Examinando por Autor "Carrillo Villa, Sandra"
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- PublicaciónAcceso abiertoFisiopatología y tratamiento del dolor de miembro fantasma(2013-12-12) Malavera Angarita, Mayra Alejandra; Carrillo Villa, Sandra; Gomezese Ribero, Omar Fernando; García, Ronald G.; Silva Sieger, Federico ArturoIntroduction: Phantom limb pain may be present in up to 80% of patients subjected to amputation because oftrauma or peripheral vascular disease. Severalfactors have been associated with its occurrence, including pre-amputation pain, the etiology, and the amputation level. Objective: To review the current status of the pathophysiological mechanisms, treatment options and their efficacy for the management of phantom limb pain. Method: Non-systematic review ofthe literature in PubMed and Cochrane, of articles describing the pathophysiology and treatment of phantom limb pain. Results and conclusions: The proposed pathophysiological mechanisms are still in research and include peripheral, central and psychologicalfactors. Treatment options are still limited, and less than 10% of patients report long-term improvement.
- PublicaciónAcceso abiertoFundamentos y aplicaciones clínicas de la estimulación magnética transcraneal en neuropsiquiatría(2014) Malavera Angarita, Mayra Alejandra; Silva Sieger, Federico Arturo; García, Ronald G.; Rueda, Ligia C.; Carrillo Villa, SandraTranscranial Magnetic Stimulation (TMS) is a non-invasive method for stimulation of brain that is based on the ability of a generated magnetic field to penetrate skull and brain meninges, inducing an electric current in the brain tissues that produces neuronal depolarization. TMS can be applied as single pulse of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies. Its mechanism of action is currently unknown. Repetitive TMS can modify the excitability of the cerebral cortex, and has been postulated as a diagnostic and therapeutic tool in the area of neuropsychiatry. The aim of this article is to review the knowledge of the TMS as regards its basic principles, pathophysiological mechanism, and its usefulness in clinical practice.
- PublicaciónAcceso abiertoRepetitive transcranial magnetic stimulation for phantom limb pain in land mine victims : A double-blinded, randomized, sham-controlled trial(2016-08) Malavera Angarita, Mayra Alejandra; Silva Sieger, Federico Arturo; Fregni, Felipe; Carrillo Villa, Sandra; García, Ronald G.We evaluated the effects of repetitive transcranial magnetic stimulation (rTMS) in the treatment of phantom limb pain (PLP) in land mine victims. Fifty-four patients with PLP were enrolled in a randomized, double-blinded, placebo-controlled, parallel group single-center trial. The intervention consisted of real or sham rTMS of M1 contralateral to the amputated leg. rTMS was given in series of 20 trains of 6-second duration (54-second intertrain, intensity 90% of motor threshold) at a stimulation rate of 10 Hz (1,200 pulses), 20 minutes per day, during 10 days. For the control group, a sham coil was used. The administration of active rTMS induced a significantly greater reduction in pain intensity (visual analogue scale scores) 15 days after treatment compared with sham stimulation (−53.38 ± 53.12% vs −22.93 ± 57.16%; mean between-group difference = 30.44%, 95% confidence interval, .30–60.58; P = .03). This effect was not significant 30 days after treatment. In addition, 19 subjects (70.3%) attained a clinically significant pain reduction (>30%) in the active group compared with 11 in the sham group (40.7%) 15 days after treatment (P = .03). The administration of 10 Hz rTMS on the contralateral primary motor cortex for 2 weeks in traumatic amputees with PLP induced significant clinical improvement in pain. Perspective High-frequency rTMS on the contralateral primary motor cortex of traumatic amputees induced a clinically significant pain reduction up to 15 days after treatment without any major secondary effect. These results indicate that rTMS is a safe and effective therapy in patients with PLP caused by land mine explosions.