Friday 24th September 


Beat Steiger
'
Pain, emotion and mood disorders?'

The definition of pain by the IASP as an “unpleasant sensory and emotionalexperience” reflects the close interrelatedness of pain and emotion. This lecturestarts with a brief historical overview of the conceptualization of painand emotion.Itfocusses on the emotional experience associated with pain: which emotions andmoods are often related to pain, how do they interfere with pain, which assessmentsare available to measure these emotional aspects of pain.
Download here the CV of Beat Steiger.





Juliana T. Clemente-Napimoga

'The Neuro-immune-emotional interface of orofacial pain'
The comprehension of orofacial pain mechanisms is still a challenge. Although the painhas been described as an aversive sensory and emotional experience, the importance ofneuroimmune interactome to pain induction and maintenance is a fact.In this sense,the literature has been discussing the communication between neuronal cells andimmune system cells present in the central nervous system, such as glial cells,endothelial cells, perivascularmacrophages,and T cells.Immune system cells have beenshown to play a role in modulating neural transmission involving painful conditions, aprocess called the Neuroimmune Interface.Microglia are phagocytic cells responsiblefor innate central nervous system (CNS) immunity. Microglial cells are being related asanimportant factor in both induction and maintenance of sensory disorders followedby peripheral neural and / or tissue injuries induced by degenerative chronic diseases.Another aspect is the activation of T cells and astrocytes by chemical mediators releasedby microglia that result in persistent inflammatory pain. Once activated, astrocyteschange their resting phenotype to an active phenotype and initiate the release ofproinflammatory cytokines by inducing a positive feedback response in second-orderneurons, amplifying pain signals, which results in neuronal phenotypic changes and theestablishment of a chronic pain picture.Otherwise, neuroimmune-linked pain sensitivitymay be further heightened byactivation of the neuroendocrine hypothalamus-pituitary-adrenal axisandautonomous nervous systemalterations due to psychosocial stress.Thus,if the immune system ispart of nervous system,it is subject to our perception,behavior and thinking. Diverse complexneuroimmunologyinteraction likely result inmultiple biobehavioral effects. Particularly, the neuroimmune interface of painfulconditions is a process dependent on emotions and decision-making ability. Thechallenge is understanding how motivation status interferes with the neuroimmunologysystem’s responsiveness.
Download here the CV of Juliana T. Clemente-Napimoga.

 

Jay Shah

'Myofascial Trigger Points and the Unique Neurobiology of Muscle Pain' and 'The Dynamic Role of Central Sensitization in the Pathophysiology and Clinical Manifestations of Myofascial Pain Syndrome'
 

 

César Fernández de las Penas
'
Management of Myalgia' 
Myalgia is one of the TMD diagnosis most frequently seen in clinical practice.The role of muscle tissues in temporomandibular and orofacial pain is crucial. It doesnot matter the use of myalgia with pain referral or the term myofascial trigger point, thecommon way is muscle referred pain. This lecture will discuss the main clinical featuresofmuscle referred pain and the neurophysiological consequences in the head and face.We will also show current evidence for referred pain from masticatory muscles and itspotential treatment with manual therapies and dry needling.
The lecture will be focussed on a proper clinical reasoning for the integration of myalgia into a bio-psycho-socialtreatment model.
Download here the CV of César Fernández de las Penas.

 

 

Saturday 25th September

 

 


Randi Abrahamsen
'
Hypnosis for sleep and pain'
R Abrahamsen a, L Baad-Hansen a, PSvensson a, R Zachariae b, Sanne Lodahl c, M Dietz c Andreas Roepstorff c, Leif Østergaard c

a Department of Clinical Oral Physiology, School of Dentistry, University of Aarhus,Aarhus, Denmark. b Psychooncology Research Unit, Aarhus University Hospital, Aarhus, Denmark. c Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark

Introduction: Chronic orofacial pain conditions can be difficult to treat effectively and often patients have poor sleep and suffer from side effects of medication. Hypnosishad been shown to offer painrelieve in various chronic pain conditions. Presenting the results from the PH.D. “Effect of hypnosison persistent orofacial pain”will give an insight into the background of hypnosis and how it can be used in the treatment of chronic orofacial pain. Aim of the study: A. Evaluate the effect of hypnosis on pain in patients suffering from painful Temporomandibular Disorders (TMD)or Persistent Ideopathic Orofacial Pain (PIOP). B. Explore the effect of hypnosis on brain activity in response to painful stimulation. Material and Methods: A. 41 PIOP and 40 TMD patients were randomized to hypnosis(H)or control(C). Outcome measures before and after treatment were compared using ANOVA between group and within-group factors(time) Tukeys HSD. B. 19 TMD patients were scanned (3T scanner, gradient-Echo EPI, slice 3.5mm, 39s/) during identical repetitive pin-prick pain stimulation incontrol, hypnotic hyperalgesia and hypnotic analgesia condition. Results: A. Hypnosis decreased daily pain intensity in PIOP patients33.1 %H compared to C 3.2%(P<0.023) and in TMD 50,4 % H where as C increased pain 0.7% (P<0.001). B. Hypnoticmodulation of brain activity was associated with a pronounced suppression of cortical activity during pain stimuli. Conclusions: Hypnosis can significantly reduce daily pain intensity in PIOP and TMD patients. TMD were able to reduce the perceived intensity of a painful stimulation and this was followed by apronounced difference in brain activity.

Download here the CV of Randi Abrahamsen.
 

Miguel Meira e Cruz
'Pain and circadian rhythms'
 

Dario Acuna-Castroviejo
'Melatonin for pain and sleep'


Vinicius Barbosa
'Cannobinoids for pain and sleep'

Medical cannabis is re-emerging as a therapeutic possibility for a number of clinical conditions thatmedicine and current science still have few tools. Those we have presents significant side effectsespecially in the long term.This presentation aims toclarify the basic concepts involved in the therapeutic use of cannabinoids,their mechanisms of action, benefits and potential harm,mainly on pain and sleep.We will assess the scientific evidence supporting the use under these conditions and what we canexpect in the future of the medicinal use of cannabis.
Download here the CV of Vinicius Barbosa.