Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Phantom limb pain (PLP) is pain felt in the missing limb in amputees. Somatosensory input delivered as high-frequency surface electrical stimulation may provoke a significant temporary decrease in PLP. Also, transcutaneous electrical nerve stimulation (TENS) is a somatosensory input that may activate descending inhibitory systems and thereby relieve pain. Our aim was to investigate changes in cortical activity following long-time sensory TENS. Time-frequency features were extracted from EEG signals of Cz and C4 channels (contralateral to the stimulation site) with or without TENS (2 subjects). We found that the TENS caused inhibition of the spectral activity of the somatosensory cortex following TENS, whereas no change was found when no stimulation was applied.Clinical Relevance- Although our preliminary results show a depression of the cortical activity following TENS, a future study with a larger population is needed to provide strong evidence to evaluate the effectiveness of sensory TENS on cortical activity. Our results may be useful for the design of TENS protocols for relief of PLP.
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PMID:Transcutaneous Electrical Stimulation Influences the Time-Frequency Map of Cortical Activity - A Pilot Study. 3301 54

Phantom limb pain is thought to be sustained by reentrant neural pathways which provoke dysfunctional reorganization in the somatosensory cortex. We hypothesized that disrupting reentrant pathways with a 6-day-long continuous peripheral nerve block reduces phantom pain 4 weeks after treatment. We enrolled patients who had an upper- or lower-limb amputation and established phantom pain. Each was randomized to receive a 6-day perineural infusion of either ropivacaine or normal saline. The primary outcome was the average phantom pain severity as measured with a Numeric Rating Scale (0-10) at 4 weeks, after which an optional crossover treatment was offered within the following 0-12 weeks. Pretreatment pain scores were similar in both groups, with a median [interquartile range] of 5.0 [4.0, 7.0] for each. After 4 weeks, average phantom limb pain intensity was a mean (SD) of 3.0 (2.9) in patients given local anesthetic versus 4.5 (2.6) in those given placebo (difference (95% CI) 1.3 (0.4, 2.2), P=0.003). Patients given local anesthetic had improved global impression of change and less pain-induced physical and emotional dysfunction, but did not differ on depression scores. For subjects who received only the first infusion (no self-selected crossover), the median decrease in phantom limb pain at 6 months for treated subjects was 3.0 [0, 5.0] vs. 1.5 [0, 5.0] for the placebo group; there appeared to be little residual benefit at 12 months. We conclude that a 6-day continuous peripheral nerve block reduces phantom limb pain as well as physical and emotional dysfunction for at least 1 month.
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PMID:Ambulatory continuous peripheral nerve blocks to treat post-amputation phantom limb pain a multicenter, randomized, quadruple-masked, placebo-controlled clinical trial. 3302 63


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