13 research outputs found
PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL
The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies
have revealed differences between conventional osteotomes, such as rotating or sawing devices, and
ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness
values of osteotomized bone surfaces.
Objective: the present study compares the micro-morphologies and roughness values of
osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery
Medical® and Piezosurgery Medical New Generation Powerful Handpiece.
Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following
osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New
Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded.
Micromorphologies and roughness values to characterize the bone surfaces following the different
osteotomy methods were described. The prepared surfaces were examined via light microscopy,
environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal
laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized
tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone
necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were
investigated, as well as the proportion of apoptosis or cell degeneration.
Results and Conclusions: The potential positive effects on bone healing and reossification
associated with different devices were evaluated and the comparative analysis among the different
devices used was performed, in order to determine the best osteotomes to be employed during
cranio-facial surgery
2D and 3D models based on patients temporomandibular joint diseases
Temporomandibulární kloub (TMK) je jedním z nejsložitějších kloubů v těle. Jeho funkce je řízena koordinací pohybů a postavení zubních oblouků, svalů a kloubů. Změna životního stylu snižuje tělesnou aktivitu, která vede k stále většímu počtu degenerativních onemocnění kloubů s různou etiologií. Proto se zvyšuje i počet pacientů, kteří si stěžují na bolest a další obtíže v oblasti TMK. Odhadem 42% populace má alespoň jeden z příznaků a 2 - 5,5 % vyhledá léčbu. Poruchy čelistního kloubu (TMD) mají klinické příznaky, které zahrnují žvýkací svaly, čelistní klouby i další související anatomické struktury. Typické jsou bolesti, zvukové fenomény, omezené otvírání úst a různé parafunkce dolní čelisti. Základem úspěšné léčby je stanovení příčiny obtíží pacienta. Terapie vychází z modelu ideální biomechaniky TMK. Rehabilitace čelistního kloubu vyžaduje komplexní dlouhodobou léčbu založenou především na fyzikální, chirurgické a protetické terapii. Podrobné znalosti o funkci a morfologii čelistního kloubu jsou nezbytné pro léčbu jeho onemocnění. Pohyby čelistního kloubu jsou biomechanicky sofistikované, ale jejich průběh není zcela objasněn. Cílem PhD práce bylo vytvořit matematický model založený na analýze čelistního kloubu, z hlediska vznikajících sil při tahu a tlaku. Získané výsledky, založené na dvou a...The temporomandibular joint (TMJ) is one of the most complex joints in the body. Its harmony is established by coordination between occlusion, muscle, and joint. Changing lifestyles, decreasing physical activity, which is increasing the number of degenerative joint diseases of various etiologies, and certain dental procedures, are increasing the number of patients complaining of pain or other problems in their temporomandibular joints. Estimated 42% of the population is affected and 2-5,5 % is seeking treatment. Temporomandibular disorders (TMD) are clinical problems that involve the masticatory muscles, the temporomandibular joints and associated anatomical structures. Typical signs and symptoms of TMD are facial pain, clicking or crepitation of the TMJs, limited jaw opening capacity and deviation in the movement patterns of the mandible. The basis of successful treatment is a determination of the patient's causal problems. The analysis is based on the model of the ideal biomechanics of TMJ. The rehabilitation of temporomandibular joint disorders needs comprehensive long-term therapy based mainly on physical, surgical, and prosthetic treatment. Detailed knowledge about the function and morphology of temporomandibular joint are necessary for clinical evaluation and treatment of temporomandibular...Department of StomatologyStomatologická klinika dětí a dospělých2. lékařská fakultaSecond Faculty of Medicin
National eHealth system – platform for preventive, predictive and personalized diabetes care
National eHealth System, covering all citizens and all healthcare levels in Republic of Macedonia, was introduced in July 2013, has been internationally
recognized System for successful reduction of waiting times and instrumental in the management of national healthcare resources. For the first time, National Diabetes Committee, formed in February 2015 according to the Law on healthcare and being overall responsible
for the diabetes care in the country, was able to derive exact figures on the national diabetes prevalence from the System, instead of extrapolations used before, serving as a basis for development of strategies for prediction and prevention of diabetic complications, as
well as for personalized diabetes care. Number of diabetes cases identified through the National eHealth
System in June 2015 was 84,568 (4.02 % of total population), 36,119 males (3.42 % of total male population) and 48,449 females (4.61% of total female population). Age stratified diabetes prevalence was as
follows: less than 20 years – 549 cases (0.11 % of respective population), 20-39 years – 3,202 (0.49 %), 40-59 years – 26,561 (4.58 %), 60-79 years – 48,470 (14.57 %), 80 years or more – 5,786 (12.96 %). Addition of parameters for metabolic control and diabetic complications in the System is under way, further facilitating the modeling of diabetes treatment, metabolic control and the outcomes. Inclusion of
pre-diabetes patients (IGT and IFG) is also planned, thus providing opportunity to also focus healthcare activities for prevention of progression into overt type 2 diabetes
Recommended from our members
EPMA-World Congress 2015: Bonn, Germany. 3-5 September 2015
Table of contents A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improving individual outcomes in hepatocellular carcinoma Jella-Andrea Abraham, Olga Golubnitschaja A2 Integrated market access approach amplifying value of “Rx-CDx” Ildar Akhmetov A3 Disaster response: an opportunity to improve global healthcare Russell J. Andrews, Leonidas Quintana A4 USA PPPM: proscriptive, profligate, profiteering medicine-good for 1 % wealthy, not for 99 % unhealthy Russell J. Andrews A5 The role of IDO in a murine model of gingivitis: predictive and therapeutic potentials Babak Baban, Jun Yao Liu, Xu Qin, Tailing Wang, Mahmood S. Mozaffari A6 Specific diets for personalised treatment of diabetes type 2 Viktoriia V. Bati, Tamara V. Meleshko, Olga B. Levchuk, Nadiya V. Boyko A7 Towards personalized physiotherapeutic approach Joanna Bauer, Ewa Boerner, Halina Podbielska A8 Cells, animal, SHIME and in silico models for detection and verification of specific biomarkers of non-communicable chronic diseases Alojz Bomba, Viktor O. Petrov, Volodymyr G. Drobnych, Rostyslav V. Bubnov, Oksana M. Bykova, Nadiya V. Boyko A9 INTERACT-chronic care model: Self-treatment by patients with decision support e-Health solution Hans-Peter Brunner-La Rocca, Lutz Fleischhacker, Olga Golubnitschaja, Frank Heemskerk, Thomas Helms, Tiny Jaarsma, Judita Kinkorova, Jan Ramaekers, Peter Ruff, Ivana Schnur, Emilio Vanoli, Jose Verdu A10 PPPM in cardiovascular medicine in 2015 Hans-Peter Brunner-La Rocca A11 Magnetic resonance imaging of nanoparticles in mice, potential for theranostic and contrast media development – pilot results Rostyslav V. Bubnov, Sergiy A. Grabovetskyi, Olena M. Mykhalchenko, Natalia O. Tymoshok, Oleksandr B. Shcherbakov, Igor P. Semeniv, Mykola Y. Spivak A12 Ultrasound diagnosis for diabetic neuropathy - comparative study Rostyslav V. Bubnov, Tetyana V. Ostapenko A13 Ultrasound for stratification patients with diabetic foot ulcers for prevention and personalized treatment - pilot results Rostyslav V. Bubnov, Nazarii M. Kobyliak, Nadiya M. Zholobak, Mykola Ya. Spivak A14 Project ImaGenX – designing and executing a questionnaire on environment and lifestyle risk of breast cancer John Paul Cauchi A15 Genomics – a new structural brand of predictive, preventive and personalized medicine or the new driver as well? Dmitrii Cherepakhin, Marina Bakay, Artem Borovikov, Sergey Suchkov A16 Survey of questionnaires for evaluation of the quality of life in various medical fields Barbara Cieślik, Agnieszka Migasiewicz, Maria-Luiza Podbielska, Markus Pelleter, Agnieszka Giemza, Halina Podbielska A17 Personalized molecular treatment for muscular dystrophies Sebahattin Cirak A18 Secondary mutations in circulating tumour DNA for acquired drug resistance in patients with advanced ALK + NSCLC Marzia Del Re, Paola Bordi, Valentina Citi, Marta Palombi, Carmine Pinto, Marcello Tiseo, Romano Danesi A19 Recombinant species-specific FcεRI alpha proteins for diagnosis of IgE-mediated allergies in dogs, cats and horses Lukas Einhorn, Judit Fazekas, Martina Muhr, Alexandra Schoos, Lucia Panakova, Ina Herrmann, Krisztina Manzano-Szalai, Kumiko Oida, Edda Fiebiger, Josef Singer, Erika Jensen-Jarolim A20 Global methodology for developmental neurotoxicity testing in humans and animals early and chronically exposed to chemical contaminants Arpiné A. Elnar, Nadia Ouamara, Nadiya Boyko, Xavier Coumoul, Jean-Philippe Antignac, Bruno Le Bizec, Gauthier Eppe, Jenny Renaut, Torsten Bonn, Cédric Guignard, Margherita Ferrante, Maria Liusa Chiusano, Salvatore Cuzzocrea, Gerard O'Keeffe, John Cryan, Michelle Bisson, Amina Barakat, Ihsane Hmamouchi, Nasser Zawia, Anumantha Kanthasamy, Glen E. Kisby, Rui Alves, Oscar Villacañas Pérez, Kim Burgard, Peter Spencer, Norbert Bomba, Martin Haranta, Nina Zaitseva, Irina May, Stéphanie Grojean, Mathilde Body-Malapel, Florencia Harari, Raul Harari, Kristina Yeghiazaryan, Olga Golubnitschaja, Vittorio Calabrese, Christophe Nemos, Rachid Soulimani A21 Mental indicators at young people with attributes hypertension and pre-hypertension Maria E. Evsevyeva, Elena A. Mishenko, Zurida V. Kumukova, Evgeniy V. Chudnovsky, Tatyana A. Smirnova A22 On the approaches to the early diagnosis of stress-induced hypertension in young employees of State law enforcement agencies Maria E. Evsevyeva, Ludmila V. Ivanova, Michail V. Eremin, Maria V. Rostovtseva A23 Сentral aortic pressure and indexes of augmentation in young persons in view of risk factors Maria E. Evsevyeva, Michail V. Eremin, Vladimir I. Koshel, Oksana V. Sergeeva, Nadesgda M. Konovalova A24 Breast cancer prediction and prevention: Are reliable biomarkers in horizon? Shantanu Girotra, Olga Golubnitschaja A25 Flammer Syndrome and potential formation of pre-metastatic niches: A multi-centred study on phenotyping, patient stratification, prediction and potential prevention of aggressive breast cancer and metastatic disease Olga Golubnitschaja, Manuel Debald, Walther Kuhn, Kristina Yeghiazaryan, Rostyslav V. Bubnov, Vadym M. Goncharenko, Ulyana Lushchyk, Godfrey Grech, Katarzyna Konieczka A26 Innovative tools for prenatal diagnostics and monitoring: improving individual pregnancy outcomes and health-economy in EU Olga Golubnitschaja, Jan Jaap Erwich, Vincenzo Costigliola, Kristina Yeghiazaryan, Ulrich Gembruch A27 Immunohistochemical assessment of APUD cells in endometriosis Vadym M. Goncharenko, Vasyl O. Beniuk, Olga V. Kalenska, Rostyslav V. Bubnov A28 Updating personalized management algorithm of endometrial hyperplasia in pre-menopause women Vadym M. Goncharenko, Vasyl O. Beniuk, Rostyslav V. Bubnov, Olga Melnychuk A29 The personified treatment approach of polimorbid patients with periodontal inflammatory diseases Irina A. Gorbacheva, Lyudmila Y. Orekhova, Vadim V. Tachalov A30 Ukrainian experience in hybrid war – the challenge to update algorithms for personalized care and early prevention of different military injuries Olena I. Grechanyk, Rizvan Ya. Abdullaiev, Rostyslav V. Bubnov A31 Tear fluid biomarkers: a comparison of tear fluid sampling and storage protocols Suzanne Hagan, Eilidh Martin, Ian Pearce, Katherine Oliver A32 The correlation of dietary habits with gingival problems during menstruation Cenk Haytac, Fariz Salimov, Servin Yoksul, Anatoly A. Kunin, Natalia S. Moiseeva A33 Genomic medicine in a contemporary Spanish population of prostate cancer: our experience Bernardo Herrera-Imbroda, Sergio del Río-González, Maria Fernanda Lara, Antonia Angulo, Francisco Javier Machuca Santa-Cruz A34 Challenges, opportunities and collaborations for personalized medicine applicability in uro-oncological disease Bernardo Herrera-Imbroda, Sergio del Río-González, Maria Fernanda Lara A35 Metabolic hallmarks of cancer as targets for a personalized therapy John Ionescu A36 Influence of genetic polymorphism as a predictor of the development of periodontal disease in patients with gastric ulcer and 12 duodenal ulcer Alfiya Z. Isamulaeva, Anatoly A. Kunin, Shamil Sh. Magomedov, Aida I. Isamulaeva A37 Challenges in diabetic macular edema Tatjana Josifova A38 Overview of the EPMA strategies in laboratory medicine relevant for PPPM Marko Kapalla, Juraj Kubáň, Olga Golubnitschaja, Vincenzo Costigliola A39 EPMA initiative for effective organization of medical travel: European concepts and criteria Vincenzo Costigliola, Marko Kapalla, Juraj Kubáň, Olga Golubnitschaja A40 Design and innovation in e-textiles: implications for PPPM Anthony Kent, Tom Fisher, Tilak Dias A41 Biobank in Pilsen as a member of national node BBMRI_CZ Judita Kinkorová, Ondřej Topolčan A42 Big data in personalized medicine: hype and hope Matthias Kohl A43 The 3P approach as the platform of the European Dentistry Department (DPPPD) Anatoly A. Kunin, Natalia S. Moiseeva A44 The endometrium cytokine patterns for predictive diagnosis of proliferation severity and cancer prevention Andrii I. Kurchenko, Vasyl A. Beniuk, Vadym M. Goncharenko, Rostyslav V. Bubnov, Nadiya V. Boyko, Andriy M. Strokan A45 A monocyte-based in-vitro system for testing individual responses to the implanted material: future for personalized implant construction Julia Kzhyshkowska, Alexandru Gudima, Ksenia S. Stankevich, Victor D. Filimonov4, Harald Klüter, Evgeniya M. Mamontova, Sergei I. Tverdokhlebov A46 Prediction and prevention of adverse health effects by meteorological factors: Biomarker patterns and creation of a device for self-monitoring and integrated care Ulyana B. Lushchyk, Viktor V. Novytskyy, Igor P. Babii, Nadiya G. Lushchyk, Lyudmyla S. Riabets, Ivanna I. Legka A47 Targeting "disease signatures" towards personalized healthcare Mira Marcus-Kalish, Alexis Mitelpunkt, Tal Galili, Neta Shachar, Yoav Benjamini A48 Influence of the skin imperfection on the personal quality of life and possible tools for objective diagnosis Agnieszka Migasiewicz, Markus Pelleter, Joanna Bauer, Ewelina Dereń, Halina Podbielska A49 The new direction in caries prevention based on the ultrastructure of dental hard tissues and filling materials Natalia S. Moiseeva, Anatoly A. Kunin, Dmitry A. Kunin A50 The use of LED radiation in prevention of dental diseases Natalia S. Moiseeva, Yury A. Ippolitov, Dmitry A. Kunin, Alexei N. Morozov, Natalia V. Chirkova, Nakhid T. Aliev A51 Status of endothelial progenitor cells in diabetic nephropathy: predictive and preventive potentials Mahmood S. Mozaffari, Jun Yao Liu, Babak Baban A52 The status of glucocorticoid-induced leucine zipper protein in salivary gland in Sjögren’s syndrome: predictive and personalized treatment potentials Mahmood S. Mozaffari, Jun Yao Liu, Rafik Abdelsayed, Xing-Ming Shi, Babak Baban A53 Maximal aerobic capacity - important quality marker of health Jaroslav Novák, Milan Štork, Václav Zeman A54 The EMPOWER project: laboratory medicine and Horizon 2020 Wytze P. Oosterhuis, Elvar Theodorsson A55 Personality profile manifestations in patient’s attitude to oral care and adherence to doctor’s prescriptions Lyudmila Y. Orekhova, Tatyana V. Kudryavtseva, Elena R. Isaeva, Vadim V. Tachalov, Ekaterina S. Loboda A56 Results of an European survey on personalized medicine addressed to directions of laboratory medicine Mario Pazzagli, Francesca Malentacchi, Irene Mancini, Ivan Brandslund, Pieter Vermeersch, Matthias Schwab, Janja Marc, Ron H.N. van Schaik, Gerard Siest, Elvar Theodorsson, Chiara Di Resta A57 MCI or early dementia predictive speech based diagnosis techniques Matus Pleva, Jozef Juhar A58 Personalized speech based mobile application for eHealth Matus Pleva, Jozef Juhar A59 Circulating tumor cell-free DNA as the biomarker in the management of cancer patients Jiří Polívka jr., Filip Janků, Martin Pešta, Jan Doležal, Milena Králíčková, Jiří Polívka A60 Complex stroke care – educational programme in Stroke Centre University Hospital Plzen Jiří Polívka, Alena Lukešová, Nina Müllerová, Petr Ševčík, Vladimír Rohan A61 Sleep apnea and sleep fragmentation contribute to brain aging Kneginja Richter, Lence Miloseva, Günter Niklewski A62 Personalised approach for sleep disturbances in shift workers Kneginja Richter, Jens Acker, Guenter Niklewski A63 Medical travel and innovative PPPM clusters: new concept of integration Olga Safonicheva, Vincenzo Costigliola A64 Medical travel and women health Olga Safonicheva A65 Continuity of generations in the training of specialists in the field of reconstructive microsurgery Maxim Sautin, Janna Sinelnikova, Sergey Suchkov A66 Telemonitoring of stroke patients – empirical evidence of individual risk management results from an observational study in Germany Songül Secer, Stephan von Bandemer A67 Women’s increasing breast cancer risk with n-6 fatty acid intake explained by estrogen-fatty acid interactive effect on DNA damage: implications for gender-specific nutrition within personalized medicine Niva Shapira A68 Cytobacterioscopy of the gingival crevicular fluid as a method for preventive diagnosis of periodontal diseases Aleksandr Shcherbakov, Anatoly A. Kunin, Natalia S. Moiseeva A69 Use of specially treated composites in dentistry to avoid violations of aesthetics Bogdan R. Shumilovich, Zhanna Lipkind, Yulia Vorobieva, Dmitry A. Kunin, Anastasiia V. Sudareva A70 National eHealth system – platform for preventive, predictive and personalized diabetes care Ivica Smokovski, Tatjana Milenkovic A72 The common energy levels of Prof. Szent-Györgyi, the intrinsic chemistry of melanin, and the muscle physiopathology. Implications in the context of Preventive, Predictive, and Personalized Medicine Arturo Solís-Herrera, María del Carmen Arias-Esparza, Sergey Suchkov A73 Plurality and individuality of hepatocellular carcinoma: PPPM perspectives Krishna Chander Sridhar, Olga Golubnitschaja A74 Strategic aspects of higher medical education reforms to secure newer educational platforms for getting biopharma professionals matures Maria Studneva, Sihong Song, James Creeden, Мark Мandrik, Sergey Suchkov A75 Overview of the strategies and activities of the European Federation of Clinical Chemistry and Laboratory Medicine, (EFLM) Elvar Theodorsson, EFLM A76 New spectroscopic techniques for point of care label free diagnostics Syed A. M. Tofail A77 Tumor markers for personalized medicine and oncology - the role of Laboratory Medicine Ondřej Topolčan, Judita Kinkorová, Ondřej Fiala, Marie Karlíková, Šárka Svobodová, Radek Kučera, Radka Fuchsová, Vladislav Třeška, Václav Šimánek, Ladislav Pecen, Jan Šoupal, Štěpán Svačina2 A78 Modern medical terminology (MMT) as a driver of the global educational reforms Evgeniya Tretyak, Maria Studneva, Sergey Suchkov A79 Juvenile hypertension; the relevance of novel predictive, preventive and personalized assessment of its determinants Francesca M. Trovato, G. Fabio Martines, Daniela Brischetto, Daniela Catalano, Giuseppe Musumeci, Guglielmo M. Trovato A80 Proteomarkers Biotech George Th. Tsangaris, Athanasios K. Anagnostopoulos A81 Proteomics and mass spectrometry based non-invasive prenatal testing of fetal health and pregnancy complications George Th. Tsangaris, Athanasios K. Anagnostopoulos A82 Integrated Ecosystem for an Integrated Care model for Heart Failure (HF) patients including related comorbidities (ZENITH) José Verdú, German Gutiérrez, Jordi Rovira, Marta Martinez, Lutz Fleischhacker, Donna Green, Arthur Garson, Elena Tamburini, Stefano Cuomo, Juan Martinez-Leon, Teresa Abrisqueta, Hans-Peter Brunner-La Rocca, Tiny Jaarsma, Teresa Arredondo, Cecilia Vera, Giuseppe Fico, Olga Golubnitschaja, Fernando Arribas, Martina Onderco, Isabel Vara, on behalf of ZENITH consortium A83 Predictive, preventive and personalized medicine in diabetes onset and complication (MOSAIC project) José Verdú, Francesco Sambo, Barbara Di Camillo, Claudio Cobelli, Andrea Facchinetti, Giuseppe Fico, Riccardo Bellazzi, Lucia Sacchi, Arianna Dagliati, Daniele Segnani, Valentina Tibollo, Manuel Ottaviano, Rafael Gabriel, Leif Groop, Jacqueline Postma, Antonio Martinez, Liisa Hakaste, Tiinamaija Tuomi, Konstantia Zarkogianni, on behalf of MOSAIC consortium A84 Possibilities for personalized therapy of diabetes using in vitro screening of insulin and oral hypoglycemic agents Igor Volchek, Nina Pototskaya, Andrey Petrov A85 The innovative technology for personalized therapy of human diseases based on in vitro drug screening Igor Volchek, Nadezhda Pototskaya, Andrey Petrov A86 Bone destruction and temporomandibular joint: predictive markers, pathogenetic aspects and quality of life Ülle Voog-Oras, Oksana Jagur, Edvitar Leibur, Priit Niibo, Triin Jagomägi, Minh Son Nguyen, Chris Pruunsild, Dagmar Piikov, Mare Saag A87 Sub-optimal health management – global vision for concepts in medical travel Wei Wang A88 Sub-optimal health management: synergic PPPM-TCAM approach Wei Wang A89 Innovative technologies for minimal invasive diagnostics Andreas Weinhäusel, Walter Pulverer, Matthias Wielscher, Manuela Hofner, Christa Noehammer, Regina Soldo, Peter Hettegger, Istvan Gyurjan, Ronald Kulovics, Silvia Schönthaler, Gabriel Beikircher, Albert Kriegner, Stephan Pabinger, Klemens Vierlinger A90 Rare disease diobanks for personalized medicine Ayşe Yüzbaşıoğlu, Meral Özgüç, Member of EuroBioBank - European Network of DNA, Cell and Tissue Banks for Rare Disease
Numerical modelling of additive manufacturing process for stainless steel tension testing samples
Nowadays additive manufacturing (AM) technologies including 3D printing grow rapidly and they are expected to replace conventional subtractive manufacturing technologies to some extents. During a selective laser melting (SLM) process as one of popular AM technologies for metals, large amount of heats is required to melt metal powders, and this leads to distortions and/or shrinkages of additively manufactured parts. It is useful to predict the 3D printed parts to control unwanted distortions and shrinkages before their 3D printing. This study develops a two-phase numerical modelling and simulation process of AM process for 17-4PH stainless steel and it considers the importance of post-processing and the need for calibration to achieve a high-quality printing at the end. By using this proposed AM modelling and simulation process, optimal process parameters, material properties, and topology can be obtained to ensure a part 3D printed successfully
Mécanismes cérébraux de la régulation de la douleur : perception de la douleur et hypoalgésie induite psychologiquement
Objectif : Cette thèse a pour but de préciser les mécanismes neuropsychologiques de
la douleur, de la régulation endogène de la douleur et de l'hypoalgésie induite
psychologiquement (HIP) par la synthèse de près de trente ans de recherche imagerie cérébrale
fonctionnelle. Méthodologie : Étant donné l'abondance des études sur le sujet et le manque
d'intégration de leurs résultats, la technique de métaanalyse quantitative basée sur les
coordonnées d'activation cérébrale fut privilégiée dans cette thèse, telle qu’implémentée dans
l'algorithme ALE (Activation Likelyhood Estimate). Une force supplémentaire de cette thèse
repose sur la rigueur du processus de sélection des articles. En effet, les études incluses dans
les métaanalyses devaient satisfaire des critères stricts d'inclusion, ceci dans le but de favoriser
la précision et la validité des conclusions subséquentes. Étude 1 : Le premier article visait à
identifier les aires cérébrales impliquées dans la réduction de la douleur par des méthodes
psychologiques d'interventions. Les articles retenus portent sur une variété de méthodes
d'intervention, telles que le placebo, l'hypnose, la méditation, la perception de contrôle sur la
stimulation douloureuse et l'induction d'émotions. Les résultats indiquent que l'HIP implique
un vaste réseau d'activation qui comprend le cortex cingulaire antérieur, l'insula antérieure, les
zones orbitofrontale et préfrontale latérale, ainsi que les régions pariétale, temporale et souscorticales.
Ces activations reflèteraient l'implication des mécanismes neuropsychologiques
cognitifs et émotionnels sous-tendent les interventions psychologiques ciblées par ces études,
incluant la conscience de soi et la motivation. De plus, les divergences de patron d'activation
entre les approches ont été explorées, notamment pour le placebo et la distraction. Étude 2 :
Le deuxième article a identifié des patrons d'activations préférentiellement associés à la
perception de la douleur, à l'HIP, ainsi que des activations communément associées à la
douleur et l'HIP. Les résultats indiquent que 1) la perception de la douleur est associée à
l'activation d'aires somatosensorielles et motrices, ce qui pourrait être le reflet de la
préparation d'une action adaptative, 2) l'HIP est liée à l'engagement de régions préfrontales
antéromédianes et orbitales, possiblement en lien avec des processus motivationnels et
émotionnels, et 3) la douleur et l'HIP sont associés à l'activation d'aires préfrontales
dorsolatérales, de l'insula antérieure et du cortex cingulaire moyen, ce qui pourrait refléter
l'engagement spontané pendant la douleur de mécanismes endogènes de régulation
descendante. Conclusion : Par ces études, cette thèse fait le point sur les mécanismes
cérébraux impliqués différentiellement dans la perception de la douleur, dans sa régulation
endogène et dans l'hypoalgésie induite psychologiquement.Objective: This thesis aims to clarify the neuropsychological mechanisms of pain,
of the endogenous regulation of pain and of psychologically induced hypoalgesia (PIH),
through the synthesis of almost thirty years of functional brain imaging
research. Methodology: Given the abundance of studies in this domain and the lack of
integration of their results, we used the quantitative meta-analysis technique based on brain
activation using the ALE (Activation likelihood Estimate) statistic. The strength of this thesis
lies in the globalized perspective of the litterature, and in the rigor of the article selection
process from which results were extracted. Indeed, the studies included in the meta-analyses
needed to meet strict inclusion criteria in order to strengthen the accuracy and the validity of
subsequent conclusions. Study 1: The first article is aimed at identifying brain areas involved
in pain reduction through psychological methods of intervention. Chosen articles that covered
a variety of approaches, such as placebo, hypnosis, meditation, perception of control over the
stimulation, and induction of emotions. Analysis across these various studies indicated that
PIH involves a broad network of activation that includes the anterior cingulate cortex,
anterior insulae, orbital and lateral prefrontal and frontal areas, as well as parietal, temporal
and subcortical regions. This activation network may reflect the involvement of diverse
neuropsychological mechanisms in the various affective, self-awareness, cognitive and
motivational processes underlying the psychological interventions targeted by these studies. In
addition, we explored some specific patterns of brain activity related to placebo and
distraction, in comparison to other approaches. We propose several hypotheses regarding the
distinctive neuropsychological processes underlying these approaches. Study 2: The second
article aimed at investigating patterns of brain activity preferentially associated with pain
perception or with PIH. First we assessed patterns of increased and decreased activity during
experimental pain in healthy volunteers. Second we determined the brain regions
preferentially activated during pain perception or during PIH with subtraction analyses. Using
a conjunction analysis, we also determined a set of brain regions possibly involved in
regulatory processes activated spontaneously during acute of pain. Our results indicate that 1)
somatosensory and motor areas are preferentially related to pain perception, which may reflect
the preparation of a motor response, 2) dorsolateral prefrontal areas, anterior insula and the
anterior midcingulate cortex were associated with both pain and PIH and may reflect the
spontaneous activation of top-down regulation mechanisms during pain, and 3) antero-medial
and orbital prefrontal regions were preferentially associated with PIH, which may indicate
motivational and emotional processes associated with the engagement of an externally driven
hypoalgesic procedure