Front Hum Neurosci
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A recent multicenter trial provided Class I evidence that for patients with an episodic migraine, non-invasive vagus nerve stimulation (nVNS) significantly increases the probability of having mild pain or being pain-free 2 h post-stimulation. Here we aimed to investigate the potential effect of nVNS in the modulation of spontaneous and pain related bioelectrical activity in a subgroup of migraine patients enrolled in the PRESTO trial by using resting-state electroencephalography and trigeminal laser-evoked potentials (LEPs). LEPs were recorded for 27 migraine patients who received active or sham nVNS over the cervical vagus nerve. ⋯ The sham device also attenuated the P2 amplitude evoked by the left trigeminal branch at T1 and T2, but this attenuation did not reach significance. No changes were observed for N1 amplitude, N1, N2, P2 latency, or pain rating. nVNS induced an increase of EEG power in both slow and fast rhythms, but this effect was not significant as compared to the sham device. These findings suggest that nVNS acts on the cortical areas that are responsible for trigeminal pain control and pave the ground for future studies aimed at confirming the possible correlations with clinical outcomes, including the effect on symptoms that are directly correlated with trigeminal pain processing and modulation.
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Background: The fibromyalgia (FM) physiopathology involves an intracortical excitability/inhibition imbalance as measured by transcranial magnetic stimulation measures (TMS). TMS measures provide an index that can help to understand how the basal neuronal plasticity state (i.e., levels of the serum neurotrophins brain-derived neurotrophic factor (BDNF) and S100-B protein) could predict the effect of therapeutic approaches on the cortical circuitries. We used an experimental paradigm to evaluate if pregabalin could be more effective than a placebo, to improve the disinhibition in the cortical circuitries in FM patients, than in healthy subjects (HS). ⋯ Conclusion: These results suggest that pregabalin's effect on cortical neural networks occurs, particularly under basal neuronal hyperexcitability, because its impact on the cortical excitability and the pain measures was observed only in the FM group. This indicates that pregabalin increased the CSP to induce inhibition in specific neural networks, while it increased the SICI to improve the excitability in other neurobiological systems. Trial registration in clinicaltrials.gov Identifier: NCT02639533.
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Introduction: The importance of obstructive sleep apnea in patients undergoing surgery with general anesthesia is well-defined, but the surgical and anesthetic implications of other sleep disorders are less clear. We sought to evaluate response to surgery with general anesthesia in patients with central disorders of hypersomnolence or restless legs syndrome. Methods: We surveyed patients on their most recent surgical procedure with general anesthesia, querying about procedure, recovery, and any changes in sleep disorder symptomatology following the procedure. ⋯ While patients in both groups were equally likely to report surgical complications and difficulty awakening from anesthesia, hypersomnolent patients were more likely to report worsened sleepiness (40% of the hypersomnolent group vs. 11% of the RLS group, p = 0.001) and worsening of their sleep disorder symptoms (40% of the hypersomnolent group vs. 9% of the RLS group, p = 0.0001). Conclusion: Patients with sleep disorders other than sleep apnea frequently report surgical or anesthetic complications. Patients with hypersomnolence disorders commonly perceive that their sleep disorder worsened following a procedure; whether this might be related to long term effects of general anesthesia in a particularly vulnerable clinical population requires further study.
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In order to achieve flexible and smooth walking, we must accomplish subtasks (e. g., loading response, forward propulsion or swing initiation) within a gait cycle. To evaluate subtasks within a gait cycle, the analysis of muscle synergies may be effective. In the case of walking, extracted sets of muscle synergies characterize muscle patterns that relate to the subtasks within a gait cycle. ⋯ Therefore, the local dynamic stability in the activations might depend on the requirement of motor output related to the subtasks within a gait cycle. We concluded that the local dynamic stability in the activation of muscle synergies decrease as walking speed accelerates. On the other hand, the orbital stability is sustained across broad walking speeds.
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The central nervous system allows for a limited time span referred to as the temporal binding window (TBW) in order to rapidly determine whether multisensory events correspond with the same event. Failure to correctly identify whether multisensory events occur simultaneously and their sequential order can lead to inaccurate representations of the physical world, poor decision-making and dangerous behavior. Damage to the neural systems that coordinate the relative timing of sensory events may explain some of the long-term consequences associated with concussion. ⋯ Results demonstrated that those with concussion history have a significantly wider TBW (less precise), with no significant change in the PSS (no change in accuracy), particularly for the TOJ task but no significant differences were found between the SJ and TOJ tasks. Importantly, a negative correlation between the time elapsed since last concussion and TBW width in the TOJ task suggests that precision in temporal perception does improve over time. These findings suggest that those with concussion history display an impairment in the perceived timing of sensory events and that monitoring performance in the SJ and TOJ tasks may be a useful additional assessment tool when making decisions about returning to regular work and play following concussion.