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Wang S, Ko CC, Chung MK. Nociceptor mechanisms underlying pain and bone remodeling via orthodontic forces: toward no pain, big gain. FRONTIERS IN PAIN RESEARCH 2024; 5:1365194. [PMID: 38455874 PMCID: PMC10917994 DOI: 10.3389/fpain.2024.1365194] [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: 01/03/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Orthodontic forces are strongly associated with pain, the primary complaint among patients wearing orthodontic braces. Compared to other side effects of orthodontic treatment, orthodontic pain is often overlooked, with limited clinical management. Orthodontic forces lead to inflammatory responses in the periodontium, which triggers bone remodeling and eventually induces tooth movement. Mechanical forces and subsequent inflammation in the periodontium activate and sensitize periodontal nociceptors and produce orthodontic pain. Nociceptive afferents expressing transient receptor potential vanilloid subtype 1 (TRPV1) play central roles in transducing nociceptive signals, leading to transcriptional changes in the trigeminal ganglia. Nociceptive molecules, such as TRPV1, transient receptor potential ankyrin subtype 1, acid-sensing ion channel 3, and the P2X3 receptor, are believed to mediate orthodontic pain. Neuropeptides such as calcitonin gene-related peptides and substance P can also regulate orthodontic pain. While periodontal nociceptors transmit nociceptive signals to the brain, they are also known to modulate alveolar bone remodeling in periodontitis. Therefore, periodontal nociceptors and nociceptive molecules may contribute to the modulation of orthodontic tooth movement, which currently remains undetermined. Future studies are needed to better understand the fundamental mechanisms underlying neuroskeletal interactions in orthodontics to improve orthodontic treatment by developing novel methods to reduce pain and accelerate orthodontic tooth movement-thereby achieving "big gains with no pain" in clinical orthodontics.
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Affiliation(s)
- Sheng Wang
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, United States
| | - Ching-Chang Ko
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, United States
| | - Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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Nurhapsari A, Cilmiaty R, Prayitno A, Purwanto B, Soetrisno S. The Role of Asiatic Acid in Preventing Dental Pulp Inflammation: An in-vivo Study. Clin Cosmet Investig Dent 2023; 15:109-119. [PMID: 37333763 PMCID: PMC10276571 DOI: 10.2147/ccide.s408158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Acute dental pulp inflammation necessitates early treatment to alleviate inflammation and pain. In the inflammatory phase, a substance is required to lower the inflammatory mediators and reactive oxygen species that play a crucial role in that phase. Asiatic acid is a natural triterpene obtained from the Centella asiatica plant with a high antioxidant value. This study examined the effect of Asiatic acid's antioxidant, anti-inflammatory, and antinociceptive properties on dental pulp inflammation. Methods The research is an experimental laboratory, with a post-test only with a control group design. The study utilised 40 male Wistar rats weighing 200-250 grams and aged 8-10 weeks. Rats were divided into five groups (control, eugenol, Asiatic Acid 0.5%; 1%; 2% group). Dental pulp inflammation was created in the maxillary incisor after six hours of administration of lipopolysaccharides (LPS). The dental pulp treatment then continued with the administration of eugenol and three different Asiatic acid concentrations (0.5%, 1% and 2%). In the next 72 hours, the teeth were biopsied, and the dental pulp was analysed using the enzyme-linked immunosorbent assay (ELISA) to measure the level of MDA, SOD, TNF-α, beta-endorphins and CGRP. Histopathological examination and the Rat Grimace Scale were utilised to determine the level of inflammation and pain, respectively. Results The effect of Asiatic Acid on MDA, TNF-α, and CGRP levels decreased significantly compared to the control group (p=<0.001). On the SOD and beta-endorphin levels, Asiatic acid treatment resulted in a considerable rise (p =<0.001). Conclusion Due to its antioxidant, anti-inflammatory, and antinociceptive characteristics, Asiatic acid can reduce inflammation and pain in acute pulp inflammation due to its ability to decrease MDA, TNFα, and CGRP levels while raising SOD and beta-endorphin levels.
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Affiliation(s)
- Arlina Nurhapsari
- Doctoral Degree of Medical Science, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
- Department of Conservative Dentistry, Faculty of Dentistry, Islam Sultan Agung University, Semarang, Central Java, Indonesia
| | - Risya Cilmiaty
- Department of Oral Disease, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
| | - Adi Prayitno
- Department of Oral Disease, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
| | - Bambang Purwanto
- Department of Internal Medicine, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
| | - Soetrisno Soetrisno
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
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Shan Z, Ren C, Gu M, Lin Y, Sum FHKMH, McGrath C, Jin L, Zhang C, Yang Y. Effects of Low-Level Laser Therapy on Dentin Hypersensitivity in Periodontally Compromised Patients Undergoing Orthodontic Treatment: A Randomised Controlled Trial. J Clin Med 2023; 12:1419. [PMID: 36835953 PMCID: PMC9961942 DOI: 10.3390/jcm12041419] [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: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVES This study aimed to assess the effects of low-level laser therapy (LLLT) on dentin hypersensitivity (DH) in periodontally compromised patients undergoing orthodontic treatment. METHODS This triple-blinded randomised controlled trial included 143 teeth with DH from 23 periodontally compromised patients. Teeth on one side of the dental arch were randomly assigned to the LLLT group (LG), while those on the contralateral side were allocated to the non-LLLT group (NG). After orthodontic treatment commenced, patients' orthodontic pain (OP) perceptions were documented in pain diaries. DH was assessed chairside by a visual analogue scale (VASDH) at fifteen timepoints across the orthodontic treatment and retention. VASDH scores were compared among timepoints by the Friedman test, among patients with varying OP perceptions using the Kruskal-Wallis tests, and between the LG and NG with the Mann-Whitney U test. RESULTS DH generally decreased over the observation (p < 0.001). The VASDH scores differed among patients with varying OP perceptions at multiple timepoints (p < 0.05). The generalized estimating equation model showed teeth in the LG had a significantly lower VASDH score than the NG at the 3rd month of treatment (p = 0.011). CONCLUSION LLLT could be potentially beneficial in managing DH in periodontally compromised patients undergoing orthodontic treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
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Huokuna J, Loimaranta V, Laine MA, Svedström-Oristo AL. Adverse effects of orthodontic forces on dental pulp. Appearance and character. A systematic review. Acta Odontol Scand 2022; 81:267-277. [PMID: 36436210 DOI: 10.1080/00016357.2022.2137232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To comprehensively assess recent data on the effects of orthodontic forces on the dental pulp and to critically evaluate, whether any of the changes are permanent. MATERIALS AND METHODS Articles published between 2/2009 and 2/2022 were searched electronically on the PubMed, EMBASE and SCOPUS databases. The initial search retrieved 780 publications and, applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 33 relevant articles were identified. Twenty articles fulfilled the requirements for high (n = 1) or moderate (n = 19) methodological quality and were included. All assessments were made independently by three researchers. RESULTS Orthodontic forces appeared to cause a reduction in pulpal blood flow and a reduction in tooth sensibility, as indicated by increased response thresholds and increased amounts of negative responses to tooth sensibility tests. In addition, there were increases in the expression or activity levels of enzymes and neuropeptides associated with hypoxia and inflammation. Fibrotic tissue formation in the pulp was also reported. CONCLUSIONS Except for some histological and morphological alterations, the observed pulpal changes were in most cases only temporary, appearing within days of initiating the treatment and usually lasting for weeks. There were no clear signs of permanent damage.
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Affiliation(s)
- Jukka Huokuna
- Institute of Dentistry, University of Turku, Turku, Finland
| | | | - Merja A. Laine
- Institute of Dentistry, University of Turku, Turku, Finland
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Neural Regulations in Tooth Development and Tooth-Periodontium Complex Homeostasis: A Literature Review. Int J Mol Sci 2022; 23:ijms232214150. [PMID: 36430624 PMCID: PMC9698398 DOI: 10.3390/ijms232214150] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
The tooth-periodontium complex and its nerves have active reciprocal regulation during development and homeostasis. These effects are predominantly mediated by a range of molecules secreted from either the nervous system or the tooth-periodontium complex. Different strategies mimicking tooth development or physiological reparation have been applied to tooth regeneration studies, where the application of these nerve- or tooth-derived molecules has been proven effective. However, to date, basic studies in this field leave many vacancies to be filled. This literature review summarizes the recent advances in the basic studies on neural responses and regulation during tooth-periodontium development and homeostasis and points out some research gaps to instruct future studies. Deepening our understanding of the underlying mechanisms of tooth development and diseases will provide more clues for tooth regeneration.
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Sobrinho JEM, Aguiar MT, Machado LC, Carlos ACAM, Nunes Alves APN, Mesquita KC, de Miranda Candeiro GT, de Barros Silva PG. Intense orthodontic forces induces the three dental pulp nitric oxide synthases isoforms and leads to orofacial discomfort in rats. Orthod Craniofac Res 2021; 25:485-493. [DOI: 10.1111/ocr.12560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/13/2021] [Accepted: 12/20/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | - Maria Thaynara Aguiar
- Christus University Center Department of Dentistry Laboratory of Pathology Fortaleza, Ceará Brazil
| | - Larissa Carvalho Machado
- Christus University Center Department of Dentistry Laboratory of Pathology Fortaleza, Ceará Brazil
| | | | | | - Karine Cestaro Mesquita
- Christus University Center Department of Dentistry Laboratory of Pathology Fortaleza, Ceará Brazil
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Vitali FC, Cardoso IV, Mello FW, Flores-Mir C, Andrada AC, Dutra-Horstmann KL, Duque TM. Effect of orthodontic force on dental pulp histomorphology and tissue factor expression. Angle Orthod 2021; 91:830-842. [PMID: 34670269 DOI: 10.2319/012221-65.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 05/01/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To evaluate the effects of orthodontic force on histomorphology and tissue factor expression in the dental pulp. MATERIALS AND METHODS Two reviewers comprehensively and systematically searched the literature in the following databases: Latin American and Caribbean Health Sciences, Embase, Cochrane, PubMed, Scopus, Web of Science, and Grey literature (Google Scholar, OpenGrey, and ProQuest) up to September 2020. According to the Population, Intervention, Comparison, Outcomes, Studies criteria, randomized clinical trials (RCTs) and observational studies that evaluated the effects of orthodontic force on dental pulp were included. Case series/reports, laboratory-based or animal studies, reviews, and studies that did not investigate the association between orthodontic force and pulpal changes were excluded. Newcastle-Ottawa Scale and Cochrane risk-of-bias tool were used to assess the risk of bias. The overall certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS 26 observational studies and five RCTs were included. A detailed qualitative analysis of articles showed a wide range of samples and applied methodologies concerning impact of orthodontic force on the dental pulp. The application of orthodontic force seems to promote several pulpal histomorphological changes, including tissue architecture, cell pattern, angiogenesis, hard tissue deposition, inflammation, and alteration of the expression levels of 14 tissue factors. CONCLUSIONS Although the included articles suggest that orthodontic forces may promote histomorphological changes in the dental pulp, due to the very low-level of evidence obtained, there could be no well-supported conclusion that these effects are actually due to orthodontic movement. Further studies with larger samples and improved methods are needed to support more robust conclusions.
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Liao Z, Long H, Song Z, He Y, Lai W. Behavioral Responses and Expression of Nociceptin/Orphanin FQ and Its Receptor (N/OFQ-NOP System) during Experimental Tooth Movement in Rats. Pain Res Manag 2021; 2021:9981732. [PMID: 34336071 PMCID: PMC8318770 DOI: 10.1155/2021/9981732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/27/2021] [Accepted: 07/13/2021] [Indexed: 02/05/2023]
Abstract
Objective To determine behavioral testing after experimental tooth movement in rats and to explore the role of nociceptin/orphanin FQ and its receptor (the N/OFQ-NOP system) in pain induced by experimental tooth movement. Design The mouth-wiping behavior of rats was assessed by studying behavioral responses after experimental tooth movement. The distribution of N/OFQ in the periodontal ligament, the trigeminal ganglion (TG), and the caudal one-third of the trigeminal subnucleus caudalis (Vc) was assessed by immunohistochemistry. The variations in N/OFQ expression in the TG and Vc were measured by Western blotting. The ongoing changes in the gene expression of the prepronociceptin gene and opioid receptor-like 1 receptor were assessed in the TG and Vc by real-time polymerase chain reaction (RT-PCR). Results Overall, the mouth-wiping behavior increased significantly. The behavior first increased and then gradually decreased to a low level, showing cyclical variation. N/OFQ immunoreactivity increased in the periodontal ligament after tooth movement. ppN/OFQ mRNA and protein levels showed a time-dependent increase in the TG and were positively correlated with pain stimulus. NOP gene levels showed large fluctuations. In the Vc, the expression and changes in the N/OFQ-NOP system showed the opposite trend as those noted in TG and the periodontal membrane. Conclusion The N/OFQ system may have a complex regulatory function in the pain induced by tooth movement and may be related to inflammation caused by orthodontic tooth movement and periodontal damage. The specific mechanism remains to be further studied.
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Affiliation(s)
- Zhengyu Liao
- The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Jiangxi Province, Department of Orthodontics, Nanchang, China
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu 610041, Sichuan, China
| | - Hu Long
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu 610041, Sichuan, China
| | - Zhiping Song
- Department of Anesthesiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yuwei He
- Department of Orthodontics, Beiping Dental Clinic, Dazhou, Sichuan Province, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu 610041, Sichuan, China
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Liu Q, He H, Mai L, Yang S, Fan W, Huang F. Peripherally Acting Opioids in Orofacial Pain. Front Neurosci 2021; 15:665445. [PMID: 34017236 PMCID: PMC8129166 DOI: 10.3389/fnins.2021.665445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
The activation of opioid receptors by exogenous or endogenous opioids can produce significant analgesic effects in peripheral tissues. Numerous researchers have demonstrated the expression of peripheral opioid receptors (PORs) and endogenous opioid peptides (EOPs) in the orofacial region. Growing evidence has shown the involvement of PORs and immune cell-derived EOPs in the modulation of orofacial pain. In this review, we discuss the role of PORs and EOPs in orofacial pain and the possible cellular mechanisms involved. Furthermore, the potential development of therapeutic strategies for orofacial pain is also summarized.
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Affiliation(s)
- Qing Liu
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Hongwen He
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Anatomy and Physiology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Lijia Mai
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Shengyan Yang
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Wenguo Fan
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Fang Huang
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Lo Giudice A, Leonardi R, Ronsivalle V, Allegrini S, Lagravère M, Marzo G, Isola G. Evaluation of pulp cavity/chamber changes after tooth-borne and bone-borne rapid maxillary expansions: a CBCT study using surface-based superimposition and deviation analysis. Clin Oral Investig 2021; 25:2237-2247. [PMID: 32860529 DOI: 10.1007/s00784-020-03539-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare volume and shape changes of pulp chamber of maxillary posterior teeth between tooth-borne and bone-borne maxillary expansions in adolescents. MATERIALS AND METHODS This study included 36 adolescents with bilateral maxillary crossbite who received tooth-borne rapid maxillary expansion (TB group, average age 14.4 years) or bone-borne rapid maxillary expansion (BB group, average age 14.7 years). Cone beam computed tomography (CBCT) was taken before treatment (T1) and after a 6-month retention period (T2). Volumetric and shape changes of pulp chamber of maxillary first molars and premolars were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student's t tests were used to (1) compare T1 and T2 volumes of pulp chambers in TB and BB groups and (2) assess differences between the two groups in the post-treatment volumetric changes and in the percentage of matching of 3D pulp models. RESULTS All investigated teeth showed a reduction of pulp volume, being this difference significant in both TB (p < 0.0001) and BB (p < 0.0001) groups. The volumetric reduction was greater in the TB group; also, subjects in the TB group showed a lower percentage of matching between T1 and T2 pulp models (p < 0.0001). The area most affected by shape change was that of pulp horns. CONCLUSIONS TB expander could induce a higher volumetric reduction of pulp chamber of posterior teeth compared with BB expander, in the short term. CLINICAL RELEVANCE The present findings add new information concerning the effects of RME protocols on pulp tissue.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | | | - Manuel Lagravère
- Orthodontic Graduate Program, Edmonton Clinic Health Academy, University of Alberta, 5th Floor, 11405 - 87 Avenue NW, Edmonton, Alberta, Canada
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, V.le San Salvatore, 67100, L'Aquila, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
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Cheng Y, Huang P, Meng B, Gan L, Wu D, Cao Y. Antinociceptive effects of the adenylyl cyclase inhibitor ST034307 on tooth-movement-induced nociception in rats. Arch Oral Biol 2018; 98:81-86. [PMID: 30465937 DOI: 10.1016/j.archoralbio.2018.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/31/2018] [Accepted: 11/12/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to investigate the antinociceptive effects of the selective adenylyl cyclase type 1 (AC1) inhibitor ST034307 on tooth movement nociception through orofacial nociceptive behavior tests and molecular examination. METHODS We placed fixed nickel-titanium alloy closed-coil springs around the incisors of male Sprague-Dawley rats to induce tooth movement. We subsequently administered ST034307 (3 mg/kg), for 2 days, intraperitoneally, and then subjected the rats to a battery of behavioral tests (n = 10/group) to assess orofacial nociception. The changes in the expression of key molecules in the anterior cingulate cortex were measured by ELISA (n = 8/group) and Western blotting (n = 8/group). RESULTS Tooth movement increased face-grooming activities and rat grimace scale scores. Tooth movement was also associated with enhanced cyclic adenosine monophosphate (cAMP) generation as well as protein kinase A (PKA) activation. Moreover, the phosphorylation of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors and expression of N-methyl-d-aspartate (NMDA) receptors in the anterior cingulate cortex increased during tooth movement. ST034307 significantly decreased mouth wiping and rat grimace scale scores, accompanied by reductions in cAMP generation, PKA activation, AMPA receptor phosphorylation, and NMDA receptor expression in the anterior cingulate cortex. CONCLUSIONS These results suggest that adenylyl cyclase type 1 plays an important role in the development of orthodontic tooth movement nociception. Furthermore, ST034307 can be used as an effective pharmacotherapy for orthodontic nociception.
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Affiliation(s)
- Yangfan Cheng
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Peina Huang
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Bowen Meng
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Lei Gan
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Dongle Wu
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yang Cao
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.
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Schou WS, Ashina S, Amin FM, Goadsby PJ, Ashina M. Calcitonin gene-related peptide and pain: a systematic review. J Headache Pain 2017; 18:34. [PMID: 28303458 PMCID: PMC5355411 DOI: 10.1186/s10194-017-0741-2] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/28/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Calcitonin gene-related peptide (CGRP) is widely distributed in nociceptive pathways in human peripheral and central nervous system and its receptors are also expressed in pain pathways. CGRP is involved in migraine pathophysiology but its role in non-headache pain has not been clarified. METHODS We performed a systematic literature search on PubMed, Embase and ClinicalTrials.gov for articles on CGRP and non-headache pain covering human studies including experimental studies and randomized clinical trials. RESULTS The literature search identified 375 citations of which 50 contained relevant original data. An association between measured CGRP levels and somatic, visceral, neuropathic and inflammatory pain was found. In 13 out of 20 studies in somatic pain conditions, CGRP levels had a positive correlation with pain. Increased CGRP levels were reported in plasma, synovial and cerebrospinal fluid in subjects with musculoskeletal pain. A randomized clinical trial on monoclonal antibody, which selectively binds to and inhibits the activity of CGRP (galcanezumab) in patients with osteoarthritis knee pain, failed to demonstrate improvement of pain compared with placebo. No studies to date have investigated the efficacy of monoclonal antibodies against CGRP receptor in non-headache pain conditions. CONCLUSION The present review revealed the association between measured CGRP levels and somatic, visceral, neuropathic and inflammatory pain. These data suggest that CGRP may act as a neuromodulator in non-headache pain conditions. However, more studies are needed to fully understand the role of CGRP in nociceptive processing and therapy of chronic pain.
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Affiliation(s)
- Wendy Sophie Schou
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Sait Ashina
- Department of Neurology, NYU Lutheran Headache Center, New York University School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - Faisal Mohammad Amin
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Peter J Goadsby
- Basic & Clinical Neuroscience, and NIHR-Wellcome Trust King's Clinical Research Facility, King's College London, London, UK
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark.
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Ohkura M, Ohkura N, Yoshiba N, Yoshiba K, Ida-Yonemochi H, Ohshima H, Saito I, Okiji T. Orthodontic force application upregulated pain-associated prostaglandin-I 2/PGI 2-receptor/TRPV1 pathway-related gene expression in rat molars. Odontology 2017. [PMID: 28631175 DOI: 10.1007/s10266-017-0309-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study aimed to analyze the mRNA expression and protein localization of prostaglandin I2 (PGI2) synthase (PGIS), the PGI2 receptor (IP receptor) and transient receptor potential cation channel, subfamily V, member 1 (TRPV1) in force-stimulated rat molars, toward the elucidation of the PGI2-IP receptor-TRPV1 pathway that is in operation in the pulp and possibly associated with orthodontic pain and inflammation. Experimental force was applied to the maxillary first and second molars by inserting an elastic band between them for 6-72 h. PGIS, PTGIR (the IP receptor gene), and TRPV1 mRNA levels in the coronal pulp were analyzed with real-time PCR. PGIS, IP receptor, and TRPV1 proteins were immunostained. The force stimulation induced significant upregulation of PGIS at 6-24 h, and PTGIR and TRPV1 at 6 and 12 h in the pulp. PGIS was immunolocalized in odontoblasts and some fibroblasts in the force-stimulated pulp. The IP receptor and TRPV1 immunoreactivities were detected on odontoblasts and some nerve fibers. It was concluded that PGIS, PTGIR, and TRPV1 in rat molar pulp were significantly upregulated shortly after the force application, and that the IP receptor was co-expressed on TRPV1-expressing nerves and odontoblasts. These findings suggest that the PGI2-IP receptor-TRPV1 pathway is associated with the acute phase of force-induced pulp changes involving odontoblasts and nerves.
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Affiliation(s)
- Mariko Ohkura
- Division of Orthodontics, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Naoto Ohkura
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Nagako Yoshiba
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Kunihiko Yoshiba
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hiroko Ida-Yonemochi
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hayato Ohshima
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Isao Saito
- Division of Orthodontics, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
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Long H, Wang Y, Jian F, Liao LN, Yang X, Lai WL. Current advances in orthodontic pain. Int J Oral Sci 2016; 8:67-75. [PMID: 27341389 PMCID: PMC4932774 DOI: 10.1038/ijos.2016.24] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 02/05/2023] Open
Abstract
Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons: the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway—periaqueductal grey and dorsal raphe—has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti-inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviating orthodontic pain in the future.
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Affiliation(s)
- Hu Long
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li-Na Liao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Yang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen-Li Lai
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Experimentally Induced Pulpal Lesion and Substance P Expression: Effect of Ketoprofen-A Preliminary Study. Int J Dent 2016; 2016:6820781. [PMID: 27034673 PMCID: PMC4789479 DOI: 10.1155/2016/6820781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/10/2016] [Indexed: 12/16/2022] Open
Abstract
Objectives. To evaluate substance P (SP) and the effect of ketoprofen administration, a nonsteroidal anti-inflammatory drug (NSAID), on SP in the pulp of upper third molars with experimentally induced pulpal lesion. Materials and Methods. A sample of 20 young systemically healthy adults of both sexes, nonsmokers, with a healthy upper third molar to extract for orthodontic purposes, was selected. Prior to the procedure, an inflammatory process was generated by mechanical exposure of the pulp. After 15 minutes, the pulp was collected using a sterile barbed broach. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration. The patients were asked to complete a diary on the postoperative pain. Results. No statistically significant difference could be detected in SP expression between the two groups. In group 1, pain manifestation was significantly delayed in comparison with group 2. Conclusions. Preventive administration of ketoprofen did not significantly affect the pulpal levels of SP but resulted in a significantly postponed manifestation of pain after extraction.
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Abstract
This paper is the thirty-seventh consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2014 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (endogenous opioids and receptors), and the roles of these opioid peptides and receptors in pain and analgesia (pain and analgesia); stress and social status (human studies); tolerance and dependence (opioid mediation of other analgesic responses); learning and memory (stress and social status); eating and drinking (stress-induced analgesia); alcohol and drugs of abuse (emotional responses in opioid-mediated behaviors); sexual activity and hormones, pregnancy, development and endocrinology (opioid involvement in stress response regulation); mental illness and mood (tolerance and dependence); seizures and neurologic disorders (learning and memory); electrical-related activity and neurophysiology (opiates and conditioned place preferences (CPP)); general activity and locomotion (eating and drinking); gastrointestinal, renal and hepatic functions (alcohol and drugs of abuse); cardiovascular responses (opiates and ethanol); respiration and thermoregulation (opiates and THC); and immunological responses (opiates and stimulants). This paper is the thirty-seventh consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2014 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (endogenous opioids and receptors), and the roles of these opioid peptides and receptors in pain and analgesia (pain and analgesia); stress and social status (human studies); tolerance and dependence (opioid mediation of other analgesic responses); learning and memory (stress and social status); eating and drinking (stress-induced analgesia); alcohol and drugs of abuse (emotional responses in opioid-mediated behaviors); sexual activity and hormones, pregnancy, development and endocrinology (opioid involvement in stress response regulation); mental illness and mood (tolerance and dependence); seizures and neurologic disorders (learning and memory); electrical-related activity and neurophysiology (opiates and conditioned place preferences (CPP)); general activity and locomotion (eating and drinking); gastrointestinal, renal and hepatic functions (alcohol and drugs of abuse); cardiovascular responses (opiates and ethanol); respiration and thermoregulation (opiates and THC); and immunological responses (opiates and stimulants).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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Sensory Neuropeptides and Endogenous Opioids Expression in Human Dental Pulp with Asymptomatic Inflammation: In Vivo Study. Mediators Inflamm 2015; 2015:879126. [PMID: 26538838 PMCID: PMC4619975 DOI: 10.1155/2015/879126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/01/2015] [Accepted: 07/07/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose. This study quantified the expression of substance P (SP), calcitonin gene-related peptide (CGRP), β-endorphins (β-End), and methionine-enkephalin (Met-Enk) in human dental pulp following orthodontic intrusion. Methods. Eight patients were selected according to preestablished inclusion criteria. From each patient, two premolars (indicated for extraction due to orthodontic reasons) were randomly assigned to two different groups: the asymptomatic inflammation group (EXPg), which would undergo controlled intrusive force for seven days, and the control group (CTRg), which was used to determine the basal levels of each substance. Once extracted, dental pulp tissue was prepared to determine the expression levels of both neuropeptides and endogenous opioids by radioimmunoassay (RIA). Results. All samples from the CTRg exhibited basal levels of both neuropeptides and endogenous opioids. By day seven, all patients were asymptomatic, even when all orthodontic-intrusive devices were still active. In the EXPg, the SP and CGRP exhibited statistically significant different levels. Although none of the endogenous opioids showed statistically significant differences, they all expressed increasing trends in the EXPg. Conclusions. SP and CGRP were identified in dental pulp after seven days of controlled orthodontic intrusion movement, even in the absence of pain.
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Uhrich E, Gautam M, Hatton J, Rowland K. Corticotropin releasing factor receptor expression in painful human dental pulp. Arch Oral Biol 2015; 60:1048-53. [PMID: 25924915 DOI: 10.1016/j.archoralbio.2015.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 02/03/2015] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Our objective was to correlate the presence of symptoms and dental pulp injury with the amount of a subtype of corticotropin releasing factor receptor (CRF-R) in symptomatic and asymptomatic human teeth. We hypothesized that patients diagnosed with irreversible pulpitis have increased levels of CRF-R. MATERIALS AND METHODS Dental history, diagnosis and radiographs were obtained from treatment records following extractions. Teeth were diagnosed as asymptomatic or symptomatic demonstrated by clinical and radiographic evaluation. Tissue sections from tooth pulp were immunoreacted with antibodies directed against CRF receptor 2 (CRF-R2) and neurofilament protein and examined to correlate CRF-R expression with pulpal diagnosis. RESULTS Our results indicated that symptomatic pulps demonstrated significantly greater expression of CRF-R2. The increased expression was localized on distinct cellular profiles throughout the pulp and was not directly correlated with neurofilament expression. CONCLUSIONS Our findings suggest that the analgesic effects of endogenously produced CRF may be enhanced via upregulation of CRF-R2 expression, and may explain the occurrence of reduced pain symptoms in some patients with irreversible pulpitis. The application of CRF-R agonists may be a feasible strategy in reducing pain associated with irreversible pulpitis.
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Affiliation(s)
- Elizabeth Uhrich
- Southern Illinois University, School of Dental Medicine, 2800 College Avenue, Alton, IL 62002, United States
| | - Medha Gautam
- Southern Illinois University, School of Dental Medicine, 2800 College Avenue, Alton, IL 62002, United States
| | - John Hatton
- Center for Advanced Dental Education, Saint Louis University, St. Louis, MO 63103, United States
| | - Kevin Rowland
- Southern Illinois University, School of Dental Medicine, 2800 College Avenue, Alton, IL 62002, United States.
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Abstract
This paper is the thirty-sixth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2013 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia; stress and social status; tolerance and dependence; learning and memory; eating and drinking; alcohol and drugs of abuse; sexual activity and hormones, pregnancy, development and endocrinology; mental illness and mood; seizures and neurologic disorders; electrical-related activity and neurophysiology; general activity and locomotion; gastrointestinal, renal and hepatic functions; cardiovascular responses; respiration and thermoregulation; and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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