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Marinkovic K, Woodruff D, White DR, Caudle MM, Cronan T. Neural indices of multimodal sensory and autonomic hyperexcitability in fibromyalgia. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2023; 14:100140. [PMID: 38033709 PMCID: PMC10687342 DOI: 10.1016/j.ynpai.2023.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 12/02/2023]
Abstract
Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and psychological distress. Research suggests people with FM experience increased somatosensory sensitization which generalizes to other sensory modalities and may indicate neural hyperexcitability. However, the available evidence is limited, and studies including measures of neural responsivity across sensory domains and both central and peripheral aspects of the neuraxis are lacking. Thirty-nine participants (51.5 ± 13.6 years of age) with no history of neurological disorders, psychosis, visual, auditory, or learning deficits, were recruited for this study. People with FM (N = 19) and control participants (CNT, N = 20) did not differ on demographic variables and cognitive capacity. Participants completed a task that combined innocuous auditory stimuli with electrocutaneous stimulation (ECS), delivered at individually-selected levels that were uncomfortable but not painful. Event-related potentials (ERPs) and electrodermal activity were analyzed to examine the central and sympathetic indices of neural responsivity. FM participants reported greater sensitivity to ECS and auditory stimulation, as well as higher levels of depression, anxiety, ADHD, and an array of pain-related experiences than CNT. In response to ECS, the P50 deflection was greater in FM than CNT participants, reflecting early somatosensory hyperexcitability. The P50 amplitude was positively correlated with the FM profile factor obtained with a principal component analysis. The N100 to innocuous tones and sympathetic reactivity to ECS were greater in FM participants, except in the subgroup treated with gabapentinoids, which aligns with previous evidence of symptomatic improvement with GABA-mimetic medications. These results support the principal tenet of generalized neural hyperexcitability in FM and provide preliminary mechanistic insight into the impact of GABA-mimetic pharmacological therapy on ameliorating the neural excitation dominance.
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Affiliation(s)
- Ksenija Marinkovic
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, 5500 Campanile Dr., San Diego, CA 92182, USA
- Department of Radiology, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Denali Woodruff
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
| | - David R. White
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
| | - Morgan M. Caudle
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, 5500 Campanile Dr., San Diego, CA 92182, USA
| | - Terry Cronan
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, 5500 Campanile Dr., San Diego, CA 92182, USA
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Nagasaka K, Otsuru N, Sato R, Watanabe H, Sakurai N, Ohno K, Kodama N, Onishi H. Cortical signature related to psychometric properties of pain vigilance in healthy individuals: A voxel-based morphometric study. Neurosci Lett 2022; 772:136445. [PMID: 35007688 DOI: 10.1016/j.neulet.2022.136445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
The Pain Vigilance and Awareness Questionnaire (PVAQ) is a questionnaire for non-clinical and clinical cases of patients, such as those suffering from chronic pain. Moreover, it is used for evaluation of two aspects of habitual attention to pain: attention to pain and attention to changes in pain. As the PVAQ assesses two different aspects of attention function, different neural basis may present. However, it remains unclear which brain regions are involved. Here, we performed voxel-based morphometry (VBM) in 30 healthy participants to determine the regional morphology associated with the two attention states. Multiple regression analysis was conducted between each score and the regional grey matter (GM) volume, which revealed that a decreased GM volume in the left anterior insular cortex (AIC) was associated with a higher attention to pain score. In contrast, no brain region was correlated with the attention to changes in pain score. Our VBM results demonstrate that attention to pain scores assessed by PVAQ are associated with morphological features of the left AIC. Moreover, they may contribute to the elucidation of the complex psychological and neurophysiological characteristics of patients with chronic pain.
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Affiliation(s)
- Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan.
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan.
| | - Rui Sato
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Hiraku Watanabe
- Graduate School, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, Japan.
| | - Noriko Sakurai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan.
| | - Ken Ohno
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan.
| | - Naoki Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan.
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan.
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