To determine the prevalence and characteristics of pain in symptomatic and asymptomatic patients with HTLV-1, for HAM/TSP, Cross-sectional study conducted in patients with HTLV seen at a referral center for patient care and research in Salvador, Bahia, Brazil. Sociodemographic data were evaluated by means of interviews. The presence of neuropathic pain was evaluated by the DN4 questionnaire, its intensity by the Visual Analog Scale and its location by the body map, Among the 115 patients, 84.3% complained of pain. The most affected locations were the lumbar spine and lower limbs (63.1%). Of these 46.1% presented defined or probable HAM/TSP. There was no association between the type of pain and presence of HAM/TSP, but symptomatic patients had a higher prevalence of pain in relation to asymptomatic for HAM/TSP, We found a high prevalence of pain in patients with HAM/TSP, mainly located in the lower back and lower limbs.

We investigated the effect of two frequencies of transcutaneous electrical nerve stimulation (TENS) applied immediately after lesion on peripheral nerve regeneration after a mouse sciatic crush injury. The animals were anesthetized and subjected to crushing of the right sciatic nerve and then separated into three groups: nontreated, Low-TENS (4 Hz), and High-TENS (100 Hz). The animals of Low- and High-TENS groups were stimulated for 2 h immediately after the surgical procedure, while the nontreated group was only positioned for the same period. After five weeks the animals were euthanized, and the nerves dissected bilaterally for histological and histomorphometric analysis. Histological assessment by light and electron microscopy showed that High-TENS and nontreated nerves had a similar profile, with extensive signs of degeneration. Conversely, Low-TENS led to increased regeneration, displaying histological aspects similar to control nerves. High-TENS also led to decreased density of fibers in the range of 6–12 μm diameter and decreased fiber diameter and myelin area in the range of 0–2 μm diameter. These findings suggest that High-TENS applied just after a peripheral nerve crush may be deleterious for regeneration, whereas Low-TENS may increase nerve regeneration capacity.

| Transcranial Direct Current Stimulation (tDCS)uses a direct electrical current to modulate the activity of cortical neurons. Anodal tDCS (positive pole) increases the excitability of cortical neurons, while cathodic tDCS (negative pole) reduces it. However, when applied in the peripheral nervous system the effects are the opposite of cranial application. Furthermore, when central and peripheral stimuli are used concomitantly, their effects can be summed up. This has been demonstrated by combining tDCS with other forms of sensory peripheral stimulation. We propose a new electrode configuration to potentiate the excitatory and inhibitory effects of tDCS on neuronal excitability and increase upper limb motor function. Our hypothesis is that placement of the electrodes in the primary motor cortex (M1) and the contralateral brachial plexus (BP) would promote this potentiation by central and peripheral synaptic summation. We will test our hypothesis in two proof-of-concept studies. Study 1) Secondary trial, in which we will evaluate the effects of these configurations on the neuronal excitability of healthy individuals; Study 2) A double-blind, randomized and crossover clinical trial in which we will test the stimulation with the anode in M1 and the cathode in the contralateral BP on the motor function and electrophysiological markers of individuals with cerebral palsy. The effects of the new configurations will be compared with the conventional configuration (M1/ contralateral supraorbital region). We expect that our investigations will identify a more efficient way to apply tDCS and consequently a better clinical use of this technique.

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