Neurophysiologie clinique = Clinical neurophysiology
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Review Meta Analysis
Repetitive peripheral magnetic stimulation to reduce pain or improve sensorimotor impairments: A literature review on parameters of application and afferents recruitment.
Repetitive peripheral magnetic stimulation (rPMS over spinal root, nerve or muscle belly) is a promising technology in physiopathology research. As compared to electrical stimulation, rPMS is deemed to activate deep conductive structures and produce strong muscle contractions and massive proprioceptive afferents with minimal cutaneous recruitment. RPMS may thus act differently on neural plasticity involved in pain reduction and motor recovery in musculoskeletal or neurological conditions. However, literature is very scant and still controversial concerning afferents recruited by rPMS, thus no consensus is reached yet for its clinical use. ⋯ The review proposed recommendations to improve rPMS application in clinical research. However, the development of guidelines still requires methodological and clinical studies enrolling larger samples and with randomized sham-controlled designs.
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Review Meta Analysis
Functional imaging of brain responses to pain. A review and meta-analysis (2000).
Brain responses to pain, assessed through positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are reviewed. Functional activation of brain regions are thought to be reflected by increases in the regional cerebral blood flow (rCBF) in PET studies, and in the blood oxygen level dependent (BOLD) signal in fMRI. rCBF increases to noxious stimuli are almost constantly observed in second somatic (SII) and insular regions, and in the anterior cingulate cortex (ACC), and with slightly less consistency in the contralateral thalamus and the primary somatic area (SI). Activation of the lateral thalamus, SI, SII and insula are thought to be related to the sensory-discriminative aspects of pain processing. ⋯ A number of brain areas activated by acute pain, particularly the thalamus and anterior cingulate, also show increases in rCBF during analgesic procedures. Taken together, these data suggest that hemodynamic responses to pain reflect simultaneously the sensory, cognitive and affective dimensions of pain, and that the same structure may both respond to pain and participate in pain control. The precise biochemical nature of these mechanisms remains to be investigated.