Major Depression Disorder (MDD) and pain appear to be reciprocal risk factors and sharing common neuroanatomical pathways and biological substrates. However, the role of MDD on pain processing ...remains still unclear. Therefore, this review aims to focus on the effect of depression on pain anticipation, and perception, before and after treatment, through functional magnetic resonance imaging (fMRI).
A bibliographic search was conducted on PubMed, Scopus and Web of Science, looking for fMRI studies exploring pain processing in MDD patients.
Amongst the 602 studies retrieved, 12 met the inclusion criteria. In terms of pain perception, studies evidenced that MDD patients generally presented increased activation in brain regions within the prefrontal cortex, insula and in the limbic system (such as amygdala, hippocampus) and occipital cortex. The studies investigating the effect of antidepressant treatment evidenced a reduced activation in areas such as insula, anterior cingulate, and prefrontal cortices. In terms of pain anticipation, contrasting results were evidenced in MDD patients, which presented both increased and decreased activity in the prefrontal cortex, the insula and the temporal lobe, alongside with increased activity in the anterior cingulate cortex, the frontal gyrus and occipital lobes.
The small number of included studies, the heterogeneous approaches of the studies might limit the conclusions of this review.
Acute pain processing in MDD patients seems to involve numerous and different brain areas. However, more specific fMRI studies with a more homogeneous population and rigorous approach should be conducted to better highlight the effect of depression on pain processing.
•This review summarizes the results from fMRI studies on pain processing in depression.•In terms of pain perception, MDD patients present increased activation in brain regions within the prefrontal cortex, insula, limbic system, and occipital cortex.•Antidepressant treatment reduced activation in insula, anterior cingulate, and prefrontal cortices.•In terms of pain anticipation, MDD patients present both increased and decreased activity in the prefrontal cortex, the insula and the temporal lobe.•fMRI studies with a more homogeneous population and rigorous approaches should be conducted to better investigate the effect of depression on pain processing.
Cerebral visual impairment (CVI) is a brain based visual disorder associated with the maldevelopment of central visual pathways. Individuals with CVI often report difficulties finding a target of ...interest in cluttered and crowded visual scenes. However, it remains unknown how manipulating task demands and other environmental factors influence visual search performance in this population.
We developed a novel and naturalistic virtual reality (VR) based static visual search task combined with eye tracking called the “virtual toy box” to objectively assess visual search performance in CVI.
A total of 38 individuals with CVI (mean age 13.18 years ± 3.58 SD) and 53 controls with neurotypical development (mean age 15.25 years ± 5.72 SD) participated in the study. In a first experiment, study subjects were instructed to search for a preselected toy presented among a varying number of surrounding distractor toys (set size ranging from 1 to 36 items). In a second experiment, we assessed the effects of manipulating item spacing and the size of the visual area explored (field of view; FOV).
Behavioral outcomes collected were success rate, reaction time, gaze error, visual search area, and off-screen percent (an index of task compliance). Compared to age-matched controls, participants with CVI showed an overall impairment with respect to all the visual search outcomes of interest. Specifically, individuals with CVI were less likely and took longer to find the target, and search patterns were less accurate and precise compared to controls. Visual search response profiles were also comparatively less efficient and were associated with a slower initial pre-search (visual orienting) response as indexed by higher slope and intercept values derived from the analysis of reaction time × set size functions. Search performance was also more negatively affected in CVI at the smallest as well as largest spacing conditions tested, while increasing FOV was associated with greater decreased gaze accuracy and precision
These results are consistent with a general profile of impaired visual search abilities in CVI as well as worsening performance with increased visual task demands and an overall sensitivity to visual clutter and crowding. The observed profile of impaired visual search performance may be associated with dysfunctions related to how visual selective attention is deployed in individuals with CVI.
•Higher order visual perceptual abilities are typically not assessed as part of a standard ophthalmological exam.•Visual search performance in CVI was characterized by using a novel virtual reality-based task combined with eye tracking.•Compared to age-matched controls, participants with CVI showed an overall impairment in performance on all visual search outcomes of interest.•The general profile observed in CVI was consistent with worsening performance with increased visual task demands and sensitivity to visual clutter and crowding.
Introduction. Kaposi sarcoma is a rare soft tissue tumor that may form masses in the skin, lymph nodes, mucosa and many other organs. It has a strong male predilection and is usually seen in the ...older population. It is caused by human herpes virus 8. Risk factors include compromised immune system, typically seen in patients with human immunodeficiency virus infection or organ transplant recipients. Case Report. We report a 66-year-old Caucasian woman with no previous history of human immunodeficiency virus infection, immunosuppressive therapy or organ transplantation. She was referred to a plastic surgeon by a dermatologist due to a suspected dermatofibroma presenting with one solitary, firm nodule on the dorsal aspect of the foot that she reported to have occurred a year before. A surgery was scheduled in 6 months, as the tumor was assessed as benign. After excisional biopsy and histological evaluation without immunohistochemical staining, that was not available, a diagnosis of benign myofibroblastic tumor was made. Later on, a new similar tumor on the hand appeared and the diagnosis was changed into a malignant tumor. Further pathological examination, using immunohistochemical staining, confirmed Kaposi sarcoma. The malignant cells showed positive immunostaining for CD34, CD31, D2-40, WT1, bcl-2, and human herpes virus 8, but they were CD99 negative. Conclusion. Nonspecific clinical presentation and absence of risk factors may mislead the doctors, delay the biopsy and thus delay adequate treatment. In the same time, histological similarities with other disorders and tumors may be challenging for pathologists and lead to wrong diagnosis. Key words: Sarcoma, Kaposi; Risk Factors; Histiocytoma, Benign Fibrous; Immunity; Diagnosis, Differential; Morphological and Microscopic Findings; Immunohistochemistry Uvod. Kaposi sarkom je redak mekotkivni tumor koji moze formirati tumore u kozi, limfnim cvorovima i brojnim drugim organima. Ima izrazenu musku polnu predilekciju i obicno se vida u starijoj populaciji. Izaziva ga humani herpes virus 8. Faktori rizika ukljucuju kompromitovan imunostatus sto se obicno vida kod pacijenata pozitivnih na virus humane imunodeficijencije ili sa transplantiranim organom. Prikaz slucaja. Prikazujemo 66 godina staru pacijentkinju bele rase koja je negativna na virus humane imunodeficijencije, nije na imunosupresivnoj terapiji i nije imala transplantaciju. Pacijentkinju je uputio plasticnom hirurgu dermatolog zbog promene suspektne na dermatofibrom, koju ima godinu dana, a koja se prezentovala u vidu solitarnog cvora, cvrste konzistencije, lokalizovanog na dorzumu stopala. Pacijentkinjaje zakazana za sest meseci jer je promena klinicki procenjena kao benigna. Nakon ekscizione biopsije i histoloske analize, bez imunohistohemijskog bojenja koje nije bilo dostupno, promenaje dijagnostikovana kao benigni miofibroblastni tumor. U daljem toku sa pojavom recidiva i novog slicnog tumora na saci, patohistoloska dijagnoza je revidirana u tumor koji bi trebalo smatrati malignim. Dalja imunohistohemijska analiza je omogucila postavljanje definitivne dijagnoze Kaposijevog sarkoma. Maligne celije su bile pozitivne na CD34, CD31, D2-40, WT1, bcl-2; CD99 negativne i pozitivne na humani herpes virus 8. Zakljucak. Nespecificna klinicka prezentacija i odsustvo faktora rizika mogu zavarati lekara, odloziti biopsiju i samim tim i adekvatno lecenje. Istovremeno histoloske slicnosti sa drugim poremecajima i tumorima mogu biti problem za patologa i usloviti postavljanje pogresne dijagnoze. Kljucne reci: Kaposi sarkom; faktori rizika; dermatofibrom; imunitet; diferencijalna dijagnoza; morfoloski i mikroskopski nalazi; imunohistohemija
Introduction. Kaposi sarcoma is a rare soft tissue tumor that may form masses
in the skin, lymph nodes, mucosa and many other organs. It has a strong male
predilection and is usually seen in the ...older population. It is caused by
human herpes virus 8. Risk factors include compromised immune system,
typically seen in patients with human immunodeficiency virus infection or
organ transplant recipients. Case Report. We report a 66-year-old Caucasian
woman with no previous history of human immunodeficiency virus infection,
immunosuppressive therapy or organ transplantation. She was referred to a
plastic surgeon by a dermatologist due to a suspected dermatofibroma
presenting with one solitary, firm nodule on the dorsal aspect of the foot
that she reported to have occurred a year before. A surgery was scheduled in
6 months, as the tumor was assessed as benign. After excisional biopsy and
histological evaluation without immunohistochemical staining, that was not
available, a diagnosis of benign myofibroblastic tumor was made. Later on, a
new similar tumor on the hand appeared and the diagnosis was changed into a
malignant tumor. Further pathological examination, using immunohistochemical
staining, confirmed Kaposi sarcoma. The malignant cells showed positive
immunostaining for CD34, CD31, D2-40, WT1, bcl-2, and human herpes virus 8,
but they were CD99 negative. Conclusion. Nonspecific clinical presentation
and absence of risk factors may mislead the doctors, delay the biopsy and
thus delay adequate treatment. In the same time, histological similarities
with other disorders and tumors may be challenging for pathologists and lead
to wrong diagnosis.
nema
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