TICAL C C HANGES HANGES IN IN B B RACHIAL RACHIAL P P LEXUS LEXUS - - PowerPoint PPT Presentation

▶
tical c
SMART_READER_LITE
LIVE PREVIEW

TICAL C C HANGES HANGES IN IN B B RACHIAL RACHIAL P P LEXUS LEXUS - - PowerPoint PPT Presentation

Sep 19, 2022 296 likes •507 views

Ncleo de Pesquisa em Neurocincia e Reabilitao C OR TICAL C C HANGES HANGES IN IN B B RACHIAL RACHIAL P P LEXUS LEXUS ORTICAL I NJUR NJURY P P ATIENTS TIENTS WITH WITH C C HRONIC HRONIC P P AIN AIN Fernanda de

slide-1
SLIDE 1

COR

ORTICAL TICAL C

CHANGES

HANGES IN IN B

BRACHIAL

RACHIAL P

PLEXUS

LEXUS

INJUR

NJURY P

PATIENTS

TIENTS WITH WITH C

CHRONIC

HRONIC P

PAIN

AIN

Fernanda ¡de ¡Figueiredo ¡Torres ¡

Novembro/2016 ¡

Núcleo ¡de ¡Pesquisa ¡em ¡ ¡ Neurociência ¡e ¡Reabilitação

slide-2
SLIDE 2

Pain after Brachial Plexus Injury

No ¡pain ¡ No ¡treatment ¡ Chronic ¡pain ¡ Mild ¡pain ¡< ¡4 ¡ Severe ¡pain ¡+ ¡ ¡ Recurrent ¡acute ¡pain ¡ No ¡ treatment ¡ Treatment ¡ No ¡ treatment ¡ Treatment ¡ No ¡opioids ¡ Opioids ¡

Vannier et al., 2008

slide-3
SLIDE 3

Brain Plasticity after Peripheral Injuries

Cohen et al., 1991; PascualLeone et al., 1996; Flor et al., 1995; Ojemann & Silbergeld, 1995

Nor Normal mal Amputee Amputee

slide-4
SLIDE 4

Brain Plasticity in Chronic Pain

slide-5
SLIDE 5

Brain Plasticity in Chronic Pain

Lotze et al., 2001

slide-6
SLIDE 6

Brain Plasticity in Chronic Pain

Lotze et al., 2001

slide-7
SLIDE 7

Brain Plasticity in Chronic Pain

Buttler & Moseley, 2013

slide-8
SLIDE 8

Brain Plasticity after BPI

slide-9
SLIDE 9

General Objective

To investigate pain influence over cortical representations in brachial plexus injury patients using transcranial magnetic stimulation.

slide-10
SLIDE 10

(Baker et al., 1985)

Transcranial Magnetic Stimulation

slide-11
SLIDE 11

1. Identification of intact cortical motor connections after injury of different brachial plexus trunks through the presence of motor evoked potentials.

Superior Trunk Biceps Brachii Superior and Middle Trunks Extensor Carpi Radialis Inferior Trunk Abductor Digiti Minimi

Methods

slide-12
SLIDE 12
  • 2. To assess cortical plasticity on the muscle groups of interest representation areas (changes in

resting motor treshold and in MEP amplitude).

Hot Spot Hot Spot Resting Motor Thr Resting Motor Threshold (RMT) eshold (RMT)

Motor Evoked Potential (MEP) Motor Evoked Potential (MEP)

Recruitment Curves (RC) Recruitment Curves (RC) Cortical Mapping Cortical Mapping

Methods

slide-13
SLIDE 13
  • 2. To assess cortical plasticity on the muscle groups of interest representation areas (changes in

resting motor treshold and in MEP amplitude).

Hot Spot Hot Spot Resting Motor Thr Resting Motor Threshold (RMT) eshold (RMT)

Motor Evoked Potential (MEP) Motor Evoked Potential (MEP)

Recruitment Curves (RC) Recruitment Curves (RC)

Pulse Latency Amplitude

Cortical Mapping Cortical Mapping

Methods

slide-14
SLIDE 14
  • 2. To assess cortical plasticity on the muscle groups of interest representation areas (changes in

resting motor treshold and in MEP amplitude).

Hot Spot Hot Spot Resting Motor Thr Resting Motor Threshold (RMT) eshold (RMT)

Motor Evoked Potential (MEP) Motor Evoked Potential (MEP)

Recruitment Curves (RC) Recruitment Curves (RC) Cortical Mapping Cortical Mapping

Methods

slide-15
SLIDE 15
  • 2. To assess cortical plasticity on the muscle groups of interest representation areas (changes in

resting motor treshold and in MEP amplitude).

Hot Spot Hot Spot Resting Motor Thr Resting Motor Threshold (RMT) eshold (RMT)

Motor Evoked Potential (MEP) Motor Evoked Potential (MEP)

Recruitment Curves (RC) Recruitment Curves (RC) Cortical Mapping Cortical Mapping

Methods

slide-16
SLIDE 16

Methods

  • 3. To verify any differences between cortical representations in brachial plexus injury

patients with or without pain. Patients Patients WITH P WITH PAIN AIN

Any degree, type or time since unilateral traumatic injury Presence of chronic pain Age ≥ 18 e ≤ 40 Both genders

Patients Patients WITHOUT P WITHOUT PAIN AIN

Any degree, type or time of unilateral traumatic injury Absence of chronic pain Age ≥ 18 e ≤ 40 Both genders

Healthy V Healthy Volunteers

  • lunteers

Healthy subjects Age ≥ 18 e ≤ 40 Both genders No Nervous System or Motor System disorders

slide-17
SLIDE 17

Methods

Exclusion criteria:

  • Cranioencephalic trauma sequelae;
  • Cognitive deficits;
  • History of CNS and PNS diseases;
  • History of chronic pain before injury.

Clinical Evaluation:

  • Subjective evaluation;
  • Identification of type of injury, complementary exams;
  • Objective evaluation (strength, sensibility, ROM);
  • Pain evaluation: Map

Map and and Intensity Intensity, BPI, DN-4, , BPI, DN-4, McGill McGill

Appr Approved

  • ved by

by the the INDC-UFRJ INDC-UFRJ Reaser Reaserch ch Ethics Ethics Committee Committee (CAAE: 21549913.4.0000.5261, (CAAE: 21549913.4.0000.5261, report eport # 642.803) # 642.803)

slide-18
SLIDE 18

Expected Results

? ¡

slide-19
SLIDE 19

Thank you!