Neuroendocrinol Lett
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Neuroendocrinol Lett · Jan 2009
ReviewA review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS.
Benign Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome (CFS) is a debilitating disease which, despite numerous biological abnormalities has remained highly controversial. Notwithstanding the medical pathogenesis of ME/CFS, the (bio)psychosocial model is adopted by many governmental organizations and medical profes-sio-nals to legitimize the combination of Cognitive Behavioral Therapy (CBT) and Graded Exercise Therapy (GET) for ME/CFS. Justified by this model CBT and GET aim at eliminating presumed psychogenic and socially induced maintaining factors and reversing deconditioning, respectively. ⋯ Exertion induces post-exertional malaise with a decreased physical performan-ce/aerobic capacity, increased muscoskeletal pain, neurocognitive impairment, "fatigue", and weakness, and a long lasting "recovery" time. This can be explained by findings that exertion may amplify pre-existing pa-thophysiological abnormalities underpinning ME/CFS, such as inflammation, immune dysfunction, oxidative and nitrosative stress, channelopathy, defec-tive stress response mechanisms and a hypoactive hypothalamic-pituitary-adrenal axis. We conclude that it is unethical to treat patients with ME/CFS with ineffective, non-evidence-based and potentially harmful "rehabilitation therapies", such as CBT/GET.
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The fetus reacts to nociceptive stimulations through different motor, autonomic, vegetative, hormonal, and metabolic changes relatively early in the gestation period. With respect to the fact that the modulatory system does not yet exist, the first reactions are purely reflexive and without connection to the type of stimulus. ⋯ Harmful (painful) stimuli, especially in fetuses have an adverse effect on the development of humans regardless of the processes in brain. Moreover, pain activates a number of subcortical mechanisms and a wide spectrum of stress responses influence the maturation of thalamocortical pathways and other cortical activation which are very important in pain processing.
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An explanation of consciousness is one of the major unsolved problems of modern science. The modern view of consciousness arose in the nineteenth century; the view presumed that mental activity correlates with distinct physical states. Is the problem of consciousness real? Crick and Koch made a tentative assumption that all different aspects of consciousness (pain, seeing, thinking, emotion, self-consciousness) are connected by a basic common mechanism. ⋯ The introduction of safe general anaesthesia represents one of the most important, although under-appreciated, advances in modern surgery. There is some difficulty in defining the term "consciousness" in relation to the anaesthetic state. The difference in brain activity between those under anaesthesia and those not under any such influence.
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Neuroendocrinol Lett · Nov 2008
Review Historical ArticlePsychosurgery: the past and present of ablation procedures.
Surgical intervention to the brain has a long history, but contemporary psychosurgery started in the mid-1930s. The first psychosurgical operation was a prefrontal leucotomy. ⋯ In recent years, the introduction of neuromodulation techniques seemed to produce a qualitative progress in modern psychosurgery. However, the controversies about these surgical interventions to the brain among psychiatrists still restrict the indications for psychosurgery to highly selected cases.