RESUMEN
STUDY DESIGN: Group comparison and cross-sectional study. OBJECTIVES: To replicate previous findings regarding electroencephalographic (EEG) pattern differences in a larger sample of patients with spinal cord injury (SCI) and chronic pain than previously studied, and examine associations between pain severity and EEG activity in a sample of patients with SCI and chronic pain. SETTING: USA. METHODS: EEG data were collected in an eyes-closed condition from 38 individuals with SCI and chronic pain, 16 individuals with SCI who did not have chronic pain and 28 healthy controls. Pain intensity experienced during the EEG assessment was assessed in the chronic pain group. Absolute and relative power in four frequency bands (delta, theta, alpha, and beta) were compared between the groups, and correlation coefficients between bandwidth activity and pain intensity in the pain group were computed. RESULTS: Previously identified activity pattern differences (that is, more theta and less alpha) in those with SCI and chronic pain versus individuals with SCI and no pain and healthy controls were largely replicated. However, few significant associations between pain severity and EEG activity measures activity were found, and those that were found (more alpha activity associated with more pain as measured from frontal electrode sites) was in a direction opposite than predicted. CONCLUSION: The findings indicate that certain EEG activity patterns may be associated with more pain or a vulnerability to experience chronic pain in persons with SCI. Research examining the extent to which changes in this EEG activity may result in pain relief is warranted.
Asunto(s)
Encéfalo/fisiopatología , Dolor Crónico/etiología , Dolor Crónico/fisiopatología , Electroencefalografía , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Estudios Transversales , Interpretación Estadística de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuralgia/etiología , Neuralgia/fisiopatología , Dimensión del DolorRESUMEN
BACKGROUND: Patient-administered measures are needed to assess disability cost-effectively in large epidemiological studies. SETTING: An outpatient clinic in a large multiple sclerosis center. METHODS: A self-administered EDSS questionnaire was developed (EDSS-S). Consecutive patients with clinically definite multiple sclerosis completed the EDSS-S (n=95). During the same visit, a physician completed an EDSS (EDSS-P). Scores below 4.0 were determined using functional system (FS) scores. Scores above 4.0 were calculated by two methods, using gait alone and using gait and functional system scores combined. RESULTS: EDSS-P scores ranged from 0-9.5 (mean 5.1, median 5.0, 78% female, age 17-78, mean age 45). Mean EDSS-P, EDSS-S and intraclass correlation coefficients of agreement were: EDSS using ambulation alone (4.6, 5.1, 0.89), EDSS using ambulation and FS scores (4.6, 5.3, 0.87), bowel/bladder FS scores (1.6, 1.7, 0.79), pyramidal FS scores (2.1, 2.4, 0.67), sensory FS scores (1.6, 2.1, 0.60), cerebellar FS scores (1.1, 1.6, 0.55), brainstem FS scores (0.5, 1.2, 0.45), vision FS scores (1.9, 1.3, 0.38), cerebral FS scores (0.6, 2.3, 0.27). CONCLUSIONS: Very good correlation was seen between patient and physician scores for EDSS and the bowel/bladder FS score. Four other FS scores correlated moderately. In general, patients scored themselves more disabled than physicians.
Asunto(s)
Evaluación de la Discapacidad , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/rehabilitación , Actividades Cotidianas , Adolescente , Adulto , Anciano , Cognición , Femenino , Marcha , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Médicos , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Visión OcularRESUMEN
A prospective survey study was performed in patients with painful diabetic polyneuropathy (PDN) to assess the nature and scope of their pain. Pain associated with diabetic neuropathy is commonly encountered in clinical practice. Yet, little is known regarding the pain experience and impact on quality of life in persons with painful diabetic neuropathy. These 105 patients noted an average of 6/10 pain, most often described as 'burning', 'electric', 'sharp', and 'dull/ache', which, for most, is worse at night time and when tired or stressed. On average, patients reported that the pain caused substantial interference in sleep and enjoyment of life and moderate interference in recreational activities, normal work, mobility, general activity, social activities, and mood. Unexpectedly, a potential genetic predisposition to the development of painful neuropathy was suggested by the fact that a majority (56%) reported a family member with PDN. Thus, this study found that pain associated with diabetic neuropathy is a significant medical issue that has a substantial impact on the quality of life of many people with this condition.
Asunto(s)
Neuropatías Diabéticas/fisiopatología , Neuropatías Diabéticas/psicología , Dolor , Calidad de Vida , Neuropatías Diabéticas/epidemiología , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Estudios Prospectivos , Estados Unidos/epidemiologíaRESUMEN
Fluctuating asymmetry was studied in cleft lip propositi and their normal sibs and parents. The traits examined were a-b ridge counts and fingerprint patterns. Propositi with a family history of this congenital malformation and their normal sibs and parents were significantly different from the controls for this type of asymmetry. Propositi without a family history and their normal sibs and parents were similar to the controls. These results support the hypothesis that familial and sporadic cases of congenital cleft lip are different entities and give evidence for a genetic mechanism in the parents and sibs of the familial cases that may account for this congenital disorder and, concomitantly, increased fluctuating asymmetry.
Asunto(s)
Labio Leporino/genética , Dermatoglifia , Femenino , Lateralidad Funcional , Humanos , MasculinoRESUMEN
Fluctuating asymmetry for the palmar atd angle was studied in propositi born with CL(P) and their normal parents and sibs. The propositi with a family history of this congenital malformation were significantly different from the controls for this type of asymmetry. The propositi without a family history and the normal parents and sibs of both types of propositi were similar to the controls. The difference between the two types of propositi suggests that in some individuals a genetic mechanism may account for CL(P) and increased fluctuating asymmetry for this dermatoglyphic trait.