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Neuromuscular disorders
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Pain impulses may be suppressed or inhibited by (1) simultaneous sensory impulses travelling via adjacent axons or (2) impulses descending from the brain. Thus, the gate control theory, proposed by Melzak and Wall in the 1960s, suggests that pain impulses are ‘checked’ in the dorsal horn of the cord; some impulses are effectively blocked and others are allowed through. This could explain why counter-stimulation sometimes reduces pain perception by encouraging impulses from fast sensory fibres. In addition, certain morphine- like compounds (endorphins and enkephalins), normally produced in the brain and spinal cord, can inhibit pain sensibility. These neurotransmitters are activated by a variety of agents, including severe pain itself, other neurological stimuli, psychological messages and placebos.
Hallucination-focused Integrative Treatment
Published in Jack A. Jenner, Hallucination-focused Integrative Therapy, 2015
Based on the data from the habitual coping monitoring, appropriate coping strategies are selected, constructed into a coping strategy and then tested in vivo. It is best to start with simple behaviour such as vocal cord exercises (humming or singing). In my experience listening to music on a digital music device without vocal cord movement is ineffective. The effect of vocal cord exercises can be strengthened by selecting certain songs. This selection is highly personal. Some choose Christmas carols because of the association with happy days. Others go for battle songs, religious tunes or anthems connected with their sports club. Sometimes shy or timid patients may select songs with powerful messages, for example ‘We are the champions’. These examples illustrate the extra value that selection may offer to the inner speech theory behind the use of vocal cords. Personal selection induces re-attribution, amplifies positive expectation and may prevent this coping becoming downgraded to no more than a kind of musical wallpaper. The chances of compliance may be increased by psychoeducation about the mechanisms of inner speech and counterstimulation.
The psychology of pain
Published in Devinder Rana, Dominic Upton, Psychology for Nurses, 2013
Factors that close the gate (i.e. reduces the pain): Medication: certain forms of medication will lead to a decrease in pain.Counter-stimulation (e.g. heat or massage): with certain types of pain (muscle strain for example) some form of heat or massage will help reduce the pain.
The relationship between children’s media habits and their anxiety and behaviour during dental treatment
Published in Acta Odontologica Scandinavica, 2018
Zahra Jamali, Masoumeh Vatandoost, Leila Erfanparast, Naser Asl Aminabadi, Sajjad Shirazi
In the second visit, after a brief initial communication, a standardized ‘tell-show-do’ method of behaviour management was used for all patients [31]. The same operator provided the dental treatments for all included children. After the application of a topical anaesthetic agent (Benzocaine, Dentsply, York, PA), the standard inferior alveolar nerve block was administered with counter-stimulation and distraction using 27-gauge (long) needle following aspiration. Counter-stimulation included the vibration of injection site with a slight thumb pressure and the vibration of an equivalent extra-oral site using the forefinger. The children were asked to raise their right and left legs for distraction during injection [32]. Subsequently, each carious lesion was removed using a high-speed dental hand piece. A standard Class I or II cavity was prepared and an amalgam restoration was accomplished. The whole treatment procedures were completed within 30-45 minutes.
Closed-Loop Neuromodulation and Self-Perception in Clinical Treatment of Refractory Epilepsy
Published in AJOB Neuroscience, 2023
Tobias Haeusermann, Cailin R. Lechner, Kristina Celeste Fong, Alissa Bernstein Sideman, Agnieszka Jaworska, Winston Chiong, Daniel Dohan
We conducted this study at a level 4 epilepsy center (Labiner et al. 2010) in an academic medical institution. At the epilepsy center, a multi-disciplinary team (neurologists, neurosurgeons, neuropsychologists, nurses, and social workers) reviewed medication-refractory cases weekly to assess appropriateness for RNS among other treatment options. When patients undergo RNS, a neurosurgeon implants the device in the skull and places electrodes near the seizure focus. Following surgery, the device records neural activity, and patients regularly upload electrocorticography data to an internet cloud service maintained by device-manufacturer NeuroPace. This service includes a clinician interface allowing epileptologists to access, download and review electrocorticographic data, and to program the RNS device when patients are present. In most cases, 2–6 months after device implantation, sufficient data will have been collected to allow the patient and clinician to define thresholds for abnormal (epileptiform) activity. Once programmed and activated, the RNS device delivers electrical counter-stimulation when electrocorticography patterns suggest seizure activity (Fountas et al. 2005; Geller 2018; Jarosiewicz and Morrell 2021; Thomas and Jobst 2015), to reduce seizure frequency and severity. In general, patients for whom stimulation has been activated are counseled not to expect immediate and permanent seizure freedom. Rather, the RNS System tends to be presented to patients as a palliative treatment (Ma and Rao 2018). It is designed to become better at recognizing and inhibiting epileptiform activity over time as the recorded data reveal more about a patient’s condition, and their neurologist(s) can better tune the device’s settings. In clinical trials and open-label follow-up studies, median seizure reduction was 44% at 1 year, 53% at 2 years, 66% at 6 years and 75% at 9 years (Bergey et al. 2015; Nair et al. 2020).
The Rhythmic Finger Focus Hypnotic Technique: Multilevel Application of Ericksonian Utilization
Published in American Journal of Clinical Hypnosis, 2020
The rhythmic finger focus hypnotic technique is guided by Michael Yapko’s definition of hypnosis: “A focused experience of attentional absorption that invites people to respond experientially on multiple levels to amplify and utilize their personal experiences in a goal directed fashion” (2012, p. 7). It involves Erickson’s concept of utilization in multiple ways: It starts by utilizing psychomotor agitation or other aspects of psychophysiological arousal, redirecting it to the rhythmic movement of the hands. The suggested focus on the resulting rhythmic sensations in the fingertips provides a source of focused absorption facilitating refocusing from pain and/or anxious thoughts. The technique utilizes the beneficial effects of counter stimulation for pain management. It utilizes neurological structure and function involving the sensitivity of the fingertips, the high degree of representation of the hands in the somatosensory cortex, and the tendency of the brain to orient to novelty. Self- soothing effects of repetitive tactile stimulation are generated and maintained whether through conscious processes or a nonconscious sensorimotor feedback loop. This approach accesses and utilizes sensorimotor learning and memory associated with the hands to access positive experiences of mastery, competence, creativity, flow, and other positive emotional experiences. It is hypothesized that the technique generates multisystem coherence not only through a self-generated feedback loop entraining sensory and motor areas of the brain, but by activating prior positive sensory, motor, behavioral and affective experiential learning involving multiple brain areas including the prefrontal cortex. It is further hypothesized that the rhythmic movement and sensory input simultaneously generated by and processed in the right and left hemispheres entrains areas in those hemispheres involved in generating sympathetic/parasympathetic balance associated with healthy allostatic functioning.