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This longitudinal study aimed to evaluate qualitative (parosmia) and quantitative (hyposmia/anosmia) olfaction 2–4 weeks (baseline) and 6 months (follow-up) after a mild traumatic brain injury (mTBI). We further evaluated the predictive value of baseline depression, anxiety, and olfaction scores on depression and anxiety at follow-up. At baseline, olfactory function and affective state were assessed in 107 participants (53 patients with mTBI; 54 healthy controls). At follow-up, data were collected on 71 participants (32 patients and 39 controls). Both at baseline and follow-up, patients with mTBI showed more signs of parosmia, depression, and anxiety compared with controls. However, patients did not, neither at baseline nor follow-up, show quantitative olfactory impairment. Moreover, although baseline scores of depression and anxiety helped predict the development of symptoms of depression and anxiety at follow-up, adding parosmia scores to the prediction model significantly increased the amount of explained variances. Clinicians should implement affective and olfactory evaluation to predict patients' affective outcome. [ABSTRACT FROM AUTHOR]

Background: Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that are being explored as therapeutic alternatives for the management of various chronic pain conditions. Objective: The primary objective of this systematic review is to assess the efficacy of TMS and tDCS in reducing clinical pain intensity in chronic orofacial pain (OFP) disorders. The secondary objectives are to describe adverse effects, duration of relief, and TMS/tDCS methodologies used in chronic OFP disorders. Methods: A search was performed in MEDLINE, Embase, Web of Science, Scopus, and Google Scholar. Inclusion criteria were 1) population: adults diagnosed with chronic OFP including neuropathic and non-neuropathic disorders; 2) intervention: active TMS or tDCS stimulation regardless of the used protocol; 3) comparison: sham TMS or tDCS stimulation; and 4) outcome: primary outcome was patient reported pain intensity. Secondary outcomes were duration of pain relief, adverse effects, and methodological parameters. Risk of bias and quality of study reporting were also assessed. Results: A total of 556 individual citations were identified by the search strategy, with 14 articles meeting selection criteria (TMS=11; tDCS=3). Data were obtained for a total of 228 patients. Included OFP disorders were trigeminal neuralgia, trigeminal neuropathy, burning mouth syndrome, atypical facial pain, and temporomandibular disorders. Significant pain reductions were obtained in both techniques. More number of sessions yielded to more durable effects. Overall, high risk of bias and poor study quality were found. Conclusion: TMS and tDCS appear to be safe and promising alternatives to reduce pain intensity in different chronic OFP disorders. Additional research effort is needed to reduce bias, improve quality, and characterize optimal brain stimulation parameters to promote their efficacy. [ABSTRACT FROM AUTHOR]

Objectives This study seeks to evaluate the effects of a mild traumatic brain injury (mTBI) on pain in patients with an isolated limb fracture (ILF) when compared to a matched cohort group with no mTBI (control group). Patients and methods All subjects included in this observational study suffered from an ILF. Groups were matched according to the type of injury, sex, age, and time since the accident. Main outcome measurements were: Standardized semi-structured interviews at follow-up of a Level I Trauma Center, and a questionnaire on fracture-related pain symptoms. Factors susceptible to influence the perception of pain, such as age, sex, severity of post-concussive symptoms, and worker compensation were also assessed. Results A total of 68 subjects (36 females; 45 years old) with an ILF were selected, 34 with a comorbid mTBI and 34 without (24/34 with an upper limb fracture per group, 71% of total sample). Patients with mTBI and an ILF reported significantly higher pain scores at the time of assessment (mean: 49 days, SD: 34.9), compared to the control group (p < 0.0001; mean difference 2.8, 95% confidence interval 1.8–4.0). Correlational analyses show no significant association between the level of pain and factors such as age, sex, severity of post-concussive symptoms, and worker compensation. Conclusions Results suggest that mTBI exacerbate perception of pain in the acute phase when occurring with an ILF, and were not explained by age, sex, post-concussive symptoms, or worker compensation. Rather, it appears possible that neurological sequelae induced by mTBI may interfere with the normal recovery of pain following trauma. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the neuropsychological consequences of a middle interhemispheric approach for the removal of tumors of the third or lateral ventricles. A retrospective analysis of eight callosotomized patients for ventricular tumors (three males/five females; mean age: 48.7 ± 11.2 years; education level: 11.9 ± 2.9 years) and eight healthy subjects was performed. An extensive neuropsychological test battery was used to evaluate global intellectual efficiency, memory capacities, executive functions, and interhemispheric transfer of a procedural learning task (serial reaction time task/SRTT). Neuropsychological results showed that: (1) five of eight patients operated through a middle transcallosal approach had disturbances of verbal or visual memory; (2) three of eight patients displayed a dysexecutive cognitive syndrome(two of eight of whom presenting with a deficit of verbal fluency); (3) two of eight patients presented a dysexecutive behavior syndrome; and (4) with regard to the SRTT, although all participants learned the task, in contrast to controls, the callosotomized patients showed an increase in reaction times and an absence of interhemispheric transfer of learning from one hand to the other. The transcallosal approach transects a large number of callosal fibers. This damage accounts for the deficits of memory, the dysexecutive cognitive and behavioral syndrome, and disturbances in interhemispheric transfer of learning.