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Zheng P, Shi Y, Qu H, Han ML, Wang ZQ, Zeng Q, Zheng M, Fan T. Effect of ultrasound-guided injection of botulinum toxin type A into shoulder joint cavity on shoulder pain in poststroke patients: study protocol for a randomized controlled trial. Trials 2024; 25:418. [PMID: 38937804 PMCID: PMC11212400 DOI: 10.1186/s13063-024-08258-8] [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: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Hemiplegic shoulder pain (HSP) is a common complication after stroke. It severely affects the recovery of upper limb motor function. Early shoulder pain in hemiplegic patients is mainly neuropathic caused by central nerve injury or neuroplasticity. Commonly used corticosteroid injections in the shoulder joint can reduce shoulder pain; however, the side effects also include soft tissue degeneration or increased tendon fragility, and the long-term effects remain controversial. Botulinum toxin injections are relatively new and are thought to block the transmission of pain receptors in the shoulder joint cavity and inhibit the production of neuropathogenic substances to reduce neurogenic inflammation. Some studies suggest that the shoulder pain of hemiplegia after stroke is caused by changes in the central system related to shoulder joint pain, and persistent pain may induce the reorganization of the cortical sensory center or motor center. However, there is no conclusive evidence as to whether or not the amelioration of pain by botulinum toxin affects brain function. In previous studies of botulinum toxin versus glucocorticoids (triamcinolone acetonide injection) in the treatment of shoulder pain, there is a lack of observation of differences in changes in brain function. As the content of previous assessments of pain improvement was predominantly subjective, objective quantitative assessment indicators were lacking. Functional near-infrared imaging (fNIRS) can remedy this problem. METHODS This study protocol is designed for a double-blind, randomized controlled clinical trial of patients with post-stroke HSP without biceps longus tenosynovitis or acromion bursitis. Seventy-eight patients will be randomly assigned to either the botulinum toxin type A or glucocorticoid group. At baseline, patients in each group will receive shoulder cavity injections of either botulinum toxin or glucocorticoids and will be followed for 1 and 4 weeks. The primary outcome is change in shoulder pain on the visual analog scale (VAS). The secondary outcome is the assessment of changes in oxyhemoglobin levels in the corresponding brain regions by fNIRS imaging, shoulder flexion, external rotation range of motion, upper extremity Fugl-Meyer, and modified Ashworth score. DISCUSSION Ultrasound-guided botulinum toxin type A shoulder joint cavity injections may provide evidence of pain improvement in patients with HSP. The results of this trial are also help to analyze the correlation between changes in shoulder pain and changes in cerebral hemodynamics and shoulder joint motor function. TRIAL REGISTRATION Chinese clinical Trial Registry, ChiCTR2300070132. Registered 03 April 2023, https://www.chictr.org.cn/showproj.html?proj=193722 .
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Affiliation(s)
- Peng Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Shi
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hang Qu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Meng Lin Han
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi Qiang Wang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Manxu Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Tao Fan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Szabó P, Bonet S, Hetényi R, Hanna D, Kovács Z, Prisztóka G, Križalkovičová Z, Szentpéteri J. Systematic review: pain, cognition, and cardioprotection-unpacking oxytocin's contributions in a sport context. Front Physiol 2024; 15:1393497. [PMID: 38915776 PMCID: PMC11194439 DOI: 10.3389/fphys.2024.1393497] [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: 03/01/2024] [Accepted: 05/13/2024] [Indexed: 06/26/2024] Open
Abstract
Introduction This systematic review investigates the interplay between oxytocin and exercise; in terms of analgesic, anti-inflammatory, pro-regenerative, and cardioprotective effects. Furthermore, by analyzing measurement methods, we aim to improve measurement validity and reliability. Methods Utilizing PRISMA, GRADE, and MECIR protocols, we examined five databases with a modified SPIDER search. Including studies on healthy participants, published within the last 20 years, based on keywords "oxytocin," "exercise" and "measurement," 690 studies were retrieved initially (455 unique records). After excluding studies of clinically identifiable diseases, and unpublished and reproduction-focused studies, 175 studies qualified for the narrative cross-thematic and structural analysis. Results The analysis resulted in five categories showing the reciprocal impact of oxytocin and exercise: Exercise (50), Physiology (63), Environment (27), Social Context (65), and Stress (49). Exercise-induced oxytocin could promote tissue regeneration, with 32 studies showing its analgesic and anti-inflammatory effects, while 14 studies discussed memory and cognition. Furthermore, empathy-associated OXTR rs53576 polymorphism might influence team sports performance. Since dietary habits and substance abuse can impact oxytocin secretion too, combining self-report tests and repeated salivary measurements may help achieve precision. Discussion Oxytocin's effect on fear extinction and social cognition might generate strategies for mental training, and technical, and tactical development in sports. Exercise-induced oxytocin can affect the amount of stress experienced by athletes, and their response to it. However, oxytocin levels could depend on the type of sport in means of contact level, exercise intensity, and duration. The influence of oxytocin on athletes' performance and recovery could have been exploited due to its short half-life. Examining oxytocin's complex interactions with exercise paves the way for future research and application in sports science, psychology, and medical disciplines. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=512184, identifier CRD42024512184.
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Affiliation(s)
- Péter Szabó
- Faculty of Sciences, Institute of Sports Science and Physical Education, University of Pécs, Pécs, Hungary
- Faculty of Humanities, University of Pécs, Pécs, Hungary
- Medical School, Institute of Transdisciplinary Discoveries, University of Pécs, Pécs, Hungary
| | - Sara Bonet
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Roland Hetényi
- RoLink Biotechnology Kft., Pécs, Hungary
- Hungarian National Blood Transfusion Service, Budapest, Hungary
- Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- National Virology Laboratory, University of Pécs, Pécs, Hungary
| | - Dániel Hanna
- RoLink Biotechnology Kft., Pécs, Hungary
- Hungarian National Blood Transfusion Service, Budapest, Hungary
- Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- National Virology Laboratory, University of Pécs, Pécs, Hungary
| | - Zsófia Kovács
- Faculty of Sciences, Institute of Sports Science and Physical Education, University of Pécs, Pécs, Hungary
| | - Gyöngyvér Prisztóka
- Faculty of Sciences, Institute of Sports Science and Physical Education, University of Pécs, Pécs, Hungary
| | - Zuzana Križalkovičová
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Department of Sport Science, Pécs, Hungary
| | - József Szentpéteri
- Medical School, Institute of Transdisciplinary Discoveries, University of Pécs, Pécs, Hungary
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Katsumata R, Hosokawa T, Manabe N, Mori H, Wani K, Ishii K, Tanikawa T, Urata N, Ayaki M, Nishino K, Murao T, Suehiro M, Fujita M, Kawanaka M, Haruma K, Kawamoto H, Takao T, Kamada T. Brain activity in response to food images in patients with irritable bowel syndrome and functional dyspepsia. J Gastroenterol 2023; 58:1178-1187. [PMID: 37572136 PMCID: PMC10657794 DOI: 10.1007/s00535-023-02031-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are caused and exacerbated by consumption of fatty foods. However, no study has evaluated brain activity in response to food images in patients with disorders of gut-brain interaction (DGBI). This study aimed to compare food preference and brain activity when viewing food images between patients with DGBI and healthy controls. METHODS FD and IBS were diagnosed using the ROME IV criteria. Food preference was assessed using a visual analog scale (VAS). Brain activity in the prefrontal cortex (PFC) in response to food images was investigated using functional near-infrared spectroscopy (fNIRS). RESULTS Forty-one patients were enrolled, including 25 with DGBI. The mean VAS scores for all foods (controls vs. FD vs. IBS: 69.1 ± 3.3 vs. 54.8 ± 3.8 vs. 62.8 ± 3.7, p = 0.02), including fatty foods (78.1 ± 5.4 vs. 43.4 ± 6.3 vs. 64.7 ± 6.1, p < 0.01), were the lowest in patients with FD among all groups. Patients with FD had significantly higher brain activity in the left PFC than those with IBS and healthy controls (mean z-scores in controls vs. FD vs. IBS: - 0.077 ± 0.03 vs. 0.125 ± 0.04 vs. - 0.002 ± 0.03, p < 0.001). CONCLUSIONS Patients with DGBI, particularly those with FD, disliked fatty foods. The brain activity in patients with DGBI differed from that in healthy controls. Increased activity in the PFC of patients with FD was confirmed.
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Affiliation(s)
- Ryo Katsumata
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan.
| | - Takayuki Hosokawa
- Department of Orthoptics, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Noriaki Manabe
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Hitoshi Mori
- Department of Neurology, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Kenta Wani
- Department of Psychiatry, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Katsunori Ishii
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Tomohiro Tanikawa
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Noriyo Urata
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Maki Ayaki
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Ken Nishino
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Takahisa Murao
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Mitsuhiko Suehiro
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Minoru Fujita
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Miwa Kawanaka
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Hirofumi Kawamoto
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
| | - Toshihiro Takao
- Department of Health Care Medicine, Kawasaki Medical School, 577, Matsushima, Kurashiki, 701-0192, Japan
| | - Tomoari Kamada
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakasange, Kita-Ku, Okayama, 700-8505, Japan
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Abstract
Pain is an unpleasant sensory and emotional experience. Understanding the neural mechanisms of acute and chronic pain and the brain changes affecting pain factors is important for finding pain treatment methods. The emergence and progress of non-invasive neuroimaging technology can help us better understand pain at the neural level. Recent developments in identifying brain-based biomarkers of pain through advances in advanced imaging can provide some foundations for predicting and detecting pain. For example, a neurologic pain signature (involving brain regions that receive nociceptive afferents) and a stimulus intensity-independent pain signature (involving brain regions that do not show increased activity in proportion to noxious stimulus intensity) were developed based on multivariate modeling to identify processes related to the pain experience. However, an accurate and comprehensive review of common neuroimaging techniques for evaluating pain is lacking. This paper reviews the mechanism, clinical application, reliability, strengths, and limitations of common neuroimaging techniques for assessing pain to promote our further understanding of pain.
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Affiliation(s)
- Jing Luo
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Hui-Qi Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
| | - Bo Gou
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China.
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
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Ito E, Oka K, Koshikawa F. Dorsolateral prefrontal cortex sensing analgesia. Biophys Physicobiol 2022; 19:1-10. [PMID: 35797407 PMCID: PMC9173858 DOI: 10.2142/biophysico.bppb-v19.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022] Open
Abstract
Chronic pain often has an unknown cause, and many patients with chronic pain learn to accept that their pain is incurable and pharmacologic treatments are only temporarily effective. Complementary and integrative health approaches for pain are thus in high demand. One such approach is soft touch, e.g., adhesion of pyramidal thorn patches in a pain region. The effects of patch adhesion on pain relief have been confirmed in patients with various types of pain. A recent study using near-infrared spectroscopy revealed that the dorsolateral prefrontal cortex (DLPFC), especially the left side, is likely to be inactivated in patients experiencing pain relief during patch treatment. Mindfulness meditation is another well-known complementary and integrative approach for achieving pain relief. The relation between pain relief due to mindfulness meditation and changes in brain regions, including the DLPFC, has long been examined. In the present review article, we survey the literature describing the effects of the above-mentioned complementary and integrative treatments on pain relief, and outline the important brain regions, including the DLPFC, that are involved in analgesia. We hope that the present article will provide clues to researchers who hope to advance neurosensory treatments for pain relief without medication.
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Affiliation(s)
- Etsuro Ito
- Department of Biology, Waseda University
| | - Kotaro Oka
- Department of Bioscience and Informatics, Keio University
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