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Bonemazzi I, Nosadini M, Pelizza MF, Paolin C, Cavaliere E, Sartori S, Toldo I. Treatment of Frequent or Chronic Primary Headaches in Children and Adolescents: Focus on Acupuncture. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1626. [PMID: 37892289 PMCID: PMC10605007 DOI: 10.3390/children10101626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Acupuncture is a spreading and promising intervention, which has proven to be very useful in the treatment and prevention of chronic pain, in particular chronic headaches, in adults; the literature about the treatment of pediatric chronic headaches is scarce. In addition, few guidelines advise its use in children. The aim of this review is to collect all relevant studies with available data about the use, effect, and tolerability of acupuncture as a treatment for pediatric primary headaches. METHODS This is a narrative review based on eight studies selected from 135 papers including pediatric cases treated with acupuncture for headache. RESULTS Despite the differences in tools, procedures, and application sites, acupuncture demonstrated a positive effect on both the frequency and intensity of headaches and was well tolerated. There are no studies considering the long-term efficacy of acupuncture. CONCLUSION Further additional studies are needed on acupuncture in children and adolescents, with larger series and standardized procedures, in order to better assess efficacy, tolerability, and long-term prognosis and to define guidelines for the use of this promising and safe treatment. It is particularly relevant to identify safe and well-tolerated treatment options in pediatric patients affected by recurrent and debilitating headaches.
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Affiliation(s)
| | | | | | | | | | | | - Irene Toldo
- Juvenile Headache Center, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padua, Italy; (I.B.); (M.N.); (M.F.P.); (C.P.); (E.C.); (S.S.)
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Simon JJ, Lang PM, Rommerskirchen L, Bendszus M, Friederich HC. Hypothalamic Reactivity and Connectivity following Intravenous Glucose Administration. Int J Mol Sci 2023; 24:ijms24087370. [PMID: 37108533 PMCID: PMC10139105 DOI: 10.3390/ijms24087370] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Dysfunctional glucose sensing in homeostatic brain regions such as the hypothalamus is interlinked with the pathogenesis of obesity and type 2 diabetes mellitus. However, the physiology and pathophysiology of glucose sensing and neuronal homeostatic regulation remain insufficiently understood. To provide a better understanding of glucose signaling to the brain, we assessed the responsivity of the hypothalamus (i.e., the core region of homeostatic control) and its interaction with mesocorticolimbic brain regions in 31 normal-weight, healthy participants. We employed a single-blind, randomized, crossover design of the intravenous infusion of glucose and saline during fMRI. This approach allows to investigate glucose signaling independent of digestive processes. Hypothalamic reactivity and connectivity were assessed using a pseudo-pharmacological design and a glycemia-dependent functional connectivity analysis, respectively. In line with previous studies, we observed a hypothalamic response to glucose infusion which was negatively related to fasting insulin levels. The observed effect size was smaller than in previous studies employing oral or intragastric administration of glucose, demonstrating the important role of the digestive process in homeostatic signaling. Finally, we were able to observe hypothalamic connectivity with reward-related brain regions. Given the small amount of glucose employed, this points toward a high responsiveness of these regions to even a small energy stimulus in healthy individuals. Our study highlights the intricate relationship between homeostatic and reward-related systems and their pronounced sensitivity to subtle changes in glycemia.
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Affiliation(s)
- Joe J Simon
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Pia M Lang
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Lena Rommerskirchen
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, 69120 Heidelberg, Germany
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Mussio CA, Harte SE, Borszcz GS. Regional Differences Within the Anterior Cingulate Cortex in the Generation Versus Suppression of Pain Affect in Rats. THE JOURNAL OF PAIN 2019; 21:121-134. [PMID: 31201992 DOI: 10.1016/j.jpain.2019.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/22/2019] [Accepted: 06/02/2019] [Indexed: 01/08/2023]
Abstract
The anterior cingulate cortex (ACC) modulates emotional responses to pain. Whereas, the caudal ACC (cACC) promotes expression of pain affect, the rostral ACC (rACC) contributes to its suppression. Both subdivisions receive glutamatergic innervation, and the present study evaluated the contribution of N-methyl-d-aspartic acid (NMDA) receptors within these subdivisions to rats' expression of pain affect. Vocalizations that follow a brief noxious tail shock (vocalization afterdischarges, VAD) are a validated rodent model of pain affect. The threshold current for eliciting VAD was increased in a dose-dependent manner by injecting NMDA into the rACC, but performance (latency, amplitude, and duration) at threshold was not altered. Alternately, the threshold current for eliciting VAD was not altered following injection of NMDA into the cACC, but its amplitude and duration at threshold were increased in a dose-dependent manner. These effects were limited to Cg1 of the rACC and cACC, and blocked by pretreatment of the ACC with the NMDA receptor antagonist d-2-amino-5-phosphonovalerate. These findings demonstrate that NMDA receptor agonism within the cACC and rACC either increases or decreases emotional responses to noxious stimulation, respectively. PERSPECTIVE: NMDA receptor activation of the rostral and caudal ACC respectively inhibited or enhanced rats' emotional response to pain. These findings mirror those obtained from human neuroimaging studies; thereby, supporting the use of this model system in evaluating the contribution of ACC to pain affect.
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Affiliation(s)
- Casey A Mussio
- Behavioral and Cognitive Neuroscience Program, Department of Psychology, Wayne State University, Detroit, Michigan
| | - Steven E Harte
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - George S Borszcz
- Behavioral and Cognitive Neuroscience Program, Department of Psychology, Wayne State University, Detroit, Michigan.
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4
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Spuz CA, Tomaszycki ML, Borszcz GS. N-methyl-D-aspartate receptor agonism and antagonism within the amygdaloid central nucleus suppresses pain affect: differential contribution of the ventrolateral periaqueductal gray. THE JOURNAL OF PAIN 2014; 15:1305-18. [PMID: 25261341 DOI: 10.1016/j.jpain.2014.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/07/2014] [Accepted: 09/16/2014] [Indexed: 01/12/2023]
Abstract
UNLABELLED The amygdala contributes to the generation of pain affect, and the amygdaloid central nucleus (CeA) receives nociceptive input that is mediated by glutamatergic neurotransmission. The present study compared the contribution of N-methyl-d-aspartate (NMDA) receptor agonism and antagonism in the CeA to generation of the affective response of rats to an acute noxious stimulus. Vocalizations that occur following a brief tail shock (vocalization afterdischarges) are a validated rodent model of pain affect and were preferentially suppressed, in a dose-dependent manner, by bilateral injection into the CeA of NMDA (.1, .25, .5, or 1 μg/side) or the NMDA receptor antagonist d-(-)-2-amino-5-phosphopentanoic acid (AP5; 1, 2, or 4 μg/side). Vocalizations that occur during tail shock were suppressed to a lesser degree, whereas spinal motor reflexes (tail flick and hind limb movements) were unaffected by injection of NMDA or AP5 into the CeA. Injection of NMDA, but not AP5, into the CeA increased c-Fos immunoreactivity in the ventrolateral periaqueductal gray, and unilateral injection of the μ-opiate receptor antagonist H-d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP; .25 μg) into ventrolateral periaqueductal gray prevented the antinociception generated by injection of NMDA into the CeA. These findings demonstrate that although NMDA receptor agonism and antagonism in the CeA produce similar suppression of pain behaviors, they do so via different neurobiologic mechanisms. PERSPECTIVE The amygdala contributes to production of the emotional dimension of pain. NMDA receptor agonism and antagonism within the CeA suppressed rats' emotional response to acute painful stimulation. Understanding the neurobiology underlying emotional responses to pain will provide insights into new treatments for pain and its associated affective disorders.
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Affiliation(s)
- Catherine A Spuz
- Department of Psychology, Behavioral & Cognitive Neuroscience Program, Wayne State University, Detroit, Michigan
| | - Michelle L Tomaszycki
- Department of Psychology, Behavioral & Cognitive Neuroscience Program, Wayne State University, Detroit, Michigan
| | - George S Borszcz
- Department of Psychology, Behavioral & Cognitive Neuroscience Program, Wayne State University, Detroit, Michigan.
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5
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Teeuwisse WM, Widya RL, Paulides M, Lamb HJ, Smit JW, de Roos A, van Buchem MA, Pijl H, van der Grond J. Short-term caloric restriction normalizes hypothalamic neuronal responsiveness to glucose ingestion in patients with type 2 diabetes. Diabetes 2012; 61:3255-9. [PMID: 22851576 PMCID: PMC3501879 DOI: 10.2337/db11-1835] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The hypothalamus is critically involved in the regulation of feeding. Previous studies have shown that glucose ingestion inhibits hypothalamic neuronal activity. However, this was not observed in patients with type 2 diabetes. Restoring energy balance by reducing caloric intake and losing weight are important therapeutic strategies in patients with type 2 diabetes. We hypothesized that caloric restriction would have beneficial effects on the hypothalamic neuronal response to glucose ingestion. Functional magnetic resonance imaging was performed in 10 male type 2 diabetic patients before and after a 4-day very-low-calorie diet (VLCD) at a 3.0 Tesla scanner using a blood oxygen level-dependent technique for measuring neuronal activity in the hypothalamus in response to an oral glucose load. Hypothalamic signals were normalized to baseline value, and differences between the pre- and postdiet condition were tested using paired t tests. Pre-VLCD scans showed no response of the hypothalamus to glucose intake (i.e., no signal decrease after glucose intake was observed). Post-VLCD scans showed a prolonged signal decrease after glucose ingestion. The results of the current study demonstrate that short-term caloric restriction readily normalizes hypothalamic responsiveness to glucose ingestion in patients with type 2 diabetes.
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Affiliation(s)
- Wouter M. Teeuwisse
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ralph L. Widya
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands
| | - Marit Paulides
- Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands
| | - Hildo J. Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Johannes W.A. Smit
- Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mark A. van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hanno Pijl
- Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- Corresponding author: Jeroen van der Grond,
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6
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Zhang Y, Glielmi CB, Jiang Y, Wang J, Wang X, Fang J, Cui C, Han J, Hu X, Zhang J. Simultaneous CBF and BOLD mapping of high frequency acupuncture induced brain activity. Neurosci Lett 2012; 530:12-7. [DOI: 10.1016/j.neulet.2012.09.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 09/19/2012] [Accepted: 09/24/2012] [Indexed: 11/29/2022]
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Functional interaction between medial thalamus and rostral anterior cingulate cortex in the suppression of pain affect. Neuroscience 2010; 172:460-73. [PMID: 21034797 DOI: 10.1016/j.neuroscience.2010.10.055] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 10/19/2010] [Accepted: 10/19/2010] [Indexed: 11/22/2022]
Abstract
The medial thalamic parafascicular nucleus (PF) and the rostral anterior cingulate cortex (rACC) are implicated in the processing and suppression of the affective dimension of pain. The present study evaluated the functional interaction between PF and rACC in mediating the suppression of pain affect in rats following administration of morphine or carbachol (acetylcholine agonist) into PF. Vocalizations that occur following a brief noxious tailshock (vocalization afterdischarges) are a validated rodent model of pain affect, and were preferentially suppressed by injection of morphine or carbachol into PF. Vocalizations that occur during tailshock were suppressed to a lesser degree, whereas, spinal motor reflexes (tail flick and hindlimb movements) were only slightly suppressed by injection of carbachol into PF and unaffected by injection of morphine into PF. Blocking glutamate receptors in rACC (NMDA and non-NMDA) by injecting D-2-amino-5-phosphonovalerate (AP-5) or 6-cyano-7-nitroquinoxaline-2,3-dione disodium (CNQX) produced dose-dependent antagonism of morphine-induced increases in vocalization thresholds. Carbachol-induced increases in vocalization thresholds were not affected by injection of either glutamate receptor antagonist into rACC. The results demonstrate that glutamate receptors in the rACC contribute to the suppression of pain affect produced by injection of morphine into PF, but not to the suppression of pain affect generated by intra-PF injection of carbachol.
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Bai L, Qin W, Tian J, Liu P, Li L, Chen P, Dai J, Craggs JG, von Deneen KM, Liu Y. Time-varied characteristics of acupuncture effects in fMRI studies. Hum Brain Mapp 2009; 30:3445-60. [PMID: 19350547 PMCID: PMC6871147 DOI: 10.1002/hbm.20769] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2008] [Revised: 01/09/2009] [Accepted: 02/07/2009] [Indexed: 11/08/2022] Open
Abstract
When studying the neural responses to acupuncture with a block-designed paradigm, its temporal dynamics predicted by the general linear model (GLM) conforms to typical "on-off" variations during a limited period of the experiment manipulation. Despite a lack of direct evidence associating its psychophysiological response, numerous clinical reports suggest that acupuncture can provide pain relief beyond a needling session. Therefore, a typical GLM analysis may be insensitive or inappropriate for identifying altered neural responses resulting from acupuncture. We developed a new approach to investigate the dynamics underlying sustained effects of acupuncture. Specifically, we designed two separate models to evaluate the baseline activities (prior to stimulation) and neural activities in sequential epochs, using three block-designed functional runs: acupuncture at acupoint ST36, nonmeridian point (NMP) stimulation, and a visual task. We found that the activity patterns during rest were associated with the stimulus types and that the resting activities might be even higher than that of stimulation phases. Such effects of the elevated activity during rest may reduce or eliminate the activity during stimulus conditions or even reverse the sign of brain activation using conventional GLM analysis. Moreover, such sustained responses, followed by acupuncture at ST36 and NMP, exhibited distinct patterns in wide brain structures, particularly in the limbic system and brainstem. These findings may pose great implications for the design and interpretation of a range of acupuncture neuroimaging studies.
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Affiliation(s)
- Lijun Bai
- Life Science Research Center, School of Electronic Engineering, Xidian University, Xi'an, Shaanxi, China
| | - Wei Qin
- Life Science Research Center, School of Electronic Engineering, Xidian University, Xi'an, Shaanxi, China
| | - Jie Tian
- Life Science Research Center, School of Electronic Engineering, Xidian University, Xi'an, Shaanxi, China
- Medical Image Processing Group, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Peng Liu
- School of Sino‐Dutch Biomedical and Information Engineering, Northeastern University, Shenyang, Liaoning, China
| | - LinLing Li
- Life Science Research Center, School of Electronic Engineering, Xidian University, Xi'an, Shaanxi, China
| | - Peng Chen
- Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, China
| | - Jianping Dai
- Department of Radiology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing, China
| | - Jason G. Craggs
- Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Karen M. von Deneen
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, Florida
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, Florida
| | - Yijun Liu
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, Florida
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, Florida
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Bai SJ, Cho ZH, Lee BH. New Trend of Pain Study by Brain Imaging Devices. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2009. [DOI: 10.5124/jkma.2009.52.2.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sun Joon Bai
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Korea
| | - Zang-Hee Cho
- Neuroscience Research Institute, Gachon University of Medicine and Science, Korea
| | - Bae Hwan Lee
- Department of Physiology, Yonsei University College of Medicine, Korea.
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Abstract
Over 2 million people in the United States are estimated to use acupuncture annually, primarily for musculoskeletal complaints and pain management, evidence that the integration of acupuncture into Western health care is increasing. Despite the increase in the quality of trials demonstrating the efficacy and safety of acupuncture in medicine, the pediatric acupuncture literature lacks the quantity and quality of the same body of evidence. Contributing to this paucity of evidence may be the acceptability of acupuncture in pediatric patients. There is an urgent need for high-quality randomized controlled trials on the use of acupuncture in the pediatric population. This review aims to highlight the evidence for use of acupuncture in pain and symptom management.
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Affiliation(s)
- Anjana Kundu
- Department of Anesthesiology and Pain Medicine, Complementary and Integrative Medicine Program, Children's Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle, WA 98105, USA.
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Vidarsdottir S, Smeets PAM, Eichelsheim DL, van Osch MJP, Viergever MA, Romijn JA, van der Grond J, Pijl H. Glucose ingestion fails to inhibit hypothalamic neuronal activity in patients with type 2 diabetes. Diabetes 2007; 56:2547-50. [PMID: 17670916 DOI: 10.2337/db07-0193] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The hypothalamus plays a critical role in the regulation of energy balance and fuel flux. Glucose ingestion inhibits hypothalamic neuronal activity in healthy humans. We hypothesized that hypothalamic neuronal activity in response to an oral glucose load would be altered in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS In this randomized, single blind, case-control study, 7 type 2 diabetic men (BMI 27.9 +/- 2.0 kg/m(2)) and 10 age-matched healthy men (BMI 26.1 +/- 3.2 kg/m(2)) were scanned twice for 38 min on separate days using functional magnetic resonance imaging. After 8 min, they ingested either a glucose solution (75 g in 300 ml water) or water (300 ml). RESULTS Glucose ingestion resulted in a prolonged significant blood oxygen level-dependent signal decrease in the upper and lower hypothalamus in healthy subjects but not in diabetic patients. CONCLUSIONS Glucose ingestion fails to inhibit hypothalamic neuronal activity in patients with type 2 diabetes. Failure of neural circuits to properly adapt to nutrient ingestion may contribute to metabolic imbalance in type 2 diabetic patients.
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Affiliation(s)
- Solrun Vidarsdottir
- Leiden University Medical Center, Department of Endocrinology and Metabolic Disease, C4-83, P.O. Box 9600, 2300 RC, Leiden, Netherlands
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Smeets PAM, Vidarsdottir S, de Graaf C, Stafleu A, van Osch MJP, Viergever MA, Pijl H, van der Grond J. Oral glucose intake inhibits hypothalamic neuronal activity more effectively than glucose infusion. Am J Physiol Endocrinol Metab 2007; 293:E754-8. [PMID: 17566114 DOI: 10.1152/ajpendo.00231.2007] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We previously showed that hypothalamic neuronal activity, as measured by the blood oxygen level-dependent (BOLD) functional MRI signal, declines in response to oral glucose intake. To further explore the mechanism driving changes in hypothalamic neuronal activity in response to an oral glucose load, we here compare hypothalamic BOLD signal changes subsequent to an oral vs. an intravenous (iv) glucose challenge in healthy humans. Seven healthy, normal-weight men received four interventions in random order after an overnight fast: 1) ingestion of glucose solution (75 g in 300 ml) or 2) water (300 ml), and 3) iv infusion of 40% glucose solution (0.5 g/kg body wt, maximum 35 g) or 4) infusion of saline (0.9% NaCl, equal volume). The BOLD signal was recorded as of 8 min prior to intervention (baseline) until 30 min after. Glucose infusion was associated with a modest and transient signal decline in the hypothalamus. In contrast, glucose ingestion was followed by a profound and persistent signal decrease despite the fact that plasma glucose levels were almost threefold lower than in response to iv administration. Accordingly, glucose ingestion tended to suppress hunger more than iv infusion (P < 0.1). We infer that neural and endocrine signals emanating from the gastrointestinal tract are critical for the hypothalamic response to nutrient ingestion.
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Affiliation(s)
- Paul A M Smeets
- University Medical Center Utrecht, Image Sciences Institute, Heidelberglaan 100, Rm. Q0S.459, 3584 CX Utrecht, The Netherlands.
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13
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Orme-Johnson DW, Schneider RH, Son YD, Nidich S, Cho ZH. Neuroimaging of meditation's effect on brain reactivity to pain. Neuroreport 2006; 17:1359-63. [PMID: 16951585 PMCID: PMC2170475 DOI: 10.1097/01.wnr.0000233094.67289.a8] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Some meditation techniques reduce pain, but there have been no studies on how meditation affects the brain's response to pain. Functional magnetic resonance imaging of the response to thermally induced pain applied outside the meditation period found that long-term practitioners of the Transcendental Meditation technique showed 40-50% fewer voxels responding to pain in the thalamus and total brain than in healthy matched controls interested in learning the technique. After the controls learned the technique and practiced it for 5 months, their response decreased by 40-50% in the thalamus, prefrontal cortex, total brain, and marginally in the anterior cingulate cortex. The results suggest that the Transcendental Meditation technique longitudinally reduces the affective/motivational dimension of the brain's response to pain.
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Affiliation(s)
- David W Orme-Johnson
- Institute for Natural Medicine and Prevention, Maharishi University of Management, Fairfield, Iowa, USA.
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14
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Cho ZH, Hwang SC, Wong EK, Son YD, Kang CK, Park TS, Bai SJ, Kim YB, Lee YB, Sung KK, Lee BH, Shepp LA, Min KT. Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms. Acta Neurol Scand 2006; 113:370-7. [PMID: 16674603 DOI: 10.1111/j.1600-0404.2006.00600.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Although acupuncture therapy has demonstrated itself to be effective in several clinical areas, the underlying mechanisms of acupuncture in general and the analgesic effect in particular are, however, still not clearly delineated. We, therefore, have studied acupuncture analgesic effect through fMRI and proposed a hypothesis, based on the obtained result, which will enlighten the central role of the brain in acupuncture therapy. METHODS The proposed model, termed as a broad sense hypothalamus-pituitary-adrenal (BS-HPA) axis, was based on our observed neuroimaging results. The model incorporates the stress-induced HPA axis model together with neuro-immune interaction including the cholinergic anti-inflammatory model. RESULTS The obtained results coupled with accumulating evidence suggest that the central nervous system is essential for the processing of these effects via its modulation of the autonomic nervous system, neuroimmune system and hormonal regulation. CONCLUSIONS Based on our fMRI study, it appears that understanding the effects of acupuncture within a neuroscience-based framework is vital. Further, we have proposed the broad sense-HPA axis hypothesis which incorporates the experimental results.
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Affiliation(s)
- Z H Cho
- Department of Radiological Sciences, University of California, Irvine, CA 92697, USA.
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15
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Smeets PAM, de Graaf C, Stafleu A, van Osch MJP, van der Grond J. Functional magnetic resonance imaging of human hypothalamic responses to sweet taste and calories. Am J Clin Nutr 2005; 82:1011-6. [PMID: 16280432 DOI: 10.1093/ajcn/82.5.1011] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Evidence exists that beverages do not trigger appropriate anticipatory physiologic responses, such as cephalic phase insulin release. Therefore, it is of interest to elucidate the food properties necessary for triggering adaptive responses. Previously, we found a prolonged dose-dependent decrease in the hypothalamic functional magnetic resonance imaging signal after ingestion of a glucose solution. OBJECTIVES The aims of the present study were to measure the effects of sweet taste and energy content on the hypothalamic response to glucose ingestion and to measure the concomitant changes in blood glucose and insulin concentrations. DESIGN Five healthy, normal-weight men participated in a randomized crossover design trial. The subjects were scanned 4 times for 37 min on separate days with functional magnetic resonance imaging. After 7 min, they ingested 1 of the following 4 stimuli (300 mL of each): water (control), a glucose solution, an aspartame (sweet taste) solution, or a maltodextrin (nonsweet carbohydrate) solution. RESULTS Glucose ingestion resulted in a prolonged and significant signal decrease in the upper hypothalamus (P < 0.05). Water, aspartame, and maltodextrin had no such effect. Glucose and maltodextrin ingestions resulted in similar increases in blood glucose and insulin concentrations. However, only glucose triggered an early rise in insulin concentrations. Aspartame did not trigger any insulin response. CONCLUSIONS Our findings suggest that both sweet taste and energy content are required for a hypothalamic response. The combination of sweet taste and energy content could be crucial in triggering adaptive responses to sweetened beverages.
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Affiliation(s)
- Paul A M Smeets
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
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Smeets PAM, de Graaf C, Stafleu A, van Osch MJP, van der Grond J. Functional MRI of human hypothalamic responses following glucose ingestion. Neuroimage 2005; 24:363-8. [PMID: 15627579 DOI: 10.1016/j.neuroimage.2004.07.073] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2004] [Revised: 07/01/2004] [Accepted: 07/16/2004] [Indexed: 11/15/2022] Open
Abstract
The hypothalamus is intimately involved in the regulation of food intake, integrating multiple neural and hormonal signals. Several hypothalamic nuclei contain glucose-sensitive neurons, which play a crucial role in energy homeostasis. Although a few functional magnetic resonance imaging (fMRI) studies have indicated that glucose consumption has some effect on the neuronal activity levels in the hypothalamus, this matter has not been investigated extensively yet. For instance, dose-dependency of the hypothalamic responses to glucose ingestion has not been addressed. We measured the effects of two different glucose loads on neuronal activity levels in the human hypothalamus using fMRI. After an overnight fast, the hypothalamus of 15 normal weight men was scanned continuously for 37 min. After 7 min, subjects ingested either water or a glucose solution containing 25 or 75 g of glucose. We observed a prolonged decrease of the fMRI signal in the hypothalamus, which started shortly after subjects began drinking the glucose solution and lasted for at least 30 min. Moreover, the observed response was dose-dependent: a larger glucose load resulted in a larger signal decrease. This effect was most pronounced in the upper anterior hypothalamus. In the upper posterior hypothalamus, the signal decrease was similar for both glucose loads. No effect was found in the lower hypothalamus. We suggest a possible relation between the observed hypothalamic response and changes in the blood insulin concentration.
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Affiliation(s)
- Paul A M Smeets
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
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Current awareness in NMR in biomedicine. NMR IN BIOMEDICINE 2003; 16:510-517. [PMID: 14719526 DOI: 10.1002/nbm.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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