DANIEL CIAMPI ARAUJO DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Non-invasive insular stimulation for peripheral neuropathic pain: Influence of target or symptom?(2022) CUNHA, Pedro Henrique Martins da; Liu Dongyang; FERNANDES, Ana Mercia; THIBES, Raissa Benocci; SATO, Joao; TANAKA, Harki; DALE, Camila; LAPA, Jorge Dornellys da Silva; MORAIS, Adriano Donizeth Silva de; SOARES, Felipe Henriques Carvalho; SILVA, Valquiria Aparecida da; GRAVEN-NIELSEN, Thomas; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deObjectives: The posterior-superior insula (PSI) has been shown to be a safe and potentially effective target for neuromodulation in peripheral neuropathic pain (PNP) in humans and animal models. However, it remains unknown whether there is a measurable responder profile to PSI stimulation. Two factors were hypothesized to influence the response of repetitive transcranial magnetic stimulation (rTMS) of the PSI: differences in rTMS target (discrete subregions of the PSI) or PNP phenotype. Methods: This is a secondary analysis from a randomized, double-blind, sham-controlled, crossover trial assessing PSI-rTMS in PNP (N = 31, 5 days rTMS) (10.1016/j.neucli.2021.06.003). Active PSI-rTMS true responders (>50% pain reduction from baseline after active but not after sham series of treatment) were compared with not true responders, to determine whether they differed with respect to 1) rTMS neuro-navigational target coordinates, and/or 2) specific neuropathic pain symptom inventory (NPSI) clusters (pinpointed pain, evoked pain, and deep pain) at baseline. Results: Mean rTMS target coordinates did not differ between true (n = 45.1%) and not true responders (p = 0.436 for X, p = 0.120 for Y, and p = 0.116 for Z). The Euclidian distance between true and not true responders was 4.04 mm. When comparing differences in responders between NPSI clusters, no participant within the evoked pain cluster was a true responder (p = 0.024). Conclusion: Response to PSI-rTMS may depend on pain cluster subtype rather than on differences in targeting within the PSI.
- The fast-posterior superior insula (Fast-PSI): A neuronavigation-free targeting method for non-invasive neuromodulation(2022) CUNHA, Pedro Henrique Martins da; TANAKA, Harki; LAPA, Jorge Dornellys da Silva; Liu Dongyang; SORTE JUNIOR, Anselmo Alves Boa; PEREIRA, Tamara Maria Ribeiro; SOARES, Felipe Henriques Carvalho; FERNANDES, Ana Mercia; SILVA, Valquiria Aparecida da; GRAVEN-NIELSEN, Thomas; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi de
- Global series: Complex regional pain syndrome: abstracts from the International Association for the Study of Pain complex regional pain syndrome SIG virtual symposia 2021(2023) LEWIS, Jennifer S.; KASHIF, Muhammad; MAAN, Aasam; ANDRADE, Daniel Ciampi de; CASEY, Michelle; MOON, Jee Youn; LIN, Chih-Peng; DANIELSSON, Lena; QUEK, Terence; TAFUR, Rodrigo Diez; ALOWEIDI, Abdelkarim; BIRKLEIN, Frank; KNUDSEN, Lone; GOEBEL, AndreasThe aim of this IASP complex regional pain syndrome (CRPS) SIG Global Series 2021 was to bring together clinicians including those from developing countries to better understand the clinical presentation of complex regional pain syndrome in countries with less well-published patient populations. The purpose was to learn from each other about the range of treatments, successful outcomes, and challenges experienced. These meeting proceedings comprise abstracts from nine countries that span 4 continents and are summaries of online presentations delivered by speakers representing these countries over the course of 2 symposia. The symposia were attended by a global audience of approximately 360 people. Patients with CRPS were described and treated by clinicians from countries across Asia (Pakistan, Jordan, South Korea, Taiwan, and Singapore), South America (Brazil and Peru), Africa (South Africa), and Europe (Norway). This reflects that CRPS exists across borders, ethnicities, and cultures. These proceedings provide a broader perspective within the international pain community about how we can better understand and treat CRPS across the globe.
- Burst Transspinal Magnetic Stimulation Alleviates Nociceptive Pain in Parkinson Disease-A Pilot Phase II Double-Blind, Randomized Study(2023) LAPA, Jorge Dornellys da Silva; CUNHA, Pedro Henrique Martins da; TEIXEIRA, Manoel Jacobsen; MEDEIROS, Vitor Macedo Brito; FERNANDES, Ana Mercia; MORAIS, Adriano Donizeth Silva de; GRAVEN-NIELSEN, Thomas; CURY, Rubens Gisbert; ANDRADE, Daniel Ciampi deBackground and Aims: Nociception is the most prevalent pain mechanism in Parkinson disease (PD). It negatively affects quality of life, and there is currently no evidence-based treatment for its control. Burst spinal cord stimulation has been used to control neuropathic pain and recently has been shown to relieve pain of nociceptive origin. In this study, we hypothesize that burst transspinal magnetic stimulation (bTsMS) reduces nociceptive pain in PD.Materials and Methods: Twenty-six patients were included in a double-blind, sham-controlled, randomized parallel trial design, and the analgesic effect of lower-cervical bTsMS was assessed in patients with nociceptive pain in PD. Five daily induction sessions were followed by maintenance sessions delivered twice a week for seven weeks. The primary outcome was the number of responders (& GE; 50% reduction of average pain intensity assessed on a numerical rating scale ranging from 0-10) during the eight weeks of treatment. Mood, quality of life, global impression of change, and adverse events were assessed throughout the study.Results: Twenty-six patients (46.2% women) were included in the study. The number of responders during treatment was significantly higher after active than after sham bTsMS (p = 0.044), mainly owing to the effect of the first week of treatment, when eight patients (61.5%) responded to active and two (15.4%) responded to sham bTsMS (p = 0.006); the number needed to treat was 2.2 at week 1. Depression symptom scores were lower after active (4.0 & PLUSMN; 3.1) than after sham bTsMS (8.7 & PLUSMN; 5.3) (p = 0.011). Patients' global impressions of change were improved after active bTsMS (70.0%) compared with sham bTsMS (18.2%; p = 0.030). Minor adverse events were reported in both arms throughout treatment sessions. One major side effect unrelated to treatment occurred in the active arm (death due to pulmonary embolism). Blinding was effective.Conclusion: BTsMS provided significant pain relief and improved the global impression of change in PD in this phase-II trial. Clinical Trial Registration: The Clinicaltrials.gov registration number for the study is NCT04546529.
- Sessions of Prolonged Continuous Theta Burst Stimulation or High-frequency 10 Hz Stimulation to Left Dorsolateral Prefrontal Cortex for 3 Days Decreased Pain Sensitivity by Modulation of the Efficacy of Conditioned Pain Modulation(2019) MARTINO, Enrico De; FERNANDES, Ana Mercia; GALHARDONI, Ricardo; SOUZA, Carolina De Oliveira; ANDRADE, Daniel Ciampi De; GRAVEN-NIELSEN, ThomasThe 10 Hz repetitive transcranial magnetic stimulation (10 Hz-rTMS) to the left dorsolateral prefrontal cortex produces analgesia, probably by activating the pain modulation system. A newer rTMS paradigm, called theta burst stimulation (TBS), has been developed. Unlike 10 Hz-rTMS, prolonged continuous TBS (pcTBS) mimics endogenous theta rhythms, which can improve induction of synaptic long-term potentiation. Therefore, this study investigated whether pcTBS to the left dorsolateral prefrontal cortex reduced pain sensitivity more efficiently compared with 10 Hz-rTMS, the analgesic effects lasted beyond the stimulation period, and the reduced pain sensitivity was associated with increased efficacy of conditioned pain modulation (CPM) and/or intracortical excitability. Sixteen subjects participated in a randomized cross-over study with pcTBS and 10 Hz-rTMS. Pain thresholds to heat (HPT), cold, pressure (PPT), intracortical excitability assessment, and CPM with mechanical and heat supra-pain threshold test stimuli and the cold pressor test as conditioning were collected before (Baseline), 3 (Day3) and 4 days (Day4) after 3-day session of rTMS. HPTs and PPTs increased with 10 Hz-rTMS and pcTBS at Day3 and Day4 compared with Baseline (P=.007). Based on pooled data from pcTBS and 10 Hz-rTMS, the increased PPTs correlated with increased efficacy of CPM at Day3 (P=.008), while no correlations were found at Day4 or with the intracortical excitability. Perspective: Preliminary results of this comparative study did not show stronger pain sensitivity reduction by pcTBS compared with 10 Hz-rTMS to the L-DPFC. Both protocols maintained increased pain thresholds up to 24-hours after the last session, which were partially associated with modulation of CPM efficacy but not with the intracortical excitability changes. (C) 2019 by the American Pain Society