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ABSTRACT BACKGROUND AND OBJECTIVES: Although craniofacial pain has been associated with negative psychological aspects, how the patient's perception of their own illness could influence craniofacial pain is not elucidated yet. Therefore, this study aims to identify the main factors and beliefs about the illness that could influence pain intensity and pain duration in people who experienced craniofacial pain in the last 24 hours. METHODS: This cross-sectional study comprised undergraduate students, aged between 18 and 40 years old, who experienced self-reported craniofacial pain in the last 24 hours. Participants answered questions regarding body functions, activities and participation, and personal factors based on the International Classification of Functioning (ICF); In addition, questions from the Brief Illness Perceptual Questionnaire (Brief IPQ) were applied. The analysis was carried out with a single and multiple regression model. RESULTS: The sample comprised 87 volunteers. Pain intensity and duration experienced in the last 24 hours were associate by concerns about the presence of an illness and the need for treatment. Pain intensity was specifically associated with the importance of treatment and the extent to which the patient is concerned about their pain (R2=0.108). Pain duration was associated with how much the individual is worried about their illness (R2=0.1459). CONCLUSION: Both pain intensity and duration experienced in the last 24 hours are associated with concerns regarding the presence of an illness and beliefs related to such illness treatment, which reinforces the influence of psychosocial aspects on pain perception.
RESUMO JUSTIFICATIVA E OBJETIVOS: Embora a dor craniofacial seja associada a aspectos psicológicos negativos, ainda não está totalmente elucidado como a percepção do paciente sobre sua própria doença pode influenciá-la. Portanto, este estudo teve como objetivo identificar os principais fatores e as crenças sobre a doença que podem influenciar a intensidade e a duração da dor em pessoas que sentiram dor craniofacial nas últimas 24 horas. MÉTODOS: Estudo transversal composto por universitários, com idade entre 18 e 40 anos, que relataram dor craniofacial nas últimas 24 horas. Os voluntários responderam a perguntas sobre funções corporais, atividades e participação e fatores pessoais com base na classificação da Classificação Internacional de Funcionalidades (CIF). Além disso, foram aplicadas questões do Questionário de Percepção de Doenças Versão Breve (Brief IPQ). A análise foi realizada com um modelo de regressão simples e múltiplo. RESULTADOS: A amostra foi composta por 87 voluntários. A intensidade e a duração da dor sentida nas últimas 24 horas foram influenciadas pela preocupação com a presença de doença e com a necessidade de tratamento. A intensidade da dor foi associada à importância do tratamento e à preocupação do paciente com sua dor (R2=0,108). A duração da dor associou-se à preocupação do indivíduo com sua doença (R2=0,1459). CONCLUSÃO: Tanto a intensidade quanto a duração da dor vivenciadas nas últimas 24 horas são influenciadas pela preocupação com a presença de doença e crenças relacionadas ao seu tratamento, o que reforça a influência dos aspectos psicossociais na percepção da dor.
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Objective To investigate the neuromodulating effect of Transcranial Direct Current Stimulation (tDCS) on Neuropathic Pain (NP). Method A systematic review of articles published in the past five years in MEDLINE, LILACS, Cochrane, Scopus, ScienceDirect, and PEDro. The search was carried out from February to May 2017 using the keywords: neuropathic pain, neuralgia, nerve pain, central pain, peripheral nerve pain, tDCS. The selected studies were full articles written in Portuguese, English, or Spanish with at least one control group, and no less than one pre- or post-intervention variable, with the exclusion of case studies or case series, animal model studies, and studies with combined therapy. The quality of the selected articles was evaluated through PEDro scale, whereas the level of agreement among reviewers was measured with the Cohen's κ test, considering P < 0.05 to be significant. Results Eight articles were selected (PEDro: 8.5 ± 0.6; Cohen's κ test: 0.703, P < 0.01), six of which were randomized controlled trials and two were controlled clinical trials. The following causes of NP were observed: spinal cord injury (SCI), amputation, stroke, multiple sclerosis (MS), and radiculopathy. All of the studies showed significant effects of tDCS on NP when compared to the control group, except for one with SCI and another related to radiculopathy. Discussion The shortage of good quality articles, the varying of ramp-on and ramp-off durations, and number of sessions, as well as the diversity of results found did not allow any definite conclusion on the efficacy of the neuromodulating effect of tDCS on NP.
