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Scientific Reports Jun 2024Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The... (Randomized Controlled Trial)
Randomized Controlled Trial
Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.
Topics: Humans; Female; Male; Oils, Volatile; Adult; Dental Anxiety; Middle Aged; Aromatherapy; Volatilization; Single-Blind Method; Young Adult
PubMed: 38898054
DOI: 10.1038/s41598-024-63657-w -
Frontiers in Neuroscience 2024In neural prostheses, intensity modulation of a single channel (i.e., through a single stimulating electrode) has been achieved by increasing the magnitude or width of...
In neural prostheses, intensity modulation of a single channel (i.e., through a single stimulating electrode) has been achieved by increasing the magnitude or width of each stimulation pulse, which risks eliciting pain or paraesthesia; and by changing the stimulation rate, which leads to concurrent changes in perceived frequency. In this study, we sought to render a perception of tactile intensity and frequency independently, by means of temporal pulse train patterns of fixed magnitude, delivered non-invasively. Our psychophysical study exploits a previously discovered frequency coding mechanism, where the perceived frequency of stimulus pulses grouped into periodic bursts depends on the duration of the inter-burst interval, rather than the mean pulse rate or periodicity. When electrical stimulus pulses were organised into bursts, perceived intensity was influenced by the number of pulses within a burst, while perceived frequency was determined by the time between the end of one burst envelope and the start of the next. The perceived amplitude was modulated by 1.6× while perceived frequency was varied independently by 2× within the tested range (20-40 Hz). Thus, the sensation of intensity might be controlled independently from frequency through a single stimulation channel without having to vary the injected electrical current. This can form the basis for improving strategies in delivering more complex and natural sensations for prosthetic hand users.
PubMed: 38894940
DOI: 10.3389/fnins.2024.1125597 -
Journal of Pain Research 2024Pain leads to activation of the autonomic nervous system and thus, among other things, to pupillary reflex dilation (PRD). Previous studies have already confirmed a...
BACKGROUND
Pain leads to activation of the autonomic nervous system and thus, among other things, to pupillary reflex dilation (PRD). Previous studies have already confirmed a correlation between the perception of pain and the pupillary reaction, measured using pupillometry. However, the previous study populations were under the influence of medication for analgesia in perioperative setting or suffered from pain. This study examines the relationship between pupillary reaction and pain perception in healthy controls and addresses the question of whether endogenous pain inhibition, clinically tested by conditioned pain modulation (CPM), can be quantified using pupillometry.
METHODS
Forty-two healthy volunteers (21 females, 21 males, mean age 27.9 ± 5.8 years, range 20-39 years) were included in this study. The PRD, as a measure of the pupillary reaction (variance from the base diameter in percent), was investigated during baseline, heat application and during CPM testing and results compared to the reported pain intensity on the numerical rating scale (NRS).
RESULTS
The volunteers showed higher variances under painful conditions compared to the measurement at rest corresponding to higher sympathetic activity during pain. Volunteers with a higher variance, ie a stronger pupillary reaction, gave higher pain ratings than subjects with a lower pupil variance. However, there was no correlation between the NRS and PRD. PRD and pain ratings during CPM were significantly lower compared to heat pain application alone. However, there was no correlation between the calculated CPM effect and the PRD.
CONCLUSION
Pupillometry is capable of objectively reflecting the pain response, eg pain relief through CPM testing. However, the CPM effect calculated from the subjective pain ratings and the objective PRD measurements is not associated suggesting that both measure different aspects of pain perception. It must be discussed whether the CPM effect can be the correct measure for the functionality of the pain system.
PubMed: 38894860
DOI: 10.2147/JPR.S461906 -
Iranian Journal of Public Health Feb 2024We aimed to evaluate the impact of pain on patients during Hysterosalpingography (HSG). (Review)
Review
BACKGROUND
We aimed to evaluate the impact of pain on patients during Hysterosalpingography (HSG).
METHODS
PubMed, PMC and other journals were searched for randomized controlled trials (RCTS) on HSG. Appropriate articles were selected for inclusion and reasonable exclusion according to keywords. Following a thorough review of the relevant literature, the process of literature screening was conducted in accordance with the aforementioned criteria. The methodological quality of the studies was assessed using the risk of bias assessment tool developed by the Cochrane Collaboration. Meta-analysis was conducted using RevMan 5.4.1 software.
RESULTS
Twelve studies were included, including 1530 cases in the experimental group and 1545 cases in the control group. The literature summarizes the basic information of patients during HSG and makes statistics on the differences in visual analog scale (VAS) and pain perception. The findings from the HSG examination revealed a lack of significant association between patients' pain sensation and their age and BMI. However, the duration of pregnancy in patients decreased following HSG treatment (95%CI (-18.84 to -3.58), =0.004).Compared with conventional testing, HSG could effectively reduce the pregnancy time of patients (95%CI (-18.84, -3.58), =0.004), reduce the VAS of patients (95%CI (-4.73, -1.51), =0.0001), and increase the number of patients without pain (95%CI (1.80, 10.43), =0.001).
CONCLUSION
During the HSG examination, acceptable pain avoidance is generated and can be relieved over time. At present, there is no effective alternative method, so the patient should cooperate with the doctor to complete the examination, to relieve the pain.
PubMed: 38894833
DOI: 10.18502/ijph.v53i2.14912 -
International Journal of Molecular... May 2024Substance P (SP) plays a crucial role in pain modulation, with significant implications for major depressive disorder (MDD), anxiety disorders, and post-traumatic stress... (Review)
Review
Substance P (SP) plays a crucial role in pain modulation, with significant implications for major depressive disorder (MDD), anxiety disorders, and post-traumatic stress disorder (PTSD). Elevated SP levels are linked to heightened pain sensitivity and various psychiatric conditions, spurring interest in potential therapeutic interventions. In chronic pain, commonly associated with MDD and anxiety disorders, SP emerges as a key mediator in pain and emotional regulation. This review examines SP's impact on pain perception and its contributions to MDD, anxiety disorders, and PTSD. The association of SP with increased pain sensitivity and chronic pain conditions underscores its importance in pain modulation. Additionally, SP influences the pathophysiology of MDD, anxiety disorders, and PTSD, highlighting its potential as a therapeutic target. Understanding SP's diverse effects provides valuable insights into the mechanisms underlying these psychiatric disorders and their treatment. Further research is essential to explore SP modulation in psychiatric disorders and develop more effective treatment strategies.
Topics: Humans; Chronic Pain; Substance P; Depressive Disorder, Major; Stress Disorders, Post-Traumatic; Anxiety Disorders; Animals; Mental Disorders
PubMed: 38892091
DOI: 10.3390/ijms25115905 -
International Journal of Molecular... May 2024Cannabinoids, the bioactive compounds found in , have been used for medicinal purposes for centuries, with early discoveries dating back to the BC era (BCE). However,... (Review)
Review
Cannabinoids, the bioactive compounds found in , have been used for medicinal purposes for centuries, with early discoveries dating back to the BC era (BCE). However, the increased recreational use of cannabis has led to a negative perception of its medicinal and food applications, resulting in legal restrictions in many regions worldwide. Recently, cannabinoids, notably Δ-tetrahydrocannabinol (THC) and cannabidiol (CBD), have gained renewed interest in the medical field due to their anti-cancer properties. These properties include the inhibition of tumour growth and cell invasion, anti-inflammatory effects, and the induction of autophagy and apoptosis. As a result, the use of cannabinoids to treat chemotherapy-associated side effects, like nausea, vomiting, and pain, has increased, and there have been suggestions to implement the large-scale use of cannabinoids in cancer therapy. However, these compounds' cellular and molecular mechanisms of action still need to be fully understood. This review explores the recent evidence of CBD's efficacy as an anti-cancer agent, which is of interest due to its non-psychoactive properties. The current review will also provide an understanding of CBD's common cellular and molecular mechanisms in different cancers. Studies have shown that CBD's anti-cancer activity can be receptor-dependent (CB1, CB2, TRPV, and PPARs) or receptor-independent and can be induced through molecular mechanisms, such as ceramide biosynthesis, the induction of ER stress, and subsequent autophagy and apoptosis. It is projected that these molecular mechanisms will form the basis for the therapeutic applications of CBD. Therefore, it is essential to understand these mechanisms for developing and optimizing pre-clinical CBD-based therapies.
Topics: Humans; Cannabidiol; Neoplasms; Cell Proliferation; Animals; Antineoplastic Agents; Apoptosis; Autophagy
PubMed: 38891847
DOI: 10.3390/ijms25115659 -
International Journal of Molecular... May 2024The loss of midbrain dopaminergic (DA) neurons is the fundamental pathological feature of Parkinson's disease (PD). PD causes chronic pain in two-thirds of patients....
The loss of midbrain dopaminergic (DA) neurons is the fundamental pathological feature of Parkinson's disease (PD). PD causes chronic pain in two-thirds of patients. Recent studies showed that the activation of the pedunculopontine tegmental nucleus (PPTg) can effectively relieve inflammatory pain and neuropathic pain. The PPTg is located in the pontomesencephalic tegmentum, a target of deep brain stimulation (DBS) treatment in PD, and is involved in motor control and sensory integration. To test whether the lesion of midbrain DA neurons induced pain hypersensitivity, and whether the chemogenetic activation of the PPTg could modulate the pain, the AAV-hM3Dq receptor was transfected and expressed into the PPTg neurons of 6-hydroxydopamine-lesioned mice. In this study, von Frey, open field, and adhesive tape removal tests were used to assess animals' pain sensitivity, locomotor activity, and sensorimotor function and somatosensory perception, respectively. Here, we found that the lesion of midbrain DA neurons induced a minor deficit in voluntary movement but did not affect sensorimotor function and somatosensory perception in the tape removal test. The results showed that lesion led to pain hypersensitivity, which could be alleviated both by levodopa and by the chemogenetic activation of the PPTg. Activating the PPTg may be a potential therapeutic strategy to relieve pain phenotypes in PD.
Topics: Animals; Pedunculopontine Tegmental Nucleus; Dopaminergic Neurons; Mice; Mesencephalon; Male; Parkinson Disease; Pain; Mice, Inbred C57BL; Deep Brain Stimulation; Disease Models, Animal; Levodopa; Oxidopamine
PubMed: 38891832
DOI: 10.3390/ijms25115636 -
International Journal of Molecular... May 2024It is remarkable how teeth maintain their healthy condition under exceptionally high levels of mechanical loading. This suggests the presence of inherent mechanical... (Review)
Review
It is remarkable how teeth maintain their healthy condition under exceptionally high levels of mechanical loading. This suggests the presence of inherent mechanical adaptation mechanisms within their structure to counter constant stress. Dentin, situated between enamel and pulp, plays a crucial role in mechanically supporting tooth function. Its intermediate stiffness and viscoelastic properties, attributed to its mineralized, nanofibrous extracellular matrix, provide flexibility, strength, and rigidity, enabling it to withstand mechanical loading without fracturing. Moreover, dentin's unique architectural features, such as odontoblast processes within dentinal tubules and spatial compartmentalization between odontoblasts in dentin and sensory neurons in pulp, contribute to a distinctive sensory perception of external stimuli while acting as a defensive barrier for the dentin-pulp complex. Since dentin's architecture governs its functions in nociception and repair in response to mechanical stimuli, understanding dentin mechanobiology is crucial for developing treatments for pain management in dentin-associated diseases and dentin-pulp regeneration. This review discusses how dentin's physical features regulate mechano-sensing, focusing on mechano-sensitive ion channels. Additionally, we explore advanced in vitro platforms that mimic dentin's physical features, providing deeper insights into fundamental mechanobiological phenomena and laying the groundwork for effective mechano-therapeutic strategies for dentinal diseases.
Topics: Dentin; Humans; Animals; Odontoblasts; Mechanotransduction, Cellular; Biomechanical Phenomena; Dental Pulp; Extracellular Matrix
PubMed: 38891829
DOI: 10.3390/ijms25115642 -
Nature Communications Jun 2024Empathy enables understanding and sharing of others' feelings. Human neuroimaging studies have identified critical brain regions supporting empathy for pain, including...
Empathy enables understanding and sharing of others' feelings. Human neuroimaging studies have identified critical brain regions supporting empathy for pain, including the anterior insula (AI), anterior cingulate (ACC), amygdala, and inferior frontal gyrus (IFG). However, to date, the precise spatio-temporal profiles of empathic neural responses and inter-regional communications remain elusive. Here, using intracranial electroencephalography, we investigated electrophysiological signatures of vicarious pain perception. Others' pain perception induced early increases in high-gamma activity in IFG, beta power increases in ACC, but decreased beta power in AI and amygdala. Vicarious pain perception also altered the beta-band-coordinated coupling between ACC, AI, and amygdala, as well as increased modulation of IFG high-gamma amplitudes by beta phases of amygdala/AI/ACC. We identified a necessary combination of neural features for decoding vicarious pain perception. These spatio-temporally specific regional activities and inter-regional interactions within the empathy network suggest a neurodynamic model of human pain empathy.
Topics: Humans; Pain Perception; Empathy; Male; Female; Adult; Young Adult; Gyrus Cinguli; Amygdala; Electroencephalography; Brain Mapping; Insular Cortex; Brain; Electrocorticography; Pain
PubMed: 38890380
DOI: 10.1038/s41467-024-49541-1 -
JMIR Formative Research Jun 2024Chronic pain is prevalent in our society, with conditions such as fibromyalgia being notably widespread. The gold standard for aiding individuals dealing with chronic...
BACKGROUND
Chronic pain is prevalent in our society, with conditions such as fibromyalgia being notably widespread. The gold standard for aiding individuals dealing with chronic pain involves interdisciplinary approaches rooted in a biopsychosocial perspective. Regrettably, access to such care is difficult for most of the people in need. Information and communication technologies (ICTs) have been used as a way of overcoming access barriers (among other advantages).
OBJECTIVE
This study addressed the little explored area of how individuals with fibromyalgia use and perceive different types of ICTs for pain management.
METHODS
A cross-sectional study was conducted using an online survey. This survey was created to assess the use of different ICT tools for pain management, satisfaction with the tools used, and perceived advantages and disadvantages. In addition, data collection encompassed sociodemographic variables and pain-related variables, pain intensity, the impact of pain on daily life activities, and fear of movement/injury beliefs. In total, 265 individuals diagnosed with fibromyalgia completed the survey.
RESULTS
Only 2 (0.75%) participants reported not having used any ICT tool for pain management. Among those who used ICT tools, an average of 10.94 (SD 4.48) of 14 different tools were used, with the most used options being instant messaging apps, websites dedicated to managing fibromyalgia, phone calls with health professionals, and online multimedia resources. Satisfaction rates were relatively modest (mean 2.09, SD 0.38) on a scale from 0 to 5, with instant messaging apps, phone calls with health professionals, fibromyalgia management websites, and online multimedia resources being the ones with higher satisfaction. Participants appreciated the ability to receive treatment from home, access to specialized treatment, and using ICTs as a supplement to in-person interventions. However, they also highlighted drawbacks, such as a lack of close contact with health professionals, difficulty expressing emotions, and a lack of knowledge or resources to use ICTs. The use of ICTs was influenced by age and educational background. Additionally, there was a negative correlation between satisfaction with ICT tools and fear of movement/injury.
CONCLUSIONS
People with fibromyalgia are prone to using ICTs for pain management, especially those tools that allow them to be in contact with health professionals and have access to online resources. However, there is still a need to improve ICT tools since satisfaction ratings are modest. Moreover, strategies aimed at older people, those with lower levels of education, and those with higher levels of fear of movement/injury can be useful to potentiate the use of ICTs among them.
PubMed: 38888943
DOI: 10.2196/55751