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Dynamic changes in central reactivity in the context of physiotherapeutic practice
Brokešová, Justýna ; Pánek, David (advisor) ; Malá, Jitka (referee)
Title: Dynamic changes in central reactivity in the context of physiotherapeutic practice Objectives: The aim of this diploma thesis is to obtain, elaborate and summarize current knowledge regarding the phenomenon of central sensitization from both Czech and for- eign literature. The main focus is on physiotherapeutic practice in the context of diagnos- tic and therapeutical methods and their application in clinical practice. Methods: This thesis is written in the form of literature review. All the studies were ob- tained from following scientific databases: PubMed, Web of Science and ScienceDirect. To accept a study into review, it had to be focused on either a diagnostic or therapeutic approach targeting central sensitization in chronic pain. From the databases mentioned above, 1032 different studies were obtained. After applying all the defined exclusion cri- teria, only 34 were left and included in the review. 21 of them were focused on evaluation methods, the topic of the rest 13 was therapeutic. Results: The most common diagnostic methods to evaluate central sensitization are CSI and QST. It was not possible to determine the optimal method due to differences between studies and heterogeneity in the central sensitivity syndrome as well. As for therapeutic approach, the most frequent was manual...
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Calcium homeostasis and modulation of nociceptive synaptic transmission
Sojka, David
This study was designed to improve our knowledge regarding mechanisms of nociceptive signaling at spinal cord level. One of the forms of spinal cord synaptic transmission modulation is central sensitization, a manifestation of synaptic plasticity at spinal cord level, which was found to be present at many chronic pain syndromes. This study deals mainly with a development of calcium imaging technique with a final goal to study mechanisms of central sensitization in vitro on population of dorsal horn neurons. We have analyzed synaptically evoked intracellular Ca changes as a result of dorsal root stimulation in a superficial dorsal horn area in spinal cord slices and found two types of Ca responses: one synchronized with electrical stimulation and a second one, delayed response due to Ca release from internal stores. The delayed Ca release was not previously shown to be present in these neurons and it was not dependent on activation of ionotropic glutamatergic receptors, suggesting involvement of metabotropic receptor pathway. The presence of this delayed type of Ca response could have a significant role in the induction of some types of chronic pain syndromes, since intracellular calcium increase is thought to be a key trigger point in spinal cord neurons sensitization. An important role in neuronal calcium...
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Variables predicting the effects of surgery in patients with low back pain
Hollasová, Sára ; Kavka, Tomáš (advisor) ; Šembera, Martin (referee)
Variables predicting the effects of surgery in patients with low back pain Abstract The theoretical part of the thesis summarizes the knowledge about pain and its types, especially chronic pain. Than we focus on low back pain and currently used approaches in the treatment of this syndrome. In this work we summarize the influence of central sensitization and adverse life experineces and posttraumatic stress disorder on pain (especially low back pain). In the practical part, we investigated the effect of central sensitization and adverse life events and posttraumatic stress disroder on the effect of spinal surgery in low back region. The results were obtained using Central Sensitization Inventory (CSI), PTSD Cecklist dor DSM-5 (PCL- 5) a Life Event Checklist (LEC-5 Standard), Short Form 36 Helth Survey Questionnaire (SF- 36), NASS Lumbar Spine Questionnaire. The obtained data were statistically evaluated and processed. Higher scores of CSI and LEC-5 (more adverse life events) were both statistically significantly correlated with worse low back surgery outcomes. At the same time, a statistically significant relationship between PCL-5 (checklist of PTSD symptoms) and CSI was confirmed. Keywords Pain, central sensitization, adverse life experiences, adverse life events, PTSD, posttraumatic stress disorder,...
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Calcium homeostasis and modulation of nociceptive synaptic transmission
Sojka, David
This study was designed to improve our knowledge regarding mechanisms of nociceptive signaling at spinal cord level. One of the forms of spinal cord synaptic transmission modulation is central sensitization, a manifestation of synaptic plasticity at spinal cord level, which was found to be present at many chronic pain syndromes. This study deals mainly with a development of calcium imaging technique with a final goal to study mechanisms of central sensitization in vitro on population of dorsal horn neurons. We have analyzed synaptically evoked intracellular Ca changes as a result of dorsal root stimulation in a superficial dorsal horn area in spinal cord slices and found two types of Ca responses: one synchronized with electrical stimulation and a second one, delayed response due to Ca release from internal stores. The delayed Ca release was not previously shown to be present in these neurons and it was not dependent on activation of ionotropic glutamatergic receptors, suggesting involvement of metabotropic receptor pathway. The presence of this delayed type of Ca response could have a significant role in the induction of some types of chronic pain syndromes, since intracellular calcium increase is thought to be a key trigger point in spinal cord neurons sensitization. An important role in neuronal calcium...
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