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Wei X, Lai Y, Lan X, Tan Y, Zhang J, Liu J, Chen J, Wang C, Zhou X, Tang Y, Liu D, Zhang J. Uncovering brain functional connectivity disruption patterns of lung cancer-related pain. Brain Imaging Behav 2024; 18:576-587. [PMID: 38316730 DOI: 10.1007/s11682-023-00836-9] [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] [Accepted: 12/01/2023] [Indexed: 02/07/2024]
Abstract
Pain is a pervasive symptom in lung cancer patients during the onset of the disease. This study aims to investigate the connectivity disruption patterns of the whole-brain functional network in lung cancer patients with cancer pain (CP+). We constructed individual whole-brain, region of interest (ROI)-level functional connectivity (FC) networks for 50 CP+ patients, 34 lung cancer patients without pain-related complaints (CP-), and 31 matched healthy controls (HC). Then, a ROI-based FC analysis was used to determine the disruptions of FC among the three groups. The relationships between aberrant FCs and clinical parameters were also characterized. The ROI-based FC analysis demonstrated that hypo-connectivity was present both in CP+ and CP- patients compared to HC, which were particularly clustered in the somatomotor and ventral attention, frontoparietal control, and default mode modules. Notably, compared to CP- patients, CP+ patients had hyper-connectivity in several brain regions mainly distributed in the somatomotor and visual modules, suggesting these abnormal FC patterns may be significant for cancer pain. Moreover, CP+ patients also showed increased intramodular and intermodular connectivity strength of the functional network, which could be replicated in cancer stage IV and lung adenocarcinoma. Finally, abnormal FCs within the prefrontal cortex and somatomotor cortex were positively correlated with pain intensity and pain duration, respectively. These findings suggested that lung cancer patients with cancer pain had disrupted connectivity in the intrinsic brain functional network, which may be the underlying neuroimaging mechanisms.
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Affiliation(s)
- Xiaotong Wei
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Yong Lai
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Xiaosong Lan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Jing Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Jiang Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Jiao Chen
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Chengfang Wang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Xiaoyu Zhou
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Yu Tang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China.
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China.
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Yan H, Shlobin NA, Jung Y, Zhang KK, Warsi N, Kulkarni AV, Ibrahim GM. Nucleus accumbens: a systematic review of neural circuitry and clinical studies in healthy and pathological states. J Neurosurg 2023; 138:337-346. [PMID: 35901682 DOI: 10.3171/2022.5.jns212548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/17/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The nucleus accumbens (NAcc) of the ventral striatum is critically involved in goal- and reward-based behavior. Structural and functional abnormalities of the NAcc or its associated neural systems are involved in neurological and psychiatric disorders. Studies of neural circuitry have shed light on the subtleties of the structural and functional derangements of the NAcc across various diseases. In this systematic review, the authors sought to identify human studies involving the NAcc and provide a synthesis of the literature on the known circuity of the NAcc in healthy and diseased states, as well as the clinical outcomes following neuromodulation. METHODS A systematic review was conducted using the PubMed, Embase, and Scopus databases. Neuroimaging studies that reported on neural circuitry related to the human NAcc with sample sizes greater than 5 patients were included. Demographic data, aim, design and duration, participants, and clinical and neurocircuitry details and outcomes of the studies were extracted. RESULTS Of 3591 resultant articles, 123 were included. The NAcc and its corticolimbic connections to other brain regions, such as the prefrontal cortex, are largely involved in reward and pain processes, with distinct functional circuitry between the shell and core in healthy patients. There is heterogeneity between clinical studies with regard to the NAcc indirect targeting coordinates, methods for postoperative confirmation, and blinded trial design. Neuromodulation studies provided promising clinical results in the context of addiction and substance misuse, obsessive-compulsive disorder, and mood disorders. The most common complications were impaired memory or concentration, and a notable serious complication was hypomania. CONCLUSIONS The functional diversity of the NAcc highlights the importance of studying the NAcc in healthy and pathological states. The results of this review suggest that NAcc neuromodulation has been attempted in the management of diverse psychiatric indications. There is promising, emerging evidence that the NAcc may be an effective target for specific reward- or pain-based pathologies with a reasonable risk profile.
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Affiliation(s)
- Han Yan
- 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.,2Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,4McMaster Medical School, Hamilton, Ontario, Canada
| | - Nathan A Shlobin
- 3Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Kristina K Zhang
- 5Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and.,6Institute of Medical Science, University of Toronto, Ontario, Canada
| | - Nebras Warsi
- 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.,5Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and
| | - Abhaya V Kulkarni
- 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.,2Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - George M Ibrahim
- 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.,5Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and.,6Institute of Medical Science, University of Toronto, Ontario, Canada
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Zhang YN, Xing XX, Chen L, Dong X, Pan HT, Hua XY, Wang K. Modification of the resting-state network involved at different stages of neuropathic pain. Neurosci Lett 2022; 789:136866. [PMID: 36075318 DOI: 10.1016/j.neulet.2022.136866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/20/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
Neuropathic pain (NeuP) is shown to be associated with abnormal changes in several specific brain regions. However, the large-scale interactivity of neuronal networks underlying the sensory and emotional abnormalities during NeuP remains unexplored. The present study aimed to explore the alterations in the relevant functional resting-state networks (RSNs) and their intra-networks at the different stages of NeuP based on resting-state functional magnetic resonance imaging (rs-fMRI). A NeuP rat model was established by chronic constriction injury (CCI). Three RSNs were identified to be associated with the NeuP, including the default mode network (DMN), sensorimotor network (SMN), and interoceptive network (IN). The functional connectivity (FC) of the left caudate putamen (CPu) within the DMN and the right piriform cortex within the IN were significantly reduced at the early stage of NeuP, when the maximum allodynia was apparent early, which reflected the suppressed function of the DMN and IN. At 4 weeks post-CCI, when negative emotions were present, the FC of the right insular cortex in the SMN and left visual cortex in the IN were significantly elevated, representing the increased excitability of both SMN and IN. Our study revealed the characteristic functional organization at the network level induced by NeuP and emphasized the role of SMN, DMN, and IN in the pathological mechanisms of NeuP.
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Affiliation(s)
- Ya-Nan Zhang
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiang-Xin Xing
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai 201203, China
| | - Liu Chen
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xin Dong
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Hao-Tian Pan
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai 201203, China.
| | - Ke Wang
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
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Vitus D, Williams MK, Rizk M, Neubert JK, Robinson M, Boissoneault J. Analgesic effects of alcohol in adults with chronic jaw pain. Alcohol Clin Exp Res 2022; 46:1515-1524. [PMID: 35989585 PMCID: PMC9427671 DOI: 10.1111/acer.14883] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although recent literature provides promising support for the analgesic properties of alcohol, potential differences in alcohol analgesia as a function of chronic pain status are not well understood. Thus, this study examined chronic pain status as a potential moderator of alcohol analgesia and distinguished between multiple aspects of pain experience and sensitivity: pain threshold, pain intensity, pain unpleasantness, and perceived relief. METHODS Social drinkers with (N = 19) and without (N = 29) chronic jaw pain completed two testing sessions in a counterbalanced order: alcohol (target BrAC = 0.08 g/dl) and placebo. In each, pressure algometry was performed at the insertion of the masseter. Alcohol analgesia was assessed by examining the main and interactive effects of beverage condition, pressure level (4, 5, or 6 pound-feet [lbf]), and chronic jaw pain status (chronic pain vs. pain-free control) on quantitative sensory testing measures and pain relief ratings following noxious stimuli. RESULTS Analyses indicated significant increases in pain threshold and pain relief and reductions in pain unpleasantness and pain intensity, under the alcohol condition. Chronic pain participants demonstrated lower pain thresholds and greater pain intensity and pain unpleasantness ratings than controls. There were no interactive effects of alcohol and pain conditions on any pain measure. CONCLUSIONS Findings provide experimental evidence of alcohol's analgesic and pain-relieving effects and suggest that these effects do not significantly differ by chronic pain status. Individuals, who self-medicate pain via alcohol consumption, irrespective of pain status, may be at increased risk to engage in hazardous drinking patterns and thus experience adverse alcohol-related consequences.
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Affiliation(s)
- Darya Vitus
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - Michelle K. Williams
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - Mehdi Rizk
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - John K. Neubert
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
- Department of Orthodontics, University of Florida, Gainesville, FL, 32610
| | - Michael Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
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Ensari I, Lipsky-Gorman S, Horan EN, Bakken S, Elhadad N. Associations between physical exercise patterns and pain symptoms in individuals with endometriosis: a cross-sectional mHealth-based investigation. BMJ Open 2022; 12:e059280. [PMID: 35851021 PMCID: PMC9297219 DOI: 10.1136/bmjopen-2021-059280] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study investigates the association of daily physical exercise with pain symptoms in endometriosis. We also examined whether an individual's typical weekly (ie, habitual) exercise frequency influences (ie, moderates) the relationship between their pain symptoms on a given day (day t) and previous-day (day t-1) exercise. PARTICIPANTS The sample included 90 382 days of data from 1009 participants (~85% non-Hispanic white) living with endometriosis across 38 countries. STUDY DESIGN This was an observational, retrospective study conducted using data from a research mobile app (Phendo) designed for collecting self-reported data on symptoms and self-management of endometriosis. PRIMARY OUTCOME MEASURES The two primary outcomes were the composite day-level pain score that includes pain intensity and location, and the change in this score from previous day (Δ-score). We applied generalised linear mixed-level models to examine the effect of previous-day exercise and habitual exercise frequency on these outcomes. We included an interaction term between the two predictors to assess the moderation effect, and adjusted for previous-day pain, menstrual status, education level and body mass index. RESULTS The association of previous-day (day t-1) exercise with pain symptoms on day t was moderated by habitual exercise frequency, independent of covariates (rate ratio=0.96, 95% CI=0.95 to 0.98, p=0.0007 for day-level pain score, B=-0.14, 95% CI=-0.26 to -0.016, p=0.026 for Δ-score). Those who regularly engaged in exercise at least three times per week were more likely to experience favourable pain outcomes after having a bout of exercise on the previous day. CONCLUSIONS Regular exercise might influence the day-level (ie, short-term) association of pain symptoms with exercise. These findings can inform exercise recommendations for endometriosis pain management, especially for those who are at greater risk of lack of regular exercise due to acute exacerbation in their pain after exercise.
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Affiliation(s)
- Ipek Ensari
- Data Science Institute, Columbia University, New York, New York, USA
| | - Sharon Lipsky-Gorman
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Emma N Horan
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Suzanne Bakken
- Data Science Institute, Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
- School of Nursing, Columbia University, New York, New York, USA
| | - Noémie Elhadad
- Data Science Institute, Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
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Arruda GT, Driusso P, Rodrigues JC, Godoy AG, Degani A, Danna-Dos-Santos A, Avila MA. Are menstrual symptoms associated with central sensitization inventory? A cross-sectional study. Eur J Pain 2022; 26:1759-1767. [PMID: 35761773 DOI: 10.1002/ejp.1999] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/13/2022] [Accepted: 06/26/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Dysmenorrhea is a prevalent pain condition that affects women of reproductive age, who are monthly exposed to this pain, usually until they reach the adult age, or even after that, which can predispose them to Central Sensitization. The present study aimed to observe the association between menstrual characteristics and central sensitivity symptoms in women. METHODS Cross-sectional study. Brazilian women (n=10,402) answered an online form comprised of questions regarding their gynecological history, the Numerical Rating Scale for pain and the Central Sensitization Inventory, part A. For the analysis, we separated women into two groups: Central Sensitivity Symptoms group (n=5,200) and No-Central Sensitivity Symptoms group (n=5,202). We performed a binary logistic regression with the backward insertion method for the variables with p<0.05 in the bivariate analysis between groups. The significance level was set at 5%. RESULTS Prevalence of dysmenorrhea was 67.3%, and 32.2% of women in the Central Sensitivity Symptoms group reported pain >8 during their menstrual period. The logistic regression showed that greater levels of menstrual pain (Odds Ratio 1.12), gynecological diseases (Odds Ratio 1.51), presence of dysmenorrhea since adolescence (Odds Ratio 1.20) and irregular menstrual cycles (Odds Ratio 1.47) increased the likelihood of women presenting with Central Sensitivity Symptoms (p<0.05 for all comparisons). CONCLUSIONS The present study shows that Central Sensitivity Symptoms are present in about 50% of women and are associated with menstrual characteristics such as dysmenorrhea-related pain intensity, cycle regularity, presence of dysmenorrhea since adolescence accompanied by gynecological diseases. SIGNIFICANCE Central sensitivity symptoms occur in 50% of women, and are more present in women with dysmenorrhea. They are associated with cycle regularity, presence of dysmenorrhea since adolescence, and gynecological diseases. LIMITATIONS Women that suffer from dysmenorrhea and of higher socioeconomic and educational levels may have been more propense to respond to the invitation; as such, the findings of the present study should be carefully interpreted.
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Affiliation(s)
- G T Arruda
- Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, Brazil.,Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, UFSCar, Brazil
| | - P Driusso
- Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, Brazil.,Laboratory of Research on Women's Health (LAMU), Physical Therapy Department, UFSCar, Brazil
| | - J C Rodrigues
- Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, Brazil.,Laboratory of Research on Women's Health (LAMU), Physical Therapy Department, UFSCar, Brazil
| | - A G Godoy
- Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, Brazil.,Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, UFSCar, Brazil
| | - A Degani
- Laboratory for Advancements in Rehabilitation Science, Department of Physical Therapy at Western Michigan University, Kalamazoo, MI, USA
| | - A Danna-Dos-Santos
- Laboratory for Advancements in Rehabilitation Science, Department of Physical Therapy at Western Michigan University, Kalamazoo, MI, USA
| | - M A Avila
- Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, Brazil.,Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, UFSCar, Brazil
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Ma J, Wu JJ, Hua XY, Zheng MX, Huo BB, Xing XX, Feng SY, Li B, Xu J. Alterations in brain structure and function in patients with osteonecrosis of the femoral head: a multimodal MRI study. PeerJ 2021; 9:e11759. [PMID: 34484979 PMCID: PMC8381875 DOI: 10.7717/peerj.11759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background Pain, a major symptom of osteonecrosis of the femoral head (ONFH), is a complex sensory and emotional experience that presents therapeutic challenges. Pain can cause neuroplastic changes at the cortical level, leading to central sensitization and difficulties with curative treatments; however, whether changes in structural and functional plasticity occur in patients with ONFH remains unclear. Methods A total of 23 ONFH inpatients who did not undergo surgery (14 males, nine females; aged 55.61 ± 13.79 years) and 20 controls (12 males, eight females; aged 47.25 ± 19.35 years) were enrolled. Functional indices of the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and a structural index of tract-based spatial statistics (TBSS) were calculated for each participant. The probability distribution of fiber direction was determined according to the ALFF results. Results ONFH patients demonstrated increased ALFF in the bilateral dorsolateral superior frontal gyrus, right medial superior frontal gyrus, right middle frontal gyrus, and right supplementary motor area. In contrast, ONFH patients showed decreased ReHo in the left superior parietal gyrus and right inferior temporal gyrus. There were no significant differences in TBSS or probabilistic tractography. Conclusion These results indicate cerebral pain processing in ONFH patients. It is advantageous to use functional magnetic resonance imaging to better understand pain pathogenesis and identify new therapeutic targets in ONFH patients.
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Affiliation(s)
- Jie Ma
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China.,Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Xin Xing
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Sheng-Yi Feng
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bo Li
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianguang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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8
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Bush NJ, Schneider V, Sevel L, Bishop MD, Boissoneault J. Associations of Regional and Network Functional Connectivity With Exercise-Induced Low Back Pain. THE JOURNAL OF PAIN 2021; 22:1606-1616. [PMID: 34111507 DOI: 10.1016/j.jpain.2021.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
Musculoskeletal pain is an aversive experience that exists within a variety of conditions and can result in significant impairment for individuals. Gaining greater understanding of the factors related to pain vulnerability and resilience to musculoskeletal pain may help target at-risk individuals for early intervention. This analysis builds on our previous work identifying regions where greater gray matter density was associated with lower pain following standardized, exercise induced musculoskeletal injury. Here we sought to examine the relationship between baseline resting state functional connectivity in a priori regions and networks, and delayed onset muscle soreness (DOMS) pain intensity following a single session of eccentric exercise in healthy adults. Participants completed a baseline functional MRI scan and a high intensity trunk exercise protocol in the erector spinae. Pain intensity ratings were collected 48-hours later. Resting state functional connectivity from four seed regions and 3 networks were separately regressed on pain intensity scores. Results revealed that connectivity between left middle frontal gyrus, the left occipital gyrus and cerebellar network seeds and clusters associated with discriminative, emotional, and cognitive aspects of pain were associated with lower post-DOMS pain. Results suggest resilience to clinically relevant pain is associated with aspects of regional and network neural coherence. Investigations of pain modulatory capacity that integrate multimodal neuroimaging metrics are called for. Perspective: Our results provide key support for the role of structural and functional coherence in regional and network connectivity in adaptive pain response and represent an important step in clarifying neural mechanisms of resilience to clinically relevant pain.
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Affiliation(s)
- Nicholas J Bush
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida
| | - Victor Schneider
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida
| | - Landrew Sevel
- Department of Physical Medicine & Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee; Osher Center for Integrative Medicine at Vanderbilt, Vanderbilt Medical Center, Nashville, Tennessee
| | - Mark D Bishop
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida; Department of Physical Therapy, University of Florida, Gainesville, Florida
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida.
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9
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Geisler M, Rizzoni E, Makris N, Pasternak O, Rathi Y, Bouix S, Herbsleb M, Bär KJ, Weiss T, Kikinis Z. Microstructural alterations in medial forebrain bundle are associated with interindividual pain sensitivity. Hum Brain Mapp 2020; 42:1130-1137. [PMID: 33170528 PMCID: PMC7856635 DOI: 10.1002/hbm.25281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/13/2020] [Accepted: 10/29/2020] [Indexed: 01/28/2023] Open
Abstract
The perception of pain to noxious stimuli, also known as pain sensitivity, varies among individuals. The comprised brain structures and their white matter pathways are complex and elusive. Here, we aimed to investigate whether variation of microstructure of the medial forebrain bundle (MFB), a tract connecting the basal forebrain with the brain stem, is associated with interindividual pain sensitivity. We assessed interindividual pain sensitivity as a rating of pain intensity to heat stimuli (45, 47, and 48.9°C) in 38 healthy men (age: 27.05 ± 5.7 years). We also reconstructed the MFB using multitensor tractography from diffusion magnetic resonance imaging (dMRI) and calculated free‐water corrected dMRI measures of fractional anisotropy (FAt), radial diffusivity (RDt), and axial diffusivity (ADt). Lower ratings of interindividual pain intensity correlated with higher FAt and lower RDt of the MFB. As changes in FAt and RDt may reflect abnormalities in myelination, the results might be interpreted as that a lower pain rating is associated with higher degree of myelination of the MFB and could represent an inhibitory pathway of pain. Our results suggest that alteration of microstructure in the MFB contributes to the interindividual variation of pain perception.
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Affiliation(s)
- Maria Geisler
- Department of Clinical Psychology, Friedrich-Schiller-University Jena, Jena, Germany
| | - Elizabeth Rizzoni
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Nikolaos Makris
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Departments of Radiology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Departments of Radiology and Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Departments of Radiology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Departments of Radiology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Departments of Radiology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Karl-Jürgen Bär
- Department of Psychosomatic Medicine, University Hospital Jena, Jena, Germany
| | - Thomas Weiss
- Department of Clinical Psychology, Friedrich-Schiller-University Jena, Jena, Germany
| | - Zora Kikinis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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10
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Comparing Central Pain Processing in Individuals With Non-Traumatic Neck Pain and Healthy Individuals: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2020; 21:1101-1124. [DOI: 10.1016/j.jpain.2020.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/16/2020] [Accepted: 02/23/2020] [Indexed: 12/29/2022]
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11
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Pain inhibition is not affected by exercise-induced pain. Pain Rep 2020; 5:e817. [PMID: 32440610 PMCID: PMC7209813 DOI: 10.1097/pr9.0000000000000817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/06/2019] [Accepted: 12/02/2019] [Indexed: 01/03/2023] Open
Abstract
Introduction: Offset analgesia (OA) and conditioned pain modulation (CPM) are frequently used paradigms to assess the descending pain modulation system. Recently, it was shown that both paradigms are reduced in chronic pain, but the influence of acute pain has not yet been adequately examined. Objectives: The aim of this study is to investigate OA and CPM after exercise-induced pain to evaluate whether these tests can be influenced by delayed-onset muscle soreness (DOMS) at a local or remote body site. Methods: Forty-two healthy adults were invited to 3 separate examination days: a baseline appointment, the consecutive day, and 7 days later. Participants were randomly divided into a rest (n = 21) and an exercise group (n = 21). The latter performed a single intensive exercise for the lower back. Before, immediately after, and on the following examination days, OA and CPM were measured at the forearm and the lower back by blinded assessor. Results: The exercise provoked a moderate pain perception and a mild delayed-onset muscle soreness on the following day. Repeated-measurements analysis of variance showed no statistically significant main effect for either OA or CPM at the forearm or lower back (P > 0.05). Conclusion: Delayed-onset muscle soreness was shown to have no effect on the inhibitory pain modulation system neither locally (at the painful body part), nor remotely. Thus, OA and CPM are robust test paradigms that probably require more intense, different, or prolonged pain to be modulated.
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12
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Boissoneault J, Sevel L, Stennett B, Alappattu M, Bishop M, Robinson M. Regional increases in brain signal variability are associated with pain intensity reductions following repeated eccentric exercise bouts. Eur J Pain 2020; 24:818-827. [PMID: 31976587 DOI: 10.1002/ejp.1532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/19/2019] [Accepted: 01/12/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traditional pain interventions limit fluctuations in pain sensation, which may paradoxically impair endogenous pain modulatory systems (EPMS). However, controlled exposures to clinically relevant pain (e.g. delayed onset muscle soreness [DOMS]) may build capacity in the EPMS. Emerging evidence suggests that regional signal variability (RSV) may be an important indicator of efficiency and modulatory capacity within brain regions. This study sought to determine the role of RSV in both susceptibility to and trainability of pain response following repeated DOMS inductions. METHODS Baseline and follow-up resting-state fMRI was performed on 12 healthy volunteers ~40 days apart. Between scanning visits, participants received four weekly DOMS inductions in alternating elbow flexors and were supplied seven days of post-induction pain ratings. Voxel-wise standard deviation of signal intensity was calculated to measure RSV. Associations among DOMS-related pain and RSV were assessed with regression. Relationships among baseline and change measurements were probed (i.e. susceptibility to DOMS; trainability following multiple inductions). RESULTS Significant association between baseline RSV in left middle frontal gyrus (MFG) and right cerebellum and reductions in DOMS-related pain unpleasantness were detected. Furthermore, increases in RSV were associated with reduced DOMS pain intensity (left lingual gyrus, right MTG, left MTG, left precuneus) and unpleasantness (left MTG, right SFG). DISCUSSION Findings suggest that RSV may be an indicator of EPMS resilience and responsivity to training, as well as an indicator that is responsive to training. Involved regions underlie cognitive, affective and representation processes. Results further clarify the potential role of RSV as an indicator of pain modulation and resilience. SIGNIFICANCE Regional signal variability may be an important indicator of endogenous pain modulatory system responsivity to training following repeated bouts of clinically relevant pain and may in fact be responsive to training itself.
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Affiliation(s)
- Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Landrew Sevel
- Department of Physical Medicine & Rehabilitation, Osher Center for Integrative Medicine at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bethany Stennett
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Meryl Alappattu
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Mark Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Michael Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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13
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Boissoneault J, Stennett B, Robinson ME. Acute alcohol intake alters resting state functional connectivity of nucleus accumbens with pain-related corticolimbic structures. Drug Alcohol Depend 2020; 207:107811. [PMID: 31891860 PMCID: PMC6981011 DOI: 10.1016/j.drugalcdep.2019.107811] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The nucleus accumbens (NAc) is a ventral striatal structure underlying reward, reinforcement, and motivation, with extensive anatomic and functional connections to a wide range of affective processing structures (medial prefrontal cortex (mPFC), amygdala, and insula). Characterizing how acute alcohol intake affects resting state functional connectivity (rsFC) between the nucleus accumbens (NAc) and these regions will improve mechanistic understanding of alcohol's neurobehavioral effects, including the neural overlap between acute alcohol effects and pain processing. METHODS Fifteen healthy social drinkers (10 women; age: 25-45 years) were included in the study. Participants completed one session in which they consumed an alcohol dose targeting a breath alcohol concentration of 0.08 g/dL, and in a second a placebo beverage. Nine-minute resting state fMRI scans were acquired 30-35 min after beverage administration during each session. rsFC between NAc and a priori corticolimbic regions of interest (mPFC, amgydala, and insula), were compared between beverage conditions. We also conducted an exploratory whole-brain seed-to-voxel analysis of NAc FC. RESULTS Alcohol intake reduced rsFC between NAc and mPFC, as well as NAc and amygdala. Alcohol also reduced rsFC between NAc and a 97-voxel cluster including bilateral paracingulate cortex and anterior cingulate cortex. CONCLUSIONS Findings suggest that acute alcohol intake reduces rsFC between NAc and several structures, including mPFC, amygdala, and rostral ACC in healthy social drinkers. These structures underlie reward, motivated behavior, and emotion regulation, and may provide mechanistic insight to how alcohol affects related processes, including pain.
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Affiliation(s)
- Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
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