Evidence for involvement of the frontal cortex in pain-related cerebral events in cats: increase in local cerebral blood flow by noxious stimuli

Continuous perfusion with morphine of the orbitofrontal cortex reduces allodynia and hyperalgesia in a rat model for mononeuropathy

Recent imaging reports demonstrate the activation of the orbitofrontal cortical (OFC) area during acute and chronic pain. The aim of this study was to compare the effects of chronic perfusion of this area with morphine on nociception in control rats and in rats subjected to mononeuropathy. Chronic perfusion of morphine, using miniosmotic pumps, produced significant and naloxone-reversible depression of tactile and cold allodynias and thermal hyperalgesia, observed in neuropathic rats, while it produced significant elevation and naloxone insensitive increase of acute nociceptive thresholds in control rats. The observed results support the idea that this area is a component of a flexible cerebral network involved in pain processing and perception.

Attenuation of neuropathic manifestations by local block of the activities of the ventrolateral orbito-frontal area in the rat

Clinical and recent imaging reports demonstrate the involvement of various cerebral prefrontal areas in the processing of pain. This has received further confirmation from animal experimentation showing an alteration of the threshold of acute nociceptive reflexes by various manipulations in the orbito-frontal cortical areas. The present study investigates the possible involvement of this area in the modulation of neuropathic manifestations in awake rats. Several groups of rats were subjected to mononeuropathy following the spared nerve injury model, known to produce evident tactile and cold allodynia and heat hyperalgesia. The activity of the ventrolateral orbital areas was selectively blocked by using either chronic or acute injection of lidocaine, electrolytic lesion, or chemical lesion with kainic acid or 6-hydroxydopamine (6-OHDA). The effects of these manipulations were compared with those following lesion of the somatic sensorimotor cortical areas. Local injection of lidocaine resulted in a reversible depression of all neuropathic manifestations while electrolytic or chemical lesions elicited transient attenuation affecting mainly the heat hyperalgesia and to a lesser extent the cold allodynia. The magnitude of the observed effects with the different procedures used can be ranked as follows: 6-OHDA<lesion<electrolytic lesion<kainic acid lesion<lidocaine injection. The observed effects were transient despite the permanence of the lesions while lesion of the somatosensorimotor cortices produced sustained reduction of the neuropathic manifestations. Our results correlate well with the established connections of the ventrolateral orbital area with the thalamic nucleus subnucleus involved in the procession of thermal nociception. The transient effects reported following permanent lesions in the orbital areas may reflect its flexible role in pain modulation. This observation provides further evidence on the plasticity of the neural networks involved in the regulation of nociceptive behavior.

Scalp-recorded contingent negative variation (CNV) increases during experimentally induced sustained ischemic pain in humans

Contingent negative variations (CNV) after acoustic stimuli (S1) followed by optical ones (S2) were recorded using electroencephalography in 22 healthy students both under control conditions and during ischemic pain to study the effects of sustained pain on CNV. Mean negative CNV-amplitudes and integrated areas below CNV were significantly larger during periods of ischemic pain than under control conditions (16.53 versus 13.11 microV, respectively (P=0.0028) and 8.318 versus 6.357 microV*s, respectively (P=0.00071)). We conclude that deep somatic pain augments CNV. Reduced CNV amplitudes occurring during migraine attacks, however, reflect other mechanisms which may mask the effects of migraine headache on CNV.

A fMRI study of brain activations during non-noxious and noxious electrical stimulation of the sciatic nerve of rats

An acute pain animal model for fMRI study would provide useful spatial and temporal information for studying the supraspinal nociceptive neuronal responses. The aim of the present study was to investigate whether the nociceptive responses in different brain areas can be differentiated by using functional magnetic resonance imaging (fMRI) in anesthetized rats. Functional changes in brain regions activated by noxious or non-noxious stimuli of the sciatic nerve were investigated using fMRI in a 4.7 T MR system in alpha-chloralose anaesthetized rats. To determine the electrical intensity for noxious and non-noxious stimuli, compound action potential recording was employed to reveal the type of fibers activated by graded electrical stimulation of sciatic nerve. It showed that innocuous A-beta fibers were excited by two times the muscle twitch threshold and nociceptive A-delta and C fibers were recruited and excited by 10 and 20 times threshold, respectively. A series of four-slice gradient echo images were acquired during innocuous (two times threshold) and noxious (10 and 20 times threshold) stimuli in a 4.7 T MR system. Contralateral somatosensory cortex was the most prominent brain area activated by innocuous stimuli. Both signal intensity and activated areas were significantly increased in the somatosensory cortex, cingulate cortex, medial thalamus and hypothalamus during noxious stimuli. These four brain areas activated by noxious stimuli were significantly suppressed by prior intravenous injection of morphine (5 mg/kg). The present findings demonstrated that the difference of the innocuous and nociceptive responses in the brain could be detected and localized by an in vivo spatial map using fMRI. Results suggest that fMRI may be an invaluable tool for studying pain in anesthetized animals.

Delta-opioid receptor-mediated increase in cortical extracellular levels of cholecystokinin-like material by subchronic morphine in rats

Numerous pharmacological data indirectly support the idea that interactions between cholecystokinin (CCK) and opioids participate in the development of tolerance to morphine. Biochemical investigations were performed with the aim of directly assessing the status of such interactions in morphine treated rats. Tolerance to the alkaloid after s.c. implantation of morphine pellets for three days was not associated with any change in the levels of both CCK like-material (CCKLM) and proCCK mRNA in the frontal cortex. However, microdialysis in the freely moving rat showed that this morphine treatment produced a significant increase (+40%) of the cortical spontaneous CCKLM outflow, which could be completely prevented by intracortical infusion of naloxone (10 microM). The opioid receptors responsible for morphine-induced cortical CCKLM overflow appeared to be of the delta type because intracortical infusion of selective delta-opioid receptor antagonists such as naltriben (10 microM) and 7-benzylidenenaltrexone (10 microM) also prevented the effect of morphine, whereas CTOP (10 microM), a selective mu-opioid receptor antagonist, and nor-binaltorphimine (10 microM), a selective K-opioid receptor antagonist, were inactive. These data indicate that morphine tolerance is associated with delta-opioid receptor mediated activation of cortical CCKergic systems in rats.

Delta(2)-opioid receptor mediation of morphine-induced CCK release in the frontal cortex of the freely moving rat

Numerous pharmacological data have been accumulated in support of the existence of physiological interactions between cholecystokinin (CCK) and opioids in the central nervous system. With the aim of further characterizing these interactions, an in vivo microdialysis approach was used to directly assess the possible influence of opioids on the extracellular levels of CCK-like material (CCKLM) in the frontal cortex of the awake, freely moving rat. Systemic administration of a high dose of morphine (10 mg/kg i.p.) produced a marked increase (up to +200%) of cortical CCKLM outflow, and this effect could be completely prevented by systemic (1.5 mg/kg i.p.) as well as intracortical (10 microM) administration of the opioid receptor antagonist naloxone. The opioid receptors activated by morphine appeared to be of the delta type because the intracortical infusion of naltrindole (10 microM) also prevented the effect of morphine, whereas CTOP (10 microM), a selective mu-opioid receptor antagonist, and nor-binaltorphimine (10 microM), a selective kappa-opioid receptor antagonist, were inactive. In addition, naltriben (10 microM), which acts selectively at the delta(2) subtype, also abolished the stimulatory effect of morphine on cortical CCKLM outflow, whereas 7-benzylidenenaltrexone (10 microM), a selective delta(1)-opioid receptor antagonist (10 microM), did not alter the morphine effect. Conversely, the direct stimulation of cortical delta(2)-opioid receptors by local infusion of [D-Ala(2)] deltorphin II mimicked the stimulatory effect of systemic morphine on CCKLM outflow. These data indicate that delta(2)-opioid receptors play a key role in opioid-CCK interactions in the rat frontal cortex.

The contribution of functional imaging techniques to our understanding of rheumatic pain

The main cerebral components of the human pain matrix have been defined using functional imaging techniques. The experience of pain is likely to be elaborated as a result of parallel processing within this matrix. There is not, therefore, a single pain center. The determinants of pain are as likely to be determined by top-down as by bottom-up processes. The precise function of the different components of the matrix are just beginning to be defined. There appear to be important adaptive responses in the forebrain components of the matrix during arthritic pain. Endogenous opioid peptides are strong candidates for the modulation of some of these responses. More extensive and sequential behavioral and functional imaging studies are required to establish the contribution these adaptive responses make to the perception of pain.

The effect of morphine on responses of ventrolateral orbital cortex (VLO) neurons to colorectal distension in the rat

In 49 halothane-anesthetized rats, we characterized the responses of single neurons in the ventrolateral orbital cortex (VLO) to a noxious visceral stimulus (colorectal balloon distension, CRD), and studied the effects of intravenous morphine on these responses using standard extracellular microelectrode recording techniques. One hundred and four neurons were isolated on the basis of spontaneous activity. Fifty-seven (55%) responded to CRD, of which 32% had excitatory and 68% had inhibitory responses. Neurons showed tendencies toward graded responses to graded CRD pressures (20-100 mmHg), with maximum excitation or inhibition occurring at 80 or 100 mmHg, respectively. Responses to noxious (pinch, heat) and innocuous (brush, tap) cutaneous stimuli were studied in 80 of the VLO neurons isolated. Thirty-three (41%) of these neurons (21 CRD-responsive and 12 CRD-nonresponsive) had cutaneous receptive fields, of which 79% were large and bilateral, 18% were small and bilateral, 3% were small and ipsilateral. Ninety-four percent of these neurons responded only to noxious cutaneous stimulation, 6% responded to both noxious and innocuous stimulation. No neurons responded solely to innocuous stimulation. Cumulative doses of morphine (0.0625, 0.125 and 0.25 mg/kg i.v.) produced statistically significant dose-dependent attenuation of neuronal responses to CRD. Naloxone (0.4 mg/kg i.v.) reversed the effects of morphine. Morphine and naloxone had no significant effects on spontaneous activity. These data support the involvement of VLO neurons in visceral nociception.

Reduced cortical responses to noxious heat in patients with rheumatoid arthritis

OBJECTIVES

To test the hypothesis that patients with chronic inflammatory pain develop adaptive cortical responses to noxious stimulation characterised by reduced anterior cingulate responses.

METHODS

Positron emission tomography was used to measure changes in regional cerebral blood flow (rCBF) in response to an acute experimental pain stimulus in six patients with rheumatoid arthritis (RA) in comparison to six age and sex matched controls. A standardised and reproducible non-painful and painful phasic heat stimulus was delivered by a thermal probe to the back of the right hand during six two minute periods during which time rCBF measurements were made. The effects of non-painful heat were subtracted from those of painful heat to weight the analysis towards the non-discriminatory or 'suffering' components of pain processing. Significance maps of pain processing were generated and compared in each group and contrasted with results obtained in a group of patients with atypical facial pain (AFP) that have been previously published.

RESULTS

The RA patients showed remarkably damped cortical and subcortical responses to pain compared with the control group. Significant differences between the two groups were observed in the prefrontal (BA 10) and anterior cingulate (BA 24) and cingulofrontal transition cortical (BA 32) areas. The reduced anterior cingulate responses to standardised heat pain were compared with the increased cingulate responses seen in patients with psychogenically maintained pain (AFP) who had both lower pain tolerance and mood than the RA group.

CONCLUSIONS

Major cortical adaptive responses to standardised noxious heat can be measured and contrasted in patients with different types of chronic pain. The different pattern of cingulate and frontal cortical responses in the patients with inflammatory and non-nociceptive pain suggest that different mechanisms are operating, possibly at a thalamocortical level. Implications for treatment strategies for chronic pain are discussed.

Effects of caudolateral neostriatal ablations on pain-related behaviour in the chicken

As a measure of pain-related behaviour, beak guarding was investigated by recording the pecking response of adult chickens to a visually attractive stimulus before and after bilateral suction ablation of the caudolateral neostriatum (CLN). Two control groups of birds were used: a sham-operated group and an ablated group, in which the ablation was confined to the rostral dorsolateral telencephalon. Comparing the birds that had undergone ablation with the sham-operated controls showed that the ablation did not affect pecking behaviour. Five days after ablation, all birds were subjected to partial amputation of one third of the beak. A significant reduction in pecking behaviour (beak-guarding) was observed in both control groups, but was not observed in those birds that had previously received CLN ablations. In a second experiment, where beak amputation preceeded CLN ablation by 6 days, ablation did not affect the reduced pecking. The absence of guarding or other pain-related behaviours would indicate that an intact CLN was necessary for these behaviours to develop but, once they had developed, ablation had no effect.

Opioids in the brain: supraspinal mechanisms in pain control

Systemically administered opioids produce a profound inhibition of noxious-evoked activity peripherally, spinally and supraspinally in several species, including man. The role of the brain in opioid mediated-pain control has been less well characterized than that occurring at lower levels in the nervous system. Yet, classical studies indicate that in morphine-induced analgesia the individual senses noxious stimuli, but the affective, motivational and aversive character of the stimulus is no longer present. This observation indicates that morphine probably exerts a specific action on those brain systems that control complex behaviors like aversion and motivation. The failure to document such effects in experimental studies may in part be explained by less suitable methods for assessing antinociception, e.g. measurements of simple reflex behaviors. Experimental animal studies show that supraspinal opioids may influence nociception by several distinct mechanisms, which differ from those seen in the spinal cord: Change of activity in descending bulbospinal pathways. Direct inhibition of noxious throughput at brainstem level. Indirect inhibition of noxious responding brainstem neurons projecting to supraspinal centers. Influence ascending forebrain systems. Direct cortical or thalamic inhibition. In humans, the antinociceptive actions of opioids occurring in the brain has until recently been like looking into a "black box". The introduction of new imaging techniques may provide new tools for directly measuring the antinociceptive action of opioids in the brain under normal and pathological conditions. In particular, the emotional-affective aspect of pain and how this is modulated by opioids will be of interest to study.

Fine structural organization of spinothalamic and trigeminothalamic lamina I terminations in the nucleus submedius of the cat

We examined lamina I trigemino- and spinothalamic tract (TSTT) terminals labeled with Phaseolus vulgaris leucoagglutinin in the nucleus submedius (Sm), a nociceptive relay in the cat's thalamus. Volume-rendered (three-dimensional) reconstructions of ten lamina I TSTT terminals identified with light and electron microscopy were built from serial ultrathin sections by computer, which enabled the overall structures of the terminal complexes to be characterized in detail. Two fundamentally different terminations were observed: compact clusters of numerous boutons, which predominate in the dense focus of a lamina I terminal field in the Sm, and boutons-of-passage, which are present throughout the terminal field and predominate in its periphery. Reconstructions of cluster terminations reveal that all boutons of each cluster make synaptic contact with protrusions and branch points on a single dendrite and involve presynaptic dendrites (PSDs) in triadic arrangements, providing a basis for the secure relay of sensory information. In contrast, reconstructions show that boutons-of-passage are generally characterized by simple contacts with PSDs, indicating an ascending inhibitory lamina I influence. These different synaptic arrangements are consistent with physiological evidence indicating that the morphologically distinct nociceptive-specific and thermoreceptive-(cold)-specific lamina I TSTT neurons terminate differently within the Sm. Thus, a suitable structural substrate exists in the cat's Sm for the inhibitory effect of cold on nociception, a behavioral and physiological phenomenon of fundamental significance. We conclude that the Sm is more than a simple relay for nociception, and that it may be an integrative comparator of ascending modality-selective information that arrives from neurons in lamina I.

Cerebral mechanisms operating in the presence and absence of inflammatory pain

Images

Ventrolateral orbital cortex and periaqueductal gray stimulation-induced effects on on- and off-cells in the rostral ventromedial medulla in the rat

On- and off-cells of the rostral ventromedial medulla are thought to be involved in bulbospinal inhibition of ascending nociceptive information. Experiments were carried out in lightly anaesthetized rats to assess the effects of prefrontal cortex stimulation on the responses of neurons in the rostral ventromedial medulla. For comparison purposes, effects of periaqueductal gray stimulation were also investigated. Single unit activity was recorded in the rostral ventromedial medulla and on-, off- and neutral-cells were identified based on the tail nocifensor reflex to noxious heat. Short (0.1-1 s) and long (10-15 s) trains of bipolar electrical stimulation (100-300 Hz) were delivered to the ventrolateral orbital cortex of the rat forebrain and the periaqueductal gray. Short-train stimulation of the periaqueductal gray (including dorsolateral, ventrolateral and the dorsal raphé regions) excited 58% (25 of 43) of on-cells and 44% (seven of 16) of off-cells in the rostral ventromedial medulla. Long trains blocked the noxious stimulus-evoked pause of all seven off-cells tested and blocked the excitatory response of two, and enhanced one of three on-cells. Such stimulation also inhibited or abolished the tail-flick reflex at currents below 100 microA. Glutamate microinjections into the periaqueductal gray inhibited the noxious-evoked response of two off- and two on-cells and increased the tail-flick latency. Short-train stimulation of the ventrolateral orbital cortex (100-400 microA) excited eight of 25 on-cells and inhibited the ongoing activity of 10 of 14 off-cells. Long-train ventrolateral orbital cortex stimulation (5-15 s, 100-200 microA, 200-300 Hz) enhanced the noxious evoked responses of 10 of 11 on-cells, prolonged the noxious heat-evoked pause of all of four off-cells and decreased the tail-flick latency (pronociception). The results of this study support the proposed role of on- and off-cells in descending inhibition of nociception from the periaqueductal gray and implicate the ventrolateral orbital cortex in the control of this pathway.

Evidence for glutamate as neurotransmitter in trigemino-and spinothalamic tract terminals in the nucleus submedius of cats

The nucleus submedius in the medial thalamus of cats is an important termination site for lamina I trigemino-and spinothalamic tract (TSTT) neurons, many of which are nociceptive-specific, and the nucleus submedius has been proposed to be a dedicated nociceptive substrate involved in the affective aspect of pain. In the present study, the distribution of glutamate was examined by immunocytochemical methods in order to evaluate the possible role of this amino acid as a neurotransmitter in TSTT terminals in the nucleus submedius. TSTT terminals were identified by anterograde transport of horseradish peroxidase and wheatgerm agglutinin-horseradish peroxidase conjugate from the spinal cord or the medullary dorsal horn. Quantitative analysis of immunogold labelling revealed that TSTT terminals contain about twice the tissue average of glutamate-like immunoreactivity. A strong positive correlation was found between the density of synaptic vesicles and the density of gold particles in these terminals, whereas no relationship was seen between these variables in GABAergic presynaptic dendrites. Enrichment of glutamate-like immunoreactivity (approximately 250% of the tissue average) was also observed in terminals of presumed cortical origin. Presynaptic dendrites and neuron cell bodies in the nucleus submedius were found to contain relatively low levels of glutamate-like immunoreactivity, at or below the tissue average. These observations provide evidence that glutamate is a neurotransmitter in lamina I TSTT terminals in the nucleus submedius. The findings also suggest glutamatergic neurotransmission between cortical afferents and nucleus submedius neurons. Glutamate is therefore likely to be an important mediator of nociceptive processing in the medial thalamus.

Responses of neurons in ventrolateral orbital cortex to noxious visceral stimulation in the rat

In pentobarbital-anesthetized rats, responses of single neurons in ventrolateral orbital cortex (VLO) to noxious visceral (colorectal distension, CRD) and cutaneous stimulation were recorded. Of 71 neurons identified on the basis of spontaneous activity, 44 responded to CRD. CRD caused inhibition of neuronal activity in 38, facilitation of activity in four and 'mixed' responses in two of these cells. Cutaneous receptive fields were identified in 31 CRD-responsive and 10 CRD-non-responsive neurons. Cutaneous receptive fields were large and bilateral. 25 CRD-responsive cells responded only to noxious cutaneous stimulation, six had wide dynamic range responses. Six CRD-non-responsive cells responded only to noxious stimuli, four had wide dynamic range responses. No VLO neuron responded only to innocuous stimuli. These data are consistent with involvement of VLO in visceral nociception, possibly in non-discriminative aspects of nociception.

Responses of neurons in the ventrolateral orbital cortex to noxious cutaneous stimulation in a rat model of peripheral mononeuropathy

The responses of ventrolateral orbital cortex neurons to noxious cold pressor were compared in rats with loose ligatures tied around their sciatic nerve with those in rats in which the sciatic nerve was exposed but not ligated. In ligated rats more cells responded to cold pressor and their average afterdischarges were longer. There were no differences in the background firing rate or the magnitude of response to the cold pressor between the two groups.

Diencephalic projections from the superficial and deep laminae of the medullary dorsal horn in the rat

An important function of the medullary dorsal horn (MDH) is the relay of nociceptive information from the face and mouth to higher centers of the central nervous system. We studied the central projection pattern of axons arising from the MDH by examining the axonal transport of Phaseolus vulgaris-leucoagglutinin (PHA-L). Labeled axon and axon terminal distributions arising from the MDH were analyzed at the light microscopic level. After large injections of PHA-L into both superficial and deep laminae of the MDH in the rat, labeled axons were observed in the nucleus submedius of the thalamus (SUB), ventroposterior thalamic nucleus medialis (VPM), ventroposterior thalamic nucleus parvicellularis (VPPC), posterior thalamic nuclei (PO), zona incerta (ZI), lateral hypothalamic nucleus (LH), and posterior hypothalamic nucleus (PH). Restriction of PHA-L into only the superficial laminae resulted in heavy axon and varicosity labeling in the SUB, VPM, PO, and VPPC and light labeling in LH. In contrast, after injections into deep laminae, labeled axons were mainly distributed in ZI and PH; some were also in VPM and LH, and fewer still in PO and SUB. Varicosities in VPM, SUB, and PO were significantly larger than those in VPPC, ZI, LH, and PH. Varicosity density was highest in SUB and lowest in the VPPC. We concluded that there are two distinct nociceptive pathways, one originating from the superficial MDH and terminating primarily in the dorsal diencephalon and the second originating from deep laminae of the MDH and terminating primarily in the ventral diencephalon. We propose that in the rat, input from the deeper laminae is primarily involved in the motivational-affective component of pain, whereas input from the superficial MDH is related to both the sensory-discriminative and motivational-affective component of pain.

The representation of prolonged and intense, noxious somatic and visceral stimuli in the ventrolateral orbital cortex of the cat

The responses of single neurones in the ventrolateral orbital (VLO) cortex to noxious pinch, heating of the skin, twisting of the joints and distension of the gall bladder were studied in cats anaesthetized with halothane. Of 60 neurones studied, 44 responded to prolonged (greater than 10 sec) stimuli that were well within the noxious range. Neurones were relatively unresponsive to innocuous stimuli or to the transient application of noxious stimuli. Many single neurones responded to a variety of modalities of noxious stimuli (e.g., skin heating and gall bladder distension). Many neurones studied showed a fluctuating level (5-15 Hz) of ongoing spontaneous activity. Neurones responded with either an increased frequency of spikes (excitation) or an inhibition of spontaneous discharge, irrespective of the source of noxious stimulation. Noxious stimuli delivered simultaneously to two different tissues (e.g., skin and visceral) sometimes produced excitation of the neurone under study, to levels above that produced by the application a noxious stimulus to only one of the tissues. Receptive fields were often large involving both contralateral and ipsilateral areas of the body, as well as both fore and hind limbs. No evidence of somatotopic organization was obtained. The responses of some neurones outlasted the application of the stimuli by many minutes. It is concluded that single neurones in the ventrolateral orbital cortex respond to the prolonged application of intensely noxious stimuli to a variety of body tissues, in a manner that is in keeping with the involvement of this cortical area in both the physiological, autonomic and experiential components of the affective-motivational aspect of pain. Furthermore, from the consequences of lesion studies in man and animals, it is proposed that the activation of cells in the orbital cortex by a variety of noxious stimuli reflects its more general role in the development and maintenance of behaviour in response to negative reinforcement of both social and physical origins.

Responses of neurons in the rat ventrolateral orbital cortex to phasic and tonic nociceptive stimulation

Responses of ventrolateral orbital cortex (VLO) neurons to innocuous touch and pressure, and noxious pinch and cold were examined by extracellular recordings. Eight neurons increased their firing rate in a graded fashion to all stimuli applied, 4 units decreased their discharges, and 6 neurons remained unaffected. All responsive units displayed the greatest change in firing rate during noxious cold, and all exhibited whole-body receptive fields. These data further implicate the VLO in nonciception.

Multiple representations of pain in human cerebral cortex

The representation of pain in the cerebral cortex is less well understood than that of any other sensory system. However, with the use of magnetic resonance imaging and positron emission tomography in humans, it has now been demonstrated that painful heat causes significant activation of the contralateral anterior cingulate, secondary somatosensory, and primary somatosensory cortices. This contrasts with the predominant activation of primary somatosensory cortex caused by vibrotactile stimuli in similar experiments. Furthermore, the unilateral cingulate activation indicates that this forebrain area, thought to regulate emotions, contains an unexpectedly specific representation of pain.

Glucose metabolic rate in normals and schizophrenics during the Continuous Performance Test assessed by positron emission tomography

Local cerebral uptake of glucose labelled with fluorine-18 was measured by positron emission tomography in 13 patients with schizophrenia and 37 right-handed volunteers. Patients received no medication for a minimum of 31 days and a mean of 30 weeks. The subjects were administered the labelled deoxyglucose just after the beginning of a 32-minute sequence of blurred numbers as visual stimuli for the Continuous Performance Test. In normal controls, task performance was associated with increases in glucose metabolic rate in the right frontal and right temporoparietal regions; occipital rates were unchanged. Patients with schizophrenia showed both absolutely and relatively reduced metabolic rates in the frontal cortex and in the temporoparietal regions compared with normal controls.

Response of regional cerebral blood flow and oxygen metabolism to thalamic stimulation in humans as revealed by positron emission tomography

To clarify functional neural pathways originating from the thalamic nucleus ventralis posterolateralis (VPL) in humans, the responses of regional CBF (rCBF) and regional CMRO2 (rCMRO2) to VPL stimulation were investigated by positron emission tomography in five patients who had undergone chronic implantation of electrodes into the VPL for therapeutic purposes. Measurement of rCBF and rCMRO2 under continuous inhalation of C15O2 and 15O2 by steady-state methods revealed significant increases of rCBF and rCMRO2 in the frontal, postcentral, and thalamic regions. The increases in rCBF and rCMRO2 of the postcentral regions were clearly predominant in the stimulated hemisphere insofar as the stimulation produced moderate paresthesia in restricted areas of the body. These results indicate that the VPL relays peripheral somatosensory information, which has previously been demonstrated to be transmitted to the frontal as well as postcentral regions.

Cerebrovascular changes elicited by electrical stimulation of the centromedian-parafascicular complex in rat

Electrical stimulation of the centromedian-parafascicular complex (CM-Pf) in anesthetized (chloralose) and paralyzed (tubocurarine) rats elicits a widespread cerebrovascular dilatation. Regional cerebral blood flow (rCBF) was measured in dissected tissue samples of 10 brain regions (medulla, pons, cerebellum, inferior colliculus, superior colliculus, frontal parietal and occipital cortices, caudate-putamen and corpus callosum) by [14C]iodoantipyrine method. In unstimulated and sham-operated rats rCBF ranged from 40 +/- 3 (ml/100 g/min) in corpus callosum to 86 +/- 6 (ml/100 g/min) in inferior colliculus. During CM-Pf stimulation, rCBF increased significantly (P less than 0.05, analysis of variance and Scheffe's test) in all cerebral regions bilaterally ranging from +118% in parietal cortex to +38% in cerebellum. Although cerebral vasodilation elicited by CM-Pf stimulation persisted after unilateral transection of the cervical sympathetic trunk, the cortical CBF was significantly reduced (P less than 0.05) on the denervated side. Acute adrenalectomy significantly (P less than 0.05) decreased elevated rCBF during CM-Pf stimulation in all cortical regions (frontal-36%, parietal -34%, and occipital -27%) and in caudate nucleus (-37%). Thus, excitation of neurons originating in, or fibers passing through the CM-Pf can elicit a powerful cerebral vasodilation. The cerebral vasodilation is modulated by cervical sympathectomy and circulating adrenal hormones. We conclude that CM-Pf elicited vasodilation is at least partly mediated by intrinsic neural pathways.

Regional cerebral blood flow (rCBF) in man during perception of radiant warmth and heat pain

The present study concerns the effects of experimental pain (radiant warmth and heat pain) on regional cerebral blood flow (rCBF) in pretrained subjects. The radiant warmth caused a general rCBF increase. However, if anxiety was avoided, heat pain caused the general rCBF level to return towards the level at rest. Thus, pain sensation per se may not cause a larger rCBF (and metabolic) response than that of the localized tactile stimulation, provided that the element of psychic apprehension and anxiety is eliminated or controlled.

Positron emission tomographic image measurement in schizophrenia and affective disorders

Two analytical methods for assessing regional glucography with positron emission tomography were compared in 16 patients with schizophrenia and 11 patients with affective disorders. Patients were off all medication a minimum of 14 days and an average of 39.8 days. The subjects were administered fluorine-18-labeled 2-deoxyglucose just before receiving a 34-minute one-per-second series of unpleasant electrical stimuli to their right forearm while resting with their eyes closed in a darkened, acoustically attenuated psychophysiological testing chamber. Following monitored stimulation in the controlled environment, the subjects were scanned and the images were converted to values of glucose use in micromoles per 100 grams per minute, according to Sokoloff's model. Data were analyzed by a four-way analysis of variance (ANOVA) for independent groups (normal subjects, schizophrenic patients, and patients with affective disorders) and for repeated measures of slice level (supraventricular, midventricular , and infraventricular ), hemisphere (right, left), and anteroposterior position (four sectors). Normal individuals and patient groups both showed a significant anteroposterior gradient in glucose use, with the highest values in the sector farthest to the front. Patients with schizophrenia and those with affective illnesses showed less of an anteroposterior gradient than normal individuals, especially at superior levels, which was statistically confirmed by ANOVA. Neither the group differences in whole-brain glucose use nor the left-right asymmetries reached statistical significance. A second technique, involving reconstruction of the lateral cortical surface, also revealed differences between schizophrenics and normal individuals in the superior frontal cortex. These results are consistent with our earlier reports of a relative hypofrontal function in schizophrenia compared with controls; they also extend the finding to the affective illnesses, the other group of major psychoses.

Rat somatosensory (SmI) cortex: I. Characteristics of neuronal responses to noxious stimulation and comparison with responses to non-noxious stimulation

Single unit responses to noxious and non-noxious somatic stimulation were investigated in the somatosensory (SmI) cortex of rats under halothane-nitrous oxide anaesthesia. Four categories of neurons were observed: (1) neurons driven by non-noxious cutaneous stimulation, (2) neurons driven by non-noxious deep stimulation, (3) neurons driven by noxious stimulation only (nociceptive specific neurons), (4) neurons driven by noxious as well as non-noxious stimulation (convergent or nociceptive non-specific neurons). The receptive fields of the neurons driven by contralateral cutaneous non-noxious stimulation were small. These neurons responded phasically to cutaneous stimulation in the majority of cases. Neurons driven by stimulation of deep receptors (e.g. joint movement) could also be recorded in the same part of SmI cortex. Neurons driven by noxious stimulation had large receptive fields and were often tonically driven by noxious stimulation. Convergent (or nociceptive non-specific) neurons could often be inhibited from body parts not included in their excitatory receptive field. Some neurons driven by noxious stimulation were able to encode stimulus parameters such as temperature of a hot water bath or surface of the skin area stimulated. The different categories of neurons defined above could be successively recorded during a given electrode penetration. Evidence for the somatotopic organization of the different categories of inputs was obtained. These results strongly suggest that the first somatosensory (SmI) neocortex is involved in nociception.

The thalamo-cortical projection of the nucleus submedius in the cat

The cortical projection of the nucleus submedius (Sm) was studied in the cat with the autoradiographic and horseradish peroxidase (HRP) methods. The results indicate that Sm projects topographically on to layer 3 of a distinct agranular cortical field that occupies the posterolateral gyrus proreus, the adjacent fundus of the rhinal sulcus, and the postero-ventral portion of the medial wall of the presylvian sulcus. This cortical field is denoted the ventrolateral orbital cortex (VLO), consonant with previous nomenclature in the rat (Krettek and Price, '77a). The more ventral part (VLO beta) is cytoarchitectonically distinct from the dorsal part (VLO alpha); the former receives input from the anterior part of Sm (Sma), while the latter receives input from the dorsal and ventral parts of Sm (Smd and Smv). A light input to superficial layer 1 of VLO probably also arises from Sm, and there may be an input to layers 5 and 6. The corticothalamic projection from VLO to Sm reciprocates the ipsilateral thalamocortical projection and also has a moderate contralateral component. A dense, subpial layer 1 input to VLO arises from cells of the ventromedial nucleus (VM) subjacent to Sm. The present experiments also indicate that clusters of cells in VM probably provide input to layer 3 of the cortex in the fundus of the presylvian sulcus, as well as area 6a beta in the lateral wall of the presylvian sulcus and the ventral bank of the cruciate sulcus. Results from the HRP experiments additionally indicate that VLO beta and the anteroventral (Smv) portion of VLO alpha are reciprocally connected with the ventral agranular insular cortex and the cingulate cortex, ipsilaterally, while the posterodorsal (Smd) portion of VLO alpha is instead connected wih specific portions of the somatosensory cortical areas bilaterally. All portions of VLO alpha appear to project to the ventrolateral periaqueductal gray. In light of the recent suggestion that Smd is involved with nociception (Craig and Burton, '81), the present results suggest that the related portion of VLO alpha may serve as a cortical representation for noxious stimuli.