Development of a Computerised Adaptive Testing and Equalisation Approaches to Assess Sleep and Quality of Life in Chronic Pain.

Background: Computerised adaptive testing (CAT) and equalisation are statistical approaches that mitigate questionnaire response burden by selecting individually tailored items according to previous response patterns; they facilitate comparing results across distinct instruments by providing conversion functions between their scores, respectively. However, they have seldom been specifically applied to the general chronic pain population. This study aimed at developing CAT and equalisation approaches for widely used sleep quality and quality of life (QoL) assessment instruments.

Insula Deep Brain Stimulation for Neuropathic Pain: A Cross-Over, Randomized, Sham-Controlled Trial.

Objective: Despite neuropathic pain affecting a significant portion of the population, many people still experience refractory conditions. Here, we evaluated the efficacy and safety of posterior-superior insula deep brain stimulation for pharmaco-resistant neuropathic pain.

Materials And Methods: This was a phase 2 randomized, double-blind, sham-controlled, cross-over trial.

Spinal Cord Stimulation Failed to Improve Parkinson's Disease Symptoms in Randomized Crossover Double-Blinded Evaluation.

Background: Epidural electrical spinal cord stimulation has been studied for more than a decade for Parkinson's disease symptoms, but compelling evidence for its effectiveness is still lacking.

Objective: The aim of this study was to evaluate the effectiveness of spinal cord stimulation in Parkinson's disease.

Methods: Participants had Parkinson's disease diagnosis, gait impairment and freezing of gait, and no pain.

Motor cortex repetitive transcranial magnetic stimulation in fibromyalgia: a multicentre randomised controlled trial.

Background: Despite affecting 2-4% of the population worldwide, fibromyalgia often remains refractory to treatment. Here we report the first international randomised double-blind, sham-controlled trial developed to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) as an add-on therapy for fibromyalgia.

Methods: Women aged ≥18 yr with fibromyalgia refractory to best available treatment were enrolled in Brazil, France, and Japan, and randomised to 10 Hz motor cortex (M1) rTMS, 3000 pulses day, or sham stimulation.

Bacterial DNA in patients with ruptured intracranial aneurysms: Investigating the potential role of periodontal and gut microbiota.

Background And Objectives: Chronic periodontal bacterial infections and disruptions in gut microbiota are responsible for systemic inflammation, which may contribute to the rupture of intracranial aneurysm. This study aimed to assess the presence of bacterial DNA from Fusobacterium nucleatum and Escherichia coli within arterial tissues of intracranial aneurysms.

Methodology: A comprehensive cross-sectional study was conducted, applying stringent inclusion and exclusion criteria to carefully select the study population from patients admitted to the Division of Neurosurgery at Hospital das Clínicas, University of São Paulo.

Intraoperative recordings from the posterior superior insula in awake humans with peripheral neuropathic pain.

Background And Objectives: The activity profile of the posterior insula in neuropathic pain (NeP) remains largely unexplored. To address this and examine its modulation by somatosensory stimulation, we recorded local field potentials (LFP) in awake patients with NeP undergoing deep brain stimulation (DBS) electrode implantation to the posterior-superior insula (PSI) for analgesic purposes.

Materials And Methods: Six patients (one woman; 32-45 years), experiencing refractory peripheral NeP and having previously responded to non-invasive stimulation of the PSI underwent stereotactic implantation of DBS electrodes to the PSI as part of a phase II clinical trial.

Evidence-Based Umbrella Review of Non-Invasive Neuromodulation in Chronic Neuropathic Pain.

Background And Objective: Non-invasive neuromodulation techniques (NIN), such as transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), have been extensively researched for their potential to alleviate pain by reversing neuroplastic changes associated with neuropathic pain (NP), a prevalent and complex condition. However, treating NP remains challenging due to the numerous variables involved, such as different techniques, dosages and aetiologies. It is necessary to provide insights for clinicians and public healthcare managers to support clinical decision-making.

Photobiomodulation therapy in diabetes: Benefits for pain relief, quality of life, and wound healing.

Globally, 537 million people suffer from diabetes mellitus (DM), a condition often associated with sensory disturbances, wound development, and chronic pain, which significantly affects the quality of life and imposes a substantial economic burden. This study evaluated the effects of photobiomodulation (PBM) therapy on nociceptive and sensory changes in diabetic patients to understand pain manifestations and explore PBM's molecular mechanisms on wound healing. Twenty patients with type 2 DM underwent clinical assessments, completed pain and quality of life questionnaires, and had their pain sensitivity evaluated using the quantitative sensory test (QST).

METHA-NeP: effectiveness and safety of methadone for neuropathic pain: a controlled randomized trial.

In this randomized, double-blind, parallel placebo-controlled clinical trial, we evaluated the efficacy of methadone as an add-on therapy for people with chronic neuropathic pain (NP). Eighty-six patients were randomly assigned to receive methadone or placebo for 8 weeks. The primary outcome was the proportion of participants achieving at least 30% pain relief from baseline using a 100-mm pain Visual Analogue Scale.

The Effects of Glibenclamide on Cognitive Performance, Quality of Life, and Emotional Aspects Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Controlled Trial.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high incidence of long-term cognitive impairment, decreased quality of life (QoL), and psychiatric disorders. The effects of glibenclamide on such outcomes in the setting of aSAH are unknown.

Objective: To assess the impact of glibenclamide in patients with aSAH on cognitive performance, QoL, and emotional aspects.

Transsylvian transopercular peri-central core hemispherotomy for treating epilepsy: anatomy, surgical technique, and clinical outcome.

Objective: The objective of this study was to display the anatomical landmarks, surgical technique, and clinical outcome of transsylvian transopercular peri-central core hemispherotomy (TTPH) for treating refractory epilepsy.

Methods: From 2011 to 2023, 26 patients (12 with Rasmussen syndrome, 8 with hemimegalencephaly/cortical malformations, and 6 with hypoxic-ischemic encephalopathy; mean [range] age 11.3 years [16 months to 35 years]; 13 females; and 13 with right-side pathology) underwent TTPH.

Large acute epidural hematoma from head pin fixation fracture.

Regarding head immobilization practices in neurosurgery, secondary fixation fractures are rare, underscoring the importance of precise pin positioning and an adequate force in the three-point clamp to achieve adequate fixation. Attention should be given to factors such as changes in bone metabolism.

Posterior insula repetitive transcranial magnetic stimulation for chronic pain in patients with Parkinson disease - pain type matters: A double-blinded randomized sham-controlled trial.

Objectives: Altered somatosensory processing in the posterior insula may play a role in chronic pain development and contribute to Parkinson disease (PD)-related pain. Posterior-superior insula (PSI) repetitive transcranial magnetic stimulation (rTMS) has been demonstrated to have analgesic effects among patients with some chronic pain conditions. This study aimed at assessing the efficacy of PSI-rTMS for treating PD-related pain.

The Effects of Head Elevation on Intracranial Pressure, Cerebral Perfusion Pressure, and Cerebral Oxygenation Among Patients with Acute Brain Injury: A Systematic Review and Meta-Analysis.

Background: Head elevation is recommended as a tier zero measure to decrease high intracranial pressure (ICP) in neurocritical patients. However, its quantitative effects on cerebral perfusion pressure (CPP), jugular bulb oxygen saturation (SjvO), brain tissue partial pressure of oxygen (PbtO), and arteriovenous difference of oxygen (AVDO) are uncertain. Our objective was to evaluate the effects of head elevation on ICP, CPP, SjvO, PbtO, and AVDO among patients with acute brain injury.

Does deep TMS really works for smoking cessation? A prospective, double blind, randomized, sham controlled study.

Introduction: A substantial proportion of smokers wishing to quit do not stop smoking when using current therapies to aid cessation. Magnetic pulses to specific brain areas designated as transcranial magnetic stimulation may modulate brain activity and thereby change chemical dependencies. Deep transcranial magnetic stimulation (dTMS) with the H4 coil stimulates neuronal pathways in the lateral prefrontal cortex and insula bilaterally, areas involved in tobacco addiction.

Trans-Spinal Theta Burst Magnetic Stimulation in Parkinson's Disease and Gait Disorders.

Background: Gait disorders in patients with Parkinson's disease (PD) can become disabling with disease progression without effective treatment.

Objectives: To investigate the efficacy of intermittent θ burst trans-spinal magnetic stimulation (TsMS) in PD patients with gait and balance disorders.

Methods: This was a randomized, parallel, double-blind, controlled trial.

New perspectives on assessment and understanding of the patient with cranial bone defect: a morphometric and cerebral radiodensity assessment.

Background: Skull defects after decompressive craniectomy (DC) cause physiological changes in brain function and patients can have neurologic symptoms after the surgery. The objective of this study is to evaluate whether there are morphometric changes in the cortical surface and radiodensity of brain tissue in patients undergoing cranioplasty and whether those variables are correlated with neurological prognosis.

Methods: This is a prospective cohort with 30 patients who were submitted to cranioplasty and followed for 6 months.

Phenotypical characterization of exteroceptive sensation and pain symptoms on diabetic patients.

Backgroud: Diabetic neuropathy (DN) is one of the most common complications of diabetes, affecting about half of individuals with the disease. Among the various symptoms of DN, the development of chronic pain stands out and manifests as exacerbated responses to sensorial stimuli. The conventional clinical treatments used for general neuropathy and associated painful symptoms, still brings uncomplete and unsatisfactory pain relief.

Homocysteine serum levels in patients with ruptured and unruptured intracranial aneurysms: a case-control study.

Background: There is very few data regarding homocysteine's influence on the formation and rupture of intracranial aneurysms.

Objective: To compare homocysteine levels between patients with ruptured and unruptured intracranial aneurysms, and to evaluate possible influences of this molecule on vasospasm and functional outcomes.

Methods: This is a retrospective, case-control study.