melbourne, Australia
| | - Maryam Zoghi
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne Parkville, Australia
| | - Shapour Jaberzadeh
- Faculty of Medicine, Department of Physiotherapy, School of Primary Health Care, Nursing and Health Sciences, Monash University Melbourne, Australia
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Vaseghi B, Zoghi M, Jaberzadeh S. Differential effects of cathodal transcranial direct current stimulation of prefrontal, motor and somatosensory cortices on cortical excitability and pain perception - a double-blind randomised sham-controlled study. Eur J Neurosci 2015; 42:2426-37. [DOI: 10.1111/ejn.13043] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/03/2015] [Accepted: 08/10/2015] [Indexed: 01/30/2023]
Affiliation(s)
- B. Vaseghi
- Department of Physiotherapy; School of Primary Health Care; Faculty of Medicine; Nursing and Health Sciences; Monash University; Frankston Vic. Australia
| | - M. Zoghi
- Department of Medicine; Royal Melbourne Hospital; The University of Melbourne; Parkville Vic. Australia
| | - S. Jaberzadeh
- Department of Physiotherapy; School of Primary Health Care; Faculty of Medicine; Nursing and Health Sciences; Monash University; Frankston Vic. Australia
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