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Rating the Intensity of a Laser Stimulus, but Not Attending to Changes in Its Location or Intensity Modulates the Laser-Evoked Cortical Activity
摘要： Top-down attention towards nociceptive stimuli can be modulated by asking participants to pay attention to specific features of a stimulus, or to provide a rating about its intensity/unpleasantness. Whether and how these different top-down processes may lead to different modulations of the cortical response to nociceptive stimuli remains an open question. We recorded electroencephalographic (EEG) responses to brief nociceptive laser stimuli in 24 healthy participants while they performed a task in which they had to compare two subsequent stimuli on their Spatial location (Location task) or Intensity (Intensity Task). In two additional blocks (Location + Ratings, and Intensity + Ratings) participants had to further provide a rating of the perceived intensity of the stimulus. Such a design allowed us to investigate whether focusing on spatial or intensity features of a nociceptive stimulus and rating its intensity would exert different effects on the EEG responses. We did not find statistical evidence for an effect on the signal while participants were focusing on different features of the signal. We only observed a significant cluster difference in frontoparietal leads at approximately 300–500 ms post-stimulus between the magnitude of the signal in the Intensity and Intensity + Rating conditions, with a less negative response in the Intensity + Rating condition in frontal electrodes, and a less positive amplitude in parietal leads. We speculatively propose that activity in those electrodes and time window reflects magnitude estimation processes. Moreover, the smaller frontal amplitude in the Intensity + Rating condition can be explained by greater working memory engagement known to reduce the magnitude of the EEG signal. We conclude that different top-down attentional processes modulate responses to nociceptive laser stimuli at different electrodes and time windows depending on the underlying processes that are engaged.
关键词： top-down modulation,pain,ratings,attention,EEG,laser evoked potentials (LEPs)
更新于2025-09-23 15:19:57
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Effect of Modified Laser Transcutaneous Irradiation on Pain and Quality of Life in Patients with Diabetic Neuropathy
摘要： Background: Diabetic neuropathy (DN) is one of the major complications developed by individuals with diabetes mellitus. DN is responsible for a high morbidity and mortality rate and impacts the public health and medical assistance resources. Intradermic laser irradiation on blood (ILIB) consists of the application of light beams on the radial arterial, providing anti-inflammatory and vasodilator effects, antiarrhythmic action, reduction of glucose, and stabilization of the hormonal and immunological systems. These effects help to maintain the physiological dynamics of the body. Objective: The goal of this research was to evaluate the effects of ILIB to relieve pain and improve the quality of life in DN patients. The sample comprised 30 diabetic volunteers with DN, randomly distributed into 3 groups: Control—conventional treatment; ILIB—100 mW, 660 – 10 nm, 30 applications in total, divided into 3 stages of 10 applications, 30 min each, daily, with a 20-day interval between each stage; SILIB—same protocol described for ILIB, with the equipment switched off. Before and after the application of the therapeutic protocols, all volunteers were evaluated by the following instruments: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), visual analog scale, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and PAIN DETECT scale. Collected data were statistically analyzed with a 95% confidence interval, p < 0.05. Results: The ILIB group presented significantly lower pain levels and a better quality of life compared with the control and SILIB groups. Conclusions: This study demonstrated that ILIB therapy was effective in reducing pain and improving quality of life in patients with DN.
关键词： photobiomodulation,diabetes mellitus,diabetic neuropathies,pain
更新于2025-09-23 15:19:57
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Short-Term Efficacy Comparison of High-Intensity and Low-Intensity Laser Therapy in the Treatment of Lateral Epicondylitis: A Randomized Double-Blind Clinical Study
摘要： Objectives: This study aims to evaluate and compare the short-term efficacies of high-intensity laser therapy (HILT) and low-intensity laser therapy (LILT) in the treatment of lateral epicondylitis (LE). Patients and methods: Sixty patients (16 males, 44 females; mean age 44.2±9.3 years; range, 18 to 65 years) with unilateral elbow pain were randomized into two groups as 30 patients treated with HILT (9 males and 21 females) and 30 patients treated with LILT (7 males and 23 females). The HILT (1,064 nm) and LILT (904 nm) were administered three times a week for three weeks, and each treatment was combined with an epicondylitis bandage. A visual analog scale (VAS), quick Disabilities of the Arm, Shoulder, and Hand (QDASH) questionnaire, Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36), and hand grip strength test were used to evaluate the patients before and three weeks after treatment. Results: The two groups had similar demographic characteristics, including age, sex, occupation, and body mass index (p>0.05). There were no statistically significant differences between the two groups in terms of the pretreatment VAS, QDASH, hand grip strength, and SF-36 scores (p>0.05). After three weeks, both groups showed significant improvements in all of the parameters (p<0.05). However, in the HILT group, the QDASH, hand grip strength, and SF-36 physical component summary (PCS) scores showed superior improvement compared to the LILT group (p<0.05). Conclusion: Each treatment modality was found to be effective and safe for the short-term treatment of LE. However, the HILT exhibited more significant effects on the hand grip strength, QDASH, and SF-36 PCS scores than the LILT.
关键词： Hand grip strength,low-intensity laser therapy,pain,high-intensity laser therapy,lateral epicondylitis
更新于2025-09-23 15:19:57
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Photobiomodulation Therapy is Able to Modulate PGE <sub/>2</sub> Levels in Patients With Chronic Nona??Specific Low Back Pain: A Randomized Placeboa??Controlled Trial
摘要： Background and Objectives: Non‐specific low back pain (LBP) is responsible for triggering increased biomarkers levels. In this way, photobiomodulation therapy (PBMT) may be an interesting alternative to treat these patients. One of the possible biological mechanisms of PBMT involved to decrease pain intensity in patients with musculoskeletal disorders is modulation of inflammatory mediators’ levels. The aim of this study was to evaluate the effects of PBMT compared with placebo on inflammatory mediators’ levels and pain intensity in patients with chronic non‐specific LBP. Study Design/Materials and Methods: A prospectively registered, randomized triple‐blinded (volunteers, therapists, and assessors), placebo‐controlled trial was performed. Eighteen patients with chronic non‐specific LBP were recruited and treated with a single session of active PBMT or placebo PBMT. The primary outcome of the study was serum prostaglandin E2 levels and the secondary outcomes were tumor necrosis factor‐α, interleukin‐6 levels, and pain intensity. All outcomes were measured before and after 15 minutes of treatment session. Results: PBMT was able to decrease prostaglandin E2 levels at post‐treatment compared with placebo, with a mean difference of ?1470 pg/ml, 95% confidence interval ?2906 to ?33.67 in patients with LBP. There was no difference between groups in the other measured outcomes. Patients did not report any adverse events. Conclusion: Our results suggest that PBMT was able to modulate prostaglandin E2 levels, indicating that this may be one of the mechanisms involved in the analgesic effects of PBMT in patients with LBP.
关键词： low‐level laser therapy,inflammatory mediators,low back pain,physical therapy,rehabilitation,musculoskeletal disorders
更新于2025-09-23 15:19:57
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Identification of the Pain Process by Cold Stimulation: Using Dynamic Causal Modeling of Effective Connectivity in Functional Near-Infrared Spectroscopy (fNIRS)
摘要： Background: Pain is an unpleasant sensory and emotional experience followed by anxiety, depression, and frustration. Functional Near-Infrared Spectroscopy (fNIRS) as an optical technique identifies the brain functional networks by investigating connectivity between functionally linked of different anatomical regions in response to pain stimulation. Methods: In this research, fNIRS was performed in order to study the difference in effective functional connectivity of the brain prefrontal cortex between the two modes of pain and rest based on the dynamic causal modeling (DCM) method. Effective functional connectivity changes in the prefrontal cortex between pain and rest states were calculated using DCM approach to investigate (1) areas known for pain sensation and (2) to analyze inter-network functional connectivity strength (FCS) by selecting several brain functional networks based on the analysis findings. All analyses were performed using toolboxes SPM-fNIRS and SPM8, Matlab software. Results: Regional hemodynamics changes caused deoxyhemoglobin concentration to decrease in the prefrontal cortex of both hemispheres, particularly on the right side. We found a simultaneous increase in the concentration of oxyhemoglobin in the prefrontal cortex of the left hemisphere in comparison to the right hemisphere, that there was a trend toward reduction in oxyhemoglobin concentration. The results indicate that during the cold pain stimulation, the connectivities between prefrontal cortex regions were significantly changed. Specifically, a significantly consistent increase in the RPFC to MPFC connectivity was found while a significant consistent decrease was observed in the both MPFC to LPFC and LPFC to MPFC connectivities. Conclusion: This study contributes to the pain research field to identify the directionality and causality of neuronal connections in the prefrontal cortex by applying DCM to fNIRS data. The results suggest that the proposed method infers directional interactions between hidden neuronal states in the brain under neuronal dynamic conditions based on optical density changes measurement.
关键词： Diagnosing pain,Neurology,Effective connectivity,Brain mapping,Dynamic causal modeling,fNIRS,Pain
更新于2025-09-19 17:15:36
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Klinische Verbesserung und Wirtschaftlichkeit nach CT-gesteuerter Radiofrequenzsakroplastie und Zementsakroplastie – ein prospektiver randomisierter Methodenvergleich
摘要： Introduction The objective of this study was a comparative analysis of cement augmentation by means of RFS and CSP with regard to outcome and cost-effectiveness. Patients and Methods CT-guided cement augmentation was performed on 100 patients with a total of 168 non-dislocated insufficiency fractures, 50 patients being treated with RFS and 50 patients with CSP. Leakages were detected by CT. Pain intensity was determined on a VAS before and after the intervention. The patients? self-sufficiency was assessed using the Barthel index. Patients were asked about any complications and their level of satisfaction. Costs incurred for carrying out the procedure were compared with the respective reimbursements received. Results Both procedures were technically fully feasible. No leakages were found in the RFS group, as opposed to 8.1 % asymptomatic leakages in the CSP group. The mean value for pain before intervention was 8.8 in the RFS group and 8.7 in the CSP group. On the second postoperative day, there was a significant pain reduction with a value of 2.4 for both groups, which remained more or less constant over the follow-up period. The Barthel index increased significantly from an average of 30 before the intervention to 80 on the fourth postoperative day and 70 after 24 months. No differences were found between the two procedures with regard to pain, improvement in functional status and satisfaction. Taking into account the state-wide base rate used for calculating reimbursement, 3,834.75 € remained for RFS and 5,084.32 € for CSP. Conclusion RFS and CSP are minimally invasive procedures that achieve equally good and sustained pain reduction, leading to markedly improved self-sufficiency of the patients. With regard to possible cement leakages, RFS is the safer method. A profit can be generated with both techniques.
关键词： radiofrequency sacroplasty,pain therapy,insufficiency fracture,sacrum,cement sacroplasty
更新于2025-09-19 17:15:36
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The influence of educational measures and low-level laser phototherapy on temporomandibular disorders
摘要： Photobiomodulation therapy (PBMT) with low-power laser is used for pain relief in several clinical conditions, including temporomandibular disorders (TMD). As musculoskeletal pain often produces changes in motor behavior, it is common for patients with TMD to present limited mandibular movements. To the date, there is no consensus about the optimal dosimetric parameters of PMBT for TMD. This randomized, controlled, double-blind clinical trial aims to evaluate pain relief and mandibular mobility in patients with TMD following treatments with 2 laser wavelengths, red (660 nm) and infrared (808 nm) individually and in combination as compared to a placebo treatment. One-hundred participants presenting myalgia and arthralgia, with disk displacement or not, will be selected based on the Research Diagnostic Criteria for Temporomandibular Disorders. All participants will be instructed about the etiology, prognosis, and self-care techniques for pain control on TMD, and followed up for 2 weeks. After this period, those who still present pain score over 4 in a visual analog scale (VAS) will be included in the study. Participants will be randomly assigned to 4 treatment groups: G1 = placebo (SHAM); G2 = PBMT with red laser (660 nm, 0.034 cm2, 88 J/cm2, 100 mW, 3 J/point); G3 = PBMT with infrared laser (808 nm, 0.034 cm2, 88 J/cm2, 100 mW, 3 J/point); and G4 = PBMT with red and infrared laser alternated between sessions. The treatment consists of 8 sessions, 2 times a week. The effect of the proposed therapies will be measured by: pain reduction in VAS; pressure pain threshold on TMJ, masseter and temporal muscles; and the amplitude of mandibular movements (opening, protrusion, and right and left lateral movements). The data will be collected at the following times: initial (T1), after the 1st treatment session (T2), at the end of treatment (T3), and 30 days after the last PBMT session (T4). For statistical analysis will be used 2-way repeated measures analysis of variance test, complemented by a post hoc Tukey test (P < .05).
关键词： pain pressure threshold,multiple wavelengths,temporomandibular disorder,low-level laser therapy,orofacial pain,phototherapy,mandibular function,counseling
更新于2025-09-19 17:13:59
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Is Low-Level Laser Therapy Effective for Pain Control After the Surgical Removal of Unerupted Third Molars? A Randomized Trial
摘要： One of the main challenges after extraction of unerupted third molars is pain control, and one of the treatments for pain control is low-level laser therapy (LLLT). Thus, this study aimed to assess the effectiveness of LLLT for pain control after extraction of lower third molars. Materials and Methods: This randomized, double-blind, split-mouth study included patients who required bilateral extraction of unerupted lower third molars. Patients received LLLT on 1 side (laser group) but not on the opposite side (control group). On the experimental side, each patient received a laser application at 5 intraoral points for 30 seconds per point. This procedure was simulated on the control side. The pain control response was assessed with a modified pain visual analog scale at the following times: immediately after surgery (T0), after laser application (T1), 24 hours after surgery (T2), 48 hours after surgery (T3), and 72 hours after surgery (T4). Results: Thirty-two patients, 56.25% of whom were women, underwent extraction; the average age was 22.2 years. At the times analyzed, the laser group presented better results than the control group. As for the times, there were differences in pain scores between T0 (8.03 ± 14.87) and T3 (2.66 ± 4.23), as well as T4 (3.36 ± 7.83), in the laser group and differences between T0 (19.76 ± 26.66) and T3 (7.11 ± 10.76), as well as T4 (6.26 ± 13.14), in the control group. Conclusion: LLLT was effective in reducing pain after surgical removal of unerupted third molars. At T3 and T4, pain reduction in relation to T0 was noted in both groups.
关键词： low-level laser therapy,pain control,extraction,randomized trial,third molars
更新于2025-09-19 17:13:59
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A Comparative Assessment of Pain Caused by the Placement of Banded Orthodontic Appliances with and without Low-Level Laser Therapy: A Randomized Controlled Prospective Study
摘要： Patients still refuse or discontinue orthodontic treatment due to related pain and discomfort. In this study, we investigate if low-level laser therapy (LLLT) can reduce pain caused by orthodontic bands. Sixty subjects who needed bands placed on the upper permanent first molars were assigned randomly to the LLLT group, placebo, and control groups. Inclusion criteria were: age range 10–14 years, fully erupted upper first molars in healthy condition, presence of tight mesial proximal contact. Exclusion criteria were: systemic or metabolic diseases, chronic pain or neurological or psychiatric disorders, use of pharmacological agents interfering with pain perception, previous orthodontic treatment or the simultaneous presence of other devices in the patient’s mouth. The assessment of pain was performed by using a numeric rating scale (NRS) considering different time intervals, i.e., immediately after bands placement, 6 h, 24 h, and from day 2 to day 5. Differences in the maximum pain and in pain experienced at each time-point, among the three groups, was assessed by using the Kruskal–Wallis H. The final sample included 56 patients, 29 males, and 27 females, with a mean age of 12.03 ± 1.3 years. Patients were randomly allocated into three groups (tested, control, and placebo group) with each group consisting respectively of 19, 20, and 17 individuals. Subjects in the LLLT experienced less pain at each time interval as well as the maximum pain score being lower in the LLLT compared to control and placebo groups. These findings were all statistically significant (p < 0.05). LLLT can alleviate the intensity of pain after the placement of orthodontic bands.
关键词： laser,orthodontic tooth movement,low-level laser therapy,dental pain,orthodontics,dental materials
更新于2025-09-19 17:13:59
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Evaluation of LED phototherapy to reduce orthodontic pain: a controlled clinical trial
摘要： Introduction The efficacy of LED phototherapy for reducing orthodontic pain during anterior retraction was evaluated. Materials and Methods Fourteen patients (mean age, 15.2 years) underwent extraction of their four first premolars and were randomly divided into LED group (LEDG): seven patients (five males, two females) who performed self-application of Biolux LED device (850 nm, 60 mW, 10.8 J/cm2) daily for 5 min to the maxillary and 5 min to the mandibular arches during the anterior retraction phase and control group (CG): seven patients (five males, two females) who did not use LED therapy. All patients completed a survey for seven consecutive days after every retraction activation for a period of 4 months (T1, T2, T3, and T4) to quantify the pain experienced using a score from 0 to 10. Results There was a significant difference (P < 0.05) in pain score between the two groups on days 1 and 2 at T3 and in the overall mean pain score, based on the four surveys, with significantly lower values in the LEDG. Friedman’s test and Tuckey’s post hoc analysis showed a reduction in the pain score for both groups over time, and although the difference was not significant between the groups at T1, T2, or T4, the pain scores were numerically lower in the LEDG than in the CG at all evaluated time points, but mainly during the first 2 days after orthodontic activation. Conclusion In conclusion, use of the 850-nm LED device after anterior retraction activation resulted in lower pain scores at all time points, indicating that LED therapy should be considered a good alternative to reduce orthodontic pain during the first 2 days postprocedure.
关键词： Orthodontics,Pain,Phototherapy,LED
更新于2025-09-19 17:13:59