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dc.contributor.authorBotelho, Leonardo Monteiropt_BR
dc.contributor.authorAngoleri, Leticia Dal Moropt_BR
dc.contributor.authorZortéa, Maxcielpt_BR
dc.contributor.authorDeitos, Alíciapt_BR
dc.contributor.authorBrietzke, Aline Patríciapt_BR
dc.contributor.authorTorres, Iraci Lucena da Silvapt_BR
dc.contributor.authorFregni, Felipept_BR
dc.contributor.authorCaumo, Wolneipt_BR
dc.date.accessioned2019-10-19T03:56:01Zpt_BR
dc.date.issued2018pt_BR
dc.identifier.issn1662-5161pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/200819pt_BR
dc.description.abstractBackground: There is limited evidence concerning the effect of intramuscular electrical stimulation (EIMS) on the neural mechanisms of pain and disability associated with chronic Myofascial Pain Syndrome (MPS). Objectives: To provide new insights into the EIMS long-term effect on pain and disability related to chronic MPS (primary outcomes). To assess if the neuroplasticity state at baseline could predict the long-term impact of EIMS on disability due to MPS we examined the relationship between the serum brain-derived-neurotrophic-factor (BDNF) and by motor evoked potential (MEP). Also, we evaluated if the EIMS could improve the descending pain modulatory system (DPMS) and the cortical excitability measured by transcranial magnetic stimulation (TMS) parameters. Methods: We included 24 right-handed female with chronic MPS, 19-65 years old. They were randomically allocated to receive ten sessions of EIMS, 2 Hz at the cervical paraspinal region or a sham intervention (n = 12). Results: A mixed model analysis of variance revealed that EIMS decreased daily pain scores by -73.02% [95% confidence interval (CI) = -95.28 to -52.30] and disability due to pain -43.19 (95%CI, -57.23 to -29.39) at 3 months of follow up. The relative risk for using analgesics was 2.95 (95% CI, 1.36 to 6.30) in the sham group. In the EIMS and sham, the change on the Numerical Pain Scale (NPS0-10) throughout CPM-task was -2.04 (0.79) vs. -0.94 (1.18), respectively, (P = 0.01). EIMS reduced the MEP -28.79 (-53.44 to -4.15), while improved DPMS and intracortical inhibition. The MEP amplitude before treatment [(Beta = -0.61, (-0.58 to -0.26)] and a more significant change from pre- to post-treatment on serum BDNF) (Beta = 0.67; CI95% = 0.07 to 1.26) were predictors to EIMS effect on pain and disability due to pain. Conclusion: These findings suggest that a bottom-up effect induced by the EIMS reduced the analgesic use, improved pain, and disability due to chronic MPS. This effect might be mediated by an enhancing of corticospinal inhibition as seen by an increase in IC and a decrease in MEP amplitude. Likewise, the MEP amplitude before treatment and the changes induced by the EIMS in the serum BDNF predicted it's long-term clinical impact on pain and disability due MPS. The trial is recorded in ClinicalTrials.gov: NCT02381171.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofFrontiers in human neuroscience. Lausanne : Frontiers Res Found. Vol. 12 (Oct. 2018), article 388, p. 1-13pt_BR
dc.rightsOpen Accessen
dc.subjectSíndromes da dor miofascialpt_BR
dc.subjectBNDFen
dc.subjectPlasticidade neuronalpt_BR
dc.subjectEIMSen
dc.subjectMPSen
dc.subjectTerapia por estimulação elétricapt_BR
dc.subjectQSTen
dc.subjectTerapêuticapt_BR
dc.subjectTMSen
dc.subjectEnsaio clínico controlado aleatóriopt_BR
dc.subjectClinical trialen
dc.titleInsights about the neuroplasticity state on the effect of intramuscular electrical stimulation in pain and disability associated with Chronic Myofascial Pain Syndrome (MPS) : a double-blind, randomized, sham-controlled trialpt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001102378pt_BR
dc.type.originEstrangeiropt_BR


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