In the past decade researchers began to assess the potential beneficial effects of non-invasive brain stimulation (NIBS) combined with a behavioral task as a treatment approach for various medical conditions. Transcranial direct current stimulation (tDCS) applied to the motor cortex combined with another treatment approach has been assessed as analgesic treatment in neuropathic and non-neuropathic pain conditions, and was found to exert only modest pain relief. Our group results show that combined tDCS and mirror therapy dramatically reduced acute phantom limb pain intensity with long-lasting effects, potentially preventing pain chronification. A review of the scientific literature indicates that our approach differs from that of others: We applied the intervention at the acute stage of the disease, whereas other studies applied the intervention in patients whose disease had already been established. We suggest that the timing of administration of the combined intervention is critical. Unlike in patients with chronic painful condition, in which the maladaptive plasticity associated with pain chronification and chronicity is well-consolidated, early treatment at the acute pain stage may be more successful in counterbalancing the not-yet consolidated maladaptive plasticity. We encourage the research community to test our hypothesis, both in the treatment of pain, and beyond.

Despite extensive research, reliable predictors of the placebo response remain elusive. The within-subject variability (WSV) of pain reports has emerged as a potential predictor, with multiple studies confirming its predictive value. But the results have been mixed. We recently showed that direction of attention moderates WSV's role in predicting the placebo response in patients with chronic back pain. This observational study aims to further examine the relationship between direction of attention, WSV, and the placebo effect in fibromyalgia patients (FM) and healthy controls. Participants completed a demographic questionnaire, clinical pain diaries (for FM), and the revised Self-Consciousness Scale (SCS-R). Afterward, participants underwent two experimental procedures: (1) the Focused Analgesia Selection Test (FAST), assessing experimental WSV of pain reports, and (2) an experimental placebo paradigm. Moderation and regression analyses examined the role of the SCS-R subscales in moderating the prediction of the placebo effect by the WSV of pain reports. Sixty-nine participants (healthy: 37, FM: 32) completed the protocol. Groups did not differ in SCS-R subscales, WSV, or placebo effect magnitude (p≥0.281). At low levels of private self-consciousness (p=0.013) and social anxiety (p=0.017) among FM, clinical WSV played a significant role in predicting the placebo effect. Public self-consciousness for FM showed a similar trend toward significance. These findings underscore attention as a relevant moderator of the placebo effect, emphasizing the need for improved measurement tools to predict the placebo effect. Perspective: We highlight the role of direction of attention in the prediction of the placebo effect. Our current findings validate our previous recent results from a cohort of chronic back pain patients, implying that direction of attention should be used in future attempts to improve the prediction of the placebo effect.

Introduction: Within-subject variability (WSV) of pain intensity reports has been shown to predict the placebo response. The focused analgesia selection test (FAST), which allows to experimentally assess WSV of pain reports, has been used as a screening tool to identify participants who are likely to have a strong placebo response in drug-development clinical trials. Yet, the reliability of FAST has not been reported. Objectives: To assess test–retest and interrater reliability of the FAST outcomes. To mimic pharma-sponsored clinical trials, we enlisted inexperienced assessors who underwent limited training. Methods: Healthy volunteers performed the FAST twice within a week and were randomly assigned to either the test–retest group or the interrater group. T-tests, partial Pearson correlations, intraclass correlations (ICC), and Bland–Altman plots were generated to assess FAST outcomes’ reliability. Results: Sixty-three participants completed the study and were assigned to the test–retest (N 5 33) or interrater (N 5 30) arms. No statistically significant differences in the FAST outcomes were detected between the 2 sessions, except for the FAST covariance (FAST CoV) in the interrater assessment (P 5 0.009). Test–retest reliabilities of the FAST-main outcomes were r 5 0.461, ICC 5 0.385 for the FAST R2 and r 5 0.605, ICC 5 0.539 for the FAST ICC and in the interrater cohort, they were FAST R2 : r 5 0.321, ICC 5 0.337 and FAST ICC: r 5 0.355, ICC 5 0.330. Conclusion: Using inexperienced assessors, the FAST outcomes test–retest ranged from moderate to strong, whereas the interrater reliability ranged from weak to poor. These results highlight the importance of adequately training study staff members before using this tool in multicentre clinical trials.

Patients with fibromyalgia experience pain, cognitive dysfunction, and atypical interoception. However, it is still unclear whether the changes in interoceptive processes have consequences in managing cognitive tasks. The current study investigates the relationship between interoception and cognition in fibromyalgia. Twenty-nine fibromyalgia patients completed clinical questionnaires, the Digit-span, and the Stroop test. Interoceptive Accuracy (IAc) was measured by the heartbeat detection task, Interoceptive Awareness (IAw) via confidence ratings, and Interoceptive Sensibility (IS) via the Multidimensional Assessment of Interoceptive Awareness questionnaire. IAc was found to be positively associated with Digit-span forward (p = 0.008), total (p = 0.004), and Stroop scores (all p ? 0.045). IS correlated negatively with Digit-span backward (p ? 0. ? 0.022) while IAw was negatively associated with Digit-span forward (p ? 0.034), total (p ? 0.008), and Stroop scores (all p ? 0.038). Moderation analysis revealed that IAc predicts Digit-span backward as symptom severity increases (p = 0.045). Despite the absence of a control group, this study provides evidence of the detailed relationships between interoception and cognitive abilities in fibromyalgia. While detecting and efficiently using body signals may be an essential tool for self-regulation in managing cognitive tasks, a higher ability to regulate body signals may exhaust cognition and predispose the patients to lower cognitive performance.

Purpose: The subjective nature of pain assessment and its large variance negatively affect patient-health care provider communication and reduce the assay sensitivity of pain clinical trials. Given the lack of an objective gold standard measure, identifying the source (true or error) of the within-subject variability of pain reports is a challenge. By assessing the within-subjects variability of pain and taste reports, alongside with interoceptive measures, the current study is aimed to investigate if the ability to reliably report bodily sensations is a cross-modal characteristic. Patients and Methods: This prospective study enrolled healthy volunteers from local universities. After consenting, subjects underwent the Focus Analgesia Selection Task (FAST), to assess within-subjects variability of pain reports in response to experimental noxious stimuli; a taste task, which similarly assesses within-subjects variability of tastes (salty and sweet) intensity reports; and the heartbeat perception task, an interoceptive task aimed to assess how accurate subjects are in monitoring and reporting their own heartbeat. In addition, all subjects completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Perceived Stress Scale (PSS), and Hospital Anxiety and Depression Scale (HADS). Spearman's correlations were used to assess relations between all measures. Results: Sixty healthy volunteers were recruited. Variability of intensity reports of different modalities were independent of each other (P > 0.05 for all correlations). The only correlation found was within modality, between variability of intensity reports of salt and sweet tastes (Spearman's r = 0.477, P < 0.001). No correlations were found between any of the task results and questionnaire results. Conclusion: Within-subjects variability of pain reports do not relate to variability of reports of other modalities or to interoceptive awareness. Further research is ongoing to investigate the clinical relevance of within-subjects' variability of pain reports.

Patients with fibromyalgia experience pain, cognitive dysfunction, and atypical interoception. However, it is still unclear whether the changes in interoceptive processes have consequences in managing cognitive tasks. The current study investigates the relationship between interoception and cognition in fibromyalgia. Twenty-nine fibromyalgia patients completed clinical questionnaires, the Digit-span, and the Stroop test. Interoceptive Accuracy (IAc) was measured by the heartbeat detection task, Interoceptive Awareness (IAw) via confidence ratings, and Interoceptive Sensibility (IS) via the Multidimensional Assessment of Interoceptive Awareness questionnaire. IAc was found to be positively associated with Digit-span forward (p = 0.008), total (p = 0.004), and Stroop scores (all p ≤ 0.045). IS correlated negatively with Digit-span backward (p ≤ 0. ≤ 0.022) while IAw was negatively associated with Digit-span forward (p ≤ 0.034), total (p ≤ 0.008), and Stroop scores (all p ≤ 0.038). Moderation analysis revealed that IAc predicts Digit-span backward as symptom severity increases (p = 0.045). Despite the absence of a control group, this study provides evidence of the detailed relationships between interoception and cognitive abilities in fibromyalgia. While detecting and efficiently using body signals may be an essential tool for self-regulation in managing cognitive tasks, a higher ability to regulate body signals may exhaust cognition and predispose the patients to lower cognitive performance.

Language and music are fundamental human tools for expression, communication, and emotional connection. Music plays a central role in shaping identity, conveying feelings, and promoting social bonds, making it an intriguing domain for technological exploration. Replicating human creativity in music, especially in songwriting, presents a complex challenge, as natural language processing (NLP) and deep learning (DL) must capture both linguistic structure and emotional nuance. This study investigates the generation of emotionally contextualised song lyrics using DL models, including LSTM, GPT-2, and T5, guided by Russell’s Circumplex Model of Emotions. The models were evaluated on readability, coherence, perplexity, structural consistency, thematic alignment, and emotional accuracy. Results show that GPT-2, particularly when fine-tuned, achieves the best balance of coherence and emotional alignment, although it still lacks some musical features such as rhyme and rhythm. LSTM exhibits patterned sequences but high variability, while T5 struggles with structural consistency and repetitive output, highlighting the challenges of small, non-specialised datasets. Overall, the work confirms the feasibility of using DL models as creative support in lyric composition, capable of offering emotionally expressive material to inspire musicians, while also pointing to the need for larger datasets and models tailored to musical structure to achieve fully convincing results.

Introdução: A obstipação é uma das doenças intestinais mais comuns que afeta por todo o mundo a população infantil. Constitui um problema comum na prática pediátrica contemplando cerca de 3–5% de todas as consultas pediátricas e 20–25% das consultas dos serviços de gastroenterologia pediátrica. A ingestão inadequada de fibra e líquidos e o sedentarismo na infância são fatores de risco para a obstipação. Objetivo: Avaliar a influência da ingestão de fibra alimentar na obstipação em crianças dos 2 aos 11 anos. Métodos: Estudo observacional transversal em 60 crianças de ambos sexos, com idades entre 2-11 anos. Todos os participantes foram recrutadas no hospital da CUF de Cascais. As características gerais e de estilo de vida das crianças foram obtidas através da aplicação de um questionário geral. A consistência das fezes foi avaliada através da aplicação da escala de Bristol. Os dados antropométricos foram obtidos pela consulta do boletim de saúde da criança. Os hábitos alimentares foram identicados pela aplicação de um questionário de frequência do consumo alimentar previamente validado para crianças portuguesas. A análise estatística foi realizada recorrendo ao software SPSS Statistics versão 22. Resultados: O índice de massa corporal médio das crianças foi 15,7 kg/m2, sendo que a maioria apresentou um peso normal. Segundo a escala de Bristol, os rapazes apresentaram uma maior prevalência de obstipação (n = 14). As crianças de 8 anos foram as que evidenciaram maior consumo calórico, macronutrientes e fibra alimentar. Em todas as crianças um consumo diário de água foi inadequado. Não foram observadas associações estatisticamente significativas da prevalência da obstipação com a ingestão alimentar de fibra e de água Conclusão: A prevalência de obstipação parece não estar relacionada com a ingestão diário de fibra alimentar