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Perfil clínico-neurofisiológico da dor em pessoas com doença de Parkinson: estudo observacional transversal

Wed, 15 Jan 2025 00:00:00 GMT

Título: Perfil clínico-neurofisiológico da dor em pessoas com doença de Parkinson: estudo observacional transversal Autor(es): Santos, Annanda Oliveira Abstract: Introduction: Parkinson's disease (PD) is a chronic, progressive neurodegenerative condition characterized by the degeneration of dopaminergic neurons in the nigrostriatal pathway and the presence of Lewy bodies, which result from misfolded α-synuclein proteins located in the dopaminergic presynaptic membrane within basal ganglia. The role of pain in PD is debated, as it may be a precursor, concurrent, or secondary symptom. Pain, whether acute or chronic, is complex and challenging in clinical management. Objective: To identify the characteristics of pain in PD and to explore its physiological mechanisms through qualitative sensory tests (QSTs). Materials and Methods: This cross-sectional epidemiological study (CAAE: 64807417.6.0000.5546) involved 33 volunteers with clinically diagnosed PD (20 men, age 58.75 ± 5.16 years; 13 women, age 65.92 ± 7.70 years). Variables analyzed included pain intensity, incidence, and impact, alongside peripheral sensory thresholds, primary and secondary hyperalgesia, ascending and descending nerve function, and thermal latency. Statistical analyses were conducted using SPSS 30.0 and GraphPad Prism 8.0, with significance set at p≤0.05. Tests included Shapiro-Wilk for normality, Mann-Whitney U, Wilcoxon, and one-way repeated measures ANOVA with Bonferroni post-hoc corrections. Results: Most participants reported moderate to severe pain in the last week, with a maximum pain intensity of 6.15 and an average of 3.61. Men reported higher average and minimum pain intensity compared to women, and pain during crises was significantly higher than at rest (p<0.001). Thermal and pain sensitivity testing revealed potential deficits in sensory accommodation, with only six volunteers enduring the maximum time for thermal stimulus, showing an average tolerance of 46.06 seconds. A total of 88 distinct pain sites were identified, highlighting pain’s significant impact on PD and suggesting sensory modulation deficits related to the condition. Conclusion: People with PD have associated chronic pain, with deficits in the excitatory and inhibitory pain pathways. In addition, pain perception is increased, corroborating the findings of chronification.

Efeitos do treinamento resistido de intensidade moderada na prevenção de anormalidades cardiovasculares de ratos com infarto agudo do miocárdio

Fri, 15 Mar 2024 00:00:00 GMT

Título: Efeitos do treinamento resistido de intensidade moderada na prevenção de anormalidades cardiovasculares de ratos com infarto agudo do miocárdio Autor(es): Dantas, Cácia Oliveira Abstract: Introduction: Acute myocardial infarction (MI) is a cardiovascular disease that affects approximately 300 thousand Brazilians annually, of which 30% die. Many factors influence the onset of MI, with emphasis on a sedentary lifestyle and poor diet. The practice of aerobic exercise is highly recommended for preventing cardiovascular diseases. However, the cardioprotective mechanism of resistance exercise still needs to be further clarified. Objective: To evaluate the effects of resistance training (RT) in preventing cardiac abnormalities in animals with isoproterenol-induced acute myocardial infarction. Methods: The animals were divided into 4 groups: 1) SED (sedentary): animals subjected to electrical stimulation and administration of saline solution (0.9%, i.p.), 2) RT (trained): animals subjected to RT and administration of saline solution, 3) MI: animals subjected to electrical stimulation and administration of isoproterenol (ISO, 100 mg/kg, i.p.) and 4) RT+MI: animals subjected to RT and administration of ISO. RT was performed with moderate intensity (60%) of the one repetition maximum test, 3x per week, for 4 weeks. Anthropometric and morphological changes, infarction area, biochemical markers of tissue injury, electrocardiogram, autonomic modulation, ventricular contractility, oxidative stress and expression of apoptotic pathway proteins were evaluated. Results: The results showed that animals in the RT and RT+MI groups had lower body mass and greater strength gains when compared to animals in the SED and MI groups. ISO increased heart size in animals in the MI and RT+MI groups. The area of myocardial injury and extravasation of lactate dehydrogenase (LDH), total creatine phosphokinase (CPK-Total) and creatine phosphokinase MB fraction (CK-MB) increased in the MI group and were significantly reduced with RT. Furthermore, RT reduced the incidence of ST elevation (40%), heart rate (12%) and QTc interval prolongation (17%). Infarction induction increased the autonomic modulation of the sympathetic nervous system that was prevented in response to RT. RT (31.6 ± 4.8 mmHg) also prevented the contractile dysfunction observed in infarcted animals (9.6 ± 2.6 mmHg). The results also revealed that RT prevented the increase in lipid peroxidation, promoted an increase in the activity of superoxide dismutase (SOD) by 40% and glutathione peroxidase (GPx) by 120% when compared to the MI group. The activity of catalase enzymes (CAT) was reduced in the MI group, but RT did not prevent this reduction. The production of reactive oxygen species (ROS), assessed by the intensity of DHE fluorescence, was elevated in the MI group (1.25 ± 0.01 a.u) compared to the SED and TR groups, being restored in response to TR ( 0.9 ± 0.02 a.u.). In the presence of apocynin, an inhibitor of NADPH oxidase (NOX), there was no increase in ROS production between the experimental groups. The results revealed a decrease in the expression of Bax (0.7 ± 0.2) and caspase 3 (0.7 ± 0.1) in animals in the EXE+IM group in relation to the MI group (Bax: 1.6 ± 0. 2 and caspase 3: 1.5 ± 0.2). Conclusion: Given this, our results indicate that RT has a cardioprotective effect in a MI model, preventing the loss of myocardial contractility and electrocardiographic changes (QTc prolongation, ST elevation and increased heart rate). Furthermore, TR reduced sympathetic autonomic modulation associated with decreased oxidative stress and inhibition of the apoptotic pathway.

Evidências científicas sobre a ação de plantas medicinais na inflamação e na dor em modelos animais de pancreatite

Thu, 27 Feb 2025 00:00:00 GMT

Título: Evidências científicas sobre a ação de plantas medicinais na inflamação e na dor em modelos animais de pancreatite Autor(es): Carlini, Camila Caroline Abstract: Pancreatitis is an inflammation of the pancreas, often caused by factors such as alcoholism and gallstones, and it can lead to severe complications, including intense abdominal pain and organ dysfunction. Currently, there is no specific and effective treatment for the disease, making further research essential to identify new therapeutic approaches. Studies involving medicinal plants have been conducted to explore alternative treatments for pancreatitis. This systematic review aimed to assess the efficacy of medicinal plants in treating inflammation and controlling pain in animal models of pancreatitis.Following the PRISMA guidelines, the article selection process resulted in 39 studies, chosen from 1,894 articles (1,081 from PUBMED, 136 from Web of Science, 565 from EMBASE, 2 from LILACS, and 110 from SCOPUS). After analysis, 32 plant species were identified, with both prophylactic and therapeutic approaches. The most studied plants included Camellia sinensis (L.), Kuntze, Curcuma longa L., Emblica officinalis Gaertn., Nardostachys jatamansi (D.Don) DC., Rheum palmatum L., Salvia miltiorrhiza Bunge, and Trigonella foenum-graecum L.The studies involved eight distinct induction models, with cerulein used in 20 studies, followed by sodium taurocholate in six studies. Larginine was used in five studies, while a combination of cerulein or CCK with ethanol was used in three studies. The remaining studies employed CCK, sodium deoxycholate, a choline-deficient diet, dimethoate, and bile duct obstruction for induction. Among the 39 studies, 27 administered the inducer via intraperitoneal injection, seven via intraductal injection (six of which involved taurocholate), two via oral administration, and the remaining three via intravenous, subcutaneous, or mechanical induction.The primary focus of the studies was inflammation reduction and the control of biochemical markers, such as amylase, which was evaluated in all studies, and lipase, assessed in 29 studies. Cytokine analysis was conducted in 20 studies, with TNF-α (15), IL-1β (12), and IL-6 (15) being the most frequently analyzed. Myeloperoxidase activity was examined in 17 studies, and malondialdehyde concentrations in 12 studies. Only one study specifically addressed hyperalgesia.From the analysis of these studies, a lack of standardization in the induction methodologies and analytical procedures was observed, hindering the identification of the most effective approach. The risk of bias analysis, conducted using the SYRCLE tool, revealed that animal allocation, researcher blinding, and outcome reporting were poorly detailed, compromising the quality of the studies. Despite these limitations, all the studies included in the review presented promising results, demonstrating the potential of medicinal plants in treating pancreatitis. This review contributes to a broader understanding of the therapeutic potential of these plants and highlights the need for more studies focusing on the abdominal pain associated with the disease.

Redes cerebrais evocadas em mulheres com fibromialgia: estudo transversal caso-controle

Thu, 28 Aug 2025 00:00:00 GMT

Título: Redes cerebrais evocadas em mulheres com fibromialgia: estudo transversal caso-controle Autor(es): Santos, Matheus Liniker de Jesus Abstract: Fibromyalgia is a chronic painful syndrome with a complex relationship with several other pathologies. Among these associations, cognitive impairment is frequently reported, especially in its interaction with brain areas involved in pain processing. The construction of functional brain networks using graph theory, specifically time-varying graphs (TVG), has shown consistent results in various studies, enabling an understanding of the coordination and integration of neural units. However, until now, networks for evoked potentials have not been developed, which could allow the integration of different study techniques and provide a deeper understanding of the cognitive dynamics involved in activities such as this. The aim of this study was to analyze the neural bioelectric behavior by constructing functional brain networks from evoked potentials in populations of healthy women compared to women with a clinical diagnosis of fibromyalgia. In this cross-sectional case-control observational study, 70 volunteers were allocated into two groups: the fibromyalgia group (Fibro) (n = 46) and the control group (Ctrl) (n = 24). After the inclusion and exclusion criteria for the groups were evaluated, and the socioeconomic and clinical questionnaires were answered, the volunteers were assessed through electroencephalogram (EEG) during the application of the event-related potential (ERP) test in the auditory P300 component. After constructing the networks using time- varying graphs (TVG) and the motif synchronization method, two moments of the weighted networks for each subject were compared: a baseline moment, prior to the stimulus, considering the sum of the edges in the time interval between -100 and -50ms; and a response moment, after the stimulus, considering the sum of the occurrences of edges in the interval between 250ms and 400ms, corresponding to the P300 potential. Finally, indices were produced to evaluate the synchronization and robustness of brain activity during the ERP, as well as the connections within and across each side of the brain. The analysis showed a reduction in brain connectivity in the frontal region, also highlighting a decrease in connections between the hemispheres in this same area in the fibromyalgia group (Fibro), compared to the control group. When investigating the baseline network and the proposed network for P300, it was observed that the baseline network did not present edges, supporting the findings for the definition of a specific network for stimulus processing. The Ctrl network had 32 edges, while the Fibro group had only two. It is important to highlight that the edges found in the Fibro group did not appear in the Ctrl group, suggesting that these edges may be associated with the fibromyalgia syndrome. The results of this study emphasize that fibromyalgia is related to a decrease in the complexity of brain activity, reinforcing the idea that the syndrome is a complex phenomenon. This finding represents a significant advancement in the understanding of the neural interaction necessary for human cognitive processing.