Friday, October 12, 2018

So many papers and other good stuff lately!

I lack motivation, which is why I haven't been blogging much this past year. But I do notice many things as I drift by them in my mental inner tube, and just now, I decided I had enough energy to list the sort of stuff I see daily - an avalanche of great stuff, semi-organized.

In the peripheral nervous system:

1. Concept of acute neuropathic pain. The role of nervi nervorum in the distinction between acute nociceptive and neuropathic pain.  This one comes from Brazil, 2016. It eluded me until now, possibly because it had not been translated into English before, but is now. Really interesting, everything you ever wanted to know about nociceptive neurons in the periphery. Well, a lot at least.
And how they can be bothered on the inside of nerves.
My whole manual therapy worldview rests on this idea - that if nociceptive neurons inside nerves get riled up for any reason, e.g., mechanical deformation of the nerve OR the vessels that feed and drain it, the nerve itself will get plenty cranky, sensitize, and make a signal large enough to eventually overcome normal descending inhibition, whereupon the spinal cord will obligingly amplify said signal, compounding it with central sensitization through several mechanisms.

Entrapment of middle cluneal nerves as an unknown cause of low back pain. The author is Japanese - Yoichi Aota. My Japanese colleagues have met him in person. 

In the central nervous system:

1. Thalamus: 
A long-overlooked brain region may be key to complex thought
This one is not about pain per se, but about how the thalamus's job is much more than just relay. 

2. Cerebellum: The Cerebellum, Autism, and How The Human Brain Gets Organized - New Research.    This is a half-hour video with Peggy Mason and Aaron Freeman at U Chicago, who shed all sorts of light on this structure and its contribution to developing brains.

3. Pain as maladaptive plasticity, by DevraJoy Sheldon. I had the pleasure of meeting Dera Joy at the last San Diego Pain Summit. What a great blogpost!

"Moseley et al 2009 noted that when individuals with CRPS crossed their upper extremities, the unaffected extremity became cooler than the involved limb. It wasn’t the limb, but the hemispace that was relevant. This is very much like a stroke with hemispatial neglect (an inattention to the environment on the involved side.) And what do we do with individuals who experience neglect, even extreme forms of it including anosognosia (denying the limb is theirs)? We help them attend to the limb and environment. We involve the limb in care and therapy. We apply stimulus to the limb to help the brain “tune in” to it and we encourage attention to the hemispace in which the limb resides. We do this to drive neuroplastic change."

She's right, that's exactly what we do.

4. The autonomic system: 
Professionalism-Autonomic Disorders: David S. Goldstein, MD, PhD He Could Have Been a Cartoonist. He Became an Expert in Autonomic Disorders Instead. Sounds like this may be the researcher to whom we owe a debt for elucidating dysautonomias. Note to self: look up all his work!

The ‘Bayesian brain’ for beginners, by way of placebo. A super good paper is linked into this blogpost.  Here it is: Symptom perception, placebo effects, and the Bayesian brain. Click on "Article as pdf" to get full text.

Studying the two together:

Skin nonlinearities and their effect on user perception for rotational skin stretch. This is REALLY exciting for me - someone has built a skin twizzler machine.  Now maybe someone can design a (really GOOD) research project to study DNM! 

Studying the therapeutic relationship:

A framework for establishing connections in physiotherapy practice. This new paper is by Maxi Miciak et al in Alberta. (* Don't miss her at the next San Diego Pain Summit where she'll be a speaker alongside Damasio!) I love how she geeks out the various components of therapeuttic relationship into an actual diagram.

Remember, for accessing beyond a paywall, scihub is our friend. 

1 comment:

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