OBJECTIVE: The objective of this study is to summarize and analyze the brain signal patterns of empathy for pain caused by facial expressions of pain utilizing activation likelihood estimation, a meta-analysis method....OBJECTIVE: The objective of this study is to summarize and analyze the brain signal patterns of empathy for pain caused by facial expressions of pain utilizing activation likelihood estimation, a meta-analysis method. DATA SOURCES: Studies concerning the brain mechanism were searched from the Science Citation Index, Science Direct, PubMed, DeepDyve, Cochrane Library, SinoMed, Wanfang, VIP, China National Knowledge Infrastructure, and other databases, such as SpringerLink, AMA, Science Online, Wiley Online, were collected. A time limitation of up to 13 December 2016 was applied to this study. DATA SELECTION: Studies presenting with all of the following criteria were considered for study inclusion: Use of functional magnetic resonance imaging, neutral and pained facial expression stimuli, involvement of adult healthy human participants over 18 years of age, whose empathy ability showed no difference from the healthy adult, a painless basic state, results presented in Talairach or Montreal Neurological Institute coordinates, multiple studies by the same team as long as they used different raw data. OUTCOME MEASURES: Activation likelihood estimation was used to calculate the combined main activated brain regions under the stimulation of pained facial expression. RESULTS: Eight studies were included, containing 178 subjects. Meta-analysis results suggested that the anterior cingulate cortex(BA32), anterior central gyrus(BA44), fusiform gyrus, and insula(BA13) were activated positively as major brain areas under the stimulation of pained facial expression. CONCLUSION: Our study shows that pained facial expression alone, without viewing of painful stimuli, activated brain regions related to pain empathy, further contributing to revealing the brain's mechanisms of pain empathy.展开更多
Pain is a strong symptom of diseases. Being an involuntary unpleasant feeling, it can be considered a reliable indicator of health issues. Pain has always been expressed verbally, but in some cases, traditional patien...Pain is a strong symptom of diseases. Being an involuntary unpleasant feeling, it can be considered a reliable indicator of health issues. Pain has always been expressed verbally, but in some cases, traditional patient self-reporting is not efficient. On one side, there are patients who have neurological disorders and cannot express themselves accurately, as well as patients who suddenly lose consciousness due to an abrupt faintness. On another side, medical staff working in crowded hospitals need to focus on emergencies and would opt for the automation of the task of looking after hospitalized patients during their entire stay, in order to notice any pain-related emergency. These issues can be tackled with deep learning. Knowing that pain is generally followed by spontaneous facial behaviors, facial expressions can be used as a substitute to verbal reporting, to express pain. In this paper, a convolutional neural network (CNN) model was built and trained to detect pain through patients’ facial expressions, using the UNBC-McMaster Shoulder Pain dataset. First, faces were detected from images using the Haarcascade Frontal Face Detector provided by OpenCV, and preprocessed through gray scaling, histogram equalization, face detection, image cropping, mean filtering, and normalization. Next, preprocessed images were fed into a CNN model which was built based on a modified version of the VGG16 architecture. The model was finally evaluated and fine-tuned in a continuous way based on its accuracy, which reached 92.5%.展开更多
Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory a...Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons： the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway--periaqueductal grey and dorsal raphe---has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti- inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviatin~ orthodontic oain in the future.展开更多
Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN...Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009.Thirty patients had CTN,and 27 had MTN.Outcomes were measured by using the visual analog pain scale(VAS) and patients’ reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.展开更多
基金supported by the National Natural Science Foundation of China,No.81473769(to WW),81772430(to WW)a grant from the Training Program of Innovation and Entrepreneurship for Undergraduates of Southern Medical University of Guangdong Province of China in 2016,No.201612121057(to WW)
文摘OBJECTIVE: The objective of this study is to summarize and analyze the brain signal patterns of empathy for pain caused by facial expressions of pain utilizing activation likelihood estimation, a meta-analysis method. DATA SOURCES: Studies concerning the brain mechanism were searched from the Science Citation Index, Science Direct, PubMed, DeepDyve, Cochrane Library, SinoMed, Wanfang, VIP, China National Knowledge Infrastructure, and other databases, such as SpringerLink, AMA, Science Online, Wiley Online, were collected. A time limitation of up to 13 December 2016 was applied to this study. DATA SELECTION: Studies presenting with all of the following criteria were considered for study inclusion: Use of functional magnetic resonance imaging, neutral and pained facial expression stimuli, involvement of adult healthy human participants over 18 years of age, whose empathy ability showed no difference from the healthy adult, a painless basic state, results presented in Talairach or Montreal Neurological Institute coordinates, multiple studies by the same team as long as they used different raw data. OUTCOME MEASURES: Activation likelihood estimation was used to calculate the combined main activated brain regions under the stimulation of pained facial expression. RESULTS: Eight studies were included, containing 178 subjects. Meta-analysis results suggested that the anterior cingulate cortex(BA32), anterior central gyrus(BA44), fusiform gyrus, and insula(BA13) were activated positively as major brain areas under the stimulation of pained facial expression. CONCLUSION: Our study shows that pained facial expression alone, without viewing of painful stimuli, activated brain regions related to pain empathy, further contributing to revealing the brain's mechanisms of pain empathy.
文摘Pain is a strong symptom of diseases. Being an involuntary unpleasant feeling, it can be considered a reliable indicator of health issues. Pain has always been expressed verbally, but in some cases, traditional patient self-reporting is not efficient. On one side, there are patients who have neurological disorders and cannot express themselves accurately, as well as patients who suddenly lose consciousness due to an abrupt faintness. On another side, medical staff working in crowded hospitals need to focus on emergencies and would opt for the automation of the task of looking after hospitalized patients during their entire stay, in order to notice any pain-related emergency. These issues can be tackled with deep learning. Knowing that pain is generally followed by spontaneous facial behaviors, facial expressions can be used as a substitute to verbal reporting, to express pain. In this paper, a convolutional neural network (CNN) model was built and trained to detect pain through patients’ facial expressions, using the UNBC-McMaster Shoulder Pain dataset. First, faces were detected from images using the Haarcascade Frontal Face Detector provided by OpenCV, and preprocessed through gray scaling, histogram equalization, face detection, image cropping, mean filtering, and normalization. Next, preprocessed images were fed into a CNN model which was built based on a modified version of the VGG16 architecture. The model was finally evaluated and fine-tuned in a continuous way based on its accuracy, which reached 92.5%.
基金supported by the National Natural Science Foundation of China (81571004, 81500884 and 81400549)the Orthodontic National Key Clinical Specialty Construction Program of China, West China Hospital of Stomatology, Sichuan University
文摘Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons： the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway--periaqueductal grey and dorsal raphe---has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti- inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviatin~ orthodontic oain in the future.
基金supported by a grant from the Beijing Municipal Project of Science and Technology (No.Y0204003040631)
文摘Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009.Thirty patients had CTN,and 27 had MTN.Outcomes were measured by using the visual analog pain scale(VAS) and patients’ reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.
