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Effect of one session of tDCS on the severity of pain in women with chronic pelvic pain. J Bodyw Mov Ther 2019; 23:678-682. [PMID: 31563388 DOI: 10.1016/j.jbmt.2017.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/25/2017] [Accepted: 12/17/2017] [Indexed: 12/18/2022]
Abstract
AIM The present study aimed to investigate the effects of tDCS on pain score in women with Chronic Pelvic Pain (CPP). MATERIALS & METHODS A total of 16 women with CPP participated in the present double-blind sham-controlled cross-over study. Each participant received a 20-min 0.3 MA of trans Cranial Direct Stimulation (tDCS) with a current density of 0.1 mA/cm2. In addition to the pain intensity, the Quality of Life (QOL), disability, and depression statuses were assessed prior to and one week after the treatment. Shapiro-Wilks goodness-of-fit test for normality, dependent t-Test, and Wilcoxon Signed- Rank Test were used for data analysis. Values of p < .05 were considered statistically significant. FINDINGS Active tDCS treatment was effective in the reduction of pain (p = .0001), improving QOL (208.938 > 193.313, P = .025), and the disability (22.375 < 30.375, P = .025). The results showed no effect of active or sham treatment on the depression (p ≥ .05). CONCLUSION The positive effects of active tDCS on CPP suggest the need to study the effect of this method on other types of chronic pain.
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Bayer KE, Neeb L, Bayer A, Wiese JJ, Siegmund B, Prüß MS. Reduction of intra-abdominal pain through transcranial direct current stimulation: A systematic review. Medicine (Baltimore) 2019; 98:e17017. [PMID: 31574799 PMCID: PMC6775377 DOI: 10.1097/md.0000000000017017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique to modulate cortical excitability and to induce neuronal plasticity. With a wide range of applications in neurological and psychiatric disorders, the efficiency of tDCS is also studied in the treatment of various pain conditions. Treatment with tDCS might accordingly provide pain relief for patients with acute or chronic pain and thus lead to an increase in quality of life. Moreover, applied as an adjunct therapy, tDCS can reduce help to reduce pain medication intake and accompanying adverse events. To this end, this review examines studies evaluating the efficacy of tDCS in pain relief in patients with intra-abdominal pain. METHODS A structured search of the PubMed medical database was carried out to identify possibly relevant studies. Studies were compared in terms of treatment characteristics, general conditions, and results. Jadad scale was applied for quality analyses. RESULTS Out of 289 articles that were found initially, 6 studies were identified that met eligibility criteria. Five out of 6 studies reported significant effects for pain reduction in different types of intra-abdominal pain. CONCLUSIONS Results indicate that tDCS might be able to reduce intra-abdominal pain. However, more randomized-controlled trials with larger sample size are necessary to define clinically relevant effects as well as treatment characteristics such as duration of stimulation.
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Affiliation(s)
- Kian-Elias Bayer
- Medizinische Klinik m. S. Gastroenterologie, Infektiologie und Rheumatologie, Charité -Universitätsmedizin Berlin
| | - Lars Neeb
- Department of Neurology, Berlin Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
| | - Arian Bayer
- Medizinische Klinik m. S. Gastroenterologie, Infektiologie und Rheumatologie, Charité -Universitätsmedizin Berlin
| | - Jakob Johann Wiese
- Medizinische Klinik m. S. Gastroenterologie, Infektiologie und Rheumatologie, Charité -Universitätsmedizin Berlin
| | - Britta Siegmund
- Medizinische Klinik m. S. Gastroenterologie, Infektiologie und Rheumatologie, Charité -Universitätsmedizin Berlin
| | - Magdalena Sarah Prüß
- Medizinische Klinik m. S. Gastroenterologie, Infektiologie und Rheumatologie, Charité -Universitätsmedizin Berlin
- Berlin Institute of Health (BIH), Berlin, Germany
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Zhang Y, Qu P. Factors associated with ovarian endometriosis malignancy and its recurrence in Chinese women. J OBSTET GYNAECOL 2019; 39:1148-1153. [PMID: 31307261 DOI: 10.1080/01443615.2019.1603209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In this study, the risk factors for ovarian endometriosis (OE) malignancy and its recurrence were explored in Chinese women. For OE malignancy occurrence, the age of marriage, abortion times, course of OE, body mass index (BMI), other benign uterine complications, and shorter parturition times were identified as risk factors using univariate analyses. Among them, age at marriage, course of OE, BMI, and decreased parturition times were identified as risk factors using multivariate analyses. For OE malignancy recurrence, the risk factors included clinical staging, histological classification, and chemotherapy by univariate analysis; and clinical stage, clear-cell carcinoma, and fewer chemotherapy cycles by multivariate analyses. In summary, we concluded that higher ages at marriage, longer courses of ovarian endometriosis, shorter parturition times, and additional benign uterine complications may increase the risk of OE malignancy. Advanced clinical stages, clear-cell carcinomas, and fewer chemotherapy cycles may promote OE malignancy recurrence. Impact statement What is already known on this subject? Endometriosis is one of the most common gynaecological diseases. Although endometriosis is not a malignant disease, endometriosis cells have characteristics similar to cancer cells. The risk of malignant transformation rates of ovarian endometriosis is said to be 1:18. However, epidemiological evidence based on large population research in ovarian endometriosis malignancy is lacking. In addition, there were few studies focussing on the long-term prognosis of ovarian endometriosis malignancies. What do the results of this study add? This study revealed the possible occurrence and recurrence risk factors of ovarian endometriosis malignancy using univariate and multivariate statistics analyses. What are the implications of these findings for clinical practice and/or further research? A clinical retrospective study with a longer follow-up period is suggested for assessing the occurrence and recurrence risk factors for ovarian endometriosis malignancies.
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Affiliation(s)
- Ying Zhang
- Department of Gynecology, Tianjin Central Hospital of Gynecology Obstetrics , Tianjin , China
| | - Pengpeng Qu
- Department of Gynecologic Oncology, Tianjin Central Hospital of Gynecology Obstetrics , Tianjin , China
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[Interest of transcranial stimulation in pelvic and perineal disorders]. Prog Urol 2019; 29:349-359. [PMID: 31036483 DOI: 10.1016/j.purol.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/26/2019] [Accepted: 03/08/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this article was to describe the diagnostic and therapeutic value of transcranial stimulation in pelvic and perineal disorders. METHODS A literature review (Medline database and Google scholar) with no time limit was performed using keywords: "transcranial direct stimulation", "transcranial magnetic stimulation", "neurogenic bladder", "urinary incontinence", "Parkinson disease", "multiple sclerosis", "stroke", "muscle spasticity", "pelvic pain", "visceral pain". RESULTS Twelve articles have been selected. Transcranial magnetic or electrical stimulation is a noninvasive neuromodulation technique widely used to establish brain maps to highlight causal relationships between brain and function. Regarding pelvic-perineal disorders, repeated transcranial stimulation has shown significant effects for the treatment of overactive bladder in Parkinson's disease (P<0.05) and multiple sclerosis, but also for the treatment of refractory chronic pelvic pain (P=0.026). Finally, therapeutic effects have also been demonstrated in irritable bowel syndrome. No evidence of efficacy was found on genito-sexual disorders. CONCLUSION Data from the literature suggest that transcranial stimulation is a noninvasive treatment that may have a role in the management of pelvic and perineal disorders. Its promising field of action would require prospective and randomized studies on a larger scale.
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Rolla E. Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Res 2019; 8:F1000 Faculty Rev-529. [PMID: 31069056 PMCID: PMC6480968 DOI: 10.12688/f1000research.14817.1] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2019] [Indexed: 12/11/2022] Open
Abstract
Endometriosis is an enigmatic disease that could start at birth. Its pathogenesis is supported by different theories. Accumulating facts relate it to a multigenic disorder. In this review of recent publications, the principal symptoms of the disease, pain and infertility, as well as its pathogenesis, diagnosis, and classification will be addressed. Endometriosis presents three main variants: superficial peritoneal disease, deep infiltrating endometriosis, and ovarian endometriomas. The management of the disease, surgery, and medical and alternative therapies will be discussed. Special reference will be made to the quality of surgery and how to understand patients with endometriosis and endometriosis.
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Affiliation(s)
- Edgardo Rolla
- Sociedad Argentina de Endometriosis, Buenos Aires, Argentina
- Sociedad Argentina de Cirugía Laparoscópica, Buenos Aires, Argentina
- World Endometriosis Society, Buenos Aires, Argentina
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Bourdel N, Chauvet P, Billone V, Douridas G, Fauconnier A, Gerbaud L, Canis M. Systematic review of quality of life measures in patients with endometriosis. PLoS One 2019; 14:e0208464. [PMID: 30629598 PMCID: PMC6328109 DOI: 10.1371/journal.pone.0208464] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/16/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Endometriosis and quality of life has been the subject of much research, however, there is little consensus on how best to evaluate quality of life in endometriosis, resulting in many and diverse scales being used. In our study, we aim to identify quality of life scales used in endometriosis, to review their strengths and weaknesses and to establish what would define an ideal scale in the evaluation of endometriosis-related quality of life. MATERIALS AND METHODS A search of the MEDLINE and EMBASE databases was carried out for publications in English and French for the period from 1980 to February 2017, using the words 'endometriosis' and 'quality of life'. Publications were selected if they reported on quality of life in patients with endometriosis and specified use of a quality of life scale. A quantitative and a qualitative analysis of each scale was performed in order to establish the strengths and weaknesses for each scale (systematic registration number: PROSPERO 2014: CRD42014014210). RESULTS A total of 1538 articles publications were initially identified. After exclusion of duplicates and application of inclusion criteria, 201 studies were selected for analysis. The SF-36, a generic HRQoL measure, was found to be the most frequently used scale, followed by the EHP-30, a measure specific to endometriosis. Both perform well, when compared with other scales, with scale weaknesses offset by strengths. EHP-5 and EQ-5D also showed to be of good quality. All four were the only scales to report on MCID studied in endometriosis patients. CONCLUSION For clinical practice, routine evaluation of HRQOL in women with endometriosis is essential both for health-care providers and patients. Both SF-36 and EHP-30 perform better overall with regard to their strengths and weaknesses when compared to other scales.
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Affiliation(s)
- Nicolas Bourdel
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- Faculty of Medecine, ISIT-University of Auvergne, Clermont-Ferrand, France
| | - Pauline Chauvet
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- Faculty of Medecine, ISIT-University of Auvergne, Clermont-Ferrand, France
| | - Valentina Billone
- Department of Mother and Child, University Hospital P. Giaccone, Palermo, Italy
| | - Giannis Douridas
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Arnaud Fauconnier
- Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, EA 7285 Research Unit ‘Risk and Safety in Clinical Medicine for Women and Perinatal Health’, Versailles-Saint-Quentin University (UVSQ), Montigny-le-Bretonneux, France
| | - Laurent Gerbaud
- Dept of Public Health, PEPRADE, Université Clermont Auvergne, CHU Clermont-Ferrand, France, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Michel Canis
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- Faculty of Medecine, ISIT-University of Auvergne, Clermont-Ferrand, France
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Straudi S, Buja S, Baroni A, Pavarelli C, Pranovi G, Fregni F, Basaglia N. The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial. Clin Rehabil 2018; 32:1348-1356. [PMID: 29783893 DOI: 10.1177/0269215518777881] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test the efficacy of transcranial direct current stimulation (tDCS) in addition to group exercise on non-specific chronic low back pain. DESIGN Double-blinded randomized control trial. SUBJECTS Patients with non-specific chronic low back pain. METHODS A total of 35 subjects were recruited and allocated to real- or sham-tDCS followed by a group exercise protocol. Each patient underwent five sessions of brain stimulation followed by 10 sessions of group exercise. Subjects were evaluated before and after tDCS, after group exercise and one month after the combined treatment. Outcome measures were Visual Analog Scale for pain intensity, Roland Morris Disability Questionnaire, EuroQuol-5 Dimension and Patient Health Questionnaire-9. RESULTS Significant between-group difference in pain intensity (-27.7 ± 30.4 mm in real-tDCS group compared to -2.2 ± 30.1 mm in sham-tDCS group) and Patient Health Questionnaire-9 (-4.9 ± 4.2 in real-tDCS group compared to -1.1 ± 2.7 in sham-tDCS group) was found one month after the combined treatment ( P < 0.05). CONCLUSION Our results showed that real-tDCS can induce significant larger effects on pain and psychological well-being, compared to sham-tDCS, when it is associated with a group exercise program. The effects were observed mostly in the follow-up.
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Affiliation(s)
- Sofia Straudi
- 1 Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Sergio Buja
- 1 Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Andrea Baroni
- 2 Translational Neurosciences and Neurotechnologies, Ferrara University, Ferrara, Italy
| | - Claudia Pavarelli
- 1 Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Giulia Pranovi
- 1 Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Felipe Fregni
- 3 Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Nino Basaglia
- 1 Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy.,2 Translational Neurosciences and Neurotechnologies, Ferrara University, Ferrara, Italy
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Study adherence in a tDCS longitudinal clinical trial with people with spinal cord injury. Spinal Cord 2017; 56:502-508. [DOI: 10.1038/s41393-017-0023-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/29/2017] [Accepted: 09/18/2017] [Indexed: 11/09/2022]
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Hou WH, Wang TY, Kang JH. The effects of add-on non-invasive brain stimulation in fibromyalgia: a meta-analysis and meta-regression of randomized controlled trials. Rheumatology (Oxford) 2016; 55:1507-17. [PMID: 27150193 DOI: 10.1093/rheumatology/kew205] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The effects of non-invasive brain stimulation (NBS), including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (TDCS), in treating FM remain inconclusive. The aim of this study was to investigate present evidence of using NBS as an add-on treatment in treating FM. METHODS We conducted a database search of the Medline, Embase, PsycINFO and Cochrane Library electronic databases, from inception to July 2015, to analyse randomized controlled trials of NBS in treating FM. A total of 16 studies were included in the current meta-analysis. RESULTS The pooled mean effect sizes of the 16 included studies revealed significant favourable effects of NBS. The weighted mean effect size in reducing pain, depression, fatigue, sleep disturbance and tender points and improving general health/function were 0.667 (95% CI 0.446, 0.889), 0.322 (95% CI 0.140, 0.504), 0.511 (95% CI 0.247, 0.774), 0.682 (95% CI 0.350, 1.014), 0.867 (95% CI 0.310, 1.425) and 0.473 (95% CI 0.285, 0.661), respectively. rTMS stimulation yielded a greater effect size compared with that of TDCS (effect size 0.698 and 0.568, respectively; P < 0.0001). The primary motor cortex (M1) stimulation yielded a subtle greater effect size in pain reduction compared with that of the dorsolateral prefrontal cortex (effect size 0.709 and 0.693, respectively; P < 0.0001). No linear relationships were found between the effect sizes and treatment regimens and dose. Most of reported adverse effects were minor. CONCLUSIONS Both rTMS and TDCS may be feasible and safe modalities for treating FM. The general effects of rTMS and TDCS are compatible in FM patients. M1 stimulation may be better in pain reduction and the dorsolateral prefrontal cortex may be better in depression improvement.
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Affiliation(s)
- Wen-Hsuan Hou
- Master Program in Long-Term Care School of Gerontology Health Management, College of Nursing Department of Physical Medicine & Rehabilitation Center of Evidence-based Medicine
| | - Tzu-Ya Wang
- Graduate Institute of Nursing, College of Nursing
| | - Jiunn-Horng Kang
- Department of Physical Medicine & Rehabilitation Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine Sleep Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
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