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Rowe G, Allahham A, Edgar DW, Rurak BK, Fear MW, Wood FM, Vallence AM. Functional Brain Changes Following Burn Injury: A Narrative Review. Neurorehabil Neural Repair 2024; 38:62-72. [PMID: 38044625 PMCID: PMC10798013 DOI: 10.1177/15459683231215331] [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] [Indexed: 12/05/2023]
Abstract
BACKGROUND Burn injuries cause significant motor and sensory dysfunctions that can negatively impact burn survivors' quality of life. The underlying mechanisms of these burn-induced dysfunctions have primarily been associated with damage to the peripheral neural architecture, however, evidence points to a systemic influence of burn injury. Central nervous system (CNS) reorganizations due to inflammation, afferent dysfunction, and pain could contribute to persistent motor and sensory dysfunction in burn survivors. Recent evidence shows that the capacity for neuroplasticity is associated with self-reported functional recovery in burn survivors. OBJECTIVE This review first outlines motor and sensory dysfunctions following burn injury and critically examines recent literature investigating the mechanisms mediating CNS reorganization following burn injury. The review then provides recommendations for future research and interventions targeting the CNS such as non-invasive brain stimulation to improve functional recovery. CONCLUSIONS Directing focus to the CNS following burn injury, alongside the development of non-invasive methods to induce functionally beneficial neuroplasticity in the CNS, could advance treatments and transform clinical practice to improve quality of life in burn survivors.
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Affiliation(s)
- Grant Rowe
- School of Psychology, College of Health and Education, Murdoch University, Murdoch, WA, Australia
| | - Amira Allahham
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Dale W. Edgar
- Fiona Wood Foundation, Murdoch, WA, Australia
- Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, Murdoch, WA, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Brittany K. Rurak
- School of Psychology, College of Health and Education, Murdoch University, Murdoch, WA, Australia
| | - Mark W. Fear
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- Fiona Wood Foundation, Murdoch, WA, Australia
| | - Fiona M. Wood
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- Fiona Wood Foundation, Murdoch, WA, Australia
- Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, Murdoch, WA, Australia
| | - Ann-Maree Vallence
- School of Psychology, College of Health and Education, Murdoch University, Murdoch, WA, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
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Millard SK, Bokelmann K, Schalbroeck R, van der Wee NJA, van Loey NEE, van Laarhoven AIM. No indications for altered EEG oscillatory activity in patients with chronic post-burn itch compared to healthy controls. Sci Rep 2022; 12:5184. [PMID: 35338171 PMCID: PMC8956573 DOI: 10.1038/s41598-022-08742-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
A large proportion of patients with burn injuries develop chronic itch, which impacts quality of life. The underlying pathophysiological mechanisms are poorly understood. This cross-sectional pilot study investigates whether altered cortical oscillatory processes are involved in chronic post-burn itch. Continuous electroencephalography (EEG) data were recorded during rest and stimulation of non-injured skin, inducing itch (histamine and electrical) and cold-pressor task pain for 15 adults with chronic post-burn itch and 15 matched healthy controls. Quantitative metrics comprised oscillatory power and peak frequencies in theta, alpha, and beta bands. No statistical differences between patients and healthy controls were found in oscillatory activity during rest or stimulation, with Bayesian analysis suggesting equivocal evidence. However, post-traumatic stress symptoms and duration of chronic itch may be associated with changes in oscillatory activity. A lack of differences in cortical oscillatory processing and itch levels at non-injured sites, suggests that itch symptoms have a localised character in this sample of patients with post-burn itch. For future studies, a biopsychological approach with integration of peripheral and central nervous system techniques, linear and non-linear EEG analysis, injured and non-injured stimulation sites, and incorporation of individual characteristics is recommended. Insight into pathophysiological mechanisms underlying chronic post-burn itch could improve diagnostics and treatments.
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Affiliation(s)
- Samantha K Millard
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Centre for Pain IMPACT, Neuroscience Research Australia, 139 Barker Street, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Science, Faculty of Medicine, University of New South Wales, 18 High St, Kensington, Sydney, NSW, 2052, Australia
| | - Klara Bokelmann
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Rik Schalbroeck
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Nancy E E van Loey
- Association of Dutch Burn Centers, Maasstad Hospital, Burn Center, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands.,Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Antoinette I M van Laarhoven
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands. .,Department of Psychiatry, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition (LIBC), Leiden University, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
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Liu S, Zhao B, Shi C, Ma X, Sabel BA, Chen X, Tao L. Ocular Dominance and Functional Asymmetry in Visual Attention Networks. Invest Ophthalmol Vis Sci 2021; 62:9. [PMID: 33825854 PMCID: PMC8039471 DOI: 10.1167/iovs.62.4.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The dorsal attention network (DAN) and the ventral attention network (VAN) are known to support visual attention, but the influences of ocular dominance on the attention networks are unclear. We aimed to explore how visual cortical asymmetry of the attention networks correlate with neurophysiological oscillation and connectivity markers of attentional processes. Methods An oddball task with concentric circle stimuli of three different sizes (i.e., spot size of 5°, 20°, or 30° of visual angle) was used to vary task difficulty. Event-related oscillations and interareal communication were tested with an electroencephalogram-based visual evoked components as a function of ocular dominance in 30 healthy subjects. Results Accuracy rates were higher in the dominant eyes compared with the nondominant eyes. Compared with the nondominant eyes, the dominant eyes had higher theta, low-alpha, and low-beta powers and lower high-alpha powers within the nodes of VAN and DAN. Furthermore, visual information processed by the dominant and nondominant eye had different fates, that is, the dominant eyes mainly relied on theta and low-alpha connectivity within both the VAN and the DAN, whereas the nondominant eyes mainly relied on theta connectivity within the VAN and high-alpha connectivity within the DAN. The difference in accuracy rate between the two eyes was correlated with the low-alpha oscillations in the anterior DAN area and low-alpha connectivity of the left DAN. Conclusions The ocular dominance processing and interareal communication reveal a cortical asymmetry underlying attention, and this reflects a two-way modulatory mechanism within attention networks in the human brain.
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Affiliation(s)
- Sinan Liu
- Department of Forensic Science, Soochow University, Suzhou, China
| | - Bingyang Zhao
- Department of Forensic Science, Soochow University, Suzhou, China
| | - Chaoqun Shi
- Department of Forensic Science, Soochow University, Suzhou, China
| | - Xuying Ma
- Department of Forensic Science, Soochow University, Suzhou, China
| | - Bernhard A Sabel
- Institute of Medical Psychology, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany
| | - Xiping Chen
- Department of Forensic Science, Soochow University, Suzhou, China
| | - Luyang Tao
- Department of Forensic Science, Soochow University, Suzhou, China
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Turner RP. Clinical Application of Combined EEG-qEEG Functional Neuroimaging in the Practice of Pediatric Neuroscience: A Personal Perspective. Clin EEG Neurosci 2021; 52:126-135. [PMID: 33370176 DOI: 10.1177/1550059420982419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This brief article is an overview of my personal experience over the past almost 10 years of the clinical use of EEG and quantitative EEG (qEEG) functional neuroimaging in a busy pediatric neurology practice. The concomitant use of surface EEG and functional electromagnetic EEG neuroimaging/qEEG in clinical practice provides significant additional clinical and neurophysiologic information. The qEEG is a noninvasive, inexpensive, portable technique with high temporal resolution (milliseconds) and improving spatial resolution (down to 3 mm3) and is an appropriate and validated tool for investigation of abnormal brain dynamics and connectivity of neuronal networks in clinical disorders of the brain. This article describes the daily applicability and utility of this modality in assisting diagnosis and clinical management of patients with a wide variety of presenting symptoms, including headaches, tics, autism spectrum disorder, inattention, sleep dysregulation, anxiety, and depression. The ease of data acquisition and analysis in clinical practices, coupled with skilled interpretation and clinical application, makes this tool one of the most valuable clinical tools to complement a thorough history and examination process.
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Affiliation(s)
- Robert P Turner
- Clinical Pediatrics, Medical University of South Carolina, Charleston, SC, USA.,Palmetto Health Children's Hospital, Columbia, SC, USA.,Network Neurology Health, Charleston, SC, USA.,Bon Secours Roper-St Francis Hospital System, Charleston, SC, USA.,HCA South Atlantic/Summerville Medical Center, Summerville, SC, USA.,MIND Research Institute, Irvine, CA, USA
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Duarte D, Bauer CCC, Pinto CB, Saleh Velez FG, Estudillo-Guerra MA, Pacheco-Barrios K, Gunduz ME, Crandell D, Merabet L, Fregni F. Cortical plasticity in phantom limb pain: A fMRI study on the neural correlates of behavioral clinical manifestations. Psychiatry Res Neuroimaging 2020; 304:111151. [PMID: 32738724 PMCID: PMC9394643 DOI: 10.1016/j.pscychresns.2020.111151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022]
Abstract
The neural mechanism of phantom limb pain (PLP) is related to the intense brain reorganization process implicating plasticity after deafferentation mostly in sensorimotor system. There is a limited understanding of the association between the sensorimotor system and PLP. We used a novel task-based functional magnetic resonance imaging (fMRI) approach to (1) assess neural activation within a-priori selected regions-of-interested (motor cortex [M1], somatosensory cortex [S1], and visual cortex [V1]), (2) quantify the cortical representation shift in the affected M1, and (3) correlate these changes with baseline clinical characteristics. In a sample of 18 participants, we found a significantly increased activity in M1 and S1 as well as a shift in motor cortex representation that was not related to PLP intensity. In an exploratory analyses (not corrected for multiple comparisons), they were directly correlated with time since amputation; and there was an association between increased activity in M1 with a lack of itching sensation and V1 activation was negatively correlated with PLP. Longer periods of amputation lead to compensatory changes in sensory-motor areas; and itching seems to be a protective marker for less signal changes. We confirmed that PLP intensity is not associated with signal changes in M1 and S1 but in V1.
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Affiliation(s)
- D Duarte
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA; Department of Psychiatry and Behavioural Neurosciences, McMaster University. 100 West 5th Street, Hamilton, ON L8N 3K7, Canada
| | - C C C Bauer
- McGovern Institute for Brain Research, MIT. 43 Vassar St, Cambridge, MA 02139, USA; Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus UNAM 3001, 76230 Juriquilla, Querétaro, 76230, México; Department of Psychology, Northeastern University, 805 Columbus Avenue, Boston, MA 02139, USA.
| | - C B Pinto
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA
| | - F G Saleh Velez
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA; University of Chicago Medical Center, Department of Neurology, University of Chicago. 5841 S Maryland Ave # C411, Chicago, IL 60637, USA
| | - M A Estudillo-Guerra
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA
| | - K Pacheco-Barrios
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud. Lima, Peru. Av. La Fontana 750 Edificio El Cubo, La Molina - Perú
| | - M E Gunduz
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA
| | - D Crandell
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA
| | - L Merabet
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School. 243 Charles St, Boston, MA 02114, USA
| | - F Fregni
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. 96 13th Street, Charlestown, Boston, MA 02129, USA; Massachusetts General Hospital, Harvard Medical School. 55 Fruit St, Boston, MA 02114, USA.
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