RESUMO
STUDY AIM: We describe a new neuronavigation-guided technique to target the posterior-superior insula (PSI) using a cooled-double-cone coil for deep cortical stimulation. INTRODUCTION: Despite the analgesic effects brought about by repetitive transcranial magnetic stimulation (TMS) to the primary motor and prefrontal cortices, a significant proportion of patients remain symptomatic. This encouraged the search for new targets that may provide stronger pain relief. There is growing evidence that the posterior insula is implicated in the integration of painful stimuli in different pain syndromes and in homeostatic thermal integration. METHODS: The primary motor cortex representation of the lower leg was used to calculate the motor threshold and thus, estimate the intensity of PSI stimulation. RESULTS: Seven healthy volunteers were stimulated at 10 Hz to the right PSI and showed subjective changes in cold perception. The technique was safe and well tolerated. CONCLUSIONS: The right posterior-superior insula is worth being considered in future studies as a possible target for rTMS stimulation in chronic pain patients.
Assuntos
Estimulação Encefálica Profunda/métodos , Neuronavegação , Dor/fisiopatologia , Percepção/fisiologia , Adulto , Córtex Cerebral/fisiologia , Feminino , Humanos , Masculino , Córtex Motor/fisiologia , Manejo da Dor , Córtex Pré-Frontal , Estimulação Magnética Transcraniana/métodos , Adulto JovemRESUMO
Schwanniomyces castellii and Endomycopsis fibuligera Produced extracellular amylase(s) when grown on various carbon sources and at different pH values. Both yeast species showed significant amylase synthesis in the presence of either maltose or soluble starch. On the other substrates tested (glucose, cellobiose, sucrose, trehalose, melezitose, raffinose, ethanol, glycerol) differences were found regarding growth and amylase production. Free glucose in the culture medium apparently inhibited enzyme synthesis. The pH range allowing maximal growth and amylase production was 4.5-6.0 for E. fibuligera and 5.5-7.0 for S. castellii.