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Daria C, Lancaster G, Murphy AJ, Henderson LA, Dawood T, Macefield VG. Relationship between muscle sympathetic nerve activity and rapid increases in circulating leukocytes during experimental muscle pain. Clin Auton Res 2024; 34:227-231. [PMID: 38227276 DOI: 10.1007/s10286-023-01012-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024]
Affiliation(s)
- Camille Daria
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Graeme Lancaster
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrew J Murphy
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Luke A Henderson
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Tye Dawood
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Vaughan G Macefield
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia.
- Department of Neuroscience, Monash University Central Clinical School, Level 6, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
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Bigalke JA, Carter JR. Sympathetic Neural Control in Humans with Anxiety-Related Disorders. Compr Physiol 2021; 12:3085-3117. [PMID: 34964121 DOI: 10.1002/cphy.c210027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Numerous conceptual models are used to describe the dynamic responsiveness of physiological systems to environmental pressures, originating with Claude Bernard's milieu intérieur and extending to more recent models such as allostasis. The impact of stress and anxiety upon these regulatory processes has both basic science and clinical relevance, extending from the pioneering work of Hans Selye who advanced the concept that stress can significantly impact physiological health and function. Of particular interest within the current article, anxiety is independently associated with cardiovascular risk, yet mechanisms underlying these associations remain equivocal. This link between anxiety and cardiovascular risk is relevant given the high prevalence of anxiety in the general population, as well as its early age of onset. Chronically anxious populations, such as those with anxiety disorders (i.e., generalized anxiety disorder, panic disorder, specific phobias, etc.) offer a human model that interrogates the deleterious effects that chronic stress and allostatic load can have on the nervous system and cardiovascular function. Further, while many of these disorders do not appear to exhibit baseline alterations in sympathetic neural activity, reactivity to mental stress offers insights into applicable, real-world scenarios in which heightened sympathetic reactivity may predispose those individuals to elevated cardiovascular risk. This article also assesses behavioral and lifestyle modifications that have been shown to concurrently improve anxiety symptoms, as well as sympathetic control. Lastly, future directions of research will be discussed, with a focus on better integration of psychological factors within physiological studies examining anxiety and neural cardiovascular health. © 2022 American Physiological Society. Compr Physiol 12:1-33, 2022.
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Affiliation(s)
- Jeremy A Bigalke
- Department of Psychology, Montana State University, Bozeman, Montana, USA
| | - Jason R Carter
- Department of Psychology, Montana State University, Bozeman, Montana, USA.,Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
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Hohenschurz-Schmidt DJ, Calcagnini G, Dipasquale O, Jackson JB, Medina S, O'Daly O, O'Muircheartaigh J, de Lara Rubio A, Williams SCR, McMahon SB, Makovac E, Howard MA. Linking Pain Sensation to the Autonomic Nervous System: The Role of the Anterior Cingulate and Periaqueductal Gray Resting-State Networks. Front Neurosci 2020; 14:147. [PMID: 33041747 PMCID: PMC7527240 DOI: 10.3389/fnins.2020.00147] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/06/2020] [Indexed: 12/27/2022] Open
Abstract
There are bi-directional interactions between the autonomic nervous system (ANS) and pain. This is likely underpinned by a substantial overlap between brain areas of the central autonomic network and areas involved in pain processing and modulation. To date, however, relatively little is known about the neuronal substrates of the ANS-pain association. Here, we acquired resting state fMRI scans in 21 healthy subjects at rest and during tonic noxious cold stimulation. As indicators of autonomic function, we examined how heart rate variability (HRV) frequency measures were influenced by tonic noxious stimulation and how these variables related to participants’ pain perception and to brain functional connectivity in regions known to play a role in both ANS regulation and pain perception, namely the right dorsal anterior cingulate cortex (dACC) and periaqueductal gray (PAG). Our findings support a role of the cardiac ANS in brain connectivity during pain, linking functional connections of the dACC and PAG with measurements of low frequency (LF)-HRV. In particular, we identified a three-way relationship between the ANS, cortical brain networks known to underpin pain processing, and participants’ subjectively reported pain experiences. LF-HRV both at rest and during pain correlated with functional connectivity between the seed regions and other cortical areas including the right dorsolateral prefrontal cortex (dlPFC), left anterior insula (AI), and the precuneus. Our findings link cardiovascular autonomic parameters to brain activity changes involved in the elaboration of nociceptive information, thus beginning to elucidate underlying brain mechanisms associated with the reciprocal relationship between autonomic and pain-related systems.
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Affiliation(s)
- David Johannes Hohenschurz-Schmidt
- Department of Neuroimaging, King's College London, London, United Kingdom.,Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Giovanni Calcagnini
- Department of Technology and Health, Italian National Institute of Health, Rome, Italy
| | - Ottavia Dipasquale
- Department of Neuroimaging, King's College London, London, United Kingdom
| | - Jade B Jackson
- Department of Neuroimaging, King's College London, London, United Kingdom.,Wolfson Centre for Age Related Diseases, King's College London, London, United Kingdom
| | - Sonia Medina
- Department of Neuroimaging, King's College London, London, United Kingdom.,Wolfson Centre for Age Related Diseases, King's College London, London, United Kingdom
| | - Owen O'Daly
- Department of Neuroimaging, King's College London, London, United Kingdom
| | - Jonathan O'Muircheartaigh
- Department of Neuroimaging, King's College London, London, United Kingdom.,Sackler Institute for Translational Neurodevelopment, King's College London, London, United Kingdom.,Centre for the Developing Brain, King's College London, London, United Kingdom.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
| | | | | | - Stephen B McMahon
- Department of Technology and Health, Italian National Institute of Health, Rome, Italy
| | - Elena Makovac
- Department of Neuroimaging, King's College London, London, United Kingdom.,Department of Technology and Health, Italian National Institute of Health, Rome, Italy
| | - Matthew A Howard
- Department of Neuroimaging, King's College London, London, United Kingdom
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Differences in regional grey matter volume of the brain are related to mean blood pressure and muscle sympathetic nerve activity in normotensive humans. J Hypertens 2020; 38:303-313. [DOI: 10.1097/hjh.0000000000002243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Macefield VG, Henderson LA. Identifying Increases in Activity of the Human RVLM Through MSNA-Coupled fMRI. Front Neurosci 2020; 13:1369. [PMID: 32038124 PMCID: PMC6985468 DOI: 10.3389/fnins.2019.01369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 12/04/2019] [Indexed: 11/13/2022] Open
Abstract
AIM We initially developed concurrent recording of muscle sympathetic nerve activity (MSNA) and functional magnetic resonance imaging (fMRI) of the brain to functionally identify the human homolog of the rostral ventrolateral medulla (RVLM). Here we summarize the cortical and subcortical connections to the RVLM, as identified using MSNA-coupled fMRI. METHODS MSNA was recorded via tungsten microelectrodes inserted into the peroneal nerve. Gradient echo, echo-planar fMRI was performed at 3T (Philips Achieva). 200 volumes (46 axial slices (TR = 8 s, TE = 4 s, flip angle = 90°, raw voxel size = 1.5 × 1.5 × 2.75 mm) were collected in a 4 s-ON, 4 s-OFF sparse sampling protocol and MSNA measured in each 1 s epoch in the 4-s period between scans. Blood oxygen level dependent (BOLD) signal intensity was measured in the corresponding 1 s epoch 4 s later to account for peripheral neural conduction and central neurovascular coupling delays. RESULTS BOLD signal intensity was positively related to bursts of MSNA in the RVLM, dorsomedial hypothalamus (DMH), ventromedial hypothalamus (VMH), insula, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex (PCC), and precuneus, and negatively related in the caudal ventrolateral medulla (CVLM), nucleus tractus solitarius (NTS), and the midbrain periaqueductal gray (PAG). During physiological increases in MSNA (tonic muscle pain), MSNA-coupled BOLD signal intensity was greater in RVLM, NTS, PAG, DMH, dlPFC, medial prefrontal cortex (mPFC), precuneus, and anterior cingulate cortex (ACC) than at rest. During pathophysiological increases in MSNA [obstructive sleep apnoea (OSA)] signal intensity was also higher in dlPFC, mPFC, ACC, and precuneus than in controls. Conversely, signal intensity was lower in RVLM in OSA than in controls, which we interpret as reflecting a withdrawal of active inhibition of the RVLM. CONCLUSION These results suggest that multiple cortical and subcortical areas are functionally coupled to the RVLM, which in turn is functionally coupled to the generation of spontaneous bursts of MSNA and their augmentation during physiological and pathophysiological increase in vasoconstrictor drive.
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Affiliation(s)
- Vaughan G. Macefield
- Human Autonomic Neurophysiology Laboratory, School of Medicine, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Luke A. Henderson
- Discipline of Anatomy and Histology, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
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Kobuch S, Henderson LA, Macefield VG, Brown R. The effects of audiovisual distraction on the muscle sympathetic responses to experimental muscle pain. Exp Brain Res 2018; 236:1919-1925. [PMID: 29696315 DOI: 10.1007/s00221-018-5271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 04/20/2018] [Indexed: 11/30/2022]
Abstract
Pain elicited by intramuscular infusion of hypertonic saline solution causes muscle sympathetic nerve activity (MSNA) to increase in some subjects, yet decrease in others. Although the direction of the response is not predictable based on baseline physiological and psychological parameters, we know that it results from sustained functional changes in specific brain regions that are responsible for the behavioral and cardiovascular responses to psychological stressors, as well as those involved in attention. The aim of this study was to investigate whether MSNA responses to experimental muscle pain in humans could be altered with an audiovisual stimulus that served to distract them from the pain. MSNA was recorded from the left common peroneal nerve of 20 young healthy individuals during a 45-min intramuscular infusion of hypertonic saline solution into the ipsilateral tibialis anterior muscle. The distracting stimulus commenced 15 min after the start of the infusion and lasted for 15 min. Fifteen subjects showed an increase in mean burst amplitude of MSNA (to 176.4 ± 7.9% of baseline), while five showed a decrease (to 73.1 ± 5.2% of baseline); distraction had no effect on these profiles. These results indicate that even though the subjects were attending to the audiovisual stimulus, and were presumably distracted from the pain, it failed to alter the MSNA responses to muscle pain.
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Affiliation(s)
- Sophie Kobuch
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Luke A Henderson
- Department of Anatomy and Histology, University of Sydney, Sydney, Australia
| | - Vaughan G Macefield
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Neuroscience Research Australia, Sydney, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia
| | - R Brown
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Neuroscience Research Australia, Sydney, Australia
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Kobuch S, Fazalbhoy A, Brown R, Macefield VG, Henderson LA. Muscle sympathetic nerve activity-coupled changes in brain activity during sustained muscle pain. Brain Behav 2018; 8:e00888. [PMID: 29541532 PMCID: PMC5840447 DOI: 10.1002/brb3.888] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Long-lasting experimental muscle pain elicits divergent muscle sympathetic responses, with some individuals exhibiting a persistent increase in muscle sympathetic nerve activity (MSNA), and others a decrease. These divergent responses are thought to result from sustained functional changes in specific brain regions that modulate the cardiovascular responses to pain. AIM The aim of this study was to investigate brain regions that are functionally coupled to the generation of an MSNA burst at rest and to determine their behavior during tonic muscle pain. METHODS Functional magnetic resonance imaging of the brain was performed concurrently with microelectrode recording of MSNA from the common peroneal nerve during a 40 min infusion of hypertonic saline into the ipsilateral tibialis anterior muscle of 37 healthy human subjects. RESULTS At rest, blood oxygen level-dependent signal intensity coupled to bursts of MSNA increased in the rostral ventrolateral medulla, insula, dorsolateral prefrontal cortex, posterior cingulate cortex, and precuneus and decreased in the region of the midbrain periaqueductal gray. During pain, MSNA-coupled signal intensity was greater in the region of the nucleus tractus solitarius, midbrain periaqueductal gray, dorsolateral prefrontal, medial prefrontal, and anterior cingulate cortices, than at rest. Conversely, MSNA-coupled signal intensity decreased during pain in parts of the prefrontal cortex. CONCLUSIONS These results suggest that multiple brain regions are recruited in a burst-to-burst manner, and the magnitude of these signal changes is correlated to the overall change in MSNA amplitude during tonic muscle pain.
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Affiliation(s)
- Sophie Kobuch
- School of Medicine Western Sydney University Sydney NSW Australia
| | - Azharuddin Fazalbhoy
- Neuroscience Research Australia Sydney NSW Australia.,School of Health Sciences RMIT University Melbourne Vic Australia
| | - Rachael Brown
- School of Medicine Western Sydney University Sydney NSW Australia.,Neuroscience Research Australia Sydney NSW Australia
| | - Vaughan G Macefield
- School of Medicine Western Sydney University Sydney NSW Australia.,Neuroscience Research Australia Sydney NSW Australia.,College of Medicine Mohammed Bin Rashid University of Medicine & Health Sciences Dubai UAE
| | - Luke A Henderson
- Department of Anatomy and Histology University of Sydney Sydney NSW Australia
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Dean C, Hillard CJ, Seagard JL, Hopp FA, Hogan QH. Upregulation of fatty acid amide hydrolase in the dorsal periaqueductal gray is associated with neuropathic pain and reduced heart rate in rats. Am J Physiol Regul Integr Comp Physiol 2017; 312:R585-R596. [PMID: 28148494 DOI: 10.1152/ajpregu.00481.2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/26/2017] [Accepted: 01/31/2017] [Indexed: 11/22/2022]
Abstract
Nerve damage can induce a heightened pain response to noxious stimulation, which is termed hyperalgesia. Pain itself acts as a stressor, initiating autonomic and sensory effects through the dorsal periaqueductal gray (dPAG) to induce both sympathoexcitation and analgesia, which prior studies have shown to be affected by endocannabinoid signaling. The present study addressed the hypothesis that neuropathic pain disrupts autonomic and analgesic regulation by endocannabinoid signaling in the dPAG. Endocannabinoid contents, transcript levels of endocannabinoid signaling components, and catabolic enzyme activity were analyzed in the dPAG of rats at 21 days after painful nerve injury. The responses to two nerve injury models were similar, with two-thirds of animals developing hyperalgesia that was maintained throughout the postinjury period, whereas no sustained change in sensory function was observed in the remaining rats. Anandamide content was lower in the dPAG of rats that developed sustained hyperalgesia, and activity of the catabolic enzyme fatty acid amide hydrolase (FAAH) was higher. Intensity of hyperalgesia was correlated to transcript levels of FAAH and negatively correlated to heart rate and sympathovagal balance. These data suggest that maladaptive endocannabinoid signaling in the dPAG after nerve injury could contribute to chronic neuropathic pain and associated autonomic dysregulation. This study demonstrates that reduced anandamide content and upregulation of FAAH in the dPAG are associated with hyperalgesia and reduced heart rate sustained weeks after nerve injury. These data provide support for the evaluation of FAAH inhibitors for the treatment of chronic neuropathic pain.
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Affiliation(s)
- Caron Dean
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin; .,Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
| | - Cecilia J Hillard
- Department of Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin; and
| | - Jeanne L Seagard
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin.,Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
| | - Francis A Hopp
- Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
| | - Quinn H Hogan
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin.,Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
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