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Bernardi S, Memè L, Belfioretti C, Bambini F, Gerardi D, Macchiarelli G, Bianchi S, Mummolo S. Psoriatic Arthritis Involving TMJ: A Review on Pathogenesis and Consideration on Eventual Gender Differences. Dent J (Basel) 2024; 12:31. [PMID: 38392235 PMCID: PMC10887631 DOI: 10.3390/dj12020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Psoriatic arthritis is defined as chronic inflammatory arthritis associated with psoriasis. The current data regarding gender differences in clinical manifestation and therapeutic outcomes of psoriatic arthritis are limited. Generally, men show a peripheral disease manifestation, while women have an axial distribution of the lesions. If we look at temporomandibular joint (TMJ) involvement, epidemiological data on the involvement of the TMJ are hard to find. Few studies on therapeutic management and the related impact on the quality of life are reported in the literature. Given the morpho-functional peculiarities of the TMJ and the different pain burdens between male and female genders, when manifestation of psoriatic arthritis occurs, clinicians should face it using a multidisciplinary approach for a correct diagnosis and successful treatment. This review aims to examine the diagnostic signs of psoriatic arthritis in the TMJ, the eventual variations of this disease in male and female patients, and the therapeutical strategies. The coordination of different specialties is fundamental to the remission of clinical symptoms and lesion regression.
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Affiliation(s)
- Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Lucia Memè
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Chiara Belfioretti
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Fabrizio Bambini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Davide Gerardi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, 'G. D'Annunzio' University of Chieti-Pescara, 66100 Chieti, Italy
| | - Guido Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Stefano Mummolo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
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Smith SA, Norbury R, Hunt AJ, Mauger AR. Intra- and interindividual reliability of muscle pain induced by an intramuscular injection of hypertonic saline injection into the quadriceps. Eur J Pain 2023; 27:1216-1225. [PMID: 37376739 DOI: 10.1002/ejp.2151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 05/05/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Intramuscular injections of hypertonic saline are commonly used to induce experimental muscle pain, but reliability data on this technique are lacking. This study investigated the intra- and interindividual reliability of pain measures from a hypertonic saline injection into the vastus lateralis. METHODS Fourteen healthy participants (6 female) attended three laboratory visits where they received an intramuscular injection of 1 mL hypertonic saline into the vastus lateralis. Changes in pain intensity were recorded on an electronic visual analogue scale, and pain quality was assessed after pain had resolved. Reliability was assessed with the coefficient of variation (CV), minimum detectable change (MDC) and intraclass correlation coefficient (ICC) with 95% CIs. RESULTS Mean pain intensity displayed high levels of intraindividual variability (CV = 16.3 [10.5-22.0]%) and 'poor' to 'very good' relative reliability (ICC = 0.71 [0.45-0.88]) but had a MDC of 11 [8-16] au (out of 100). Peak pain intensity exhibited high levels of intraindividual variability (CV = 14.8 [8.8-20.8]%) with 'moderate' to 'excellent' levels of relative reliability (ICC = 0.81 [0.62-0.92]), whereas the MDC was 18 [14-26] au. Measures of pain quality exhibited good reliability. Interindividual variability in pain measures was high (CV > 37%). CONCLUSIONS Intramuscular injections of 1 mL of hypertonic saline into the vastus lateralis display substantial levels of interindividual variability, but MDC is below the clinically important changes in pain. This model of experimental pain is suitable for studies involving repeated exposures. SIGNIFICANCE Many pain research studies have performed intramuscular injections of hypertonic saline to investigate responses to muscle pain. However, the reliability of this technique is not well established. We examined the pain response over three repeated sessions of a hypertonic saline injection. The pain induced by hypertonic saline has considerable interindividual variability but has largely acceptable intraindividual reliability. Therefore, the injections of hypertonic saline to induce muscle pain are a reliable model of experimental muscle pain.
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Affiliation(s)
- Samuel A Smith
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
| | - Ryan Norbury
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
- Faculty of Sport, Allied Health, and Performance Science, St Mary's University, Twickenham, UK
| | - Adam J Hunt
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
| | - Alexis R Mauger
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
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3
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Dubey NK, Mishra S, Goswami C. Progesterone interacts with the mutational hot-spot of TRPV4 and acts as a ligand relevant for fast Ca 2+-signalling. BIOCHIMICA ET BIOPHYSICA ACTA. BIOMEMBRANES 2023; 1865:184178. [PMID: 37225030 DOI: 10.1016/j.bbamem.2023.184178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 05/03/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
Steroids are also known to induce immediate physiological and cellular response which occurs within minutes to seconds, or even faster. Such non-genomic actions of steroids are rapid and are proposed to be mediated by different ion channels. Transient receptor potential vanilloid sub-type 4 (TRPV4), is a non-specific polymodal ion channel which is involved in several physiological and cellular processes. In this work, we explored the possibilities of Progesterone (P4) as an endogenous ligand for TRPV4. We demonstrate that P4 docks as well as physically interacts with the TM4-loop-TM5 region of TRPV4, a region which is a mutational hotspot for different diseases. Live cell imaging experiments with a genetically encoded Ca2+-sensor suggests that P4 causes quick influx of Ca2+ specifically in the TRPV4 expressing cells, which can be partially blocked by TRPV4-specific inhibitor, suggesting that P4 can act as a ligand for TRPV4. Such P4-mediated Ca2+-influx is altered in cells expressing disease causing TRPV4 mutants, namely in L596P, R616Q, and also in embryonic lethal mutant L618P. P4 dampens, both in terms of "extent" as well as the "pattern" of the Ca2+-influx by other stimulus too in cells expressing TRPV4-Wt, suggesting that P4 crosstalk with the TRPV4-mediated Ca2+-signalling, both in quick and long-term manner. We propose that P4 crosstalk with TRPV4 might be relevant for both acute and chronic pain as well as for other health-related functions.
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Affiliation(s)
- Nishant Kumar Dubey
- National Institute of Science Education and Research Bhubaneswar, School of Biological Sciences, P.O. Jatni, Khurda 752050, Odisha, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - Subham Mishra
- National Institute of Science Education and Research Bhubaneswar, School of Biological Sciences, P.O. Jatni, Khurda 752050, Odisha, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - Chandan Goswami
- National Institute of Science Education and Research Bhubaneswar, School of Biological Sciences, P.O. Jatni, Khurda 752050, Odisha, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India.
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Hornung RS, Kinchington PR, Umorin M, Kramer PR. PAQR8 and PAQR9 expression is altered in the ventral tegmental area of aged rats infected with varicella zoster virus. Mol Pain 2023; 19:17448069231202598. [PMID: 37699860 PMCID: PMC10515525 DOI: 10.1177/17448069231202598] [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: 07/06/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
Infection with varicella zoster virus (VZV) results in chicken pox and reactivation of VZV results in herpes zoster (HZ) or what is often referred to as shingles. Patients with HZ experience decreased motivation and increased emotional distress consistent with functions of the ventral tegmental area (VTA) of the brain. In addition, activity within the ventral tegmental area is altered in patients with HZ. HZ primarily affects individuals that are older and the VTA changes with age. To begin to determine if the VTA has a role in HZ symptoms, a screen of 10,000 genes within the VTA in young and old male rats was completed after injecting the whisker pad with VZV. The two genes that had maximal change were membrane progesterone receptors PAQR8 (mPRβ) and PAQR9 (mPRε). Neurons and non-neuronal cells expressed both PAQR8 and PAQR9. PAQR8 and PAQR9 protein expression was significantly reduced after VZV injection of young males. In old rats PAQR9 protein expression was significantly increased after VZV injection and PAQR9 protein expression was reduced in aged male rats versus young rats. Consistent with previous results, pain significantly increased after VZV injection of the whisker pad and aged animals showed significantly more pain than young animals. Our data suggests that PAQR8 and PAQR9 expression is altered by VZV injection and that these changes are affected by age.
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Affiliation(s)
- Rebecca S Hornung
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, TX, USA
| | - Paul R Kinchington
- Department of Ophthalmology and of Molecular Microbiology and Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mikhail Umorin
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, TX, USA
| | - Phillip R Kramer
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, TX, USA
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Sepulveda DE, Morris DP, Raup-Konsavage WM, Sun D, Vrana KE, Graziane NM. Evaluating the Antinociceptive Efficacy of Cannabidiol Alone or in Combination with Morphine Using the Formalin Test in Male and Female Mice. Cannabis Cannabinoid Res 2022; 7:648-657. [PMID: 34846928 PMCID: PMC9587782 DOI: 10.1089/can.2021.0108] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Phytocannabinoids have emerged as a potential alternative treatment option for individuals experiencing persistent pain. However, evidence-based research regarding their clinical utility in both males and females remains incomplete. In addition, it is unknown whether combining readily available cannabinoids with opioids has a synergistic or subadditive effect on pain modulation. To begin to fill this knowledge gap, we investigated the antinociceptive effects of the phytocannabinoid, CBD, either alone or in combination with opioids in male and female C57BL/6J mice. Results: Using the formalin test, our results show that CBD (10 mg/kg, i.p.) treatment evoked antinociception in phase I, but not in phase II, of the formalin test in male mice. However, in female mice, CBD showed no significant antinociceptive effect. In addition, a direct sex comparison showed that CBD evoked a significant increase in nociceptive behaviors in female versus male mice during phase I of the formalin test. Furthermore, we show that CBD (10 mg/kg, i.p.) in combination with low-dose morphine (1 mg/kg, i.p.) was ineffective at eliciting a synergistic antinociceptive response in both male and female mice. Lastly, consistent with previous literature, we showed that females treated with a relatively higher dose of morphine (10 mg/kg, i.p.) displayed a significant increase in the variability of nociceptive behaviors compared to morphine-treated male mice. Conclusion: Overall, our results suggest that CBD treatment may have beneficial antinociceptive effects during the acute phase of persistent pain, but these effects are more beneficial to males than females. We provide further pre-clinical support that treatments geared toward reducing nociceptive behaviors differentially affect males and females.
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Affiliation(s)
- Diana E. Sepulveda
- Department of Pharmacology, Penn State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Department of Anesthesiology and Perioperative Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | | | - Wesley M. Raup-Konsavage
- Department of Pharmacology, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Dongxiao Sun
- Department of Pharmacology, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Kent E. Vrana
- Department of Pharmacology, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Nicholas M. Graziane
- Department of Pharmacology, Penn State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Department of Anesthesiology and Perioperative Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
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Kolatorova L, Vitku J, Suchopar J, Hill M, Parizek A. Progesterone: A Steroid with Wide Range of Effects in Physiology as Well as Human Medicine. Int J Mol Sci 2022; 23:7989. [PMID: 35887338 PMCID: PMC9322133 DOI: 10.3390/ijms23147989] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/16/2022] Open
Abstract
Progesterone is a steroid hormone traditionally linked with female fertility and pregnancy. In current reproductive medicine, progesterone and its analogues play crucial roles. While the discovery of its effects has a long history, over recent decades, various novel actions of this interesting steroid have been documented, of which its neuro- and immunoprotective activities are the most widely discussed. Discoveries of the novel biological activities of progesterone have also driven research and development in the field of progesterone analogues used in human medicine. Progestogen treatment has traditionally and predominately been used in maintaining pregnancy, the prevention of preterm labor, various gynecological pathologies, and in lowering the negative effects of menopause. However, there are also various other medical fields where progesterone and its analogues could find application in the future. The aim of this work is to show the mechanisms of action of progesterone and its metabolites, the physiological and pharmacological actions of progesterone and its synthetic analogues in human medicine, as well as the impacts of its production and use on the environment.
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Affiliation(s)
- Lucie Kolatorova
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 8, 116 94 Prague, Czech Republic; (J.V.); (M.H.)
| | - Jana Vitku
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 8, 116 94 Prague, Czech Republic; (J.V.); (M.H.)
| | - Josef Suchopar
- DrugAgency, a.s., Klokotska 833/1a, 142 00 Prague, Czech Republic;
| | - Martin Hill
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 8, 116 94 Prague, Czech Republic; (J.V.); (M.H.)
| | - Antonin Parizek
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General Teaching Hospital, Apolinarska 18, 128 51 Prague, Czech Republic;
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7
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Norbury R, Smith SA, Burnley M, Judge M, Mauger AR. The effect of hypertonic saline evoked muscle pain on neurophysiological changes and exercise performance in the contralateral limb. Exp Brain Res 2022; 240:1423-1434. [PMID: 35288782 PMCID: PMC9038847 DOI: 10.1007/s00221-022-06342-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/24/2022] [Indexed: 11/07/2022]
Abstract
Non-local muscle pain may impair endurance performance through neurophysiological mechanisms, but these are relatively unknown. This study examined the effects of muscle pain on neuromuscular and neurophysiological responses in the contralateral limb. On separate visits, nine participants completed an isometric time to task failure (TTF) using the right knee extensors after intramuscular injection of isotonic saline (CTRL) or hypertonic saline (HYP) into the left vastus lateralis. Measures of neuromuscular fatigue were taken before, during and after the TTF using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation. Mean pain intensity was greater in the left leg in HYP (3.3 ± 1.9) compared to CTRL (0.4 ± 0.7; P < 0.001) which was combined with a reduced TTF by 9.8% in HYP (4.54 ± 0.56 min) compared to CTRL (5.07 ± 0.77 min; P = 0.005). Maximum voluntary force was not different between conditions (all P > 0.05). Voluntary activation was lower in HYP compared to CTRL (P = 0.022). No difference was identified between conditions for doublet amplitude (P > 0.05). Furthermore, no difference in MEP·Mmax−1 or the TMS silent period between conditions was observed (all P > 0.05). Non-local pain impairs endurance performance of the contralateral limb. This impairment in performance is likely due to the faster attainment of the sensory tolerance limit from a greater amount of sensory feedback originating from the non-exercising, but painful, left leg.
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Affiliation(s)
- Ryan Norbury
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chipperfield Building Room 114, Canterbury Campus, Kent, CT2 7PE, UK
| | - Samuel A Smith
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chipperfield Building Room 114, Canterbury Campus, Kent, CT2 7PE, UK
| | - Mark Burnley
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chipperfield Building Room 114, Canterbury Campus, Kent, CT2 7PE, UK
| | - Megan Judge
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chipperfield Building Room 114, Canterbury Campus, Kent, CT2 7PE, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chipperfield Building Room 114, Canterbury Campus, Kent, CT2 7PE, UK.
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8
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Miyazaki M, Maeda S. Changes in hamstring flexibility and muscle strength during the menstrual cycle in healthy young females. J Phys Ther Sci 2022; 34:92-98. [PMID: 35221510 PMCID: PMC8860697 DOI: 10.1589/jpts.34.92] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/11/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to elucidate changes in flexibility and muscle strength during the menstrual cycle in detail and to investigate the relationship between flexibility and muscle strength. [Participants and Methods] Sixteen healthy young female and eight male participants were measured during the follicular, ovulation and luteal phases. Range of motion, passive torque at the onset of pain, passive stiffness and muscle strength were measured using an isokinetic dynamometer. Additionally, electromyography was measured during muscle strength measurement. [Results] In the female group, range of motion and passive torque at the onset of pain were significantly increased during the ovulatory and luteal phases compared with the follicular phase. Passive stiffness decreased significantly during the ovulatory phase compared with the follicular phase. Isometric muscle force and electromyographic activity were significantly increased during the luteal phase compared with the ovulation phase. There was no correlation between stiffness and muscle strength. However, there was a positive correlation between electromyographic activity and muscle strength. [Conclusion] Our findings suggest that changes in flexibility during the ovulatory and luteal phases are influenced by fluctuations in sex hormones. However, the changes in muscle strength showed little relation to flexibility, suggesting the involvement of neural mechanisms.
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Affiliation(s)
- Manabu Miyazaki
- Department of Physical Therapy, Faculty of Medical Science for Health, Teikyo Heisei University: 2-51-4 Higashi-Ikebukuro, Toshima-ku, Tokyo 170-8445, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | - Seiji Maeda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.,Faculty of Sport Sciences, Waseda University, Japan
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Norbury R, Smith SA, Burnley M, Judge M, Mauger AR. The effect of elevated muscle pain on neuromuscular fatigue during exercise. Eur J Appl Physiol 2022; 122:113-126. [PMID: 34586471 PMCID: PMC8748369 DOI: 10.1007/s00421-021-04814-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/15/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE Muscle pain can impair exercise performance but the mechanisms for this are unknown. This study examined the effects of muscle pain on neuromuscular fatigue during an endurance task. METHODS On separate visits, twelve participants completed an isometric time-to-task failure (TTF) exercise of the right knee extensors at ~ 20% of maximum force following an intramuscular injection of isotonic saline (CTRL) or hypertonic saline (HYP) into the vastus lateralis. Measures of neuromuscular fatigue were taken before, during and after the TTF using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation. RESULTS The mean pain intensity was 57 ± 10 in HYP compared to 38 ± 18 in CTRL (P < 0.001). TTF was reduced in HYP (4.36 ± 0.88 min) compared to CTRL (5.20 ± 0.39 min) (P = 0.003). Maximum voluntary force was 12% lower at minute 1 (P = 0.003) and 11% lower at minute 2 in HYP (P = 0.013) compared to CTRL. Voluntary activation was 4% lower at minute 1 in HYP compared to CTRL (P = 0.006) but not at any other time point (all P > 0.05). The TMS silent period was 9% longer at 100 s during the TTF in HYP compared to CTRL (P = 0.026). CONCLUSION Muscle pain reduces exercise performance through the excacerbation of neuromuscular fatigue that is central in origin. This appears to be from inhibitory feedback from group III/IV nociceptors which acts to reduce central motor output.
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Affiliation(s)
- Ryan Norbury
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Samuel A Smith
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Mark Burnley
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Megan Judge
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK.
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10
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Linnstaedt SD, Mauck MC, Son EY, Tungate AS, Pan Y, Rueckeis C, Yu S, Lechner M, Datner E, Cairns BA, Danza T, Velilla MA, Pearson C, Shupp JW, Smith DJ, McLean SA. Peritraumatic 17β-estradiol levels influence chronic posttraumatic pain outcomes. Pain 2021; 162:2909-2916. [PMID: 34028234 PMCID: PMC8464624 DOI: 10.1097/j.pain.0000000000002282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
ABSTRACT Biologic factors that predict risk for and mediate the development of common outcomes of trauma exposure such as chronic posttraumatic pain (CPTP) are poorly understood. In the current study, we examined whether peritraumatic circulating 17β-estradiol (E2) levels influence CPTP trajectories. 17β-estradiol levels were measured in plasma samples (n = 254) collected in the immediate aftermath of trauma exposure from 3 multiethnic longitudinal cohorts of men and women trauma survivors. Chronic posttraumatic pain severity was evaluated 6 weeks, 6 months, and 1 year after traumatic stress exposure. Repeated measures mixed models were used to test the relationship between peritraumatic E2 levels and prospective CPTP. Secondary analyses in a nested cohort assessed the influence of participant body mass index on the E2-CPTP relationship. In women, a statistically significant inverse relationship between peritraumatic E2 and CPTP was observed (β = -0.280, P = 0.043) such that higher E2 levels predicted lower CPTP severity over time. Secondary analyses identified an E2 * body mass index interaction in men from the motor vehicle collision cohort such that obese men with higher E2 levels were at greater risk of developing CPTP. In nonobese men from the motor vehicle collision cohort and in men from the major thermal burn injury cohort, no statistically significant relationship was identified. In conclusion, peritraumatic circulating E2 levels predict CPTP vulnerability in women trauma survivors. In addition, these data suggest that peritraumatic administration of E2 might improve CPTP outcomes for women; further research is needed to test this possibility.
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Affiliation(s)
- Sarah D. Linnstaedt
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Matthew C. Mauck
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Esther YeEun Son
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Andrew S. Tungate
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Yue Pan
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - Cathleen Rueckeis
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Shan Yu
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Megan Lechner
- Forensic Nursing Program, Memorial Health System, Colorado Springs, CO, USA
| | - Elizabeth Datner
- Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Bruce A. Cairns
- Jaycee Burn Center, University of North Carolina, Chapel Hill, NC, USA
| | - Teresa Danza
- Forensic Nursing Program, Albuquerque SANE Collaborative, Albuquerque, NM, USA
| | | | - Claire Pearson
- Department of Emergency Medicine, Detroit Receiving, Detroit, MI, USA
| | | | - David J. Smith
- Department of Surgery, University of South Florida, Tampa, FL, USA
| | - Samuel A. McLean
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA
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11
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Clephane K, Lorenz TK. Putative Mental, Physical, and Social Mechanisms of Hormonal Influences on Postpartum Sexuality. CURRENT SEXUAL HEALTH REPORTS 2021; 13:136-148. [DOI: 10.1007/s11930-021-00321-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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De Ridder D, Adhia D, Vanneste S. The anatomy of pain and suffering in the brain and its clinical implications. Neurosci Biobehav Rev 2021; 130:125-146. [PMID: 34411559 DOI: 10.1016/j.neubiorev.2021.08.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 02/08/2023]
Abstract
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Chronic pain, with a prevalence of 20-30 % is the major cause of human suffering worldwide, because effective, specific and safe therapies have yet to be developed. It is unevenly distributed among sexes, with women experiencing more pain and suffering. Chronic pain can be anatomically and phenomenologically dissected into three separable but interacting pathways, a lateral 'painfulness' pathway, a medial 'suffering' pathway and a descending pain inhibitory pathway. One may have pain(fullness) without suffering and suffering without pain(fullness). Pain sensation leads to suffering via a cognitive, emotional and autonomic processing, and is expressed as anger, fear, frustration, anxiety and depression. The medial pathway overlaps with the salience and stress networks, explaining that behavioural relevance or meaning determines the suffering associated with painfulness. Genetic and epigenetic influences trigger chronic neuroinflammatory changes which are involved in transitioning from acute to chronic pain. Based on the concept of the Bayesian brain, pain (and suffering) can be regarded as the consequence of an imbalance between the two ascending and the descending pain inhibitory pathways under control of the reward system. The therapeutic clinical implications of this simple pain model are obvious. After categorizing the working mechanisms of each of the available treatments (pain killers, psychopharmacology, psychotherapy, neuromodulation, psychosurgery, spinal cord stimulation) to 1 or more of the 3 pathways, a rational combination can be proposed of activating the descending pain inhibitory pathway in combination with inhibition of the medial and lateral pathway, so as to rebalance the pain (and suffering) pathways.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | - Divya Adhia
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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A Female Psoriatic Arthritis Patient Involving the TMJ. Case Rep Dent 2021; 2021:6638638. [PMID: 33628524 PMCID: PMC7892245 DOI: 10.1155/2021/6638638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 02/08/2023] Open
Abstract
Psoriatic arthritis (PsA) is an inflammatory chronic arthritis associated with psoriasis. Currently, data about gender differences in clinical manifestation and therapeutic outcomes of PsA are limited. Frequently, women manifest a peripheral disease while men have an axial localization. Moreover, women display higher disease activity and physical activity limitations, if compared to men. Although the involvement of the temporomandibular joint (TMJ) is quite rare, it can seriously impact the quality of life. The morpho-functional peculiarities of TMJ require a multidisciplinary approach to perform a correct diagnosis and a successful treatment. Here, we report a case of a woman affected by PsA involving TMJ treated by combining pharmacological therapy and an occlusal splint. The coordination between different specialties led to a complete remission of clinical symptoms and a regression of lesions.
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14
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Krunic J, Mladenovic I, Radovic I, Stojanovic N. Changes in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders. J Oral Rehabil 2020; 48:124-131. [PMID: 33064877 DOI: 10.1111/joor.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Menstrual cycle may contribute to experimental pain measures in healthy women and women with chronic pain. OBJECTIVES The present study aimed to investigate variation in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders (TMD) and to explore the effect of TMD pain and psychosocial variables on the pulp response. METHODS This longitudinal study involved 47 regularly menstruating women aged 20-45, 24 healthy and 23 with diagnosed painful TMD. The electric and cold stimuli were performed by electric pulp tester and refrigerant spray, respectively, on mandibular lateral incisors, in five menstrual phases (menstrual, follicular, periovulatory, luteal and premenstrual). Research Diagnostic Criteria for TMD were used to assess TMD, chronic pain, depression and somatisation. Regression analysis was performed to investigate the effect of the predictor variables on the pulp sensitivity. RESULTS Significant phase-related differences were observed for pain intensity to cold stimuli. Higher pain sensitivity was reported in menstrual in comparison with luteal phase (P = .019) among healthy women, and in menstrual in comparison with follicular (P = .033), periovulatory (P = .003) and luteal (P = .007) phases in TMD women. No significant differences were recorded for electric stimuli. Regression analysis identified depression as the determinant of cold and electric response in menstrual phase, regardless of age and presence of TMD. CONCLUSION Menstrual phase in healthy and TMD women with regular menstrual cycle is characterised with higher pulp sensitivity to cold stimuli. Depressive symptoms independently influence pulp response in this phase.
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Affiliation(s)
- Jelena Krunic
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Irena Mladenovic
- Department of Prosthodontics, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Ivana Radovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikola Stojanovic
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
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15
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Peripheral blood neuroendocrine hormones are associated with clinical indices of sport-related concussion. Sci Rep 2019; 9:18605. [PMID: 31819094 PMCID: PMC6901546 DOI: 10.1038/s41598-019-54923-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 11/19/2019] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to evaluate the relationship between neuroendocrine hormones and clinical recovery following sport-related concussion (SRC). Ninety-five athletes (n = 56 male, n = 39 female) from a cohort of 11 interuniversity sport teams at a single institution provided blood samples; twenty six athletes with SRC were recruited 2–7 days post-injury, and 69 uninjured athletes recruited prior to the start of their competitive season. Concentrations of seven neuroendocrine hormones were quantitated in either plasma or serum by solid-phase chemiluminescent immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms at the time of blood sampling in all athletes. Multivariate partial least squares (PLS) analyses were used to evaluate the relationship between blood hormone concentrations and both (1) time to physician medical clearance and (2) initial symptom burden. A negative relationship was observed between time to medical clearance and both dehydroepiandrosterone sulfate (DHEA-S) and progesterone; a positive relationship was found between time to medical clearance and prolactin. Cognitive, somatic, fatigue and emotion symptom clusters were associated with distinct neuroendocrine signatures. Perturbations to the neuroendocrine system in athletes following SRC may contribute to initial symptom burden and longer recovery times.
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16
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Mattu AT, Iannetta D, MacInnis MJ, Doyle‐Baker PK, Murias JM. Menstrual and oral contraceptive cycle phases do not affect submaximal and maximal exercise responses. Scand J Med Sci Sports 2019; 30:472-484. [DOI: 10.1111/sms.13590] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/09/2019] [Accepted: 10/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Anmol T. Mattu
- Faculty of Kinesiology University of Calgary Calgary AB Canada
| | - Danilo Iannetta
- Faculty of Kinesiology University of Calgary Calgary AB Canada
| | | | - Patricia K. Doyle‐Baker
- Faculty of Kinesiology University of Calgary Calgary AB Canada
- School of Architecture, Planning and Landscape University of Calgary Calgary AB Canada
| | - Juan M. Murias
- Faculty of Kinesiology University of Calgary Calgary AB Canada
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Quinlan J. Caesarean delivery: Bringing more than just a bundle of joy. Can J Pain 2019; 3:5-9. [PMID: 35005413 PMCID: PMC8730553 DOI: 10.1080/24740527.2019.1574538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Chronic postsurgical pain (CPSP) is a potential complication of all surgical procedures, including caesarean delivery (CD). Psychological factors such as anxiety and depression with negative coping strategies are known to increase the risk of the development of CPSP. Aim: This short review will appraise some additional features that are unique to CD and assess the interplay between them and persisting pain. Methods: This is a narrative review with a focus on describing relevant features associated with the development of CPSP after CD. Results: Hormone changes, postpartum depression, breastfeeding, and sleep disturbance each may affect the mother’s pain in the short and long term. Together they have the potential to negatively impact the mother–infant bond. Conclusions: In the weeks after delivery, pain, depression, and poor sleep negatively impact the mother’s quality of life and her ability to care for, and bond with, her baby. This represents a critical time for the emotional, social, and behavioral development of the infant. Far-reaching benefits for the whole family may be realized by the early identification and management of persisting postoperative pain and postpartum depression.
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Affiliation(s)
- Jane Quinlan
- Nuffield Division of Anaesthetics, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
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18
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Peng KP, May A. Oral contraceptive use and its association with symptomatology in migraine patients. CEPHALALGIA REPORTS 2019. [DOI: 10.1177/2515816319856007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Hormonal changes in natural menstrual cycles are known to modulate and even worsen headache symptoms in migraineurs; however, the impact of oral contraceptive pills (OCP), including combined oral contraceptive (COC) and progestogen-only pills on migraine symptomatology, is little investigated. Method: In this retrospective cohort study of 1758 migraine patients, data from 1032 female patients aged 15–45 years were accessed and their contraceptive methods, if any, were analyzed. Further comparisons were conducted between patients with OCP use and those without OCP use regarding the demographics, headache symptoms, and associated symptoms. Most OCP users in this study were assumed to have used COC, but information of individual hormone content of OCP was not collected. Patients with nonoral hormonal contraceptives were excluded for further comparison. Results: The use of OCP was common (47.8%) among the study cohort. Compared to those without OCP use ( n = 410), patients with OCP use ( n = 493) were younger (27.4 ± 7.0 vs. 32.8 ± 7.9, p < 0.001), had lower headache frequency (days per month, 11.1 ± 7.5 vs. 12.3 ± 8.8, p = 0.03), were less likely to have osmophobia (47.3 vs. 54.4%, p = 0.033) or cranial autonomic symptoms (44.8 vs. 53.2%, p = 0.013), and more commonly reported menstrually-related worsening of headache (52.3 vs. 42.4%, p = 0.012). The proportion of migraine with aura or other headache characteristics including severity, unilaterality, and pulsatile characteristic showed no differences between groups. Conclusion: Our data provide real-life information about contraceptive use among patients with migraine. The use of OCP is associated with differences in migraine symptomatology. Further studies are needed to determine whether this relationship is causal and any possible underlying mechanism.
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Affiliation(s)
- Kuan-Po Peng
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ansdell P, Brownstein CG, Škarabot J, Hicks KM, Simoes DCM, Thomas K, Howatson G, Hunter SK, Goodall S. Menstrual cycle-associated modulations in neuromuscular function and fatigability of the knee extensors in eumenorrheic women. J Appl Physiol (1985) 2019; 126:1701-1712. [DOI: 10.1152/japplphysiol.01041.2018] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Sex hormone concentrations of eumenorrheic women typically fluctuate across the menstrual cycle and can affect neural function such that estrogen has neuroexcitatory effects, and progesterone induces inhibition. However, the effects of these changes on corticospinal and intracortical circuitry and the motor performance of the knee extensors are unknown. The present two-part investigation aimed to 1) determine the measurement error of an exercise task, transcranial magnetic stimulation (TMS)-, and motor nerve stimulation (MNS)-derived responses in women ingesting a monophasic oral contraceptive pill (hormonally-constant) and 2) investigate whether these measures were modulated by menstrual cycle phase (MCP), by examining them before and after an intermittent isometric fatiguing task (60% of maximal voluntary contraction, MVC) with the knee extensors until task failure in eumenorrheic women on days 2, 14, and 21 of the menstrual cycle. The repeatability of neuromuscular measures at baseline and fatigability ranged between moderate and excellent in women taking the oral contraceptive pill. MVC was not affected by MCP ( P = 0.790). Voluntary activation (MNS and TMS) peaked on day 14 ( P = 0.007 and 0.008, respectively). Whereas corticospinal excitability was unchanged, short-interval intracortical inhibition was greatest on day 21 compared with days 14 and 2 ( P < 0.001). Additionally, time to task failure was longer on day 21 than on both days 14 and 2 (24 and 36%, respectively, P = 0.030). The observed changes were larger than the associated measurement errors. These data demonstrate that neuromuscular function and fatigability of the knee extensors vary across the menstrual cycle and may influence exercise performance involving locomotor muscles. NEW & NOTEWORTHY The present two-part study first demonstrated the repeatability of transcranial magnetic stimulation- and electrical motor nerve stimulation-evoked variables in a hormonally constant female population. Subsequently, it was demonstrated that the eumenorrheic menstrual cycle affects neuromuscular function. Changing concentrations of neuroactive hormones corresponded to greater voluntary activation on day 14, greater intracortical inhibition on day 21, and lowest fatigability on day 21. These alterations of knee extensor neuromuscular function have implications for locomotor activities.
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Affiliation(s)
- Paul Ansdell
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Callum G. Brownstein
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Université Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France
| | - Jakob Škarabot
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Kirsty M. Hicks
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Davina C. M. Simoes
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Kevin Thomas
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa
| | - Sandra K. Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin
| | - Stuart Goodall
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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