La vision joue un rôle très important dans la prévention du danger. La douleur a aussi pour fonction de prévenir les lésions corporelles. Nous avons donc testé l’hypothèse qu’une hypersensibilité à la douleur découlerait de la cécité en guise de compensation sensorielle. En effet, une littérature exhaustive indique qu’une plasticité intermodale s’opère chez les non-voyants, ce qui module à la hausse la sensibilité de leurs sens résiduels. De plus, plusieurs études montrent que la douleur peut être modulée par la vision et par une privation visuelle temporaire. Dans une première étude, nous avons mesuré les seuils de détection thermique et les seuils de douleur chez des aveugles de naissance et des voyants à l’aide d’une thermode qui permet de chauffer ou de refroidir la peau. Les participants ont aussi eu à quantifier la douleur perçue en réponse à des stimuli laser CO2 et à répondre à des questionnaires mesurant leur attitude face à des situations douloureuses de la vie quotidienne. Les résultats obtenus montrent que les aveugles congénitaux ont des seuils de douleur plus bas et des rapports de douleur plus élevés que leurs congénères voyants. De plus, les résultats psychométriques indiquent que les non-voyants sont plus attentifs à la douleur. Dans une deuxième étude, nous avons mesuré l’impact de l'expérience visuelle sur la perception de la douleur en répliquant la première étude dans un échantillon d’aveugles tardifs. Les résultats montrent que ces derniers sont en tous points similaires aux voyants quant à leur sensibilité à la douleur. Dans une troisième étude, nous avons testé les capacités de discrimination de température des aveugles congénitaux, car la détection de changements rapides de température est cruciale pour éviter les brûlures. Il s’est avéré que les aveugles de naissance ont une discrimination de température plus fine et qu’ils sont plus sensibles à la sommation spatiale de la chaleur. Dans une quatrième étude, nous avons examiné la contribution des fibres A∂ et C au traitement nociceptif des non-voyants, car ces récepteurs signalent la première et la deuxième douleur, respectivement. Nous avons observé que les aveugles congénitaux détectent plus facilement et répondent plus rapidement aux sensations générées par l’activation des fibres C. Dans une cinquième et dernière étude, nous avons sondé les changements potentiels qu’entrainerait la perte de vision dans la modulation descendante des intrants nociceptifs en mesurant les effets de l’appréhension d’un stimulus nocif sur la perception de la douleur. Les résultats montrent que, contrairement aux voyants, les aveugles congénitaux voient leur douleur exacerbée par l’incertitude face au danger, suggérant ainsi que la modulation centrale de la douleur est facilitée chez ces derniers. En gros, ces travaux indiquent que l’absence d’expérience visuelle, plutôt que la cécité, entraine une hausse de la sensibilité nociceptive, ce qui apporte une autre dimension au modèle d’intégration multi-sensorielle de la vision et de la douleur. / Vision is important for avoiding encounters with objects in the environment that may imperil physical integrity. Since pain also plays a major role in preventing bodily injury, we tested whether, in the absence of vision, pain hypersensitivity would arise from an adaptive shift to other sensory channels. Indeed, a wealth of literature indicates that blindness leads to sensory compensation and crossmodal plasticity. Furthermore, studies have shown that pain perception can be modulated by vision and by temporary visual deprivation. In a first study, we measured innocuous and noxious thermal thresholds using a Peltier-based thermotester in congenitally blind and normal sighted participants. We also assessed their suprathreshold pain ratings using a CO2 laser device and evaluated their attitude towards daily pain encounters using questionnaires on attention and anxiety. Results show that congenitally participants have lower pain thresholds and higher suprathreshold pain ratings. The psychometric data further indicates that they are more attentive to pain compared to their sighted peers. In a second study, we investigated whether visual experience has an impact on pain perception by replicating the first study in late blind participants. Results indicate that individuals who lost sight later in life are similar to the sighted in every aspect of pain perception that we measured. In a third study, we tested whether blind individuals have supranormal skills in detecting small and quick increases in temperature, as these thermal cues of the environment might help identifying and avoiding potentially harmful objects. Results show that congenitally blind participants outperform their sighted peers and that they are more susceptible to spatial summation of heat. In a fourth study, we examined the contribution of A∂ and C-fibres to blind individuals’ nociceptive processing, as these fibres are thought to signal the first and second pain, respectively. Our findings indicate that congenital blindness leads to an enhanced detection to C-fibre mediated sensations and to faster reaction times to these nociceptive inputs. In a fifth and final study, we probed the potential changes in the descending modulation of nociceptive inputs following visual deprivation by measuring the effects of psychological factors like anticipation and anxiety on blind individuals’ pain perception. Results show that congenitally blind participants are more sensitive to pain in response to uncertainty about threat, suggesting that they are more susceptible to top-down modulation of pain. Overall, this work indicates that visual deprivation from birth, but not later in life, causes a leftward shift in the stimulus–response function to nociceptive stimuli and lends new support to a model of sensory integration of vision and pain processing.

Fascial tissues form a continuous whole-body three-dimensional network penetrating all parts of the human body. They include all fibrous connective tissue that significantly contributes both to themaintaining of the integrity of the organism and the functioning of body systems and the somesthetic perception.That is because of the facia is richly populated by proprioceptiveand mechanosensitive nociceptive nerve endings. Although the stretching is a routine method used in sports and rehabilitation, its exact mechanism of influence and effects on the body are not fully understood so far. Stretching exercises affect the mechanical state of the myofascial tissues and also the quality of the nociception and proprioception by alteration of their preload. There is evidence about some differences of the mechanical properties of the tissuesboth between thesexes and hypermobile individuals. The theses assesses the effect of static stretching m. QF on the somesthetic perception by measuring pressure pain threshold (PPT) using pressure algometry and the quality of propcioception bygoniometric measurement considering the interindividual variance in quality of the connective tissues. Our research includes testing of 29 healthy subjects (14 women and 15 men) and it has proved significant impact of the intervention on the...

Ankyrin receptor TRPA1 is an ion channel widely expressed on primary afferent sensory neurons, where it acts as a polymodal sensor of nociceptive stimuli. Apart from pungent chemicals (e. g. isothiocyanates, cinnamaldehyde and its derivatives, acrolein, menthol), it could be activated by cold temperatures, depolarizing voltages or intracellular calcium ions. TRPA1 channel is a homotetramer in which each subunit consists of cytoplasmic N and C termini and a transmembrane region. The transmembrane part is organized into six alpha- helices connected by intra- and extracellular loops. The N terminus comprises a tandem set of 16 to 17 ankyrin repeats (AR), while the C terminus has a substantially shorter, dominantly helical structure. In 2015, a partial cryo-EM structure of TRPA1 was resolved; however, the functional roles of the individual regions of the receptor have not yet been fully understood. This doctoral thesis is concerned to elucidate the role of highly conserved sequence and structural motifs within the cytoplasmic termini and the S4-S5 region of TRPA1 in voltage- and chemical sensitivity of the receptor. The probable binding site for calcium ions that are the most important physiological modulators of TRPA1 was described by using homology modeling, molecular-dynamics simulations,...

Respostas adaptativas ao estresse podem ser acompanhadas por alterações nos comportamentos emocionais, em particular relacionados com medo e ansiedade, bem como alterações na sensibilidade dolorosa. Ainda, tem sido investigado o papel do óxido nítrico em áreas encefálicas relacionadas ao comportamento defensivo. Embora várias evidências têm demonstrado que o enriquecimento ambiental promove melhora nos processos de memória, no aprendizado e em respostas nociceptivas, a relação entre o estresse crônico e as vantagens da utilização do enriquecimento ambiental ainda são pouco investigadas. O presente estudo teve como objetivo investigar se o enriquecimento ambiental promove alteração do comportamento emocional, da sensibilidade nociceptiva, bem como na imunorreatividade à nNOS no núcleo central da amígdala, na formação hipocampal e na região dorsolateral da substância cinzenta periaquedutal, em ratos submetidos ao estresse por isolamento social ou estresse crônico variado e mantidos em ambiente enriquecido ou sem enriquecimento. Ratos machos Wistar (~70g) foram divididos aleatoriamente em dois grandes grupos experimentais: Ambiente Padrão (Padrão) ou Ambiente Enriquecido (EE), mantidos por 38 dias. Cada grupo foi subdividido dependendo do tipo de estresse crônico: Controle (sem estresse), Isolamento Social (por 38 dias) e Estresse Crônico Variado (do dia 28 ao dia 37). Ao fim do tempo experimental (dia 38) os ratos foram avaliados quanto ao comportamento emocional pelos testes de labirinto em cruz elevado (LCE) e claro/escuro (TCE) e sensibilidade nociceptiva pelo teste da placa quente (a qual foi realizada em duas etapas, sendo a primeira medida no dia 0 e outra no dia 38). A eutanásia dos ratos ocorreu no dia 39, para coleta do encéfalo para análise da imunorreatividade à óxido nítrico sintase neuronal (nNOS). Levando-se em consideração o comportamento emocional e a sensibilidade nociceptiva, os diferentes tipos de estresse crônico diminuíram a porcentagem de tempo, a frequência de entrada e a exploração da extremidade dos braços abertos e na frequência de mergulho de cabeça no teste do LCE, apesar de não alterar a sensibilidade nociceptiva. Por outro lado, o enriquecimento ambiental aumentou a porcentagem de tempo, a frequência de entrada e a exploração da extremidade dos braços abertos no teste do LCE, apesar de não alterar a sensibilidade nociceptiva. Foi observado aumento da imunorreatividade à nNOS na formação hipocampal em diferentes tipos de estresse crônico. Em particular, na região de CA3 houve interação significante entre os fatores estresse por isolamento social e ambiente de manutenção. Deste modo, os resultados obtidos neste trabalho sugerem que a formação hipocampal desempenha importante função no efeito ansiogênico exercido pelos diferentes tipos de estressores crônicos (aqui representados pelo isolamento social e pelo estresse crônico variado) provavelmente pela ativação do sistema nitrérgico e sugere-se que o enriquecimento possa prevenir o comportamento do tipo ansioso. / Adaptive responses to stress may be accompanied by changes in emotional behaviors, in particular related to fear and anxiety, as well as changes in pain sensitivity. Furthermore, the role of nitric oxide in brain areas related to defensive behavior has been investigated. Although several evidences have shown that environmental enrichment improves memory processes, learning and nociceptive responses, the relationship between chronic stress and the advantages of using environmental enrichment is still poorly investigated. The present study aimed to investigate whether environmental enrichment promotes alteration of the emotional behavior, nociceptive sensitivity, as well as immunoreactivity to neuronal nitric oxide synthase (nNOS) in the central nucleus of the amygdala, hippocampal formation and dorsolateral periaqueductal gray matter in rats submitted to social isolation stress or chronic unpredictable stress and reared in enriched environment or standard environment. Male Wistar rats (~ 70g) were randomly divided into two major experimental groups: Standard Environment (Standard) or Enriched Environment (EE), maintained for 38 days. Each group was subdivided according to the type of chronic stress: Control (without stress), Social Isolation (for 38 days) and Chronic Unpredictable Stress (from day 28 to day 37). At the end of the experimental time (day 38), the rats were evaluated for emotional behavior by elevated plus maze (EPM) and light/dark box (LDBT) tests and nociceptive sensitivity by the hot plate test (which was performed in two steps , the first being measured on day 0 and the other on day 38). Euthanasia of rats occurred on day 39, to collect the brain for nNOS immunoreactivity analysis. Taking into account emotional behavior and nociceptive sensitivity, the different types of chronic stress decreased the percentage of time, the frequency of entry of the open arms, end-arm exploration and the head dipping frequency in the EPM, despite of not altering the nociceptive sensitivity. On the other hand, environmental enrichment increased the percentage of time, the frequency of entry of the open arms and the end arm-exploration in the EPM test, although it did not alter the nociceptive sensitivity. Increased immunoreactivity to nNOS in hippocampal formation was observed in different types of chronic stress. In particular, in the CA3 region there was a significant interaction between stress factors due to social isolation and maintenance environment. Thus, the results obtained in this study suggest that hippocampal formation plays an important role in the anxiogenic effect exerted by the different types of chronic stressors (represented here by social isolation and by chronic chronic stress) probably due to the activation of the nitrergic system and it is suggested that environmental enrichment can prevent of anxiety-like behavior.

A Doença de Parkinson (DP) é causada pela degeneração progressiva de neurônios no sistema nervoso central, principalmente os neurônios dopaminérgicos nigroestriatais, levando a sintomas motores como a bradicinesia, rigidez e tremor. Os sintomas não motores (SNM), como a dor, estão presentes em muitos doentes e representam um impacto negativo na qualidade de vida. A estimulação encefálica profunda é um tratamento bem estabelecido para o tratamento dos sintomas motores da DP. Entretanto, o seu impacto sobre os sintomas não motores ainda é bastante desconhecido. O objetivo do presente estudo foi avaliar os efeitos da EEP sobre as diferentes características da dor e sensibilidade, e de outros SNM nos indivíduos com DP. Foram avaliados 41 indivíduos com diagnóstico de DP (14 do sexo feminino), idade de 60 ± 10,4 anos, com 15 ± 7,6 anos da duração da doença e estágio intermediário de evolução (Escala de Hoehn & Yahr = 2,80 ± 0,64). Os doentes foram submetidos a implante de sistema de estimulação bilateral do núcleo subtalâmico guiado por eletrofisiologia intraoperatória. Foram avaliados, prospectivamente, antes e um ano após, o procedimento de forma encoberta. O desfecho principal foi a mudança da prevalência da dor após a cirurgia. Os desfechos secundários incluíam mudanças nos sintomas motores (UPDRS parte III), na qualidade de vida (escala SF-36), na avaliação de humor (Escala Hospitalar de Ansiedade e Depressão [EHAD]), nos outros sintomas não motores (Escala dos sintomas não motores [ESNM]) e nas características da dor. Foram avaliadas as dimensões da dor (questionário de McGill), a intensidade e o impacto nas atividades de vida diária da dor (escala visual analógica da dor [EVA], inventário breve da dor [IBD]), a presença de dor neuropática (Douleur Neuropathique-4 Questionnaire [DN-4]) e o perfil dos sintomas neuropáticos (inventário de sintomas de dor neuropática (ISDN), o perfil de catastrofismo da dor (Escala catastrófica da dor [ECD]) e os limiares de sensitivos por meio da análise quantificada dos limiares de sensibilidade. Houve redução de prevalência da dor de 70% para 21% após a cirurgia (p < 0,05). Houve melhora na intensidade (EVA: antes = 80 ± 13,2; depois = 42,2 ± 17,8, p = 0,007) e nos diferentes aspectos da dor, além de outros sintomas não motores (ESNM: antes = 114,80 ± 59,89; depois = 62,68 ± 22,76; p < 0,001), como a cognição, humor, atenção, alucinação e trato gastrointestinal. Houve melhora na detecção de estímulos térmicos e mecânicos após a cirurgia, além de redução da sensibilidade aos limiares de dor (p < 0,05). A melhora na intensidade da dor foi fortemente relacionada com a melhora na qualidade vida (r = 0,708; p < 0,005). Não houve correlação entre a melhora da dor e a resposta à dopamina pré-operatória ou a melhora motora após a cirurgia (r = 0,247; p = 0,197 e r = 0,249; p = 0,193, respectivamente). Concluise que a ECP do núcleo subtalâmico diminui a prevalência e diferentes aspectos da dor após a cirurgia, e essa melhora está diretamente associada à melhora da qualidade de vida. A melhora motora ou dos outros SNM não foi relacionada à melhora da dor, sugerindo que a ECP apresenta diferentes mecanismos de ação sobre os sintomas nos indivíduos com DP / Parkinson disease (PD) is caused by progressive degeneration of neurons throughout the nervous system, especially the dopamine neurons, leading to motor symptoms as bradykinesia, rigidity and tremor. Non-motor symptoms (NMS), such as pain, are present in a large proportion of Parkinson\'s disease patients and have a major negative impact on patients quality of life. Subthalamic deep brain stimulation has gained general use in the management of motor symptoms in these patients. However, its impact on non-motor symptoms remains largely unknown. The aim of this study was to evaluate the effect of subthalamic deep brain stimulation (STN-DBS) on the different characteristics of pain, sensibility and other NMS in patients with PD. Forty-one patients with PD were evaluated (14 female), mean age 60 ± 10,4 years. The mean duration of the disease was 15 ± 7.6 years, and the Hoehn & Yahr off-medication score was 2.80 ± 0.64. The patients underwent stereotactic implantation of bilateral subthalamic nucleus stimulation system guided by intraoperative electrophysiology. They were evaluated before and 01 year after surgery. The primary outcome was change in pain prevalence after surgery. Secondary outcome measures were changes in motor function (PDRS part III), quality of life (SF-36 scale), presence of NMS (Non-motor symptoms scale [NMSS] and Hospital Anxiety and Depression Scale [HADS]), and characteristics of pain. We evaluated pain dimensions (Short Form of McGill Pain Questionnaire [MPQ]), pain intensity and impact of pain in daily activities (Brief Pain Inventory [BPI] and Visual Analogic Scale [VAS]), presence of neuropathic pain (Douleur Neuropathique-4 Questionnaire [DN-4]) and its symptom profile (Neuropathic Pain Symptom Inventory [NPSI]), catastrophizing (Pain Catatrosphizing Scale [PCS]) and the sensory thresholds throught the quantitative sensory threshold test. The prevalence of pain changed from 70% to 21% after surgery (p < 0.001). There were also significant improvements in pain intensity (VAS: before = 80 ± 13.2; after = 42.2 ± 17.8, p = 0.007), in different aspects of pain and NMS (before = 114.80 ± 59.89; after = 62.68 ± 22.76; p < 0.001) as cognition, attention, mood and gastrointestinal function. There was improvement on cold and heat detection thresholds (p < 0.05). There was a strong correlation between the change in pain intensity and the improvement in quality of life (r = 0.708; p < 0.005). No correlation was found between pain improvement and preoperative response to levodopa or motor improvement during stimulation (r = 0.247; p = 0.197 and r = 0.249; p = 0.193, respectively) or with changes in other non-motor symptoms. In conclusion, STN-DBS decreased pain intensity. The pain relief was directly associated with improvement in quality of life. Motor and NMS improvements after STN-DBS did not correlate with pain relief, suggesting differents mechanisms of DBS action in PD patients

Respostas adaptativas ao estresse podem ser acompanhadas por alterações nos comportamentos emocionais, em particular relacionados com medo e ansiedade, bem como alterações na sensibilidade dolorosa. Ainda, tem sido investigado o papel do óxido nítrico em áreas encefálicas relacionadas ao comportamento defensivo. Embora várias evidências têm demonstrado que o enriquecimento ambiental promove melhora nos processos de memória, no aprendizado e em respostas nociceptivas, a relação entre o estresse crônico e as vantagens da utilização do enriquecimento ambiental ainda são pouco investigadas. O presente estudo teve como objetivo investigar se o enriquecimento ambiental promove alteração do comportamento emocional, da sensibilidade nociceptiva, bem como na imunorreatividade à nNOS no núcleo central da amígdala, na formação hipocampal e na região dorsolateral da substância cinzenta periaquedutal, em ratos submetidos ao estresse por isolamento social ou estresse crônico variado e mantidos em ambiente enriquecido ou sem enriquecimento. Ratos machos Wistar (~70g) foram divididos aleatoriamente em dois grandes grupos experimentais: Ambiente Padrão (Padrão) ou Ambiente Enriquecido (EE), mantidos por 38 dias. Cada grupo foi subdividido dependendo do tipo de estresse crônico: Controle (sem estresse), Isolamento Social (por 38 dias) e Estresse Crônico Variado (do dia 28 ao dia 37). Ao fim do tempo experimental (dia 38) os ratos foram avaliados quanto ao comportamento emocional pelos testes de labirinto em cruz elevado (LCE) e claro/escuro (TCE) e sensibilidade nociceptiva pelo teste da placa quente (a qual foi realizada em duas etapas, sendo a primeira medida no dia 0 e outra no dia 38). A eutanásia dos ratos ocorreu no dia 39, para coleta do encéfalo para análise da imunorreatividade à óxido nítrico sintase neuronal (nNOS). Levando-se em consideração o comportamento emocional e a sensibilidade nociceptiva, os diferentes tipos de estresse crônico diminuíram a porcentagem de tempo, a frequência de entrada e a exploração da extremidade dos braços abertos e na frequência de mergulho de cabeça no teste do LCE, apesar de não alterar a sensibilidade nociceptiva. Por outro lado, o enriquecimento ambiental aumentou a porcentagem de tempo, a frequência de entrada e a exploração da extremidade dos braços abertos no teste do LCE, apesar de não alterar a sensibilidade nociceptiva. Foi observado aumento da imunorreatividade à nNOS na formação hipocampal em diferentes tipos de estresse crônico. Em particular, na região de CA3 houve interação significante entre os fatores estresse por isolamento social e ambiente de manutenção. Deste modo, os resultados obtidos neste trabalho sugerem que a formação hipocampal desempenha importante função no efeito ansiogênico exercido pelos diferentes tipos de estressores crônicos (aqui representados pelo isolamento social e pelo estresse crônico variado) provavelmente pela ativação do sistema nitrérgico e sugere-se que o enriquecimento possa prevenir o comportamento do tipo ansioso. / Adaptive responses to stress may be accompanied by changes in emotional behaviors, in particular related to fear and anxiety, as well as changes in pain sensitivity. Furthermore, the role of nitric oxide in brain areas related to defensive behavior has been investigated. Although several evidences have shown that environmental enrichment improves memory processes, learning and nociceptive responses, the relationship between chronic stress and the advantages of using environmental enrichment is still poorly investigated. The present study aimed to investigate whether environmental enrichment promotes alteration of the emotional behavior, nociceptive sensitivity, as well as immunoreactivity to neuronal nitric oxide synthase (nNOS) in the central nucleus of the amygdala, hippocampal formation and dorsolateral periaqueductal gray matter in rats submitted to social isolation stress or chronic unpredictable stress and reared in enriched environment or standard environment. Male Wistar rats (~ 70g) were randomly divided into two major experimental groups: Standard Environment (Standard) or Enriched Environment (EE), maintained for 38 days. Each group was subdivided according to the type of chronic stress: Control (without stress), Social Isolation (for 38 days) and Chronic Unpredictable Stress (from day 28 to day 37). At the end of the experimental time (day 38), the rats were evaluated for emotional behavior by elevated plus maze (EPM) and light/dark box (LDBT) tests and nociceptive sensitivity by the hot plate test (which was performed in two steps , the first being measured on day 0 and the other on day 38). Euthanasia of rats occurred on day 39, to collect the brain for nNOS immunoreactivity analysis. Taking into account emotional behavior and nociceptive sensitivity, the different types of chronic stress decreased the percentage of time, the frequency of entry of the open arms, end-arm exploration and the head dipping frequency in the EPM, despite of not altering the nociceptive sensitivity. On the other hand, environmental enrichment increased the percentage of time, the frequency of entry of the open arms and the end arm-exploration in the EPM test, although it did not alter the nociceptive sensitivity. Increased immunoreactivity to nNOS in hippocampal formation was observed in different types of chronic stress. In particular, in the CA3 region there was a significant interaction between stress factors due to social isolation and maintenance environment. Thus, the results obtained in this study suggest that hippocampal formation plays an important role in the anxiogenic effect exerted by the different types of chronic stressors (represented here by social isolation and by chronic chronic stress) probably due to the activation of the nitrergic system and it is suggested that environmental enrichment can prevent of anxiety-like behavior.

INTRODUÇÃO: Sabe-se que a doença periodontal é a doença infecciosa crônica mais prevalente na população adulta, acometendo 1/5 da população em fase ativa de trabalho e causadora de dor. As citocinas e demais substâncias moduladoras da inflamação que promovem e perpetuam a doença periodontal interagem e agravam outras doenças como o diabetes mellitus, aterosclerose e doenças autoimunes. O periodonto, com suas aferências proprioceptivas especializadas, desempenha importante papel de regulação dos movimentos da mastigação. Apesar da região orofacial ter uma ampla área de representação no córtex cerebral não se sabem os efeitos de uma inflamação crônica periodontal nesta representação. Ansiedade e estresse são conhecidos fatores correlacionados à doença periodontal e moduladores de condições dolorosas. Assim, são objetivos deste estudo a avaliação da sensibilidade mecânica em vibrissas, avaliação da ansiedade e o mapeamento do córtex motor de ratos com doença periodontal de 14 e 28 dias de evolução. MÉTODOS: Foram utilizados ratos Wistar machos pesando inicialmente entre 140 e 180 gramas, divididos em 3 grupos principais: grupo controle, grupo sham e grupo de estudo, em que a doença periodontal foi induzida por amarria no primeiro molar inferior direito. Os animais foram avaliados com 14 e 28 dias de doença, sendo a sensibilidade mecânica aferida por filamentos de Von Frey e a ansiedade avaliada por meio do labirinto em cruz elevado. O mapeamento do córtex motor foi realizado por estimulação elétrica epidural de um a dez volts. RESULTADOS: Ambos os períodos de evolução da doença causaram alterações condizentes com doença periodontal. Não houve diferenças no ganho de peso dos animais independente do grupo ao longo do estudo. Nos animais com 28 dias de doença houve maior nocicepção no lado doente com diferença estatística (p=0,042). Os animais do grupo de estudo 14 dias demonstraram mais comportamentos sugestivos de ansiedade nos parâmetros de congelamento (p=0,031), entradas nas extremidades dos braços abertos (p=0,048) e esticamento nos braços abertos (p=0,047) do labirinto em cruz elevado do que os grupos sham e controle. Os animais do grupo de estudo de 28 dias apresentaram maior comportamento de dor e medo observado através da presença do congelamento (p=0,016). O mapeamento do córtex motor evidenciou áreas representativas da mandíbula sobrepostas à área das vibrissas. Foi observada uma expansão da área da mandíbula no grupo da doença periodontal de 14 dias (p=0,038). CONCLUSÃO: A doença periodontal com 14 dias de evolução causou um aumento da resposta motora ipsilateral da mandíbula-mais-vibrissas e alterações de comportamento sugestivas de ansiedade / BACKGROUND: Periodontal disease is the most prevalent chronical infectious disease in adults, affecting 1/5 of people in active phase of labor and causing pain. Cytokines and substances that modulate inflammation promotes and perpetuate de periodontal disease, interacting and worsening other conditions such as diabetes mellitus, aterosclerosis and autoimmune diseases. The periodontium has specialized proprioceptive afferents and plays a role in the regulation of masticatory movements. Despite the wide brain cortical representation area of the orofacial structures, the periodontium has not been described in the literature and the effects of a chronical inflammation in its representation has not been clarified. Anxiety and stress are factors correlated to periodontal disease and modulators of pain. The aim of this study was evaluate vibrissae nociception through mechanical response, anxiety and the motor cortex mapping in rats with periodontal disease after 14 or 28 days of evolution. METHODS: Male Wistar rats (initial weight 140-180 grams) divided into 3 main groups: controls, sham and periodontal disease induced by placement of a cotton ligature in the mandibular right first molar tooth. The evaluations took place after 14 or 28 days of disease. Mechanical response was evaluated by von Frey filaments and anxiety was evaluated through the elevated plus maze. Epidural electrical stimulation (1 to 10 volts) was the method used for the cortical motor mapping. RESULTS: Both evolution periods caused clinical outcomes consistent to periodontal disease. There was no difference in the weight gain of the animals, whatever the group during the study. The animals with 28 days appeared to have a higher nociception in the side affected, with statistical difference (p=0.042). Animals with the disease evolution through 14 days showed more anxious behavior seen by freezing (p=0.031), entries in the extremities of open arms (p=0.048) and stretching in open arms (p=0.047) than the sham and control groups, in the elevated plus maze test. The 28 day disease evolution group showed more pain and fear behavior, seen by freezing (p=0.016). The cortical motor mapping showed an overlapping of jaw and vibrissae areas. There was an expansion of the mandibular area in the 14-day disease group (p=0.038). CONCLUSION: at 14-days, PD led to an expansion of the mandibular-plus-vibrissae motor cortical representation ipsilateral to the disease and behaviors suggestive of anxiety

Les facteurs psychologiques tels que l'hypnose, l'émotion, le stress et l’attention exercent un effet modulant puissant sur la nociception et la douleur. Toutefois, l’influence de l'attention sur la nociception et la douleur, ainsi que les mécanismes neuronaux sous-jacents, ne sont pas clairs. La littérature actuelle sur la modulation attentionnelle des réponses spinales nociceptives, telles que mesurées par le réflexe RIII, et de la perception de l’intensité de la douleur est discordante et souvent contradictoire. Ce mémoire fournit un nouveau cadre pour examiner la modulation du réflexe RIII et de la douleur par l’attention. Une tâche de discrimination sensorielle a été décomposée en trois composantes attentionnelles : la vigilance, l’orientation, et le contrôle exécutif. Auparavant, la nature multidimensionnelle de l’attention fut largement ignorée dans la littérature. Nous démontrons que les composantes attentionnelles ont des effets modulatoires distincts sur la nociception et la douleur et suggérons que ceci représente une partie de la confusion présente dans la littérature. En prenant compte du stress indépendamment, nous démontrons, pour la première fois, que le stress inhibe la modulation attentionnelle du réflexe RIII ce qui indique une interaction et dissociation de la modulation des réponses nociceptives par l’attention et le stress. Ces résultats importants clarifient, en grande partie, les contradictions dans la littérature, puisque les tâches cognitives produisent souvent des augmentations du stress ce qui confond l’interprétation des résultats. De plus, la tâche de discrimination inclut des stimuli visuels et somatosensoriels et révèle que l’influence de l'attention sur la douleur est spatialement spécifique tandis que la modulation attentionnelle de la nociception est spécifique à la modalité des stimuli, au moins en ce qui concerne les modalités examinées. A partir de ces résultats, un nouveau modèle de la modulation attentionnelle des processus de la douleur, basée sur les composantes attentionnelles, a été proposé. Celui-ci est appuyé par la littérature et fournit une explication systématique et intégratrice des résultats antérieurement contradictoires. De plus, à partir de ce modèle, plusieurs mécanismes neuronaux ont été proposés pour sous-tendre la modulation attentionnelle de la nociception et de la douleur. / Psychological factors such as hypnosis, emotion, stress, and attention produce powerful modulatory effects on nociception and pain. However, the influence of attention on nociception and pain and the underlying neural mechanism responsible are unclear. The current literature on attentional modulation of spinal nociceptive responses, as measured by the RIII reflex, and pain perception (pain intensity) is inconsistent and often contradictory. The present thesis provides a new component-based framework for the examination of attentional modulation of the RIII reflex and pain. A delayed-discrimination task was decomposed into the three components of attention – namely alerting, orienting, and executive control (sensory working memory). Previously, the multidimensional nature of attention was largely ignored in the pain literature. We show that each component of attention exerts a distinct modulatory effect on nociception and pain and suggest that this accounts for some of the confusion in the literature. By considering stress separately, we demonstrate for the first time that stress blocks attentional modulation of the RIII reflex, indicating an interaction and dissociation of attention- and stress-mediated modulation of spinal nociceptive responses. This important finding clarifies much of the disagreement in the literature, since cognitive tasks often induce increases in stress that consequently confound interpretation. Additionally, both visual and somatosensory stimuli were included in the discrimination task, revealing that the influence of attention on pain intensity is spatially-specific whereas attentional modulation of nociception is modality-specific, at least for the modalities investigated. From these findings a component-based model for the attentional modulation of pain processes is proposed. This model is substantially supported by the literature and provides a meaningful and cohesive explanation of the seemingly contradictory results across studies. Moreover, this model suggests potential neural mechanisms underlying the attentional modulation of pain.

Le wind-up est une augmentation progressive, fréquence dépendante, de la réponse d'un neurone lors de l'application répétitive de stimuli électriques nociceptifs identiques sur un même territoire. Ce phénomène est essentiellement exprimé par les neurones WDR de la moelle comme du trijumeau. Il dépend en partie de l'activation des récepteurs NMDA et NK1. Il est apparenté chez l'homme à la sommation temporelle et a des conséquences sur la perception de la douleur. Sa signification fonctionnelle n'est pas encore clairement établie. Chez le rat anesthésié et au sein du complexe sensitif du trijumeau, l'objectif de ce travail est : 1) d'analyser les caractéristiques et la fonction du wind-up des neurones WDR trigéminaux, 2) d'identifier les réseaux neuronaux sous tendant le wind-up et 3) d'établir le rôle des rNMDA et des rNK1 dans le wind-up. Nous avons adopté une approche électrophysiologique lors d'enregistrements extracellulaires au sein du Sp5O associés à des micro injections dans le Sp5C. De plus, une approche neuroanatomique a permis d'identifier des réseaux d'interneurones véhiculant le message depuis le Sp5C vers le Sp5O. 1) le wind-up des neurones WDR du Sp5O dépend de l'intensité de la stimulation nociceptive et permet d'améliorer les capacités de codage de stimuli nociceptifs de courte durée. Par ailleurs, nous montrons que le wind-up entraine une modification transitoire (environ 2min) de l'excitabilité des neurones WDR. Cette modification d'excitabilité générée par la wind-up est responsable uniquement de la facilitation des réponses évoquées par la mise en jeu des fibres C. Nous suggérons que l'augmentation de l'excitabilité centrale générée par le wind-up et la sensibilisation centrale sont des phénomènes différents. 2) le wind-up dépend de l'activation des rNMDA locaux alors qu'il est soumis à une inhibition via les rNMDA situés dans les couches superficielles du Sp5C. Le modèle trigéminal permet donc de montrer que, dès l'étage segmentaire, il existe un ajustement permanent de l'amplification du message douloureux. 3) enfin, le développement du wind-up dépend également de l'activation des rNK1 situés sur des interneurones localisés dans la couche III du Sp5C. En conclusion, il apparaît que le wind-up est un phénomène segmentaire permettant le codage de stimulations nociceptives de courte durée et sous tendu à la mise en jeu de voies polysynaptiques rNK1 et rNMDA dépendantes.

The aims of the thesis were (i) to investigate the impact of repetitive low-intensity work exposure on proprioception and (ii) to examine effects of muscle stretching (especially sensory effects and effects on muscle nociception) and to relate its application to the prevention, alleviation and/or treatment of work-related neuromuscular disorders. The effects of low-intensity repetitive work on the shoulder proprioception were tested in healthy subjects. The effect of working time on the retention of subjective fatigue and their relation to changes in proprioception, and the immediate effect of stretching on shoulder proprioception were investigated. A new method to test the stretchability of the rectus femoris muscle was investigated for reliability and validity and used to assess the effects of a two-week stretching regimen on range of motion and on subjective stretch sensation. Finally, the interactions between innocuous muscle stretch and nociceptive chemical stimulation on discharge behavior of nociceptive dorsal horn neurons in the feline spinal cord were explored. The main findings were as follows: 1) The repetitive low-intensity work to fatigue diminished the shoulder proprioception; the working time as well as the retention of subjective fatigue were partly related to the extent of changed proprioception. 2) There was no effect of acute muscle stretching on the proprioception. 3) The new method for testing muscle stretchability proved valid and reliable. A two-week stretching regimen increased the tolerance to stretch torque, but the range of motion remained unchanged. 4) Half of the nociceptive dorsal horn neurons that responded to close arterial injections of bradykinin were modulated by muscle stretching applied directly after the injections. Altogether, the results give credence to the hypothesis of an involvement of sensory information distortion due to repetitive low-intensity work exposure in the development of work-related neuromuscular disorders. Increased tolerance to stretch torque may be an important mechanism in explaining improvements following stretch treatment. The spinal interactions between innocuous stretch and nociceptive muscle afferent inputs indicate a possible mechanism involved in stretching-induced pain alleviation.