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Xavier Navarro - One of the best experts on this subject based on the ideXlab platform.
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transcranial direct current stimulation and Visual Illusion effect according to sensory phenotypes in patients with spinal cord injury and neuropathic pain
The Journal of Pain, 2021Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation combined with Visual Illusion, following a previously published protocol, has differential effects on pain-related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of transcranial direct current stimulation and Visual Illusion for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory, and Patient Health Questionnaire-9. There was significant improvement in the combined treatment group according to NPSI, Brief Pain Inventory, and Patient Health Questionnaire-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, 5 subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified 5 clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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Transcranial Direct Current Stimulation and Visual Illusion Effect According to Sensory Phenotypes in Patients With Spinal Cord Injury and Neuropathic Pain.
The Journal of Pain, 2020Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI), following a previously published protocol, has differential effects on pain–related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of tDCS and VI for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory (BPI), and Patient Health Questionnaire-9 (PHQ-9). There was significant improvement in the combined treatment group according to NPSI, BPI and PHQ-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, five subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified five clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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the effects of transcranial direct current stimulation with Visual Illusion in neuropathic pain due to spinal cord injury an evoked potentials and quantitative thermal testing study
European Journal of Pain, 2013Co-Authors: Hatice Kumru, Dolors Soler, Joan Vidal, Josep Maria Tormos, Xavier Navarro, Alvaro Pascualleone, Josep VallssoleAbstract:Background: Neuropathic pain (NP) is common in spinal cord injury (SCI) patients. One of its manifestations is a lowering of pain perception threshold in quantitative thermal testing (QTT) in dermatomes rostral to the injury level. Transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI) improves pain in SCI patients. We studied whether pain relief with tDCS + VI intervention is accompanied by a change in contact heat- evoked potentials (CHEPs) or in QTT. Methods: We examined 18 patients with SCI and NP before and after 2 weeks of daily tDCS + VI intervention. Twenty SCI patients without NP and 14 healthy subjects served as controls. We assessed NP intensity using a numerical rating scale (NRS) and determined heat and pain thresholds with thermal probes. CHEPs were recorded to stimuli applied at C4 level, and subjects rated their perception of evoked pain using NRS during CHEPs. Results: Thirteen patients reported a mean decrease of 50% in the NRS for NP after tDCS + VI. Evoked pain perception was significantly higher than in the other two groups, and reduced significantly together with CHEPs amplitude after tDCS + VI with respect to baseline. Pain perception threshold was significantly lower than in the other two groups before tDCS + VI intervention, and increased significantly afterwards. Conclusion: Two weeks of tDCS + VI induced significant changes in CHEPs, evoked pain and heat pain threshold in SCI patients with NP. These neurophysiological tests might be objective biomarkers of treatment effects for NP in patients with SCI.
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Effectiveness of transcranial direct current stimulation and Visual Illusion on neuropathic pain in spinal cord injury.
Brain, 2010Co-Authors: Maria Dolors Soler, Hatice Kumru, Raul Pelayo, Joan Vidal, Josep Maria Tormos, Felipe Fregni, Xavier Navarro, Alvaro Pascual-leoneAbstract:The aim of this study was to evaluate the analgesic effect of transcranial direct current stimulation of the motor cortex and techniques of Visual Illusion, applied isolated or combined, in patients with neuropathic pain following spinal cord injury. In a sham controlled, double-blind, parallel group design, 39 patients were randomized into four groups receiving transcranial direct current stimulation with walking Visual Illusion or with control Illusion and sham stimulation with Visual Illusion or with control Illusion. For transcranial direct current stimulation, the anode was placed over the primary motor cortex. Each patient received ten treatment sessions during two consecutive weeks. Clinical assessment was performed before, after the last day of treatment, after 2 and 4 weeks follow-up and after 12 weeks. Clinical assessment included overall pain intensity perception, Neuropathic Pain Symptom Inventory and Brief Pain Inventory. The combination of transcranial direct current stimulation and Visual Illusion reduced the intensity of neuropathic pain significantly more than any of the single interventions. Patients receiving transcranial direct current stimulation and Visual Illusion experienced a significant improvement in all pain subtypes, while patients in the transcranial direct current stimulation group showed improvement in continuous and paroxysmal pain, and those in the Visual Illusion group improved only in continuous pain and dysaesthesias. At 12 weeks after treatment, the combined treatment group still presented significant improvement on the overall pain intensity perception, whereas no improvements were reported in the other three groups. Our results demonstrate that transcranial direct current stimulation and Visual Illusion can be effective in the management of neuropathic pain following spinal cord injury, with minimal side effects and with good tolerability.
Dolors Soler - One of the best experts on this subject based on the ideXlab platform.
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transcranial direct current stimulation and Visual Illusion effect according to sensory phenotypes in patients with spinal cord injury and neuropathic pain
The Journal of Pain, 2021Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation combined with Visual Illusion, following a previously published protocol, has differential effects on pain-related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of transcranial direct current stimulation and Visual Illusion for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory, and Patient Health Questionnaire-9. There was significant improvement in the combined treatment group according to NPSI, Brief Pain Inventory, and Patient Health Questionnaire-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, 5 subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified 5 clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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Transcranial Direct Current Stimulation and Visual Illusion Effect According to Sensory Phenotypes in Patients With Spinal Cord Injury and Neuropathic Pain.
The Journal of Pain, 2020Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI), following a previously published protocol, has differential effects on pain–related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of tDCS and VI for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory (BPI), and Patient Health Questionnaire-9 (PHQ-9). There was significant improvement in the combined treatment group according to NPSI, BPI and PHQ-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, five subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified five clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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Gestural Interaction and Visual Illusion for Lower Limbs’ Neuropathic Pain Treatment
IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2018Co-Authors: Jaume Lopez-carballo, Neus Rodriguez, Dolors Soler, Eloy Opisso, Mateu SbertAbstract:Pain caused by a lesion or a disease affecting the somatosensory nervous system is known as Neuropathic pain . It has been shown that neuropathic pain can be treated with the combination of simultaneous transcranial direct current stimulation and the generation of the Visual Illusion that the patient retains control of the affected limbs. For persons with neuropathic pain in the lower limbs, the Visual Illusion consists of an image of the patient walking normally. Such a Visual Illusion has classically been generated by using a physical mirror and a projector. The objective of this paper is to develop and validate a computer-based version of the Visual Illusion, including Gestural Control. The developed system has been validated in a trial and has been successfully implanted in daily clinical practice in a reference neurorehabilitation hospital. A retrospective statistical analysis shows that the patients treated with the computer-based system reduce their pain level significantly more than the patients treated with the mirror and projector treatment before the introduction of the computer-based version. Furthermore, it also makes possible to bring the therapy to the home of the patients, where the treatment can be self-administered while still being monitored by the clinical staff.
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the effects of transcranial direct current stimulation with Visual Illusion in neuropathic pain due to spinal cord injury an evoked potentials and quantitative thermal testing study
European Journal of Pain, 2013Co-Authors: Hatice Kumru, Dolors Soler, Joan Vidal, Josep Maria Tormos, Xavier Navarro, Alvaro Pascualleone, Josep VallssoleAbstract:Background: Neuropathic pain (NP) is common in spinal cord injury (SCI) patients. One of its manifestations is a lowering of pain perception threshold in quantitative thermal testing (QTT) in dermatomes rostral to the injury level. Transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI) improves pain in SCI patients. We studied whether pain relief with tDCS + VI intervention is accompanied by a change in contact heat- evoked potentials (CHEPs) or in QTT. Methods: We examined 18 patients with SCI and NP before and after 2 weeks of daily tDCS + VI intervention. Twenty SCI patients without NP and 14 healthy subjects served as controls. We assessed NP intensity using a numerical rating scale (NRS) and determined heat and pain thresholds with thermal probes. CHEPs were recorded to stimuli applied at C4 level, and subjects rated their perception of evoked pain using NRS during CHEPs. Results: Thirteen patients reported a mean decrease of 50% in the NRS for NP after tDCS + VI. Evoked pain perception was significantly higher than in the other two groups, and reduced significantly together with CHEPs amplitude after tDCS + VI with respect to baseline. Pain perception threshold was significantly lower than in the other two groups before tDCS + VI intervention, and increased significantly afterwards. Conclusion: Two weeks of tDCS + VI induced significant changes in CHEPs, evoked pain and heat pain threshold in SCI patients with NP. These neurophysiological tests might be objective biomarkers of treatment effects for NP in patients with SCI.
Hatice Kumru - One of the best experts on this subject based on the ideXlab platform.
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transcranial direct current stimulation and Visual Illusion effect according to sensory phenotypes in patients with spinal cord injury and neuropathic pain
The Journal of Pain, 2021Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation combined with Visual Illusion, following a previously published protocol, has differential effects on pain-related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of transcranial direct current stimulation and Visual Illusion for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory, and Patient Health Questionnaire-9. There was significant improvement in the combined treatment group according to NPSI, Brief Pain Inventory, and Patient Health Questionnaire-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, 5 subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified 5 clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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Transcranial Direct Current Stimulation and Visual Illusion Effect According to Sensory Phenotypes in Patients With Spinal Cord Injury and Neuropathic Pain.
The Journal of Pain, 2020Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI), following a previously published protocol, has differential effects on pain–related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of tDCS and VI for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory (BPI), and Patient Health Questionnaire-9 (PHQ-9). There was significant improvement in the combined treatment group according to NPSI, BPI and PHQ-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, five subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified five clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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the effects of transcranial direct current stimulation with Visual Illusion in neuropathic pain due to spinal cord injury an evoked potentials and quantitative thermal testing study
European Journal of Pain, 2013Co-Authors: Hatice Kumru, Dolors Soler, Joan Vidal, Josep Maria Tormos, Xavier Navarro, Alvaro Pascualleone, Josep VallssoleAbstract:Background: Neuropathic pain (NP) is common in spinal cord injury (SCI) patients. One of its manifestations is a lowering of pain perception threshold in quantitative thermal testing (QTT) in dermatomes rostral to the injury level. Transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI) improves pain in SCI patients. We studied whether pain relief with tDCS + VI intervention is accompanied by a change in contact heat- evoked potentials (CHEPs) or in QTT. Methods: We examined 18 patients with SCI and NP before and after 2 weeks of daily tDCS + VI intervention. Twenty SCI patients without NP and 14 healthy subjects served as controls. We assessed NP intensity using a numerical rating scale (NRS) and determined heat and pain thresholds with thermal probes. CHEPs were recorded to stimuli applied at C4 level, and subjects rated their perception of evoked pain using NRS during CHEPs. Results: Thirteen patients reported a mean decrease of 50% in the NRS for NP after tDCS + VI. Evoked pain perception was significantly higher than in the other two groups, and reduced significantly together with CHEPs amplitude after tDCS + VI with respect to baseline. Pain perception threshold was significantly lower than in the other two groups before tDCS + VI intervention, and increased significantly afterwards. Conclusion: Two weeks of tDCS + VI induced significant changes in CHEPs, evoked pain and heat pain threshold in SCI patients with NP. These neurophysiological tests might be objective biomarkers of treatment effects for NP in patients with SCI.
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Effectiveness of transcranial direct current stimulation and Visual Illusion on neuropathic pain in spinal cord injury.
Brain, 2010Co-Authors: Maria Dolors Soler, Hatice Kumru, Raul Pelayo, Joan Vidal, Josep Maria Tormos, Felipe Fregni, Xavier Navarro, Alvaro Pascual-leoneAbstract:The aim of this study was to evaluate the analgesic effect of transcranial direct current stimulation of the motor cortex and techniques of Visual Illusion, applied isolated or combined, in patients with neuropathic pain following spinal cord injury. In a sham controlled, double-blind, parallel group design, 39 patients were randomized into four groups receiving transcranial direct current stimulation with walking Visual Illusion or with control Illusion and sham stimulation with Visual Illusion or with control Illusion. For transcranial direct current stimulation, the anode was placed over the primary motor cortex. Each patient received ten treatment sessions during two consecutive weeks. Clinical assessment was performed before, after the last day of treatment, after 2 and 4 weeks follow-up and after 12 weeks. Clinical assessment included overall pain intensity perception, Neuropathic Pain Symptom Inventory and Brief Pain Inventory. The combination of transcranial direct current stimulation and Visual Illusion reduced the intensity of neuropathic pain significantly more than any of the single interventions. Patients receiving transcranial direct current stimulation and Visual Illusion experienced a significant improvement in all pain subtypes, while patients in the transcranial direct current stimulation group showed improvement in continuous and paroxysmal pain, and those in the Visual Illusion group improved only in continuous pain and dysaesthesias. At 12 weeks after treatment, the combined treatment group still presented significant improvement on the overall pain intensity perception, whereas no improvements were reported in the other three groups. Our results demonstrate that transcranial direct current stimulation and Visual Illusion can be effective in the management of neuropathic pain following spinal cord injury, with minimal side effects and with good tolerability.
Joan Vidal - One of the best experts on this subject based on the ideXlab platform.
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transcranial direct current stimulation and Visual Illusion effect according to sensory phenotypes in patients with spinal cord injury and neuropathic pain
The Journal of Pain, 2021Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation combined with Visual Illusion, following a previously published protocol, has differential effects on pain-related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of transcranial direct current stimulation and Visual Illusion for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory, and Patient Health Questionnaire-9. There was significant improvement in the combined treatment group according to NPSI, Brief Pain Inventory, and Patient Health Questionnaire-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, 5 subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified 5 clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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Transcranial Direct Current Stimulation and Visual Illusion Effect According to Sensory Phenotypes in Patients With Spinal Cord Injury and Neuropathic Pain.
The Journal of Pain, 2020Co-Authors: Dolors Soler, Hatice Kumru, Joan Vidal, David Morina, Xavier NavarroAbstract:Abstract Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI), following a previously published protocol, has differential effects on pain–related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. Sixty-five patients were given a daily 20-minutes combined treatment of tDCS and VI for 2 weeks. Sixty-five patients served as a control group. Clinical assessment was performed before and 2 weeks later, by using Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory (BPI), and Patient Health Questionnaire-9 (PHQ-9). There was significant improvement in the combined treatment group according to NPSI, BPI and PHQ-9, but no changes in the control group. Following a cluster analysis of NPSI items at baseline assessment, five subgroups of patients with different pain-related characteristics were identified among the treated group, although differences between clusters were not significant. There was also improvement in mood, sleep quality, and enjoyment of life in the treated group. Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. Perspective In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with Visual Illusion in patients with NP after an SCI. We have identified five clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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the effects of transcranial direct current stimulation with Visual Illusion in neuropathic pain due to spinal cord injury an evoked potentials and quantitative thermal testing study
European Journal of Pain, 2013Co-Authors: Hatice Kumru, Dolors Soler, Joan Vidal, Josep Maria Tormos, Xavier Navarro, Alvaro Pascualleone, Josep VallssoleAbstract:Background: Neuropathic pain (NP) is common in spinal cord injury (SCI) patients. One of its manifestations is a lowering of pain perception threshold in quantitative thermal testing (QTT) in dermatomes rostral to the injury level. Transcranial direct current stimulation (tDCS) combined with Visual Illusion (VI) improves pain in SCI patients. We studied whether pain relief with tDCS + VI intervention is accompanied by a change in contact heat- evoked potentials (CHEPs) or in QTT. Methods: We examined 18 patients with SCI and NP before and after 2 weeks of daily tDCS + VI intervention. Twenty SCI patients without NP and 14 healthy subjects served as controls. We assessed NP intensity using a numerical rating scale (NRS) and determined heat and pain thresholds with thermal probes. CHEPs were recorded to stimuli applied at C4 level, and subjects rated their perception of evoked pain using NRS during CHEPs. Results: Thirteen patients reported a mean decrease of 50% in the NRS for NP after tDCS + VI. Evoked pain perception was significantly higher than in the other two groups, and reduced significantly together with CHEPs amplitude after tDCS + VI with respect to baseline. Pain perception threshold was significantly lower than in the other two groups before tDCS + VI intervention, and increased significantly afterwards. Conclusion: Two weeks of tDCS + VI induced significant changes in CHEPs, evoked pain and heat pain threshold in SCI patients with NP. These neurophysiological tests might be objective biomarkers of treatment effects for NP in patients with SCI.
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Effectiveness of transcranial direct current stimulation and Visual Illusion on neuropathic pain in spinal cord injury.
Brain, 2010Co-Authors: Maria Dolors Soler, Hatice Kumru, Raul Pelayo, Joan Vidal, Josep Maria Tormos, Felipe Fregni, Xavier Navarro, Alvaro Pascual-leoneAbstract:The aim of this study was to evaluate the analgesic effect of transcranial direct current stimulation of the motor cortex and techniques of Visual Illusion, applied isolated or combined, in patients with neuropathic pain following spinal cord injury. In a sham controlled, double-blind, parallel group design, 39 patients were randomized into four groups receiving transcranial direct current stimulation with walking Visual Illusion or with control Illusion and sham stimulation with Visual Illusion or with control Illusion. For transcranial direct current stimulation, the anode was placed over the primary motor cortex. Each patient received ten treatment sessions during two consecutive weeks. Clinical assessment was performed before, after the last day of treatment, after 2 and 4 weeks follow-up and after 12 weeks. Clinical assessment included overall pain intensity perception, Neuropathic Pain Symptom Inventory and Brief Pain Inventory. The combination of transcranial direct current stimulation and Visual Illusion reduced the intensity of neuropathic pain significantly more than any of the single interventions. Patients receiving transcranial direct current stimulation and Visual Illusion experienced a significant improvement in all pain subtypes, while patients in the transcranial direct current stimulation group showed improvement in continuous and paroxysmal pain, and those in the Visual Illusion group improved only in continuous pain and dysaesthesias. At 12 weeks after treatment, the combined treatment group still presented significant improvement on the overall pain intensity perception, whereas no improvements were reported in the other three groups. Our results demonstrate that transcranial direct current stimulation and Visual Illusion can be effective in the management of neuropathic pain following spinal cord injury, with minimal side effects and with good tolerability.
Kathleen A. Turano - One of the best experts on this subject based on the ideXlab platform.
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Visual Illusion in virtual world alters women’s target-directed walking
Experimental Brain Research, 2004Co-Authors: Sidhartha Chaudhury, Jane M. Eisinger, Lei Hao, John Hicks, Raghu Chivukula, Kathleen A. TuranoAbstract:In this study we investigated whether a Visual Illusion located in far space alters a person’s open-loop, target-directed walking path in the same manner as it alters the perception of the target’s position. Through the use of immersive VR the subject was able to walk physically to the location of a target embedded in a scene that was manipulated to create a Visual Illusion, known as the induced Roelofs effect. This Illusion has been shown to alter the perception of a target’s position. The experiment consisted of two tasks: a perception task and an action task. In the perception task, subjects viewed the scene for 1 s, it disappeared, and they were to report the target’s location verbally. The results showed that the Visual Illusion altered the reported positions in all but one subject. In the action task, subjects viewed the scene for 1 s, it disappeared, and the subjects were asked to walk to the target’s location. The results showed that the Illusion significantly altered the walking paths of most of the women and less than half of the men. A significant gender effect was observed; women’s walking paths deviated, on average, by 7.1° and men’s, by only 2.0°. These results indicate that action tasks in far space are susceptible to the effects of Visual Illusions, unlike the action tasks in near space that reportedly have been resistant to them. Furthermore, the significant gender effect suggests that men and women either have different strategies and/or employ different mechanisms when executing a Visually guided task in far space.
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Visual Illusion in virtual world alters women's target-directed walking.
Experimental Brain Research, 2004Co-Authors: Sidhartha Chaudhury, Jane M. Eisinger, Lei Hao, Raghu Chivukula, John C. Hicks, Kathleen A. TuranoAbstract:In this study we investigated whether a Visual Illusion located in far space alters a person’s open-loop, target-directed walking path in the same manner as it alters the perception of the target’s position. Through the use of immersive VR the subject was able to walk physically to the location of a target embedded in a scene that was manipulated to create a Visual Illusion, known as the induced Roelofs effect. This Illusion has been shown to alter the perception of a target’s position. The experiment consisted of two tasks: a perception task and an action task. In the perception task, subjects viewed the scene for 1 s, it disappeared, and they were to report the target’s location verbally. The results showed that the Visual Illusion altered the reported positions in all but one subject. In the action task, subjects viewed the scene for 1 s, it disappeared, and the subjects were asked to walk to the target’s location. The results showed that the Illusion significantly altered the walking paths of most of the women and less than half of the men. A significant gender effect was observed; women’s walking paths deviated, on average, by 7.1° and men’s, by only 2.0°. These results indicate that action tasks in far space are susceptible to the effects of Visual Illusions, unlike the action tasks in near space that reportedly have been resistant to them. Furthermore, the significant gender effect suggests that men and women either have different strategies and/or employ different mechanisms when executing a Visually guided task in far space.
