1
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Islam J, Rahman MT, Kc E, Park YS. Deciphering the functional role of insular cortex stratification in trigeminal neuropathic pain. J Headache Pain 2024; 25:76. [PMID: 38730344 PMCID: PMC11084050 DOI: 10.1186/s10194-024-01784-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
Trigeminal neuropathic pain (TNP) is a major concern in both dentistry and medicine. The progression from normal to chronic TNP through activation of the insular cortex (IC) is thought to involve several neuroplastic changes in multiple brain regions, resulting in distorted pain perception and associated comorbidities. While the functional changes in the insula are recognized contributors to TNP, the intricate mechanisms underlying the involvement of the insula in TNP processing remain subjects of ongoing investigation. Here, we have overviewed the most recent advancements regarding the functional role of IC in regulating TNP alongside insights into the IC's connectivity with other brain regions implicated in trigeminal pain pathways. In addition, the review examines diverse modulation strategies that target the different parts of the IC, thereby suggesting novel diagnostic and therapeutic management of chronic TNP in the future.
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Affiliation(s)
- Jaisan Islam
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Md Taufiqur Rahman
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Elina Kc
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Young Seok Park
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea.
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea.
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2
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Koolschijn RS, Clarke WT, Ip IB, Emir UE, Barron HC. Event-related functional magnetic resonance spectroscopy. Neuroimage 2023; 276:120194. [PMID: 37244321 PMCID: PMC7614684 DOI: 10.1016/j.neuroimage.2023.120194] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023] Open
Abstract
Proton-Magnetic Resonance Spectroscopy (MRS) is a non-invasive brain imaging technique used to measure the concentration of different neurochemicals. "Single-voxel" MRS data is typically acquired across several minutes, before individual transients are averaged through time to give a measurement of neurochemical concentrations. However, this approach is not sensitive to more rapid temporal dynamics of neurochemicals, including those that reflect functional changes in neural computation relevant to perception, cognition, motor control and ultimately behaviour. In this review we discuss recent advances in functional MRS (fMRS) that now allow us to obtain event-related measures of neurochemicals. Event-related fMRS involves presenting different experimental conditions as a series of trials that are intermixed. Critically, this approach allows spectra to be acquired at a time resolution in the order of seconds. Here we provide a comprehensive user guide for event-related task designs, choice of MRS sequence, analysis pipelines, and appropriate interpretation of event-related fMRS data. We raise various technical considerations by examining protocols used to quantify dynamic changes in GABA, the primary inhibitory neurotransmitter in the brain. Overall, we propose that although more data is needed, event-related fMRS can be used to measure dynamic changes in neurochemicals at a temporal resolution relevant to computations that support human cognition and behaviour.
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Affiliation(s)
- Renée S Koolschijn
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, United Kingdom; Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.
| | - William T Clarke
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, United Kingdom; Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom
| | - I Betina Ip
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, United Kingdom
| | - Uzay E Emir
- School of Health Sciences, Purdue University, West Lafayette, United States
| | - Helen C Barron
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, United Kingdom; Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom.
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3
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Lea-Carnall CA, El-Deredy W, Stagg CJ, Williams SR, Trujillo-Barreto NJ. A mean-field model of glutamate and GABA synaptic dynamics for functional MRS. Neuroimage 2023; 266:119813. [PMID: 36528313 PMCID: PMC7614487 DOI: 10.1016/j.neuroimage.2022.119813] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/31/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
Advances in functional magnetic resonance spectroscopy (fMRS) have enabled the quantification of activity-dependent changes in neurotransmitter concentrations in vivo. However, the physiological basis of the large changes in GABA and glutamate observed by fMRS (>10%) over short time scales of less than a minute remain unclear as such changes cannot be accounted for by known synthesis or degradation metabolic pathways. Instead, it has been hypothesized that fMRS detects shifts in neurotransmitter concentrations as they cycle from presynaptic vesicles, where they are largely invisible, to extracellular and cytosolic pools, where they are detectable. The present paper uses a computational modelling approach to demonstrate the viability of this hypothesis. A new mean-field model of the neural mechanisms generating the fMRS signal in a cortical voxel is derived. The proposed macroscopic mean-field model is based on a microscopic description of the neurotransmitter dynamics at the level of the synapse. Specifically, GABA and glutamate are assumed to cycle between three metabolic pools: packaged in the vesicles; active in the synaptic cleft; and undergoing recycling and repackaging in the astrocytic or neuronal cytosol. Computational simulations from the model are used to generate predicted changes in GABA and glutamate concentrations in response to different types of stimuli including pain, vision, and electric current stimulation. The predicted changes in the extracellular and cytosolic pools corresponded to those reported in empirical fMRS data. Furthermore, the model predicts a selective control mechanism of the GABA/glutamate relationship, whereby inhibitory stimulation reduces both neurotransmitters, whereas excitatory stimulation increases glutamate and decreases GABA. The proposed model bridges between neural dynamics and fMRS and provides a mechanistic account for the activity-dependent changes in the glutamate and GABA fMRS signals. Lastly, these results indicate that echo-time may be an important timing parameter that can be leveraged to maximise fMRS experimental outcomes.
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Affiliation(s)
- Caroline A Lea-Carnall
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, UK.
| | - Wael El-Deredy
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Chile; Valencian Graduate School and Research Network of Artificial Intelligence.; Department of Electronic Engineering, School of Engineering, Universitat de Val..ncia, Spain..
| | - Charlotte J Stagg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Stephen R Williams
- Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK
| | - Nelson J Trujillo-Barreto
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, UK
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4
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Pasanta D, He JL, Ford T, Oeltzschner G, Lythgoe DJ, Puts NA. Functional MRS studies of GABA and glutamate/Glx - A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 144:104940. [PMID: 36332780 PMCID: PMC9846867 DOI: 10.1016/j.neubiorev.2022.104940] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/19/2022] [Accepted: 10/30/2022] [Indexed: 11/05/2022]
Abstract
Functional magnetic resonance spectroscopy (fMRS) can be used to investigate neurometabolic responses to external stimuli in-vivo, but findings are inconsistent. We performed a systematic review and meta-analysis on fMRS studies of the primary neurotransmitters Glutamate (Glu), Glx (Glutamate + Glutamine), and GABA. Data were extracted, grouped by metabolite, stimulus domain, and brain region, and analysed by determining standardized effect sizes. The quality of individual studies was rated. When results were analysed by metabolite type small to moderate effect sizes of 0.29-0.47 (p < 0.05) were observed for changes in Glu and Glx regardless of stimulus domain and brain region, but no significant effects were observed for GABA. Further analysis suggests that Glu, Glx and GABA responses differ by stimulus domain or task and vary depending on the time course of stimulation and data acquisition. Here, we establish effect sizes and directionality of GABA, Glu and Glx response in fMRS. This work highlights the importance of standardised reporting and minimal best practice for fMRS research.
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Affiliation(s)
- Duanghathai Pasanta
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, London SE5 8AB, United Kingdom; Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, London SE5 8AB, United Kingdom
| | - Talitha Ford
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Locked Bag 20000, Geelong, Victoria 3220, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Georg Oeltzschner
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 700. N. Broadway, 21207 Baltimore, United States; Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N. Wolfe Street, 21205 Baltimore, United States
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, London SE5 8AB, United Kingdom
| | - Nicolaas A Puts
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, London SE5 8AB, United Kingdom; MRC Centre for Neurodevelopmental Disorders, New Hunt's House, Guy's Campus, King's College London, London, SE1 1UL London, United Kingdom.
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5
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Koush Y, Rothman DL, Behar KL, de Graaf RA, Hyder F. Human brain functional MRS reveals interplay of metabolites implicated in neurotransmission and neuroenergetics. J Cereb Blood Flow Metab 2022; 42:911-934. [PMID: 35078383 PMCID: PMC9125492 DOI: 10.1177/0271678x221076570] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 01/28/2023]
Abstract
While functional MRI (fMRI) localizes brain activation and deactivation, functional MRS (fMRS) provides insights into the underlying metabolic conditions. There is much interest in measuring task-induced and resting levels of metabolites implicated in neuroenergetics (e.g., lactate, glucose, or β-hydroxybutyrate (BHB)) and neurotransmission (e.g., γ-aminobutyric acid (GABA) or pooled glutamate and glutamine (Glx)). Ultra-high magnetic field (e.g., 7T) has boosted the fMRS quantification precision, reliability, and stability of spectroscopic observations using short echo-time (TE) 1H-MRS techniques. While short TE 1H-MRS lacks sensitivity and specificity for fMRS at lower magnetic fields (e.g., 3T or 4T), most of these metabolites can also be detected by J-difference editing (JDE) 1H-MRS with longer TE to filter overlapping resonances. The 1H-MRS studies show that JDE can detect GABA, Glx, lactate, and BHB at 3T, 4T and 7T. Most recently, it has also been demonstrated that JDE 1H-MRS is capable of reliable detection of metabolic changes in different brain areas at various magnetic fields. Combining fMRS measurements with fMRI is important for understanding normal brain function, but also clinically relevant for mechanisms and/or biomarkers of neurological and neuropsychiatric disorders. We provide an up-to-date overview of fMRS research in the last three decades, both in terms of applications and technological advances. Overall the emerging fMRS techniques can be expected to contribute substantially to our understanding of metabolism for brain function and dysfunction.
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Affiliation(s)
- Yury Koush
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Douglas L Rothman
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Kevin L Behar
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robin A de Graaf
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Fahmeed Hyder
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
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6
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Dwyer GE, Craven AR, Bereśniewicz J, Kazimierczak K, Ersland L, Hugdahl K, Grüner R. Simultaneous Measurement of the BOLD Effect and Metabolic Changes in Response to Visual Stimulation Using the MEGA-PRESS Sequence at 3 T. Front Hum Neurosci 2021; 15:644079. [PMID: 33841118 PMCID: PMC8024522 DOI: 10.3389/fnhum.2021.644079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
The blood oxygen level dependent (BOLD) effect that provides the contrast in functional magnetic resonance imaging (fMRI) has been demonstrated to affect the linewidth of spectral peaks as measured with magnetic resonance spectroscopy (MRS) and through this, may be used as an indirect measure of cerebral blood flow related to neural activity. By acquiring MR-spectra interleaved with frames without water suppression, it may be possible to image the BOLD effect and associated metabolic changes simultaneously through changes in the linewidth of the unsuppressed water peak. The purpose of this study was to implement this approach with the MEGA-PRESS sequence, widely considered to be the standard sequence for quantitative measurement of GABA at field strengths of 3 T and lower, to observe how changes in both glutamate (measured as Glx) and GABA levels may relate to changes due to the BOLD effect. MR-spectra and fMRI were acquired from the occipital cortex (OCC) of 20 healthy participants whilst undergoing intrascanner visual stimulation in the form of a red and black radial checkerboard, alternating at 8 Hz, in 90 s blocks comprising 30 s of visual stimulation followed by 60 s of rest. Results show very strong agreement between the changes in the linewidth of the unsuppressed water signal and the canonical haemodynamic response function as well as a strong, negative, but not statistically significant, correlation with the Glx signal as measured from the OFF spectra in MEGA-PRESS pairs. Findings from this experiment suggest that the unsuppressed water signal provides a reliable measure of the BOLD effect and that correlations with associated changes in GABA and Glx levels may also be measured. However, discrepancies between metabolite levels as measured from the difference and OFF spectra raise questions regarding the reliability of the respective methods.
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Affiliation(s)
- Gerard Eric Dwyer
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | - Justyna Bereśniewicz
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Katarzyna Kazimierczak
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Lars Ersland
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Renate Grüner
- NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway.,Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, University of Bergen, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Department of Physics and Technology, University of Bergen, Bergen, Norway
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7
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Increased Glutamate concentrations during prolonged motor activation as measured using functional Magnetic Resonance Spectroscopy at 3T. Neuroimage 2020; 223:117338. [DOI: 10.1016/j.neuroimage.2020.117338] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 01/20/2023] Open
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8
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Archibald J, MacMillan EL, Graf C, Kozlowski P, Laule C, Kramer JLK. Metabolite activity in the anterior cingulate cortex during a painful stimulus using functional MRS. Sci Rep 2020; 10:19218. [PMID: 33154474 PMCID: PMC7645766 DOI: 10.1038/s41598-020-76263-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023] Open
Abstract
To understand neurochemical brain responses to pain, proton magnetic resonance spectroscopy (1H-MRS) is used in humans in vivo to examine various metabolites. Recent MRS investigations have adopted a functional approach, where acquisitions of MRS are performed over time to track task-related changes. Previous studies suggest glutamate is of primary interest, as it may play a role during cortical processing of noxious stimuli. The objective of this study was to examine the metabolic effect (i.e., glutamate) in the anterior cingulate cortex during noxious stimulation using fMRS. The analysis addressed changes in glutamate and glutamate + glutamine (Glx) associated with the onset of pain, and the degree by which fluctuations in metabolites corresponded with continuous pain outcomes. Results suggest healthy participants undergoing tonic noxious stimulation demonstrated increased concentrations of glutamate and Glx at the onset of pain. Subsequent reports of pain were not accompanied by corresponding changes in glutamate of Glx concentrations. An exploratory analysis on sex revealed large effect size changes in glutamate at pain onset in female participants, compared with medium-sized effects in male participants. We propose a role for glutamate in the ACC related to the detection of a noxious stimulus.
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Affiliation(s)
- J Archibald
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
- Department of Experimental Medicine, University of British Columbia, Vancouver, Canada.
| | - E L MacMillan
- Department of Radiology, University of British Columbia, Vancouver, Canada
- ImageTech Lab, Simon Fraser University, Surrey, Canada
- Philips Healthcare Canada, Markham, Canada
| | - C Graf
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - P Kozlowski
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Hughill Center, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
| | - C Laule
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Hughill Center, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - J L K Kramer
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Center for Brain Health (DMCH), Vancouver, Canada
- Hughill Center, Vancouver, Canada
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9
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Archibald J, MacMillan EL, Enzler A, Jutzeler CR, Schweinhardt P, Kramer JL. Excitatory and inhibitory responses in the brain to experimental pain: A systematic review of MR spectroscopy studies. Neuroimage 2020; 215:116794. [DOI: 10.1016/j.neuroimage.2020.116794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 01/21/2023] Open
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10
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Sanaei Nezhad F, Lea‐Carnall CA, Anton A, Jung J, Michou E, Williams SR, Parkes LM. Number of subjects required in common study designs for functional GABA magnetic resonance spectroscopy in the human brain at 3 Tesla. Eur J Neurosci 2020; 51:1784-1793. [PMID: 31705723 PMCID: PMC7216844 DOI: 10.1111/ejn.14618] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 10/22/2019] [Accepted: 10/24/2019] [Indexed: 01/16/2023]
Abstract
Magnetic resonance spectroscopy (MRS) is a research tool for measuring the concentration of metabolites such as γ-aminobutyric acid (GABA) and glutamate in the brain. MEGA-PRESS has been the preferred pulse sequence for GABA measurements due to low physiological GABA concentrations, hence low signal. To compensate, researchers incorporate long acquisition durations (7-10 min) making functional measurements of this metabolite challenging. Here, the acquisition duration and sample sizes required to detect specific concentration changes in GABA using MEGA-PRESS at 3 T are presented for both between-groups and within-session study designs. 75 spectra were acquired during rest using MEGA-PRESS from 41 healthy volunteers in 6 different brain regions at 3 T with voxel sizes between 13 and 22 cm3 . Between-group and within-session variance was calculated for different acquisition durations and power calculations were performed to determine the number of subjects required to detect a given percentage change in GABA/NAA signal ratio. Within-subject variability was assessed by sampling different segments of a single acquisition. Power calculations suggest that detecting a 15% change in GABA using a 2 min acquisition and a 27 cm3 voxel size, depending on the region, requires between 8 and 93 subjects using a within-session design. A between-group design typically requires more participants to detect the same difference. In brain regions with suboptimal shimming, the subject numbers can be up to 4-fold more. Collecting data for longer than 4 min in brain regions examined in this study is deemed unnecessary, as variance in the signal did not reduce further for longer durations.
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Affiliation(s)
- Faezeh Sanaei Nezhad
- Division of Informatics, Imaging and Data ScienceUniversity of ManchesterManchesterUK
| | | | - Adriana Anton
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - JeYoung Jung
- School of PsychologyUniversity of NottinghamNottinghamUK
| | - Emilia Michou
- School of Rehabilitation SciencesUniversity of PatrasPatrasGreece
| | - Stephen R. Williams
- Division of Informatics, Imaging and Data ScienceUniversity of ManchesterManchesterUK
| | - Laura M. Parkes
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
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11
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Mullins PG. Towards a theory of functional magnetic resonance spectroscopy (fMRS): A meta-analysis and discussion of using MRS to measure changes in neurotransmitters in real time. Scand J Psychol 2018; 59:91-103. [PMID: 29356002 DOI: 10.1111/sjop.12411] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/01/2017] [Indexed: 02/06/2023]
Abstract
Proton magnetic resonance spectroscopy is a powerful tool to investigate neurochemistry and physiology in vivo. Recently researchers have started to use MRS to measure neurotransmitter changes related to neural activity, so called functional MRS (fMRS). Particular interest has been placed on measuring glutamate changes associated with neural function, but differences are reported in the size of changes seen. This review discusses fMRS, and includes meta-analyses of the relative size of glutamate changes seen in fMRS, and the impact experimental design and stimulus paradigm may have. On average glutamate was found to increase by 6.97% (±1.739%) in response to neural activation. However, factors of experimental design may have a large impact on the size of these changes. For example an increase of 4.749% (±1.45%) is seen in block studies compared to an increase of 13.429% (±3.59) in studies using event related paradigms. The stimulus being investigated also seems to play a role with prolonged visual stimuli showing a small mean increase in glutamate of 2.318% (±1.227%) while at the other extreme, pain stimuli show a mean stimulation effect of 14.458% (±3.736%). These differences are discussed with regards to possible physiologic interpretations, as well experimental design implications.
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12
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Jelen LA, King S, Mullins PG, Stone JM. Beyond static measures: A review of functional magnetic resonance spectroscopy and its potential to investigate dynamic glutamatergic abnormalities in schizophrenia. J Psychopharmacol 2018; 32:497-508. [PMID: 29368979 DOI: 10.1177/0269881117747579] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abnormalities of the glutamate system are increasingly implicated in schizophrenia but their exact nature remains unknown. Proton magnetic resonance spectroscopy (1H-MRS), while fundamental in revealing glutamatergic alterations in schizophrenia, has, until recently, been significantly limited and thought to only provide static measures. Functional magnetic resonance spectroscopy (fMRS), which uses sequential scans for dynamic measurement of a range of brain metabolites in activated brain areas, has lately been applied to a variety of task or stimulus conditions, producing interesting insights into neurometabolite responses to neural activation. Here, we summarise the existing 1H-MRS studies of brain glutamate in schizophrenia. We then present a comprehensive review of research studies that have utilised fMRS, and lastly consider how fMRS methods might further the understanding of glutamatergic abnormalities in schizophrenia.
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Affiliation(s)
- Luke A Jelen
- 1 The Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,2 South London and Maudsley NHS Foundation Trust, UK
| | - Sinead King
- 1 The Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Paul G Mullins
- 3 Bangor Imaging Unit, School of Psychology, Bangor University, Gwynedd, UK
| | - James M Stone
- 1 The Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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13
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Woodcock EA, Anand C, Khatib D, Diwadkar VA, Stanley JA. Working Memory Modulates Glutamate Levels in the Dorsolateral Prefrontal Cortex during 1H fMRS. Front Psychiatry 2018; 9:66. [PMID: 29559930 PMCID: PMC5845718 DOI: 10.3389/fpsyt.2018.00066] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/19/2018] [Indexed: 12/15/2022] Open
Abstract
Glutamate is involved in excitatory neurotransmission and metabolic processes related to brain function. Previous studies using proton functional magnetic resonance spectroscopy (1H fMRS) have demonstrated elevated cortical glutamate levels by 2-4% during visual and motor stimulation, relative to periods of no stimulation. Here, we extended this approach to working memory cognitive task performance, which has been consistently associated with dorsolateral prefrontal cortex (dlPFC) activation. Sixteen healthy adult volunteers completed a continuous visual fixation "rest" task followed by a letter 2-back working memory task during 1H fMRS acquisition of the left dlPFC, which encompassed Brodmann areas 45 and 46 over a 4.5-cm3 volume. Using a 100% automated fitting procedure integrated with LCModel, raw spectra were eddy current-, phase-, and shift-corrected prior to quantification resulting in a 32s temporal resolution or 8 averages per spectra. Task compliance was high (95 ± 11% correct) and the mean Cramer-Rao Lower Bound of glutamate was 6.9 ± 0.9%. Relative to continuous passive visual fixation, left dlPFC glutamate levels were significantly higher by 2.7% (0.32 mmol/kg wet weight) during letter 2-back performance. Elevated dlPFC glutamate levels reflect increased metabolic activity and excitatory neurotransmission driven by working memory-related cognitive demands. These results provide the first in vivo demonstration of elevated dlPFC glutamate levels during working memory.
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Affiliation(s)
- Eric A. Woodcock
- Brain Imaging Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Chaitali Anand
- Brain Imaging Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Dalal Khatib
- Brain Imaging Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A. Diwadkar
- Brain Imaging Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Jeffrey A. Stanley
- Brain Imaging Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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Assessment of intra- and inter-regional interrelations between GABA+, Glx and BOLD during pain perception in the human brain – A combined 1H fMRS and fMRI study. Neuroscience 2017; 365:125-136. [DOI: 10.1016/j.neuroscience.2017.09.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/01/2017] [Accepted: 09/21/2017] [Indexed: 11/22/2022]
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15
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de Matos NM, Hock A, Wyss M, Ettlin DA, Brügger M. Neurochemical dynamics of acute orofacial pain in the human trigeminal brainstem nuclear complex. Neuroimage 2017; 162:162-172. [DOI: 10.1016/j.neuroimage.2017.08.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 01/25/2023] Open
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16
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Zunhammer M, Schweizer LM, Witte V, Harris RE, Bingel U, Schmidt-Wilcke T. Combined glutamate and glutamine levels in pain-processing brain regions are associated with individual pain sensitivity. Pain 2016; 157:2248-2256. [PMID: 27649042 DOI: 10.1097/j.pain.0000000000000634] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The relationship between glutamate and γ-aminobutyric acid (GABA) levels in the living human brain and pain sensitivity is unknown. Combined glutamine/glutamate (Glx), as well as GABA levels can be measured in vivo with single-voxel proton magnetic resonance spectroscopy. In this cross-sectional study, we aimed at determining whether Glx and/or GABA levels in pain-related brain regions are associated with individual differences in pain sensitivity. Experimental heat, cold, and mechanical pain thresholds were obtained from 39 healthy, drug-free individuals (25 men) according to the quantitative sensory testing protocol and summarized into 1 composite measure of pain sensitivity. The Glx levels were measured using point-resolved spectroscopy at 3 T, within a network of pain-associated brain regions comprising the insula, the anterior cingulate cortex, the mid-cingulate cortex, the dorsolateral prefrontal cortex, and the thalamus. GABA levels were measured using GABA-edited spectroscopy (Mescher-Garwood point-resolved spectroscopy) within the insula, the anterior cingulate cortex, and the mid-cingulate cortex. Glx and/or GABA levels correlated positively across all brain regions. Gender, weekly alcohol consumption, and depressive symptoms were significantly associated with Glx and/or GABA levels. A linear regression analysis including all these factors indicated that Glx levels pooled across pain-related brain regions were positively associated with pain sensitivity, whereas no appreciable relationship with GABA was found. In sum, we show that the levels of the excitatory neurotransmitter glutamate and its precursor glutamine across pain-related brain regions are positively correlated with individual pain sensitivity. Future studies will have to determine whether our findings also apply to clinical populations.
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Affiliation(s)
| | - Lauren M Schweizer
- Abteilung für Neurologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany
| | - Vanessa Witte
- Abteilung für Neurologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany
| | - Richard E Harris
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Ulrike Bingel
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Germany
| | - Tobias Schmidt-Wilcke
- Abteilung für Neurologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany
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Hansen TM, Olesen AE, Simonsen CW, Fischer IW, Lelic D, Drewes AM, Frøkjaer JB. Acute Metabolic Changes Associated With Analgesic Drugs: An MR Spectroscopy Study. J Neuroimaging 2016; 26:545-51. [DOI: 10.1111/jon.12345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/15/2016] [Indexed: 12/22/2022] Open
Affiliation(s)
- Tine Maria Hansen
- Mech-Sense, Department of Radiology; Aalborg University Hospital; Aalborg Denmark
- Department of Clinical Medicine; Aalborg University; Aalborg Denmark
| | - Anne Estrup Olesen
- Mech-Sense, Department of Gastroenterology & Hepatology; Aalborg University Hospital; Aalborg Denmark
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | | | - Iben Wendelboe Fischer
- Mech-Sense, Department of Gastroenterology & Hepatology; Aalborg University Hospital; Aalborg Denmark
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Dina Lelic
- Mech-Sense, Department of Gastroenterology & Hepatology; Aalborg University Hospital; Aalborg Denmark
| | - Asbjørn Mohr Drewes
- Department of Clinical Medicine; Aalborg University; Aalborg Denmark
- Mech-Sense, Department of Gastroenterology & Hepatology; Aalborg University Hospital; Aalborg Denmark
| | - Jens Brøndum Frøkjaer
- Mech-Sense, Department of Radiology; Aalborg University Hospital; Aalborg Denmark
- Department of Clinical Medicine; Aalborg University; Aalborg Denmark
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Apšvalka D, Gadie A, Clemence M, Mullins PG. Event-related dynamics of glutamate and BOLD effects measured using functional magnetic resonance spectroscopy (fMRS) at 3T in a repetition suppression paradigm. Neuroimage 2015; 118:292-300. [PMID: 26072254 DOI: 10.1016/j.neuroimage.2015.06.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/01/2015] [Accepted: 06/04/2015] [Indexed: 12/30/2022] Open
Abstract
Proton MR spectroscopy ((1)H-MRS) complements other brain research methods by providing measures of neurometabolites noninvasively in a localized brain area. Improvements in MR scanner technologies, and data acquisition and analysis methods should allow functional (1)H-MRS (fMRS) to measure neurometabolite concentration changes during task-induced brain activation. The aim of the current study was to further develop event-related fMRS at 3T to investigate glutamate dynamics in response to repetition suppression. A secondary aim was to investigate the relationship between blood-oxygen-level-dependent (BOLD) responses and glutamate dynamics in the same paradigm at the same time. A novel approach of interleaved water-suppressed (metabolite) and unsuppressed (water) fMRS was used to simultaneously detect the event-related dynamics of glutamate and BOLD signal to repetition suppression in the lateral occipital cortex of thirteen (N=13) volunteers. On average, (1)H-MRS-visible glutamate increased after novel visual stimuli presentations by 12% and decreased by 11-13% on repeated compared to novel presentations. The BOLD signal, as measured by water peak amplitude changes, showed significant difference between Task and Rest trials, and, on a GLM based analysis of the time series, demonstrated a significant difference between the novel and repeated trials, however appeared to be decoupled from the glutamate response as no correlation was found between the two. These results are the first demonstration that reductions in neuronal activity typical of repetition suppression effects are reflected by reduced glutamatergic and BOLD measures, that glutamate and BOLD responses may not be coupled as previously thought, and that these changes and relationships can be measured simultaneously using event-related fMRS at 3T.
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Affiliation(s)
- Dace Apšvalka
- Bangor Imaging Center, School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK
| | - Andrew Gadie
- Bangor Imaging Center, School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK
| | - Matthew Clemence
- Philips Healthcare, Philips Centre, Guildford Business Park, Guildford, Surrey GU2 8HX, UK
| | - Paul G Mullins
- Bangor Imaging Center, School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK.
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Meier ML, de Matos NMP, Brügger M, Ettlin DA, Lukic N, Cheetham M, Jäncke L, Lutz K. Equal pain-Unequal fear response: enhanced susceptibility of tooth pain to fear conditioning. Front Hum Neurosci 2014; 8:526. [PMID: 25100974 PMCID: PMC4103082 DOI: 10.3389/fnhum.2014.00526] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 06/28/2014] [Indexed: 01/11/2023] Open
Abstract
Experimental fear conditioning in humans is widely used as a model to investigate the neural basis of fear learning and to unravel the pathogenesis of anxiety disorders. It has been observed that fear conditioning depends on stimulus salience and subject vulnerability to fear. It is further known that the prevalence of dental-related fear and phobia is exceedingly high in the population. Dental phobia is unique as no other body part is associated with a specific phobia. Therefore, we hypothesized that painful dental stimuli exhibit an enhanced susceptibility to fear conditioning when comparing to equal perceived stimuli applied to other body sites. Differential susceptibility to pain-related fear was investigated by analyzing responses to an unconditioned stimulus (UCS) applied to the right maxillary canine (UCS-c) vs. the right tibia (UCS-t). For fear conditioning, UCS-c and USC-t consisted of painful electric stimuli, carefully matched at both application sites for equal intensity and quality perception. UCSs were paired to simple geometrical forms which served as conditioned stimuli (CS+). Unpaired CS+ were presented for eliciting and analyzing conditioned fear responses. Outcome parameter were (1) skin conductance changes and (2) time-dependent brain activity (BOLD responses) in fear-related brain regions such as the amygdala, anterior cingulate cortex, insula, thalamus, orbitofrontal cortex, and medial prefrontal cortex. A preferential susceptibility of dental pain to fear conditioning was observed, reflected by heightened skin conductance responses and enhanced time-dependent brain activity (BOLD responses) in the fear network. For the first time, this study demonstrates fear-related neurobiological mechanisms that point toward a superior conditionability of tooth pain. Beside traumatic dental experiences our results offer novel evidence that might explain the high prevalence of dental-related fears in the population.
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Affiliation(s)
- Michael L. Meier
- Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of ZurichZurich, Switzerland
- Chiropractic Medicine, Balgrist University HospitalZurich, Switzerland
| | - Nuno M. P. de Matos
- Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of ZurichZurich, Switzerland
| | - Mike Brügger
- Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of ZurichZurich, Switzerland
- MRI Technology, Institute for Biomedical Engineering, Swiss Federal Institute of Technology and the University of ZurichZurich, Switzerland
| | - Dominik A. Ettlin
- Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of ZurichZurich, Switzerland
| | - Nenad Lukic
- Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of ZurichZurich, Switzerland
| | - Marcus Cheetham
- Institute of Psychology, Department of Neuropsychology, University of ZurichZurich, Switzerland
| | - Lutz Jäncke
- Institute of Psychology, Department of Neuropsychology, University of ZurichZurich, Switzerland
| | - Kai Lutz
- Institute of Psychology, Department of Neuropsychology, University of ZurichZurich, Switzerland
- Center for Neurology and Rehabilitation CereneoVitznau, Switzerland
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20
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Hansen TM, Olesen AE, Simonsen CW, Drewes AM, Frøkjær JB. Cingulate metabolites during pain and morphine treatment as assessed by magnetic resonance spectroscopy. J Pain Res 2014; 7:269-76. [PMID: 24899823 PMCID: PMC4038455 DOI: 10.2147/jpr.s61193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Experimental investigation of cerebral mechanisms underlying pain and analgesia are important in the development of methods for diagnosis and treatment of pain. The aim of the current study was to explore brain metabolites in response to pain and treatment with morphine. Methods Proton magnetic resonance spectroscopy of the anterior cingulate cortex was performed in 20 healthy volunteers (13 males and seven females, aged 24.9±2.6 years) during rest and acute pain before and during treatment with 30 mg of oral morphine or placebo in a randomized, double-blinded, cross-over study design. Pain was evoked by skin stimulation applied to the right upper leg using a contact heat-evoked potential stimulator. Results Data from 12 subjects were valid for analysis. Painful stimulation induced an increase in N-acetylaspartate/creatine compared with rest (F=5.5, P=0.04). During treatment with morphine, painful stimulation induced decreased glutamate/creatine (F=7.3, P=0.02), myo-inositol/creatine (F=8.38, P=0.02), and N-acetylaspartate/creatine (F=13.8, P=0.004) concentrations, whereas an increase in the pain-evoked N-acetylaspartate/creatine concentration (F=6.1, P=0.04) was seen during treatment with placebo. Conclusion This explorative study indicates that neuronal metabolites in the anterior cingulate cortex, such as N-acetylaspartate, glutamate, and myo-inositol, could be related to the physiology of pain and treatment with morphine. This experimental method has the potential to enable the study of brain metabolites involved in pain and its treatment, and may in the future be used to provide further insight into these mechanisms.
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Affiliation(s)
- Tine Maria Hansen
- Mech-Sense, Department of Radiology, Aalborg University, Aalborg, Denmark
| | - Anne Estrup Olesen
- Mech-Sense, Department of Gastroenterology, Aalborg University, Aalborg, Denmark
| | | | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology, Aalborg University, Aalborg, Denmark ; Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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21
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Ernst J, Böker H, Hättenschwiler J, Schüpbach D, Northoff G, Seifritz E, Grimm S. The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate. Soc Cogn Affect Neurosci 2013; 9:857-63. [PMID: 23596189 DOI: 10.1093/scan/nst058] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Alexithymia and increased interoceptive awareness have been associated with affective disorders as well as with altered insula and anterior cingulate cortex (ACC) function. Brain imaging studies have demonstrated an association between neurotransmitter function and affective disorders as well as personality traits. Here, we first examined the relationship between alexithymic facets as assessed with the Toronto Alexithymia Scale (TAS-20) and interoceptive awareness (assessed with the Body Perception Questionnaire) in 18 healthy subjects. Second, we investigated their association with glutamate and gamma-aminobutyric acid (GABA) concentrations in the left insula and the ACC using 3-Tesla proton magnetic resonance spectroscopy. Behaviorally, we found a close association between alexithymia and interoceptive awareness. Furthermore, glutamate levels in the left insula were positively associated with both alexithymia and awareness of autonomic nervous system reactivity, while GABA concentrations in ACC were selectively associated with alexithymia. Although preliminary, our results suggest that increased glutamate-mediated excitatory transmission-related to enhanced insula activity-reflects increased interoceptive awareness in alexithymia. Suppression of the unspecific emotional arousal evoked by increased awareness of bodily responses in alexithymics might thus be reflected in decreased neuronal activity mediated by increased GABA concentration in ACC.
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Affiliation(s)
- Jutta Ernst
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
| | - Heinz Böker
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
| | - Joe Hättenschwiler
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
| | - Daniel Schüpbach
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
| | - Georg Northoff
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
| | - Erich Seifritz
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
| | - Simone Grimm
- Clinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, GermanyClinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, GermanyClinic for Affective Disorders and General Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, 8029 Zurich, Switzerland, Center for Anxiety and Depression, 8008 Zurich, Switzerland, University of Ottawa, Institute of Mental Health Research, Ottawa K1Z 7K4, Canada, Department of Psychiatry, Campus Benjamin Franklin, Charité, 14050 Berlin, and Languages of Emotion Cluster of Excellence, Freie Universität Berlin, 14195 Berlin, Germany
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Gutzeit A, Froehlich JM, Hergan K, Graf N, Binkert CA, Meier D, Brügger M, Reischauer C, Sutter R, Herdener M, Schubert T, Kos S, Grosshans M, Straka M, Mutschler J. Insula-specific H magnetic resonance spectroscopy reactions in heavy smokers under acute nicotine withdrawal and after oral nicotine substitution. Eur Addict Res 2013; 19:184-93. [PMID: 23257512 DOI: 10.1159/000345915] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 11/19/2012] [Indexed: 12/30/2022]
Abstract
The aim of this study was to clarify whether addiction-specific neurometabolic reaction patterns occur in the insular cortex during acute nicotine withdrawal in tobacco smokers in comparison to nonsmokers. Fourteen male smokers and 10 male nonsmokers were included. Neurometabolites of the right and the left insular cortices were quantified by magnetic resonance spectroscopy (MRS) on a 3-Tesla scanner. Three separate MRS measurements were performed in each subject: among the smokers, the first measurement was done during normal smoking behavior, the second measurement during acute withdrawal (after 24 h of smoking abstinence), and the third shortly after administration of an oral nicotine substitute. Simultaneously, craving, withdrawal symptoms, and CO levels in exhaled air were determined during the three phases. The participants in the control group underwent the same MR protocol. In the smokers, during withdrawal, the insular cortex showed a significant increase in glutamine (Gln; p = 0.023) as well as a slight increase not reaching significance for glutamine/glutamate (Glx; p = 0.085) and a nonsignificant drop in myoinositol (mI; p = 0.381). These values tended to normalize after oral nicotine substitution treatment, even though differences were not significant: Gln (p = 0.225), Glx (p = 0.107) and mI (p = 0.810). Overall, the nonsmokers (control group) did not show any metabolic changes over all three phases (p > 0.05). In smokers, acute nicotine withdrawal produces a neurometabolic reaction pattern that is partly reversed by the administration of an oral nicotine substitute. The results are consistent with the expression of an addiction-specific neurometabolic shift in the brain and confirm the fact that the insular cortex seems to play a possible role in nicotine dependence.
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Affiliation(s)
- Andreas Gutzeit
- Department of Radiology, Cantonal Hospital Winterthur, CH–8401Winterthur, Switzerland.
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Differential NMR spectroscopy reactions of anterior/posterior and right/left insular subdivisions due to acute dental pain. Eur Radiol 2012; 23:450-60. [DOI: 10.1007/s00330-012-2621-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 06/22/2012] [Accepted: 06/28/2012] [Indexed: 12/26/2022]
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Reidler JS, Mendonca ME, Santana MB, Wang X, Lenkinski R, Motta AF, Marchand S, Latif L, Fregni F. Effects of Motor Cortex Modulation and Descending Inhibitory Systems on Pain Thresholds in Healthy Subjects. THE JOURNAL OF PAIN 2012; 13:450-8. [DOI: 10.1016/j.jpain.2012.01.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 12/14/2011] [Accepted: 01/21/2012] [Indexed: 11/15/2022]
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Brügger M, Lutz K, Brönnimann B, Meier M, Luechinger R, Barlow A, Jäncke L, Ettlin D. Tracing Toothache Intensity in the Brain. J Dent Res 2011; 91:156-60. [DOI: 10.1177/0022034511431253] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Identification of brain regions that differentially respond to pain intensity may improve our understanding of trigeminally mediated nociception. This report analyzed cortical responses to painless and painful electrical stimulation of a right human maxillary canine tooth. Functional magnetic resonance images were obtained during the application of five graded stimulus strengths, from below, at, and above the individually determined pain thresholds. Study participants reported each stimulus on a visual rating scale with respect to evoked sensation. Based on hemodynamic responses of all pooled stimuli, a cerebral network was identified that largely corresponds to the known lateral and medial nociceptive system. Further analysis of the five graded stimulus strengths revealed positive linear correlations for the anterior insula bilaterally, the contralateral (left) anterior mid-cingulate, as well as contralateral (left) pregenual cingulate cortices. Cerebral toothache intensity coding on a group level can thus be attributed to specific subregions within the cortical pain network.
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Affiliation(s)
- M. Brügger
- University of Zürich, Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, Plattenstrasse 11, Zürich 8032, Switzerland
- Swiss Federal Institute of Technology and the University of Zürich, Institute of Biomedical Engineering, Zürich, Switzerland
| | - K. Lutz
- University of Zürich, Department of Psychology, Neuro-psychology, Zürich, Switzerland
| | - B. Brönnimann
- University of Zürich, Department of Psychology, Neuro-psychology, Zürich, Switzerland
| | - M.L. Meier
- University of Zürich, Department of Psychology, Neuro-psychology, Zürich, Switzerland
| | - R. Luechinger
- Swiss Federal Institute of Technology and the University of Zürich, Institute of Biomedical Engineering, Zürich, Switzerland
| | - A. Barlow
- Consumer Healthcare, GlaxoSmithKline, Weybridge, UK
| | - L. Jäncke
- University of Zürich, Department of Psychology, Neuro-psychology, Zürich, Switzerland
| | - D.A. Ettlin
- University of Zürich, Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, Plattenstrasse 11, Zürich 8032, Switzerland
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