Pain perception in individuals with prolonged disorders of consciousness (PDOC) is still a matter of debate. Advanced neuroimaging studies suggest some cortical activations even in patients with unresponsive wakefulness syndrome (UWS) compared to those with a minimally conscious state (MCS). Therefore, pain perception has to be considered even in individuals with UWS. However, advanced neuroimaging assessment can be challenging to conduct, and its findings are sometimes difficult to be interpreted. Conversely, multichannel electroencephalography (EEG) and laser-evoked potentials (LEPs) can be carried out quickly and are more adaptable to the clinical needs. In this scoping review, we dealt with the neurophysiological basis underpinning pain in PDOC, pointing out how pain perception assessment in these individuals might help in reducing the misdiagnosis rate. The available literature data suggest that patients with UWS show a more severe functional connectivity breakdown among the pain-related brain areas compared to individuals in MCS, pointing out that pain perception increases with the level of consciousness. However, there are noteworthy exceptions, because some UWS patients show pain-related cortical activations that partially overlap those observed in MCS individuals. This suggests that some patients with UWS may have residual brain functional connectivity supporting the somatosensory, affective, and cognitive aspects of pain processing (i.e., a conscious experience of the unpleasantness of pain), rather than only being able to show autonomic responses to potentially harmful stimuli. Therefore, the significance of the neurophysiological approach to pain perception in PDOC seems to be clear, and despite some methodological caveats (including intensity of stimulation, multimodal paradigms, and active vs. passive stimulation protocols), remain to be solved. To summarize, an accurate clinical and neurophysiological assessment should always be performed for a better understanding of pain perception neurophysiological underpinnings, a more precise differential diagnosis at the level of individual cases as well as group comparisons, and patient-tailored management.
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http://dx.doi.org/10.3390/brainsci11050665 | DOI Listing |
Int J Dent Hyg
December 2024
Aster Medcity, Kochi, Kerala, India.
Aim Of The Study: The aim of the study is to investigate the effectiveness of virtual reality (VR) in mitigating pain associated with dental scaling procedures. Furthermore, the study aims to evaluate individuals' tolerance levels to VR during dental scaling sessions.
Materials And Methods: A randomised split-mouth design study was conducted on 29 systemically healthy adult patients aged 18 years and above.
J Neurochem
January 2025
Department of Oral Physiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Different taste cells express unique cell-type markers, enabling researchers to distinguish them and study their functional differentiation. Using single-cell RNA-Seq of taste cells in mouse fungiform papillae, we found that Cellular Communication Network Factor 3 (Ccn3) was highly expressed in Type III taste cells but not in Type II taste cells. Ccn3 is a protein-coding gene involved in various biological processes, such as cell proliferation, angiogenesis, tumorigenesis, and wound healing.
View Article and Find Full Text PDFJ Neurol
December 2024
APHM, Hôpital de la Timone, CEMEREM, Marseille, France.
Objective: In this multicentric study, we were interested in the vision-related quality of life and its association with visual impairment in neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in comparison to multiple sclerosis (MS) and healthy controls.
Methods: We analysed extracted data from the German NEMOS registry including National Eye Institute Visual Function Questionnaire (NEI-VFQ) scores, high and low contrast visual acuity (HCVA, LCVA), visually evoked potentials (VEP) and the scores for the expanded disability status scale (EDSS) and other neurological tests which assessed their disease-related impairment. The mean follow-up time of our patients was 1.
Scand J Pain
January 2024
Department of Anesthesiology, Center for Cancer, and Organ Diseases, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Objectives: Music festivals are often a source of joy, but also a risk of injury. While previous studies suggest music can relieve pain, its effect has not been tested in festival settings, nor has the effect of high-energy vs soothing music been compared. We hypothesized that guests at a heavy metal music festival would experience less pain when listening to thrash heavy metal compared to relaxing music, with the effect being influenced by music preference and increased with higher alcohol intake.
View Article and Find Full Text PDFInt J Comput Assist Radiol Surg
December 2024
Department of Surgery, DIAKONEO KdöR, Klinik Hallerwiese-Cnopfsche Kinderklinik, Sankt-Johannis-Mühlgasse 19, 90419, Nürnberg, Germany.
Background: Virtual reality (VR) technology has gained significant importance in medical practice, particularly as an innovative approach to enhance patient experience and comfort. This prospective feasibility study investigates the impact of using VR headsets on stress and pain reduction during port surgeries under local anesthesia.
Methods: In this prospective analysis, patients undergoing port implantation at the Klinikum rechts der Isar Technical University Munich were divided into two groups.
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