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Biomedical subjects

H Flor

Publications and source records attributed to H Flor.

At least 73 records · Page 4Linked to original sources
PubMed1997

Cerebral processing of words and the development of chronic pain.

The processing of pain-related, body-related, and neutral words was assessed in individuals with prechronic pain and matched healthy controls. Integrated surface electromyogram, heart rate, skin conductance level, and visual event-related potentials from 11 electrode sites were recorded during the presentation of three word types at perception threshold. Startle responses were recorded from words presented above perception threshold. The patient and control groups did not differ in recognition performance. Pain-related words evoked an enhanced early component (N100) of the visual event-related potential only in the prechronic pain group. In both groups the late slow wave and the startle response were enhanced for body- and pain-related words compared with those for neutral words. All word types elicited larger late positivities in the prechronic pain group and in the right compared with the left hemisphere. These data suggest differential cortical processing of pain-related material in persons at a prechronic pain stage.

Adult↗
PubMed1996

Non-invasive functional mapping of the human motor cortex using near-infrared spectroscopy.

We applied non-invasive multisite near-infrared spectroscopy (NIRS) to assess oxygenation changes during performance of a sequential finger opposition task in five healthy human adults. Oxygenation response was localized anatomically using three-dimensional high-resolution magnetic resonance imaging (3D MRI). NIRS measurements showed a localized increase in [oxy-Hb] and a decrease in [deoxy-Hb] in all subjects. The largest response was obtained when the measurement position was over the primary motor and sensory cortex hand area. Interestingly, changes in [deoxy-Hb] seemed to be more localized than changes in [oxy-Hb]. We conclude that this simple, non-invasive and flexible optical bedside method may be used for functional brain mapping.

Adult↗
PubMed1996

Slow potentials, event-related potentials, "gamma-band" activity, and motor responses during aversive conditioning in humans.

We examined slow potentials, transient event-related potentials, and oscillatory-like responses in the electroencephalogram during aversive conditioning in humans, in order to determine what is happening in the neocortex when behavioral adaptations are learned. Pictures of an angry and a happy human face served as reinforced (CS+) and unreinforced (CS-) conditioned stimuli, respectively, in one group, and either the reversed condition or two discriminably different neutral faces in two other groups (total n = 48 subjects). The unconditioned stimulus (US) was intracutaneous shock delivered to the left hand 5 s after CS+ onset. The electroencephalographic (EEG) activity was recorded from Fz, Cz, Pz, C3, and C4, electromyographic (EMG) activity from bilateral forearm and corrugator muscles, and skin conductance from the right hand. During acquisition a negative slow potential developed after CS+ (not CS-), which was more pronounced when a neutral face served as CS+. Early (iCNV, initial contingent negative variation) and late (tCNV, terminal contingent negative variation) components of the slow-potential response were positively related to the magnitude of conditioned EMG responses. Differentiation of tCNV was larger when neutral faces signaled the US; iCNV persisted during extinction when a happy face served as CS+. Late-occurring event-related potentials (ERPs) elicited by the US diminished over conditioning, whereas short-latency US components and ERPs elicited by CS events did not. Fourier analysis revealed oscillatory ("gamma-band") activity between 30 and 40 Hz, which persisted up to 3 s after US delivery and diminished as conditioning progressed. Our findings indicate that learning is expressed in neocortical structures at the earliest stages of conditioning. The functional roles of the three types of EEG response in learning are discussed.

Adult↗
PubMed1996

Evidence for a change in neural processing in phantom limb pain patients.

The present study was designed to investigate differences in neural processing of pain-related semantic information in amputees with and without chronic phantom limb pain and healthy controls. One-hundred-and-twenty words (40 neutral, 40 body-related, 40 pain-related) were presented in pseudorandom order to probe group differences in the perception of pain-related information. Visual evoked potentials (VEP) to the words were recorded from 11 scalp locations, EMG was measured at the stump and the contralateral side and bilaterally from the M. corrugator. In addition, heart rate and skin conductance responses were obtained. Both early and late VEP components were altered. Pain-free amputees showed a reduced N100 amplitude compared to phantom limb pain patients and healthy controls whereas the phantom limb pain patients displayed a significantly enhanced late positivity (500-800 msec after word onset). VEP components were unaffected by word type. The peripheral EMG responses were significantly different among the groups: phantom limb pain patients showed larger EMG reactions on the stump than on the contralateral side, whereas pain-free amputees showed the opposite effect. The data suggest an enhanced central and peripheral processing of visual stimuli in phantom limb pain patients.

Adult↗
PubMed1996

Reorganizational and perceptional changes after amputation.

The demonstration of cortical representational shifts in adult animals subsequent to deafferentation from amputation or dorsal rhizotomy has spurred attempts to elucidate the perceptual correlates of reorganization. Because the hand is flanked by the face and the trunk on the cortical homunculus it has been suggested that cortical remapping in arm amputees leads to a mislocalization of sensations from these sites to the phantom arm in a systematic manner with modality specific one-to-one topographical correspondence. Therefore, we assessed shifts of representational zones by magnetic source imaging in eight arm-amputees and examined them for referred sensation by somaesthetic stimuli of different modalities at standardized sites. It was found that referred phantom sensations can be evoked from sites on the face and the trunk ipsilateral but also contralateral to the amputation and that the extent of physiological reorganization as revealed by magnetic source imaging strongly correlates with the number of sites, be it ipsi- or contralateral, from where painful stimuli evoke referred sensation. Thus, it seems that the extent of reorganization after amputation is closely related to nociceptive inputs. The mislocalization evoked from both sides of the body, suggesting involvement of bilateral pathways, demonstrates that the perceptual changes go beyond what can be explained by shifts in neighbouring cortical representational zones.

Adult↗
PubMed1996

Startle reflex and emotion modulation impairment after a right amygdala lesion.

In the present study, startle responses during resting states as well as during the presentation of a set of emotive slides were recorded from a 32-year-old male patient with a rare localized lesion of the right amygdala. The startle reflex is a response modulated by affective states: it has been reliably used in the literature to measure the aversiveness of emotive stimuli. The animal literature has shown that the circuit of this reflex is directly influenced by amygdala projections. The startle responses of the patient were compared with those of eight age-matched normal subjects. The patient's startle amplitudes showed an overall impaired response and an inhibited reflex contralateral to the lesion. In addition, he failed to show the typical startle potentiation induced by an aversive emotive background. The data confirm, in the human, previous results from the literature in other species on amygdala involvement in startle and emotional responses. Furthermore, the observation of the importance of the right amygdala in the modulation of emotion is consistent with the hypothesis of right hemisphere specialization for aversive emotions. The results are discussed in the context of the literature on human amygdala lesions.

Adult↗
PubMed1996

Cortical correlates of semantic classical conditioning.

Event-related potentials to visually displayed pseudowords were registered from 13 individuals. In a differential conditioning paradigm, half of the pseudowords had previously been paired with a painful electric shock (shock words) and the other half had been presented without shock (nonshock words). Participants were asked to decide if the words had been presented during the conditioning phase or not. Larger N100 amplitudes and a more negative-going slow wave 400-800 ms after word presentation were found for shock as compared with nonshock words. This effect was stronger over the left than over the right hemisphere. This left-lateralized negativity might reflect the activation of a cell assembly representing the memory of the learned word-shock contingency. Furthermore, the increased N100 amplitude elicited by shock as compared with nonshock words may be interpreted as an increased attentive facilitation for aversive pain-related information as a consequence of conditioning.

Adult↗
PubMed1995

Cortical reorganization in human amputees and mislocalization of painful stimuli to the phantom limb.

In human arm amputees, a significant relationship was found between the amount of reorganization in the primary somato-sensory cortex, and the amount of body surface from which painful stimuli evoked sensations that were perceived to be emanating from the now missing extremity, i.e. the phantom limb. This mislocalization could be evoked almost equally from stimulation of either side of the body. Based on these findings obtained by magnetic source imaging and psychophysical testing in eight amputees, it is concluded that the extent of the generally known cortical reorganization contralateral to the amputation is an indicator of more widespread plastic changes in the brain involving bilateral pathways.

Adult↗
PubMed1995

Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation.

Although phantom-limb pain is a frequent consequence of the amputation of an extremity, little is known about its origin. On the basis of the demonstration of substantial plasticity of the somatosensory cortex after amputation or somatosensory deafferentation in adult monkeys, it has been suggested that cortical reorganization could account for some non-painful phantom-limb phenomena in amputees and that cortical reorganization has an adaptive (that is, pain-preventing) function. Theoretical and empirical work on chronic back pain has revealed a positive relationship between the amount of cortical alteration and the magnitude of pain, so we predicted that cortical reorganization and phantom-limb pain should be positively related. Using non-invasive neuromagnetic imaging techniques to determine cortical reorganization in humans, we report a very strong direct relationship (r = 0.93) between the amount of cortical reorganization and the magnitude of phantom limb pain (but not non-painful phantom phenomena) experienced after arm amputation. These data indicate that phantom-limb pain is related to, and may be a consequence of, plastic changes in primary somatosensory cortex.

Adult↗
PubMed1994

Extensive reorganization of the somatosensory cortex in adult humans after nervous system injury.

Magnetic source imaging revealed that the topographic representation in the somatosensory cortex of the face area in upper extremity amputees was shifted an average of 1.5 cm toward the area that would normally receive input from the now absent nerves supplying the hand and fingers. Observed alterations provide evidence for extensive plastic reorganization in the adult human cortex following nervous system injury, but they are not a sufficient cause of the phantom phenomenon termed 'facial remapping'.

Adult↗
PubMed1994

Behavioral treatment of scoliosis and kyphosis.

A behavioral treatment of scoliosis and kyphosis was tested with 27 adolescent patients (19 scoliosis, eight kyphosis patients) to determine in which cases the conspicuous and restraining brace treatment could be replaced. In 22 compliant patients, posture biofeedback (PB) was highly effective compared to five non-compliant patients. Biologically more mature scoliosis patients (menarche at the beginning of treatment) seemed to profit more from PB. With kyphosis patients the PB treatment resulted in rapid straightening of the spine and removal of structural deformities of Scheuermann's disease. PB may serve as an unobtrusive yet effective treatment alternative for both juvenile scoliosis and kyphosis.

Adolescent↗
PubMed1993

Assessment of pain-related cognitions in chronic pain patients.

The construction of the Pain-Related Self Statements Scale (PRSS) and the Pain-Related Control Scale (PRCS) is described. The PRSS assesses situation-specific aspects of patients' cognitive coping with pain, while the PRCS measures general attitudes towards pain. The reliability and validity of these scales were determined in a sample of 120 chronic pain patients suffering from various rheumatic disorders, 213 patients who suffered from chronic back pain, 44 patients with temporomandibular pain and dysfunction and 38 healthy controls. The analysis of the PRSS yielded two scales termed 'Catastrophizing' and 'Coping'; the PRSC consists of the subscales 'Helplessness' and 'Resourcefulness'. All four subscales were demonstrated to be valid and sensitive to change, and they are closely related to pain intensity and interference from pain experiences.

Adaptation, Psychological↗
PubMed1993

Comparison of the efficacy of electromyographic biofeedback, cognitive-behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain.

In this study, three types of treatments for chronic musculoskeletal pain were compared. Fifty-seven patients who suffered from chronic back pain and 21 patients who suffered from temporomandibular pain and dysfunction were randomly assigned to either electromyographic (EMG) biofeedback, cognitive-behavioral therapy, or conservative medical treatment. At posttreatment, improvements were noted in all three treatment groups, with the biofeedback group displaying the most substantial change. At the 6- and 24-month follow-up, only the biofeedback group maintained significant reductions in pain severity, interference, affective distress, pain-related use of the health care system, stress-related reactivity of the affected muscles, and an increase in active coping self-statements. Treatment outcome was predicted by chronicity and treatment-specific variables. Analysis of attrition showed a significant effect for therapist and extent of somatic pathology. Results suggest that pain patients who suffer from musculoskeletal pain problems and display few physical disabilities may profit the most from short-term EMG biofeedback treatment.

Adult↗
PubMed1992

Dimensional analysis of the human EEG and intelligence.

The purpose of this study was the determination of the relationship between the dimensional complexity of the electroencephalogam (EEG) and the level of intelligence in humans. In two experiments 34 male subjects were divided into two groups, with high and low levels of intelligence (as measured by the intelligence quotient (IQ)). During a resting phase and various mental imagery conditions the EEG was recorded from several scalp sites. Nonlinear analysis, based on the theory of deterministic chaos, revealed that subjects with high IQs demonstrate higher dimensional complexity of the EEG attractors than subjects with low IQs only during resting conditions. During performance of the imagery tasks the less intelligent subjects increase the complexity of electrical brain dynamics such that IQ-dependency vanishes. The gross (mass) neuronal manifestation of general intelligence seems to depend on task conditions and may be related to the individual brain dynamics only when no specific task is present.

Adult↗
PubMed1992

Discrimination of muscle tension in chronic pain patients and healthy controls.

The purpose of this study was to assess the perception of muscle tension in chronic pain patients and healthy controls. Twenty chronic back pain patients, 20 patients who suffered from temporomandibular pain and dysfunction, and 20 healthy controls were instructed to produce eight different levels of muscle contraction in either the m. masseter or the m. erector spinae. Each level was produced three times; trials were presented in random order. Analyses of the accuracy and the sensitivity of discrimination of muscle tension levels revealed that the patients were less able to perceive muscle contraction levels correctly and that they underestimated their actual levels of muscle tension. Patients and controls did not differ in the extent to which they contracted muscles not involved in the task. Patients suffering from musculoskeletal disorders seem to display a genuine deficit in discrimination of muscle tension that is related to neither local physiological changes at the site of pain, lack of motivation, in-attention, nor fatigue.

Adult↗
PubMed1992

Symptom-specific psychophysiological responses in chronic pain patients.

Symptom-specific psychophysiological responding was assessed in 20 chronic back pain patients, 20 patients suffering from temporomandibular pain and dysfunction, and 20 matched healthy controls. Surface EMG from the lower and upper back, the masseter, and the biceps muscles, and heart rate and skin conductance level were continuously recorded during adaptation, resting baseline, and stressful and neutral imagery phases. Univariate and multivariate analyses of variance were performed on raw data as well as data corrected for autocorrelation. The results showed significantly higher EMG reactivity which was lateralized to the left side at the patients' site of pain but not distal sites. This hyperreactivity was observed only during stressful imagery. The healthy controls displayed a significantly higher response in heart rate, but skin conductance level was not significantly different. The results are interpreted as indicative of idiosyncratic muscular response patterns to personally relevant situations at the site of pain in patients suffering from chronic muscular pain.

Adult↗
PubMed1989

Psychophysiology of chronic pain: do chronic pain patients exhibit symptom-specific psychophysiological responses?

Theoretical as well as methodological issues associated with psychophysiological mechanisms of chronic pain syndromes are reviewed and discussed. Results of studies on psychophysiological responses in patients with recurrent headaches, chronic back pain, and temporomandibular pain disorders are presented. These studies are evaluated on the basis of a set of 12 theoretical and methodological criteria that include diagnostic procedures, use of control groups, sample description, use of multiple and relevant physiological measures, introduction of ecologically valid and actually stress-inducing stressors, use of adequate adaptation and baseline periods, adequacy of data acquisition, and analysis. Results on baseline levels, reactivity to stress and pain stimuli, and return to baseline levels are presented. When only the most methodologically sound studies are included, the data suggest that baseline levels, regardless of type of physiological measure, are not generally elevated in chronic pain patients. The presence of symptom-specific stress-related psychophysiological responses is more commonly observed, and the evidence on return to baseline is at this time inconclusive.

Arousal↗