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Kim EJ, Kong MS, Park S, Cho J, Kim JJ. Periaqueductal gray activates antipredatory neural responses in the amygdala of foraging rats. eLife 2024; 12:RP88733. [PMID: 39133827 PMCID: PMC11318971 DOI: 10.7554/elife.88733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Pavlovian fear conditioning research suggests that the interaction between the dorsal periaqueductal gray (dPAG) and basolateral amygdala (BLA) acts as a prediction error mechanism in the formation of associative fear memories. However, their roles in responding to naturalistic predatory threats, characterized by less explicit cues and the absence of reiterative trial-and-error learning events, remain unexplored. In this study, we conducted single-unit recordings in rats during an 'approach food-avoid predator' task, focusing on the responsiveness of dPAG and BLA neurons to a rapidly approaching robot predator. Optogenetic stimulation of the dPAG triggered fleeing behaviors and increased BLA activity in naive rats. Notably, BLA neurons activated by dPAG stimulation displayed immediate responses to the robot, demonstrating heightened synchronous activity compared to BLA neurons that did not respond to dPAG stimulation. Additionally, the use of anterograde and retrograde tracer injections into the dPAG and BLA, respectively, coupled with c-Fos activation in response to predatory threats, indicates that the midline thalamus may play an intermediary role in innate antipredatory-defensive functioning.
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Affiliation(s)
- Eun Joo Kim
- Department of Psychology, University of WashingtonSeattleUnited States
| | - Mi-Seon Kong
- Department of Psychiatry and Behavioral Sciences, University of WashingtonSeattleUnited States
| | - Sanggeon Park
- Department of Brain and Cognitive Sciences, Scranton College, Ewha Womans UniversitySeoulRepublic of Korea
- Brain Disease Research Institute, Ewha Brain Institute, Ewha Womans UniversitySeoulRepublic of Korea
| | - Jeiwon Cho
- Department of Brain and Cognitive Sciences, Scranton College, Ewha Womans UniversitySeoulRepublic of Korea
- Brain Disease Research Institute, Ewha Brain Institute, Ewha Womans UniversitySeoulRepublic of Korea
| | - Jeansok John Kim
- Department of Psychology, University of WashingtonSeattleUnited States
- Program in Neuroscience, University of WashingtonSeattleUnited States
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2
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Kissinger ST, O'neil E, Li B, Johnson KW, Krajewski JL, Kato AS. Distinctive Neurophysiological Signatures of Analgesia after Inflammatory Pain in the ACC of Freely Moving Mice. J Neurosci 2024; 44:e2231232024. [PMID: 38755005 PMCID: PMC11255429 DOI: 10.1523/jneurosci.2231-23.2024] [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: 11/30/2023] [Revised: 04/11/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024] Open
Abstract
Preclinical assessments of pain have often relied upon behavioral measurements and anesthetized neurophysiological recordings. Current technologies enabling large-scale neural recordings, however, have the potential to unveil quantifiable pain signals in conscious animals for preclinical studies. Although pain processing is distributed across many brain regions, the anterior cingulate cortex (ACC) is of particular interest in isolating these signals given its suggested role in the affective ("unpleasant") component of pain. Here, we explored the utility of the ACC toward preclinical pain research using head-mounted miniaturized microscopes to record calcium transients in freely moving male mice expressing genetically encoded calcium indicator 6f (GCaMP6f) under the Thy1 promoter. We verified the expression of GCaMP6f in excitatory neurons and found no intrinsic behavioral differences in this model. Using a multimodal stimulation paradigm across naive, pain, and analgesic conditions, we found that while ACC population activity roughly scaled with stimulus intensity, single-cell representations were highly flexible. We found only low-magnitude increases in population activity after complete Freund's adjuvant (CFA) and insufficient evidence for the existence of a robust nociceptive ensemble in the ACC. However, we found a temporal sharpening of response durations and generalized increases in pairwise neural correlations in the presence of the mechanistically distinct analgesics gabapentin or ibuprofen after (but not before) CFA-induced inflammatory pain. This increase was not explainable by changes in locomotion alone. Taken together, these results highlight challenges in isolating distinct pain signals among flexible representations in the ACC but suggest a neurophysiological hallmark of analgesia after pain that generalizes to at least two analgesics.
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Affiliation(s)
- Samuel T Kissinger
- Lilly Research Laboratories, Department of Neuroscience, Indianapolis, Indiana 46285
| | - Estefania O'neil
- Lilly Research Laboratories, Department of Neuroscience, Indianapolis, Indiana 46285
| | - Baolin Li
- Lilly Research Laboratories, Department of Neuroscience, Indianapolis, Indiana 46285
| | - Kirk W Johnson
- Lilly Research Laboratories, Department of Neuroscience, Indianapolis, Indiana 46285
| | - Jeffrey L Krajewski
- Lilly Research Laboratories, Department of Neuroscience, Indianapolis, Indiana 46285
| | - Akihiko S Kato
- Lilly Research Laboratories, Department of Neuroscience, Indianapolis, Indiana 46285
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3
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O'Malley CA, Smith SA, Mauger AR, Norbury R. Exercise-induced pain within endurance exercise settings: Definitions, measurement, mechanisms and potential interventions. Exp Physiol 2024. [PMID: 38985528 DOI: 10.1113/ep091687] [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: 03/27/2024] [Accepted: 06/18/2024] [Indexed: 07/12/2024]
Abstract
Pain can be defined as an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage. Though consistent with this definition, different types of pain result in different behavioural and psychophysiological responses. For example, the transient, non-threatening, acute muscle pain element of exercise-induced pain (EIP) is entirely different from other pain types like delayed onset muscle soreness, muscular injury or chronic pain. However, studies often conflate the definitions or assume parity between distinct pain types. Consequently, the mechanisms through which pain might impact exercise behaviour across different pain subcategories may be incorrectly assumed, which could lead to interventions or recommendations that are inappropriate. Therefore, this review aims to distinguish EIP from other subcategories of pain according to their aetiologies and characteristics, thereby providing an updated conceptual and operational definition of EIP. Secondly, the review will discuss the experimental pain models currently used across several research domains and their relevance to EIP with a focus on the neuro-psychophysiological mechanisms of EIP and its effect on exercise behaviour and performance. Finally, the review will examine potential interventions to cope with the impact of EIP and support wider exercise benefits. HIGHLIGHTS: What is the topic of this review? Considerations for future research focusing on exercise-induced pain within endurance exercise settings. What advances does it highlight? An updated appraisal and guide of research concerning exercise-induced pain and its impact on endurance task behaviour, particularly with reference to the aetiology, measurement, and manipulation of exercise-induced pain.
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Affiliation(s)
- Callum A O'Malley
- School of Sport, Exercise, and Nutritional Sciences, University of Exeter, Exeter, UK
| | - Samuel A Smith
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
| | - Alexis R Mauger
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
| | - Ryan Norbury
- Faculty of Sport, Technology, and Health Sciences, St Mary's University, Twickenham, UK
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4
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Grajales-Reyes JG, Chen B, Meseguer D, Schneeberger M. Burning Question: How Does Our Brain Process Positive and Negative Cues Associated with Thermosensation? Physiology (Bethesda) 2024; 39:0. [PMID: 38536114 DOI: 10.1152/physiol.00034.2023] [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: 01/01/2024] [Revised: 03/06/2024] [Accepted: 03/22/2024] [Indexed: 05/16/2024] Open
Abstract
Whether it is the dramatic suffocating sensation from a heat wave in the summer or the positive reinforcement arising from a hot drink on a cold day; we can certainly agree that our thermal environment underlies our daily rhythms of sensation. Extensive research has focused on deciphering the central circuits responsible for conveying the impact of thermogenesis on mammalian behavior. Here, we revise the recent literature responsible for defining the behavioral correlates that arise from thermogenic fluctuations in mammals. We transition from the physiological significance of thermosensation to the circuitry responsible for the autonomic or behavioral responses associated with it. Subsequently, we delve into the positive and negative valence encoded by thermoregulatory processes. Importantly, we emphasize the crucial junctures where reward, pain, and thermoregulation intersect, unveiling a complex interplay within these neural circuits. Finally, we briefly outline fundamental questions that are pending to be addressed in the field. Fully deciphering the thermoregulatory circuitry in mammals will have far-reaching medical implications. For instance, it may lead to the identification of novel targets to overcome thermal pain or allow the maintenance of our core temperature in prolonged surgeries.
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Affiliation(s)
- Jose G Grajales-Reyes
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Bandy Chen
- Department of Cellular and Molecular Physiology, Laboratory of Neurovascular Control of Homeostasis, Yale School of Medicine, New Haven, Connecticut, United States
- Wu Tsai Institute for Mind and Brain, Yale University, New Haven, Connecticut, United States
| | - David Meseguer
- Department of Cellular and Molecular Physiology, Laboratory of Neurovascular Control of Homeostasis, Yale School of Medicine, New Haven, Connecticut, United States
- Wu Tsai Institute for Mind and Brain, Yale University, New Haven, Connecticut, United States
| | - Marc Schneeberger
- Department of Cellular and Molecular Physiology, Laboratory of Neurovascular Control of Homeostasis, Yale School of Medicine, New Haven, Connecticut, United States
- Wu Tsai Institute for Mind and Brain, Yale University, New Haven, Connecticut, United States
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Kim EJ, Kong MS, Park S, Cho J, Kim JJ. Periaqueductal gray activates antipredatory neural responses in the amygdala of foraging rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.05.19.541463. [PMID: 38559038 PMCID: PMC10979854 DOI: 10.1101/2023.05.19.541463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Pavlovian fear conditioning research suggests that the interaction between the dorsal periaqueductal gray (dPAG) and basolateral amygdala (BLA) acts as a prediction error mechanism in the formation of associative fear memories. However, their roles in responding to naturalistic predatory threats, characterized by less explicit cues and the absence of reiterative trial-and-error learning events, remain unexplored. In this study, we conducted single-unit recordings in rats during an 'approach food-avoid predator' task, focusing on the responsiveness of dPAG and BLA neurons to a rapidly approaching robot predator. Optogenetic stimulation of the dPAG triggered fleeing behaviors and increased BLA activity in naive rats. Notably, BLA neurons activated by dPAG stimulation displayed immediate responses to the robot, demonstrating heightened synchronous activity compared to BLA neurons that did not respond to dPAG stimulation. Additionally, the use of anterograde and retrograde tracer injections into the dPAG and BLA, respectively, coupled with c-Fos activation in response to predatory threats, indicates that the midline thalamus may play an intermediary role in innate antipredatory defensive functioning.
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6
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Nardelli D, Gambioli F, De Bartolo MI, Mancinelli R, Biagioni F, Carotti S, Falato E, Leodori G, Puglisi-Allegra S, Vivacqua G, Fornai F. Pain in Parkinson's disease: a neuroanatomy-based approach. Brain Commun 2024; 6:fcae210. [PMID: 39130512 PMCID: PMC11311710 DOI: 10.1093/braincomms/fcae210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 04/23/2024] [Accepted: 06/17/2024] [Indexed: 08/13/2024] Open
Abstract
Parkinson's disease is a progressive neurodegenerative disorder characterized by the deposition of misfolded alpha-synuclein in different regions of the central and peripheral nervous system. Motor impairment represents the signature clinical expression of Parkinson's disease. Nevertheless, non-motor symptoms are invariably present at different stages of the disease and constitute an important therapeutic challenge with a high impact for the patients' quality of life. Among non-motor symptoms, pain is frequently experienced by patients, being present in a range of 24-85% of Parkinson's disease population. Moreover, in more than 5% of patients, pain represents the first clinical manifestation, preceding by decades the exordium of motor symptoms. Pain implies a complex biopsychosocial experience with a downstream complex anatomical network involved in pain perception, modulation, and processing. Interestingly, all the anatomical areas involved in pain network can be affected by a-synuclein pathology, suggesting that pathophysiology of pain in Parkinson's disease encompasses a 'pain spectrum', involving different anatomical and neurochemical substrates. Here the various anatomical sites recruited in pain perception, modulation and processing are discussed, highlighting the consequences of their possible degeneration in course of Parkinson's disease. Starting from peripheral small fibres neuropathy and pathological alterations at the level of the posterior laminae of the spinal cord, we then describe the multifaceted role of noradrenaline and dopamine loss in driving dysregulated pain perception. Finally, we focus on the possible role of the intertwined circuits between amygdala, nucleus accumbens and habenula in determining the psycho-emotional, autonomic and cognitive experience of pain in Parkinson's disease. This narrative review provides the first anatomically driven comprehension of pain in Parkinson's disease, aiming at fostering new insights for personalized clinical diagnosis and therapeutic interventions.
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Affiliation(s)
- Domiziana Nardelli
- Laboratory of Microscopic and Ultrastructural Anatomy, Campus Biomedico University of Roma, Rome 00128, Italy
| | - Francesco Gambioli
- Laboratory of Microscopic and Ultrastructural Anatomy, Campus Biomedico University of Roma, Rome 00128, Italy
| | | | - Romina Mancinelli
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Roma, Rome 00161, Italy
| | | | - Simone Carotti
- Laboratory of Microscopic and Ultrastructural Anatomy, Campus Biomedico University of Roma, Rome 00128, Italy
| | - Emma Falato
- Laboratory of Microscopic and Ultrastructural Anatomy, Campus Biomedico University of Roma, Rome 00128, Italy
| | - Giorgio Leodori
- IRCCS Neuromed, Pozzilli, IS 86077, Italy
- Department of Human Neuroscience, Sapienza University of Roma, Rome 00185, Italy
| | | | - Giorgio Vivacqua
- Laboratory of Microscopic and Ultrastructural Anatomy, Campus Biomedico University of Roma, Rome 00128, Italy
| | - Francesco Fornai
- IRCCS Neuromed, Pozzilli, IS 86077, Italy
- Department of Experimental Morphology and Applied Biology, University of Pisa, Pisa 56122, Italy
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7
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Carrascosa AJ, Navarrete F, Saldaña R, García-Gutiérrez MS, Montalbán B, Navarro D, Gómez-Guijarro FM, Gasparyan A, Murcia-Sánchez E, Torregrosa AB, Pérez-Doblado P, Gutiérrez L, Manzanares J. Cannabinoid Analgesia in Postoperative Pain Management: From Molecular Mechanisms to Clinical Reality. Int J Mol Sci 2024; 25:6268. [PMID: 38892456 PMCID: PMC11172912 DOI: 10.3390/ijms25116268] [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: 04/26/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Postoperative pain (POP) is a challenging clinical phenomenon that affects the majority of surgical patients and demands effective management to mitigate adverse outcomes such as persistent pain. The primary goal of POP management is to alleviate suffering and facilitate a seamless return to normal function for the patient. Despite compelling evidence of its drawbacks, opioid analgesia remains the basis of POP treatment. Novel therapeutic approaches rely on multimodal analgesia, integrating different pharmacological strategies to optimize efficacy while minimizing adverse effects. The recognition of the imperative role of the endocannabinoid system in pain regulation has prompted the investigation of cannabinoid compounds as a new therapeutic avenue. Cannabinoids may serve as adjuvants, enhancing the analgesic effects of other drugs and potentially replacing or at least reducing the dependence on other long-term analgesics in pain management. This narrative review succinctly summarizes pertinent information on the molecular mechanisms, clinical therapeutic benefits, and considerations associated with the plausible use of various cannabinoid compounds in treating POP. According to the available evidence, cannabinoid compounds modulate specific molecular mechanisms intimately involved in POP. However, only two of the eleven clinical trials that evaluated the efficacy of different cannabinoid interventions showed positive results.
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Affiliation(s)
- Antonio J. Carrascosa
- Servicio de Anestesiologia y Reanimación, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain; (A.J.C.); (R.S.); (B.M.); (F.M.G.-G.); (E.M.-S.); (P.P.-D.)
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Raquel Saldaña
- Servicio de Anestesiologia y Reanimación, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain; (A.J.C.); (R.S.); (B.M.); (F.M.G.-G.); (E.M.-S.); (P.P.-D.)
| | - María S. García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Belinda Montalbán
- Servicio de Anestesiologia y Reanimación, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain; (A.J.C.); (R.S.); (B.M.); (F.M.G.-G.); (E.M.-S.); (P.P.-D.)
| | - Daniela Navarro
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Fernando M. Gómez-Guijarro
- Servicio de Anestesiologia y Reanimación, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain; (A.J.C.); (R.S.); (B.M.); (F.M.G.-G.); (E.M.-S.); (P.P.-D.)
| | - Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Elena Murcia-Sánchez
- Servicio de Anestesiologia y Reanimación, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain; (A.J.C.); (R.S.); (B.M.); (F.M.G.-G.); (E.M.-S.); (P.P.-D.)
| | - Abraham B. Torregrosa
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Paloma Pérez-Doblado
- Servicio de Anestesiologia y Reanimación, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain; (A.J.C.); (R.S.); (B.M.); (F.M.G.-G.); (E.M.-S.); (P.P.-D.)
| | - Luisa Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (D.N.); (A.G.); (A.B.T.); (L.G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
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Segebarth PB, Schallmo M, Odum S, Hietpas K, Michalek C, Chapman TM, Leas D, Milam RA, Hamid N. Opioid-Free Analgesia is Safe and Effective in Anterior Cervical Spine Surgery: A Randomized Controlled Trial. Clin Spine Surg 2024; 37:138-148. [PMID: 38553433 DOI: 10.1097/bsd.0000000000001608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/28/2024] [Indexed: 05/07/2024]
Abstract
STUDY DESIGN Randomized controlled trial (RCT). OBJECTIVE Compare the efficacy of a multimodal, opioid-free (OF) pain management pathway with a traditional opioid-containing (OC) pathway in patients undergoing anterior cervical procedures. SUMMARY OF BACKGROUND DATA Previous studies have compared opioid-based pain regimens to opioid-sparing regimens following cervical spine surgery, but have been limited by high rates of crossover, retrospective designs, reliance on indwelling pain catheters, opioid utilization for early postoperative analgesia, and/or a lack of patient-reported outcome measures. METHODS This is a RCT in which patients were allocated to either an OF or OC perioperative pain management protocol. Eligible study participants included adult (age up to 18 y) patients who underwent primary, 1-level or 2-level anterior cervical surgery [anterior cervical discectomy and fusion (ACDF), anterior cervical disc arthroplasty (ACDA), or hybrid (ACDF and ACDA at different levels)] for degenerative pathology. The primary outcome variable was subjective pain level at 24 hours postoperative. The final study cohort consisted of 50 patients (22 OF, 28 OC). RESULTS Patients in the OF group reported lower median postoperative pain levels at 6 hours (4 for OF vs. 7 for OC; P =0.041) and 24 hours (3 for OF vs. 5 for OC; P =0.032). At 2-week and 6-week follow-up, pain levels were similar between groups. Patients in the OF group reported greater comfort at 12 hours (9 for OF vs. 5 for OC; P =0.003) and 24 hours (9 for OF vs. 5 for OC; P =0.011) postoperatively. Notably, there were no significant differences in patients' reported pain satisfaction, overall surgical satisfaction, or overall sense of physical and mental well-being. In addition, there were no significant differences in falls, delirium, or constipation postoperatively. CONCLUSIONS A multimodal OF pain management pathway following anterior cervical surgery for degenerative disease results in statistically noninferior pain control and equivalent patient-reported outcome measures compared with a traditional OC pathway.
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9
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Florence TJ, Bari A, Vivas AC. Functional Stimulation and Imaging to Predict Neuromodulation of Chronic Low Back Pain. Neurosurg Clin N Am 2024; 35:191-197. [PMID: 38423734 DOI: 10.1016/j.nec.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Back pain is one of the most common aversive sensations in human experience. Pain is not limited to the sensory transduction of tissue damage; rather, it encompasses a range of nervous system activities including lateral modulation, long-distance transmission, encoding, and decoding. Although spine surgery may address peripheral pain generators directly, aberrant signals along canonical aversive pathways and maladaptive influence of affective and cognitive states can result in persistent subjective pain refractory to classical surgical intervention. The clinical identification of who will benefit from surgery-and who will not-is increasingly grounded in neurophysiology.
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Affiliation(s)
- Timothy J Florence
- UCLA Neurosurgery, 300 Stein Plaza Driveway, Suite 562, Los Angeles, CA 90095, USA
| | - Ausaf Bari
- UCLA Neurosurgery, 300 Stein Plaza Driveway, Suite 562, Los Angeles, CA 90095, USA
| | - Andrew C Vivas
- UCLA Neurosurgery, 300 Stein Plaza Driveway, Suite 562, Los Angeles, CA 90095, USA.
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10
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Chen H, Bleimeister IH, Nguyen EK, Li J, Cui AY, Stratton HJ, Smith KM, Baccei ML, Ross SE. The functional and anatomical characterization of three spinal output pathways of the anterolateral tract. Cell Rep 2024; 43:113829. [PMID: 38421871 PMCID: PMC11025583 DOI: 10.1016/j.celrep.2024.113829] [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: 04/18/2023] [Revised: 10/24/2023] [Accepted: 02/03/2024] [Indexed: 03/02/2024] Open
Abstract
The nature of spinal output pathways that convey nociceptive information to the brain has been the subject of controversy. Here, we provide anatomical, molecular, and functional characterizations of two distinct anterolateral pathways: one, ascending in the lateral spinal cord, triggers nociceptive behaviors, and the other one, ascending in the ventral spinal cord, when inhibited, leads to sensorimotor deficits. Moreover, the lateral pathway consists of at least two subtypes. The first is a contralateral pathway that extends to the periaqueductal gray (PAG) and thalamus; the second is a bilateral pathway that projects to the bilateral parabrachial nucleus (PBN). Finally, we present evidence showing that activation of the contralateral pathway is sufficient for defensive behaviors such as running and freezing, whereas the bilateral pathway is sufficient for attending behaviors such as licking and guarding. This work offers insight into the complex organizational logic of the anterolateral system in the mouse.
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Affiliation(s)
- Haichao Chen
- Tsinghua Medicine, Tsinghua University, Beijing 100084, China; Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Isabel H Bleimeister
- Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; Medical Scientist Training Program, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Eileen K Nguyen
- Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; Medical Scientist Training Program, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jie Li
- Department of Anesthesiology, Pain Research Center, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA
| | - Abby Yilin Cui
- Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Harrison J Stratton
- Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kelly M Smith
- Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Mark L Baccei
- Department of Anesthesiology, Pain Research Center, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA
| | - Sarah E Ross
- Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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11
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Wang J, Zheng G, Wang L, Meng L, Ren J, Shang L, Li D, Bao Y. Dysregulation of sphingolipid metabolism in pain. Front Pharmacol 2024; 15:1337150. [PMID: 38523645 PMCID: PMC10957601 DOI: 10.3389/fphar.2024.1337150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/27/2024] [Indexed: 03/26/2024] Open
Abstract
Pain is a clinical condition that is currently of great concern and is often caused by tissue or nerve damage or occurs as a concomitant symptom of a variety of diseases such as cancer. Severe pain seriously affects the functional status of the body. However, existing pain management programs are not fully satisfactory. Therefore, there is a need to delve deeper into the pathological mechanisms underlying pain generation and to find new targets for drug therapy. Sphingolipids (SLs), as a major component of the bilayer structure of eukaryotic cell membranes, also have powerful signal transduction functions. Sphingolipids are abundant, and their intracellular metabolism constitutes a huge network. Sphingolipids and their various metabolites play significant roles in cell proliferation, differentiation, apoptosis, etc., and have powerful biological activities. The molecules related to sphingolipid metabolism, mainly the core molecule ceramide and the downstream metabolism molecule sphingosine-1-phosphate (S1P), are involved in the specific mechanisms of neurological disorders as well as the onset and progression of various types of pain, and are closely related to a variety of pain-related diseases. Therefore, sphingolipid metabolism can be the focus of research on pain regulation and provide new drug targets and ideas for pain.
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Affiliation(s)
- Jianfeng Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guangda Zheng
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Linfeng Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Linghan Meng
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Juanxia Ren
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Lu Shang
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Dongtao Li
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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12
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Dabala E, Guédon A, Ficheux G, Béal L, Moxham B, Plaisant O. Homologies of spinal ascending nociceptive pathways between rats and macaques: can we transpose to human? A review and analysis of the literature. Surg Radiol Anat 2023; 45:1443-1460. [PMID: 37507602 DOI: 10.1007/s00276-023-03212-w] [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: 11/28/2022] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Due to the difficulty of using neural tracers in humans, knowledge of the nociceptive system's anatomy is mainly derived from studies in animals and mainly in rats. The aim of this study was to investigate the morphological differences of the ascending spinal nociceptive pathways between the rat and the macaque monkey; in order to evaluate the variability of this anatomy during phylogenesis, and thus to know if the anatomical description of these pathways can be transposed from the rat to the human. METHODS A review and analysis of the literature were performed. The criteria used for comparison were: origins, pathways, their terminations in target structures, and projections from target structures of ascending spinal nociceptive pathways. The monkey was used as an intermediate species for comparison because of the lack of data in humans. The hypothesis of transposition of anatomy between rat and human was considered rejected if differences were found between rat and monkey. RESULTS An anatomical difference in termination was found for the spino-annular or spino-periaqueductal grey (spino-PAG) pathway and transposition of its anatomy from rat to human was rejected. No difference was found in other pathways and the transposition of their anatomy from rat to human was therefore, not rejected. CONCLUSION This work highlights the conservation of most of the ascending spinal nociceptive pathways' anatomy between rat and monkey. Thus, the possibility for a transposition of their anatomy between rat and human is not rejected.
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Affiliation(s)
- Eric Dabala
- Department of Anatomy, Université Catholique de Lille, Lille, France.
- Université Paris Cité, Paris, France.
| | - Alexis Guédon
- Université Paris Cité, Paris, France
- Department of Interventional Neuroradiology, INSERM UMR_S 1140, Lariboisière Hospital, AP-HP Nord, Paris, France
| | - Guillaume Ficheux
- Department of Anatomy, Université Catholique de Lille, Lille, France
| | - Louis Béal
- Department of Anatomy, Université Catholique de Lille, Lille, France
| | - Bernard Moxham
- Cardiff School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK
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13
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Szabo E, Ashina S, Melo-Carrillo A, Bolo NR, Borsook D, Burstein R. Peripherally acting anti-CGRP monoclonal antibodies alter cortical gray matter thickness in migraine patients: A prospective cohort study. Neuroimage Clin 2023; 40:103531. [PMID: 37866119 PMCID: PMC10623369 DOI: 10.1016/j.nicl.2023.103531] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Migraine is underpinned by central nervous system neuroplastic alterations thought to be caused by the repetitive peripheral afferent barrage the brain receives during the headache phase (cortical hyperexcitability). Calcitonin gene-related peptide monoclonal antibodies (anti-CGRP-mAbs) are highly effective migraine preventative treatments. Their ability to alter brain morphometry in treatment-responders vs. non-responders is not well understood. Our aim was to determine the effects of the anti-CGRP-mAb galcanezumab on cortical thickness after 3-month treatment of patients with high-frequency episodic or chronic migraine. High-resolution magnetic resonance imaging was performed pre- and post-treatment in 36 migraine patients. In this group, 19 patients were classified responders (≥50 % reduction in monthly migraine days) and 17 were considered non-responders (<50 % reduction in monthly migraine days). Following cross-sectional processing to analyze the baseline differences in cortical thickness, two-stage longitudinal processing and symmetrized percent change were conducted to investigate treatment-related brain changes. At baseline, no significant differences were found between the responders and non-responders. After 3-month treatment, decreased cortical thickness (compared to baseline) was observed in the responders in regions of the somatosensory cortex, anterior cingulate cortex, medial frontal cortex, superior frontal gyrus, and supramarginal gyrus. Non-responders demonstrated decreased cortical thickness in the left dorsomedial cortex and superior frontal gyrus. We interpret the cortical thinning seen in the responder group as suggesting that reduction in head pain could lead to changes in neural swelling and dendritic complexity and that such changes reflect the recovery process from maladaptive neural activity. This conclusion is further supported by our recent study showing that 3 months after treatment initiation, the incidence of premonitory symptoms and prodromes that are followed by headache decreases but not the incidence of the premonitory symptoms or prodromes themselves (that is, cortical thinning relates to reductions in the nociceptive signals in the responders). We speculate that a much longer recovery period is required to allow the brain to return to a more 'normal' functioning state whereby prodromes and premonitory symptoms no longer occur.
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Affiliation(s)
- Edina Szabo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA
| | - Sait Ashina
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Agustin Melo-Carrillo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA
| | - Nicolas R Bolo
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - David Borsook
- Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Rami Burstein
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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14
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Lyubashina OA, Sivachenko IB, Sushkevich BM, Busygina II. Opposing effects of 5-HT1A receptor agonist buspirone on supraspinal abdominal pain transmission in normal and visceral hypersensitive rats. J Neurosci Res 2023; 101:1555-1571. [PMID: 37331003 DOI: 10.1002/jnr.25222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/11/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023]
Abstract
The serotonergic 5-HT1A receptors are implicated in the central mechanisms of visceral pain, but their role in these processes is controversial. Considering existing evidences for organic inflammation-triggered neuroplastic changes in the brain serotonergic circuitry, the ambiguous contribution of 5-HT1A receptors to supraspinal control of visceral pain in normal and post-inflammatory conditions can be assumed. In this study performed on male Wistar rats, we used microelectrode recording of the caudal ventrolateral medulla (CVLM) neuron responses to colorectal distension (CRD) and electromyography recording of CRD-evoked visceromotor reactions (VMRs) to evaluate post-colitis changes in the effects of 5-HT1A agonist buspirone on supraspinal visceral nociceptive transmission. In rats recovered from trinitrobenzene sulfonic acid colitis, the CRD-induced CVLM neuronal excitation and VMRs were increased compared with those in healthy animals, revealing post-inflammatory intestinal hypersensitivity. Intravenous buspirone (2 and 4 mg/kg) under urethane anesthesia dose-dependently suppressed CVLM excitatory neuron responses to noxious CRD in healthy rats, but caused dose-independent increase in the already enhanced nociceptive activation of CVLM neurons in post-colitis animals, losing also its normally occurring faciliatory effect on CRD-evoked inhibitory medullary neurotransmission and suppressive action on hemodynamic reactions to CRD. In line with this, subcutaneous injection of buspirone (2 mg/kg) in conscious rats, which attenuated CRD-induced VMRs in controls, further increased VMRs in hypersensitive animals. The data obtained indicate a shift from anti- to pronociceptive contribution of 5-HT1A-dependent mechanisms to supraspinal transmission of visceral nociception in intestinal hypersensitivity conditions, arguing for the disutility of buspirone and possibly other 5-HT1A agonists for relieving post-inflammatory abdominal pain.
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Affiliation(s)
- Olga A Lyubashina
- Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology of the Russian Academy of Sciences, Saint Petersburg, Russia
| | - Ivan B Sivachenko
- Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology of the Russian Academy of Sciences, Saint Petersburg, Russia
| | - Boris M Sushkevich
- Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology of the Russian Academy of Sciences, Saint Petersburg, Russia
| | - Irina I Busygina
- Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology of the Russian Academy of Sciences, Saint Petersburg, Russia
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15
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Cherup NP, Robayo LE, Vastano R, Fleming L, Levin BE, Widerström-Noga E. Neuropsychological Function in Traumatic Brain Injury and the Influence of Chronic Pain. Percept Mot Skills 2023; 130:1495-1523. [PMID: 37219529 DOI: 10.1177/00315125231174082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Cognitive dysfunction, pain, and psychological morbidity all present unique challenges to those living with traumatic brain injury (TBI). In this study we examined (a) the impact of pain across domains of attention, memory, and executive function, and (b) the relationships between pain and depression, anxiety, and post-traumatic stress disorder (PTSD) in persons with chronic TBI. Our sample included 86 participants with a TBI and chronic pain (n = 26), patients with TBI and no chronic pain (n = 23), and a pain-free control group without TBI (n = 37). Participants visited the laboratory and completed a comprehensive battery of neuropsychological tests as part of a structured interview. Multivariate analysis of covariance using education as a covariate, failed to detect a significant group difference for neuropsychological composite scores of attention, memory, and executive function (p = .165). A follow-up analysis using multiple one-way analysis of variance (ANOVA) was conducted for individual measures of executive function. Post-hoc testing indicated that those in both TBI groups preformed significantly worse on measures of semantic fluency when compared to controls (p < 0.001, ηρ2 = .16). Additionally, multiple ANOVAs indicated that those with TBI and pain scored significantly worse across all psychological assessments (p < .001). We also found significant associations between measures of pain and most psychological symptoms. A follow-up stepwise linear regression among those in the TBI pain group indicated that post concussive complaints, pain severity, and neuropathic pain symptoms differentially contributed to symptoms of depression, anxiety, and PTSD. These findings suggest deficits in verbal fluency among those living with chronic TBI, with results also reinforcing the multidimensional nature of pain and its psychological significance in this population.
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Affiliation(s)
- Nicholas P Cherup
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Linda E Robayo
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Roberta Vastano
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Loriann Fleming
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Bonnie E Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eva Widerström-Noga
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
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16
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Vizin RC, Almeida MC, Soriano RN, Romanovsky AA. Selection of preferred thermal environment and cold-avoidance responses in rats rely on signals transduced by the dorsal portion of the lateral funiculus of the spinal cord. Temperature (Austin) 2023; 10:121-135. [PMID: 37187830 PMCID: PMC10177698 DOI: 10.1080/23328940.2023.2191378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 05/17/2023] Open
Abstract
Thermoregulatory behaviors are powerful effectors for core body temperature (Tc) regulation. We evaluated the involvement of afferent fibers ascending through the dorsal portion of the lateral funiculus (DLF) of the spinal cord in "spontaneous" thermal preference and thermoregulatory behaviors induced by thermal and pharmacological stimuli in a thermogradient apparatus. In adult Wistar rats, the DLF was surgically severed at the first cervical vertebra bilaterally. The functional effectiveness of funiculotomy was verified by the increased latency of tail-flick responses to noxious cold (-18°C) and heat (50°C). In the thermogradient apparatus, funiculotomized rats showed a higher variability of their preferred ambient temperature (Tpr) and, consequently, increased Tc fluctuations, as compared to sham-operated rats. The cold-avoidance (warmth-seeking) response to moderate cold (whole-body exposure to ~17°C) or epidermal menthol (an agonist of the cold-sensitive TRPM8 channel) was attenuated in funiculotomized rats, as compared to sham-operated rats, and so was the Tc (hyperthermic) response to menthol. In contrast, the warmth-avoidance (cold-seeking) and Tc responses of funiculotomized rats to mild heat (exposure to ~28°C) or intravenous RN-1747 (an agonist of the warmth-sensitive TRPV4; 100 μg/kg) were unaffected. We conclude that DLF-mediated signals contribute to driving spontaneous thermal preference, and that attenuation of these signals is associated with decreased precision of Tc regulation. We further conclude that thermally and pharmacologically induced changes in thermal preference rely on neural, presumably afferent, signals that travel in the spinal cord within the DLF. Signals conveyed by the DLF are important for cold-avoidance behaviors but make little contribution to heat-avoidance responses.
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Affiliation(s)
- Robson C.L. Vizin
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), St. Joseph’s Hospital and Medical Center, Dignity Health, Phoenix, AZ, USA
- Center for Natural and Human Sciences, Federal University of ABC, São Bernardo do Campo, SP, Brazil
| | - Maria C. Almeida
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), St. Joseph’s Hospital and Medical Center, Dignity Health, Phoenix, AZ, USA
- Center for Natural and Human Sciences, Federal University of ABC, São Bernardo do Campo, SP, Brazil
| | - Renato N. Soriano
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), St. Joseph’s Hospital and Medical Center, Dignity Health, Phoenix, AZ, USA
- Department of Basic Life Sciences, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - Andrej A. Romanovsky
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), St. Joseph’s Hospital and Medical Center, Dignity Health, Phoenix, AZ, USA
- School of Molecular Sciences, University of Arizona, Tempe, AZ, USA
- Zharko Pharma, Inc, Olympia, WA, USA
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17
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Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society-American Academy of Pain Medicine Pain Taxonomy Diagnostic Criteria for Acute Needle Pain. THE JOURNAL OF PAIN 2023; 24:387-402. [PMID: 36243317 DOI: 10.1016/j.jpain.2022.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/05/2022]
Abstract
Needle procedures are among the most common causes of pain and distress for individuals seeking health care. While needle pain is especially problematic for children needle pain and associated fear also has significant impact on adults and can lead to avoidance of appropriate medical care. Currently there is not a standard definition of needle pain. A taxonomy, or classification system, for acute needle pain would aid research efforts and enhance clinical care. To meet this need, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks public-private partnership with the U.S. Food and Drug Administration, the American Pain Society, and the American Academy of Pain Medicine formed the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society-American Academy of Pain Medicine Pain Taxonomy initiative. One of the goals of this initiative was to develop taxonomies for acute pain disorders, including needle pain. To accomplish this, a working group of experts in needle pain was convened. Based on available literature and expert opinion, the working group used a 5-dimenional structure (diagnostic criteria, common features, modulating factors, impact and/or functional consequences, and putative mechanisms) to develop an acute pain taxonomy that is specific needle pain. As part of this, a set of 4 diagnostic criteria, with 2 modifiers to account for the influence of needle associated fear, are proposed to define the types of acute needle pain. PERSPECTIVE: This article presents a taxonomy for acute needle pain. This taxonomy could help to standardize definitions of acute pain in clinical studies of patients undergoing needle procedures.
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18
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Alam MJ, Chen JDZ. Electrophysiology as a Tool to Decipher the Network Mechanism of Visceral Pain in Functional Gastrointestinal Disorders. Diagnostics (Basel) 2023; 13:627. [PMID: 36832115 PMCID: PMC9955347 DOI: 10.3390/diagnostics13040627] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/27/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Abdominal pain, including visceral pain, is prevalent in functional gastrointestinal (GI) disorders (FGIDs), affecting the overall quality of a patient's life. Neural circuits in the brain encode, store, and transfer pain information across brain regions. Ascending pain signals actively shape brain dynamics; in turn, the descending system responds to the pain through neuronal inhibition. Pain processing mechanisms in patients are currently mainly studied with neuroimaging techniques; however, these techniques have a relatively poor temporal resolution. A high temporal resolution method is warranted to decode the dynamics of the pain processing mechanisms. Here, we reviewed crucial brain regions that exhibited pain-modulatory effects in an ascending and descending manner. Moreover, we discussed a uniquely well-suited method, namely extracellular electrophysiology, that captures natural language from the brain with high spatiotemporal resolution. This approach allows parallel recording of large populations of neurons in interconnected brain areas and permits the monitoring of neuronal firing patterns and comparative characterization of the brain oscillations. In addition, we discussed the contribution of these oscillations to pain states. In summary, using innovative, state-of-the-art methods, the large-scale recordings of multiple neurons will guide us to better understanding of pain mechanisms in FGIDs.
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Affiliation(s)
- Md Jahangir Alam
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jiande D. Z. Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
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19
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Astrocyte reactivity in the glia limitans superficialis of the rat medial prefrontal cortex following sciatic nerve injury. Histochem Cell Biol 2023; 159:185-198. [PMID: 36326875 DOI: 10.1007/s00418-022-02161-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
The glia limitans superficialis (GLS) on the rodent cortical surface consists of astrocyte bodies intermingled with their cytoplasmic processes. Many studies have observed astrocyte reactivity in the medial prefrontal cortex (mPFC) parenchyma induced by a peripheral nerve injury, while the response of GLS astrocytes is still not fully understood. The aim of our study was to identify the reactivity of rat GLS astrocytes in response to sciatic nerve compression (SNC) over different time periods. The alteration of GLS astrocyte reactivity was monitored using immunofluorescence (IF) intensities of glial fibrillary acidic protein (GFAP), glutamine synthetase (GS), and NFκBp65. Our results demonstrated that SNC induced GLS astrocyte reactivity seen as increased intensities of GFAP-IF, and longer extensions of cytoplasmic processes into lamina I. First significant increase of GFAP-IF was observed on post-operation day 7 (POD7) after SNC with further increases on POD14 and POD21. In contrast, dynamic alteration of the extension of cytoplasmic processes into lamina I was detected as early as POD1 and continued throughout the monitored survival periods of both sham and SNC operations. The reactivity of GLS astrocytes was not associated with their proliferation. In addition, GLS astrocytes also displayed a significant decrease in GS immunofluorescence (GS-IF) and NFκB immunofluorescence (NFκB-IF) in response to sham and SNC operation compared with naïve control rats. These results suggest that damaged peripheral tissues (following sham operation as well as peripheral nerve lesions) may induce significant changes in GLS astrocyte reactivity. The signaling mechanism from injured peripheral tissue and nerve remains to be elucidated.
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20
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Sun G, McCartin M, Liu W, Zhang Q, Kenefati G, Chen ZS, Wang J. Temporal pain processing in the primary somatosensory cortex and anterior cingulate cortex. Mol Brain 2023; 16:3. [PMID: 36604739 PMCID: PMC9817351 DOI: 10.1186/s13041-022-00991-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023] Open
Abstract
Pain is known to have sensory and affective components. The sensory pain component is encoded by neurons in the primary somatosensory cortex (S1), whereas the emotional or affective pain experience is in large part processed by neural activities in the anterior cingulate cortex (ACC). The timing of how a mechanical or thermal noxious stimulus triggers activation of peripheral pain fibers is well-known. However, the temporal processing of nociceptive inputs in the cortex remains little studied. Here, we took two approaches to examine how nociceptive inputs are processed by the S1 and ACC. We simultaneously recorded local field potentials in both regions, during the application of a brain-computer interface (BCI). First, we compared event related potentials in the S1 and ACC. Next, we used an algorithmic pain decoder enabled by machine-learning to detect the onset of pain which was used during the implementation of the BCI to automatically treat pain. We found that whereas mechanical pain triggered neural activity changes first in the S1, the S1 and ACC processed thermal pain with a reasonably similar time course. These results indicate that the temporal processing of nociceptive information in different regions of the cortex is likely important for the overall pain experience.
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Affiliation(s)
- Guanghao Sun
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA
| | - Michael McCartin
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Weizhuo Liu
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Qiaosheng Zhang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA
| | - George Kenefati
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA
| | - Zhe Sage Chen
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA
- Department of Neuroscience & Physiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Jing Wang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA.
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA.
- Department of Neuroscience & Physiology, New York University Grossman School of Medicine, New York, NY, 10016, USA.
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, 10016, USA.
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21
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Winslow BD, Kwasinski R, Whirlow K, Mills E, Hullfish J, Carroll M. Automatic detection of pain using machine learning. FRONTIERS IN PAIN RESEARCH 2022; 3:1044518. [DOI: 10.3389/fpain.2022.1044518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Pain is one of the most common symptoms reported by individuals presenting to hospitals and clinics and is associated with significant disability and economic impacts; however, the ability to quantify and monitor pain is modest and typically accomplished through subjective self-report. Since pain is associated with stereotypical physiological alterations, there is potential for non-invasive, objective pain measurements through biosensors coupled with machine learning algorithms. In the current study, a physiological dataset associated with acute pain induction in healthy adults was leveraged to develop an algorithm capable of detecting pain in real-time and in natural field environments. Forty-one human subjects were exposed to acute pain through the cold pressor test while being monitored using electrocardiography. A series of respiratory and heart rate variability features in the time, frequency, and nonlinear domains were calculated and used to develop logistic regression classifiers of pain for two scenarios: (1) laboratory/clinical use with an F1 score of 81.9% and (2) field/ambulatory use with an F1 score of 79.4%. The resulting pain algorithms could be leveraged to quantify acute pain using data from a range of sources, such as ECG data in clinical settings or pulse plethysmography data in a growing number of consumer wearables. Given the high prevalence of pain worldwide and the lack of objective methods to quantify it, this approach has the potential to identify and better mitigate individual pain.
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22
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Decision Making and Fibromyalgia: A Systematic Review. Brain Sci 2022; 12:brainsci12111452. [DOI: 10.3390/brainsci12111452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Decision making (DM) is the ability to choose among multiple options, considering external and internal variables and identifying potential paths of action that need to be assessed. Some brain areas involved in decision making are also implicated in pain processing, such as in fibromyalgia (FM). FM is a syndrome characterized by chronic widespread musculoskeletal pain and cognitive difficulties. We conducted a systematic review with the aim of identifying articles that evaluated DM in people with fibromyalgia, highlighting the main assessment tools. This work was conducted according to the PRISMA statement by consulting six online databases and providing a quality assessment of each search that met the inclusion criteria. In line with the limited interest in this in the scientific landscape to date, we found nine studies that evaluated the performance of DM in patients with FM; furthermore, we discovered that only certain types of DM were tested. The importance of our work lies in shedding light on a cognitive ability that is often undervalued in the scientific landscape but essential in everyday life. This review can serve as a starting point for further studies to clarify the relationship between DM and FM, improving understanding of the topic.
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Liu X, Xu Z, Fu X, Liu Y, Jia H, Yang Z, Zhang J, Wei S, Duan X. Stable, long-term single-neuronal recording from the rat spinal cord with flexible carbon nanotube fiber electrodes. J Neural Eng 2022; 19. [DOI: 10.1088/1741-2552/ac9258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 09/15/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. Flexible implantable electrodes enable months-long stable recording of single-unit signals from rat brains. Despite extensive efforts in the development of flexible probes for brain recording, thus far there are no conclusions on their application in long-term single neuronal recording from the spinal cord which is more mechanically active. To this end, we realized the chronic recording of single-unit signals from the spinal cord of freely-moving rats using flexible carbon nanotube fiber (CNTF) electrodes. Approach. We developed flexible CNTF electrodes for intraspinal recording. Continuous in vivo impedance monitoring and histology studies were conducted to explore the critical factors determining the longevity of the recording, as well as to illustrate the evolution of the electrode-tissue interface. Gait analysis were performed to evaluate the biosafety of the chronic intraspinal implantation of the CNTF electrodes. Main results. By increasing the insulation thickness of the CNTF electrodes, single-unit signals were continuously recorded from the spinal cord of freely-moving rats without electrode repositioning for 3-4 months. Single neuronal and local field potential activities in response to somatic mechanical stimulation were successfully recorded from the spinal dorsal horns. Histological data demonstrated the ability of the CNTF microelectrodes to form an improved intraspinal interfaces with greatly reduced gliosis compared to their stiff metal counterparts. Continuous impedance monitoring suggested that the longevity of the intraspinal recording with CNTF electrodes was determined by the insulation durability. Gait analysis showed that the chronic presence of the CNTF electrodes caused no noticeable locomotor deficits in rats. Significance. It was found that the chronic recording from the spinal cord faces more stringent requirements on the electrode structural durability than recording from the brain. The stable, long-term intraspinal recording provides unique capabilities for studying the physiological functions of the spinal cord relating to motor, sensation, and autonomic control in both health and disease.
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Viseux FJF, Simoneau M, Billot M. A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060812. [PMID: 35744075 PMCID: PMC9230450 DOI: 10.3390/medicina58060812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control.
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Affiliation(s)
- Frédéric J. F. Viseux
- Centre d’Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France
- Département Sciences de l’Homme et du Vivant (SHV), Université Polytechnique Hauts-de-France (UPHF), LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
- Correspondence:
| | - Martin Simoneau
- Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC G1V 0A6, Canada;
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) du CIUSSS de la Capitale Nationale, Québec, QC G1M 2S8, Canada
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, F-86000 Poitiers, France;
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Chae Y, Park HJ, Lee IS. Pain modalities in the body and brain: Current knowledge and future perspectives. Neurosci Biobehav Rev 2022; 139:104744. [PMID: 35716877 DOI: 10.1016/j.neubiorev.2022.104744] [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: 03/18/2022] [Revised: 05/29/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022]
Abstract
Development and validation of pain biomarkers has become a major issue in pain research. Recent advances in multimodal data acquisition have allowed researchers to gather multivariate and multilevel whole-body measurements in patients with pain conditions, and data analysis techniques such as machine learning have led to novel findings in neural biomarkers for pain. Most studies have focused on the development of a biomarker to predict the severity of pain with high precision and high specificity, however, a similar approach to discriminate different modalities of pain is lacking. Identification of more accurate and specific pain biomarkers will require an in-depth understanding of the modality specificity of pain. In this review, we summarize early and recent findings on the modality specificity of pain in the brain, with a focus on distinct neural activity patterns between chronic clinical and acute experimental pain, direct, social, and vicarious pain, and somatic and visceral pain. We also suggest future directions to improve our current strategy of pain management using our knowledge of modality-specific aspects of pain.
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Affiliation(s)
- Younbyoung Chae
- College of Korean Medicine, Kyung Hee University, Seoul, the Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, the Republic of Korea
| | - Hi-Joon Park
- College of Korean Medicine, Kyung Hee University, Seoul, the Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, the Republic of Korea
| | - In-Seon Lee
- College of Korean Medicine, Kyung Hee University, Seoul, the Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, the Republic of Korea.
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26
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Pidoux L, Delanoe K, Barbier J, Marchand F, Lingueglia E, Deval E. Single Subcutaneous Injection of Lysophosphatidyl-Choline Evokes ASIC3-Dependent Increases of Spinal Dorsal Horn Neuron Activity. Front Mol Neurosci 2022; 15:880651. [PMID: 35774865 PMCID: PMC9239072 DOI: 10.3389/fnmol.2022.880651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/05/2022] [Indexed: 11/24/2022] Open
Abstract
Lysophosphatidyl-choline (LPC), a member of the phospholipid family, is an emerging player in pain. It is known to modulate different pain-related ion channels, including Acid-Sensing Ion Channel 3 (ASIC3), a cationic channel mainly expressed in peripheral sensory neurons. LPC potentiates ASIC3 current evoked by mild acidifications, but can also activate the channel at physiological pH. Very recently, LPC has been associated to chronic pain in patients suffering from fibromyalgia or osteoarthritis. Accordingly, repetitive injections of LPC within mouse muscle or joint generate both persistent pain-like and anxiety-like behaviors in an ASIC3-dependent manner. LPC has also been reported to generate acute pain behaviors when injected intraplantarly in rodents. Here, we explore the mechanism of action of a single cutaneous injection of LPC by studying its effects on spinal dorsal horn neurons. We combine pharmacological, molecular and functional approaches including in vitro patch clamp recordings and in vivo recordings of spinal neuronal activity. We show that a single cutaneous injection of LPC exclusively affects the nociceptive pathway, inducing an ASIC3-dependent sensitization of nociceptive fibers that leads to hyperexcitabilities of both high threshold (HT) and wide dynamic range (WDR) spinal neurons. ASIC3 is involved in LPC-induced increase of WDR neuron’s windup as well as in WDR and HT neuron’s mechanical hypersensitivity, and it participates, together with TRPV1, to HT neuron’s thermal hypersensitivity. The nociceptive input induced by a single LPC cutaneous rather induces short-term sensitization, contrary to previously described injections in muscle and joint. If the effects of peripheral LPC on nociceptive pathways appear to mainly depend on peripheral ASIC3 channels, their consequences on pain may also depend on the tissue injected. Our findings contribute to a better understanding of the nociceptive signaling pathway activated by peripheral LPC via ASIC3 channels, which is an important step regarding the ASIC3-dependent roles of this phospholipid in acute and chronic pain conditions.
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Affiliation(s)
- Ludivine Pidoux
- Université Côte d’Azur, CNRS, IPMC, LabEx ICST, FHU InovPain, Valbonne, France
| | - Kevin Delanoe
- Université Côte d’Azur, CNRS, IPMC, LabEx ICST, FHU InovPain, Valbonne, France
| | - Julie Barbier
- Université Clermont Auvergne, Inserm U1107 Neuro-Dol, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France
| | - Fabien Marchand
- Université Clermont Auvergne, Inserm U1107 Neuro-Dol, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France
| | - Eric Lingueglia
- Université Côte d’Azur, CNRS, IPMC, LabEx ICST, FHU InovPain, Valbonne, France
| | - Emmanuel Deval
- Université Côte d’Azur, CNRS, IPMC, LabEx ICST, FHU InovPain, Valbonne, France
- *Correspondence: Emmanuel Deval,
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Quirion B, Beaulieu C, Côté L, Parent JL, Gendron L. Distribution of delta and mu opioid receptor mRNA in rodent dorsal root ganglia neurons. Eur J Neurosci 2022; 56:4031-4044. [PMID: 35674691 PMCID: PMC9543299 DOI: 10.1111/ejn.15733] [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: 09/15/2021] [Revised: 05/24/2022] [Accepted: 06/02/2022] [Indexed: 12/01/2022]
Abstract
Primary afferents are responsible for transmitting signals produced by noxious stimuli from the periphery to the spinal cord. Mu and delta opioid receptors (MOP and DOP) have analgesic properties and are highly expressed in dorsal root ganglia (DRG) neurons. In humans, spinal DOP is almost exclusively located on central terminals of DRG neurons, whereas in rodents, it is expressed both on presynaptic terminals and spinal neurons. In this study, we aimed to assess the distribution of MOP and DOP in the DRGs of mice and rats. Using in situ hybridization and immunofluorescence, we visualized MOP and DOP mRNA together with various neuronal markers. In rats and mice, we show that both receptors are expressed, albeit to different extents, in all types of neurons, namely, large and medium myelinated neurons (NF200-positive), small nonpeptidergic (IB4- or P2X3R-positive) and peptidergic C fibres (Tac1-positive). Overall, DOP mRNA was found to be mainly expressed in large and medium myelinated neurons, whereas MOP mRNA was mainly found in C fibres. The distribution of MOP and DOP, however, slightly differs between rats and mice, with a higher proportion of small nonpeptidergic C fibres expressing DOP mRNA in mice than in rats. We further found that neither morphine nor inflammation affected the distribution of the receptor mRNA. Because of their location, our results confirm that MOP and DOP have the potential to alleviate similar types of pain and that this effect could slightly differ between species.
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Affiliation(s)
- Béatrice Quirion
- Département de Pharmacologie-Physiologie, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Claudie Beaulieu
- Département de Pharmacologie-Physiologie, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Laurie Côté
- Département de Pharmacologie-Physiologie, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Département de Médecine, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Luc Parent
- Département de Médecine, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis Gendron
- Département de Pharmacologie-Physiologie, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Quebec Pain Research Network
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28
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First-order Layer in Artificial Pain Pathway. Neural Process Lett 2022. [DOI: 10.1007/s11063-022-10884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractThe neural mechanisms involved in pain perception consist of a pathway which carry signals from the periphery to the cerebral cortex. First-order pain neurons transduce the potentially damaging stimuli detected by the sensorial extremes into long-ranging electrical signals that are transmitted to higher order neurons where the organisation is more heterarchical, especially in the cerebral cortex. However, the first order neurones, as their name states, have a degree of branching which clearly identifies them as hierarchical elements in the arrangement of pain pathway. This research aims to develop an artificial neural pain pathway that mimics this biological process, in particular the first order neurones. First, the research proposes the periodogram method on the condition monitoring data with a minor malfunction and operational damage. As the pain is associated with actual or potential tissue damage, using such data from a machinery system can provide insights which can be used to improve the computational effectiveness. Then, a one-dimensional convolutional neural network model is introduced to represent the second and third orders of the pain pathway. The research findings found clear support for studying the similarities between the major components of biological information processing of tissue damage and statistical signal processing for damage estimation.
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29
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Kohoutová L, Atlas LY, Büchel C, Buhle JT, Geuter S, Jepma M, Koban L, Krishnan A, Lee DH, Lee S, Roy M, Schafer SM, Schmidt L, Wager TD, Woo CW. Individual variability in brain representations of pain. Nat Neurosci 2022; 25:749-759. [PMID: 35637368 PMCID: PMC9435464 DOI: 10.1038/s41593-022-01081-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 04/22/2022] [Indexed: 01/22/2023]
Abstract
Characterizing cerebral contributions to individual variability in pain processing is crucial for personalized pain medicine, but has yet to be done. In the present study, we address this problem by identifying brain regions with high versus low interindividual variability in their relationship with pain. We trained idiographic pain-predictive models with 13 single-trial functional MRI datasets (n = 404, discovery set) and quantified voxel-level importance for individualized pain prediction. With 21 regions identified as important pain predictors, we examined the interindividual variability of local pain-predictive weights in these regions. Higher-order transmodal regions, such as ventromedial and ventrolateral prefrontal cortices, showed larger individual variability, whereas unimodal regions, such as somatomotor cortices, showed more stable pain representations across individuals. We replicated this result in an independent dataset (n = 124). Overall, our study identifies cerebral sources of individual differences in pain processing, providing potential targets for personalized assessment and treatment of pain.
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Affiliation(s)
- Lada Kohoutová
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Jason T Buhle
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Stephan Geuter
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Marieke Jepma
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Leonie Koban
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM, CNRS, Sorbonne University, Paris, France
| | - Anjali Krishnan
- Department of Psychology, Brooklyn College of the City University of New York, New York, NY, USA
| | - Dong Hee Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Sungwoo Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Mathieu Roy
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Scott M Schafer
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Liane Schmidt
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM, CNRS, Sorbonne University, Paris, France
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea.
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea.
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30
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Dedek A, Hildebrand ME. Advances and Barriers in Understanding Presynaptic N-Methyl-D-Aspartate Receptors in Spinal Pain Processing. Front Mol Neurosci 2022; 15:864502. [PMID: 35431805 PMCID: PMC9008455 DOI: 10.3389/fnmol.2022.864502] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/04/2022] [Indexed: 12/16/2022] Open
Abstract
For decades, N-methyl-D-aspartate (NMDA) receptors have been known to play a critical role in the modulation of both acute and chronic pain. Of particular interest are NMDA receptors expressed in the superficial dorsal horn (SDH) of the spinal cord, which houses the nociceptive processing circuits of the spinal cord. In the SDH, NMDA receptors undergo potentiation and increases in the trafficking of receptors to the synapse, both of which contribute to increases in excitability and plastic increases in nociceptive output from the SDH to the brain. Research efforts have primarily focused on postsynaptic NMDA receptors, despite findings that presynaptic NMDA receptors can undergo similar plastic changes to their postsynaptic counterparts. Recent technological advances have been pivotal in the discovery of mechanisms of plastic changes in presynaptic NMDA receptors within the SDH. Here, we highlight these recent advances in the understanding of presynaptic NMDA receptor physiology and their modulation in models of chronic pain. We discuss the role of specific NMDA receptor subunits in presynaptic membranes of nociceptive afferents and local SDH interneurons, including their modulation across pain modalities. Furthermore, we discuss how barriers such as lack of sex-inclusive research and differences in neurodevelopmental timepoints have complicated investigations into the roles of NMDA receptors in pathological pain states. A more complete understanding of presynaptic NMDA receptor function and modulation across pain states is needed to shed light on potential new therapeutic treatments for chronic pain.
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Affiliation(s)
- Annemarie Dedek
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
- Neuroscience Department, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Michael E. Hildebrand
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
- Neuroscience Department, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- *Correspondence: Michael E. Hildebrand,
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31
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Di Domenico H, Beaume JB, Peyrard A, Samozino P, Bowen M, Hintzy F, Millet GP, Hayes M, Lapole T, Rupp T. Neuromuscular fatigability during repeated sprints assessed with an innovative cycle ergometer. Eur J Appl Physiol 2022; 122:1189-1204. [PMID: 35212845 DOI: 10.1007/s00421-021-04871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/07/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Repeated sprint ability is an integral component of team sports. This study aimed to evaluate fatigability development and its aetiology during and immediately after a cycle repeated sprint exercise performed until a given fatigability threshold. METHODS On an innovative cycle ergometer, 16 healthy males completed an RSE (10-s sprint/28-s recovery) until task failure (TF): a 30% decrease in sprint mean power (Pmean). Isometric maximum voluntary contraction of the quadriceps (IMVC), central alterations [voluntary activation (VA)], and peripheral alterations [twitch (Pt)] were evaluated before (pre), immediately after each sprint (post), at TF and 3 min after. Sprints were expressed as a percentage of the total number of sprints to TF (TSTF). Individual data were extrapolated at 20, 40, 60, and 80% TSTF. RESULTS Participants completed 9.7 ± 4.2 sprints before reaching a 30% decrease in Pmean. Post-sprint IMVCs were decreased from pre to 60% TSTF and then plateaued (pre: 345 ± 56 N, 60% 247 ± 55 N, TF: 233 ± 57 N, p < 0.001). Pt decreased from 20% and plateaued after 40% TSTF (p < 0.001, pre-TF = - 45 ± 13%). VA was not significantly affected by repeated sprints until 60% TSTF (pre-TF = - 6.5 ± 8.2%, p = 0.036). Unlike peripheral parameters, VA recovered within 3 min (p = 0.042). CONCLUSION During an RSE, Pmean and IMVC decreases were first concomitant to peripheral alterations up to 40% TSTF and central alterations was only observed in the second part of the test, while peripheral alterations plateaued. The distinct recovery kinetics in central versus peripheral components of fatigability further confirm the necessity to reduce traditional delays in neuromuscular fatigue assessment post-exercise.
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Affiliation(s)
- H Di Domenico
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France
| | - J B Beaume
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France
| | - A Peyrard
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France
| | - P Samozino
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France
| | - M Bowen
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France
| | - F Hintzy
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France
| | - G P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - M Hayes
- Environmental Extremes Laboratory, School of Sport and Health Sciences, University of Brighton, Eastbourne, UK
| | - T Lapole
- Inter-University Laboratory of Human Movement Sciences, Univ Lyon, UJM-Saint-Etienne, EA 7424, 42023, Saint-Étienne, France
| | - Thomas Rupp
- Inter-University Laboratory of Human Movement Sciences, Univ Savoie Mont-Blanc, EA 7424, Chambéry, France.
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32
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Impaired visceral pain-related functions of the midbrain periaqueductal gray in rats with colitis. Brain Res Bull 2022; 182:12-25. [DOI: 10.1016/j.brainresbull.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/12/2022] [Accepted: 02/03/2022] [Indexed: 11/18/2022]
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33
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Yang NN, Tan CX, Lin LL, Su XT, Li YJ, Qi LY, Wang Y, Yang JW, Liu CZ. Potential Mechanisms of Acupuncture for Functional Dyspepsia Based on Pathophysiology. Front Neurosci 2022; 15:781215. [PMID: 35145373 PMCID: PMC8822151 DOI: 10.3389/fnins.2021.781215] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Functional dyspepsia (FD), a common disorder of gastrointestinal function, originated from the gastroduodenum. Although the therapeutic effect of acupuncture has been investigated by various high-quality randomized controlled trials, the potential mechanisms showed obvious heterogeneity. This review summarized the potential mechanisms of acupuncture on FD in order to guide for future laboratory and clinical studies. Here, we argued that the primary cause of FD was gastroduodenal low-grade inflammation and acid exposure, which impaired mucosal integrity, caused brain-gut axis dysfunction, and impaired brain network connectivity, all of which generated various symptom patterns. Overall the clinical studies indicated that acupuncture was a promising treatment to alleviate symptoms in FD patients, whose efficacy was influenced by acupoints and individual variance. Mechanistically, studies with animal models of FD and patients have shown that acupuncture, a non-invasive strategy for nerve stimulation, may have the potential to control intestinal inflammation and suppress acid-secretion via different somatic autonomic reflex pathways, regulate the brain-gut axis through intestinal microbiota, and has the potential to ameliorate FD-symptoms. The cumulative evidence demonstrated that acupuncture is a promising treatment to alleviate symptoms of FD patients.
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Choo YJ, Kwak SG, Chang MC. Effectiveness of Repetitive Transcranial Magnetic Stimulation on Managing Fibromyalgia: A Systematic Meta-Analysis. PAIN MEDICINE 2022; 23:1272-1282. [PMID: 34983056 DOI: 10.1093/pm/pnab354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 12/25/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE In fibromyalgia, central sensitization is a key mechanism, and repetitive transcranial magnetic stimulation (rTMS) has been reported to potentially manage symptoms of fibromyalgia. In this meta-analysis, we evaluated the therapeutic effect of rTMS in patients with fibromyalgia according to stimulation locations and follow-up time points. METHODS We searched the MEDLINE, Cochrane, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases for articles published from January 1, 1990 to August 26, 2021, including randomized controlled studies investigating the effectiveness of rTMS on managing fibromyalgia. RESULTS In total, 10 papers and 299 participants were included. The high-frequency rTMS on the left primary motor cortex (Lt. M1) had a significant effect on pain reduction immediately and 1-4 weeks after the end of the session but had no significant effect after 5-12 weeks. Additionally, after high-frequency rTMS sessions on the Lt. M1, the effect on patients' quality of life (QoL) appeared late at 5-12 weeks of follow-up. In contrast, high-frequency rTMS on the left dorsolateral prefrontal cortex (Lt. DLPFC) did not reduce pain from fibromyalgia. The effect on controlling the affective problem was not observed after rTMS treatment on both the Lt. M1 and Lt. DLPFC. CONCLUSIONS High-frequency rTMS had a positive pain-reducing effect immediately and at 1-4 weeks after completing the rTMS sessions, and the patients' QoL improved after 5-12 weeks. However, Lt. DLPFC stimulation was not effective in controlling fibromyalgia symptoms.
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Affiliation(s)
- Yoo Jin Choo
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
| | - Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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35
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Alfaro-Rodriguez A, Cortes-Altamirano J, Reyes-Long S, Bandala C, Morraz-Varela A, Bonilla-Jaime H. Neuropathic Pain in Parkinson's Disease. Neurol India 2022; 70:1879-1886. [DOI: 10.4103/0028-3886.359257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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36
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Lukas P, Gerdle B, Nilsson L, Wodlin NB, Fredrikson M, Arendt-Nielsen L, Kjølhede P. Association Between Experimental Pain Thresholds and Trajectories of Postoperative Recovery Measures After Benign Hysterectomy. J Pain Res 2022; 15:3657-3674. [PMID: 36447527 PMCID: PMC9701515 DOI: 10.2147/jpr.s383795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Quantitative sensory testing (QST) can be applied to quantify the sensitivity to different painful stimuli. This study aims to evaluate the association between preoperative pressure and thermal pain thresholds and trajectories of measurements of postoperative recovery (patient-reported daily maximum and average pain intensity, sum score of symptoms, and analgesic consumption) after benign hysterectomy. Patients and Methods A prospective, longitudinal single-blinded, observational multicenter study was conducted in five hospitals in the southeast of Sweden between 2011 and 2017. A total of 406 women scheduled for abdominal or vaginal hysterectomy for benign conditions were enrolled in the study. QST measuring pressure (PPT), heat (HPT), and cold pain thresholds (CPT) were performed preoperatively. The cut-off levels for dichotomizing the pain thresholds (low/high) were set at the 25-percentile for PPT and HPT and the 75-percentile for CPT. The Swedish Postoperative Symptom Questionnaire was used to measure postoperative pain and other symptoms of discomfort (symptom sum score) on 13 occasions for six weeks postoperatively. Daily analgesic consumption of opioids and non-opioids was registered. Results A CPT above the 75-percentile was associated with high postoperative maximum pain intensity (p = 0.04), high symptom sum score (p = 0.03) and greater consumption of non-opioids (p = 0.03). A HPT below the 25-percentile was only associated with greater consumption of non-opioids (p = 0.02). PPT was not associated with any of the outcome measures. Conclusion CPT seemed to be predictive for postoperative pain and symptoms of discomfort after benign hysterectomy. Preoperative QST may be used to individualize the management of postoperative recovery for low pain threshold individuals.
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Affiliation(s)
- Peter Lukas
- Department of Obstetrics and Gynecology in Linköping, and Department of Biomedical and Clinical Sciences, Faculty of Medicine Health Sciences, Linköping University, Linköping, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Faculty of Medicine Health Sciences, Linköping University, Linköping, Sweden
| | - Lena Nilsson
- Department of Anesthesiology and Intensive Care in Linköping, and Department of Biomedical and Clinical Sciences, Faculty of Medicine Health Sciences, Linköping University, Linköping, Sweden
| | - Ninnie Borendal Wodlin
- Department of Obstetrics and Gynecology in Linköping, and Department of Biomedical and Clinical Sciences, Faculty of Medicine Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Forum Östergötland, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.,Occupational and Environmental Medicine, Department of Experimental and Clinical Medicine, Faculty of Medicine Health Sciences, Linköping University, Linköping, Sweden
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Medical Gastroenterology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology in Linköping, and Department of Biomedical and Clinical Sciences, Faculty of Medicine Health Sciences, Linköping University, Linköping, Sweden
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Verdugo RJ, Matamala JM, Inui K, Kakigi R, Valls-Solé J, Hansson P, Bernhard Nilsen K, Lombardi R, Lauria G, Petropoulos IN, Malik RA, Treede RD, Baumgärtner U, Jara PA, Campero M. Review of techniques useful for the assessment of sensory small fiber neuropathies: Report from an IFCN expert group. Clin Neurophysiol 2022; 136:13-38. [DOI: 10.1016/j.clinph.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/09/2023]
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38
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Beyond the Raskin Protocol: Ketamine, Lidocaine, and Other Therapies for Refractory Chronic Migraine. Curr Pain Headache Rep 2021; 25:77. [PMID: 34894295 PMCID: PMC8665315 DOI: 10.1007/s11916-021-00992-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 10/31/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the available evidence and therapeutic considerations for intravenous drug therapy for refractory chronic migraine. RECENT FINDINGS In carefully monitored settings, the inpatient administration of intravenous lidocaine and ketamine can be successful in treating refractory chronic migraine. Many patients with refractory chronic migraine have experienced treatment failure with the Raskin protocol. The use of aggressive inpatient infusion therapy consisting of intravenous lidocaine or ketamine, along with other adjunctive medications, has become increasingly common for these patients when all other treatments have failed. There is a clear need for prospective studies in this population comprised of patients who have largely been excluded from other studies.
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Dai W, Liu RH, Qiu E, Liu Y, Chen Z, Chen X, Ao R, Zhuo M, Yu S. Cortical mechanisms in migraine. Mol Pain 2021; 17:17448069211050246. [PMID: 34806494 PMCID: PMC8606910 DOI: 10.1177/17448069211050246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Migraine is the second most prevalent disorder in the world; yet, its underlying mechanisms are still poorly understood. Cumulative studies have revealed pivotal roles of cerebral cortex in the initiation, propagation, and termination of migraine attacks as well as the interictal phase. Investigation of basic mechanisms of the cortex in migraine not only brings insight into the underlying pathophysiology but also provides the basis for designing novel treatments. We aim to summarize the current research literatures and give a brief overview of the cortex and its role in migraine, including the basic structure and function; structural, functional, and biochemical neuroimaging; migraine-related genes; and theories related to cortex in migraine pathophysiology. We propose that long-term plasticity of synaptic transmission in the cortex encodes migraine.
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Affiliation(s)
- Wei Dai
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Ren-Hao Liu
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, 12480Xi'an Jiaotong University, Xi'an, China
| | - Enchao Qiu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Yinglu Liu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Zhiye Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Ran Ao
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Min Zhuo
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, 12480Xi'an Jiaotong University, Xi'an, China.,International Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Department of Physiology, 1 King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
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40
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Lütolf R, Rosner J, Curt A, Hubli M. Identifying Discomplete Spinal Lesions: New Evidence from Pain-Autonomic Interaction in Spinal Cord Injury. J Neurotrauma 2021; 38:3456-3466. [PMID: 34806429 DOI: 10.1089/neu.2021.0280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The clinical evaluation of spinal afferents is an important diagnostic and prognostic marker for neurological and functional recovery after spinal cord injury (SCI). Particularly important regarding neuropathic pain following SCI is the function of the spinothalamic tract (STT) conveying nociceptive and temperature information. Here, we investigated the added value of neurophysiological methods revealing discomplete STT lesions; that is, residual axonal sparing in clinically complete STT lesions. Specifically, clinical pinprick testing and thermal thresholds were compared with objective contact heat-evoked potentials (CHEPs) and a novel measure of pain-autonomic interaction employing heat-induced sympathetic skin responses (SSR). The test stimuli (i.e., contact heat, pinprick) were applied below the lesion level in 32 subjects with thoracic SCI while corresponding heat-evoked responses (i.e., CHEPs and SSR) were recorded above the lesion (i.e., scalp and hand, respectively). Readouts of STT function were related to neuropathic pain characteristics. In subjects with abolished pinprick sensation, measures of thermosensation (10%), CHEPs (33%), and SSR (48%) revealed residual STT function. Importantly, SSRs can be used as an objective readout and when abolished, no other proxy indicated residual STT function. No relationship was found between STT function readouts and spontaneous neuropathic pain intensity and extent. However, subjects with clinically preserved STT function presented more often with allodynia (54%) than subjects with discomplete (13%) or complete STT lesions (18%). In individuals with absent pinprick sensation, discomplete STT lesions can be revealed employing pain-autonomic measures. The improved sensitivity to discerning STT lesion completeness might support the investigation of its association with neuropathic pain following SCI.
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Affiliation(s)
- Robin Lütolf
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jan Rosner
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Department of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Armin Curt
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Michèle Hubli
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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Khaleghzadeh-Ahangar H, Khandan S, Khosravi S. Intraventricular insulin adjacent to the arcuate nucleus reduced the formalin-induced pain through dorsal raphe nucleus opioid receptors in the STZ-induced diabetic rats. Behav Brain Res 2021; 418:113662. [PMID: 34774584 DOI: 10.1016/j.bbr.2021.113662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022]
Abstract
Diabetes mellitus is one of the diseases that affect nociception. In type 1 diabetes, the insulin release declines. One of the regions that respond to insulin and have insulin receptors is the hypothalamus, especially the arcuate nucleus. This hypothalamic nucleus has proopiomelanocortin (POMC)-containing neurons that affect the pain endogenous modulatory pathways such as dorsal raphe nucleus (DR) via releasing endorphins. So it was tried to investigate the influence of insulin within the arcuate nucleus with/without DR opioid receptors blockade on the nociception in the formalin test paradigm. In the present study, the role of different doses of insulin (2, 10, and 50 mIU/0.5 µl saline) within the arcuate nucleus was investigated via formalin test in type 1 (STZ-induced) diabetic rats. To perform the formalin test, 50 µl of formalin 2.5% was injected subcutaneously (s.c.) into the right palm. The behavior of the animal after the stimulation of pain receptors by s.c. formalin injection was scored from 0 (no distinguished pain) to 3 (the most nociception and highest pain score). Insulin within the arcuate nucleus diminished the nociception in formalin-induced paw in the STZ-induced diabetic rats. Intra-DR naloxone 0.2 µg/0.5 µl saline prevented this analgesia. A possible suggested mechanism for this observation is that insulin reinforces the POMC and endorphin release from the arcuate nucleus and decreases pain through DR.
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Affiliation(s)
- Hossein Khaleghzadeh-Ahangar
- Department of Physiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran; Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Shaghayegh Khandan
- Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Saeideh Khosravi
- Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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42
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Williamson TK, Rodriguez HC, Gonzaba A, Poddar N, Norwood SM, Gupta A. H-Wave ® Device Stimulation: A Critical Review. J Pers Med 2021; 11:jpm11111134. [PMID: 34834486 PMCID: PMC8619115 DOI: 10.3390/jpm11111134] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/30/2022] Open
Abstract
Pain treatments have historically centered on drugs, but an “opioid crisis” has necessitated new standards of care, with a paradigm shift towards multi-modal pain management emphasizing early movement, non-narcotics, and various adjunctive therapies. Electrotherapies remain understudied and most lack high-quality clinical trials, despite a desperate need for effective adjunctive options. A systematic search of human clinical studies on H-Wave® device stimulation (HWDS) was conducted as well as a comprehensive review of articles articulating possible HWDS mechanisms of action. Studies unrelated to H-Wave were excluded. Data synthesis summarizes outcomes and study designs, categorized as pre-clinical or clinical. Pre-clinical studies demonstrated that HWDS utilizes a biphasic waveform to induce non-fatiguing muscle contractions which positively affect nerve function, blood and lymph flow. Multiple clinical studies have reported significant benefits for diabetic and non-specific neuropathic pain, where function also improved, and pain medication usage substantially dropped. In conclusion, low- to moderate-quality HWDS studies have reported reduced pain, restored functionality, and lower medication use in a variety of disorders, although higher-quality research is needed to verify condition-specific applicability. HWDS has enough reasonable evidence to be considered as an adjunctive component of non-opioid multi-modal pain management, given its excellent safety profile and relative low cost. Level of Evidence: III.
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Affiliation(s)
- Tyler K. Williamson
- University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX 78209, USA;
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, NY 10016, USA
| | - Hugo C. Rodriguez
- Department of Orthopaedic Surgery, Holy Cross Orthopedic Institute, Fort Lauderdale, FL 33334, USA;
| | - Andrew Gonzaba
- Ross University School of Medicine, Miramar, FL 33027, USA;
| | - Neil Poddar
- Future Biologics, Lawrenceville, GA 30043, USA;
| | | | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
- Correspondence:
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Lactoferrin and Its Potential Impact for the Relief of Pain: A Preclinical Approach. Pharmaceuticals (Basel) 2021; 14:ph14090868. [PMID: 34577568 PMCID: PMC8468947 DOI: 10.3390/ph14090868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/21/2021] [Accepted: 08/25/2021] [Indexed: 02/08/2023] Open
Abstract
Pain is one of the most disabling symptoms of several clinical conditions. Neurobiologically, it is classified as nociceptive, inflammatory, neuropathic and dysfunctional. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are conventionally prescribed for the treatment of pain. Long-term administration of opioids results in the loss of analgesic efficacy, leading to increased dosage, tolerance, and addiction as the main drawbacks of their use, while the adverse effects of NSAIDs include gastric ulcer formation, intestinal bleeding, acute kidney injury, and hepatotoxicity. Lactoferrin is an iron-binding, anti-inflammatory glycoprotein that displays analgesic activities associated, in part, by interacting with the low-density lipoprotein receptor-related protein (LRP), which may result in the regulation of the DAMP-TRAF6-NFκB, NO-cGMP-ATP K+-sensitive channel and opioid receptor signaling pathways. This review summarizes and discusses for the first time the analgesic effects of lactoferrin and its presumable mechanisms based on pre-clinical trials. Given its anti-nociceptive and anti-inflammatory properties, lactoferrin may be used as an adjunct to enhance the efficacy and to decrease the tolerogenic effects of canonical therapeutic drugs prescribed for pain treatment.
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44
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Gregus AM, Levine IS, Eddinger KA, Yaksh TL, Buczynski MW. Sex differences in neuroimmune and glial mechanisms of pain. Pain 2021; 162:2186-2200. [PMID: 34256379 PMCID: PMC8277970 DOI: 10.1097/j.pain.0000000000002215] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
ABSTRACT Pain is the primary motivation for seeking medical care. Although pain may subside as inflammation resolves or an injury heals, it is increasingly evident that persistency of the pain state can occur with significant regularity. Chronic pain requires aggressive management to minimize its physiological consequences and diminish its impact on quality of life. Although opioids commonly are prescribed for intractable pain, concerns regarding reduced efficacy, as well as risks of tolerance and dependence, misuse, diversion, and overdose mortality rates limit their utility. Advances in development of nonopioid interventions hinge on our appreciation of underlying mechanisms of pain hypersensitivity. For instance, the contributory role of immunity and the associated presence of autoimmune syndromes has become of particular interest. Males and females exhibit fundamental differences in innate and adaptive immune responses, some of which are present throughout life, whereas others manifest with reproductive maturation. In general, the incidence of chronic pain conditions, particularly those with likely autoimmune covariates, is significantly higher in women. Accordingly, evidence is now accruing in support of neuroimmune interactions driving sex differences in the development and maintenance of pain hypersensitivity and chronicity. This review highlights known sexual dimorphisms of neuroimmune signaling in pain states modeled in rodents, which may yield potential high-value sex-specific targets to inform future analgesic drug discovery efforts.
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Affiliation(s)
- Ann M Gregus
- School of Neuroscience, Virginia Polytechnic and State University, Blacksburg, VA, United States
| | - Ian S Levine
- School of Neuroscience, Virginia Polytechnic and State University, Blacksburg, VA, United States
| | | | - Tony L Yaksh
- Departments of Anesthesiology and
- Pharmacology, University of California San Diego, La Jolla, CA, United States
| | - Matthew W Buczynski
- School of Neuroscience, Virginia Polytechnic and State University, Blacksburg, VA, United States
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45
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Chen Z, Dai W, Chen X, Liu M, Ma L, Yu S. Voxel-based quantitative susceptibility mapping revealed increased cerebral iron over the whole brain in chronic migraine. Mol Pain 2021; 17:17448069211020894. [PMID: 34056969 PMCID: PMC8168017 DOI: 10.1177/17448069211020894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The previous documents demonstrated that iron deposition was identified in brain deep nuclei and periaqueductal gray matter region in chronic migraine (CM), and less is known about the cerebral iron deposition in CM. The aim of this study is to investigate the cerebral iron deposition in CM using an advanced voxel-based quantitative susceptibility mapping. Methods A multi-echo gradient echo MR sequence was obtained from 14 CM patients and 28 normal controls (NC), and quantitative susceptibility mapping images were reconstructed and voxel-based analysis was performed over the whole cerebrum. The susceptibility value of all the positive brain regions was extracted and correlation was calculated between the susceptibility value and the clinical variables. Results The brain regions with increased susceptibility value in CM patients located in right precuneus, insula, supramarginal gyrus, dorsolateral superior frontal gyrus, postcentral gyrus, cuneus and left postcentral gyrus compared with NC. The correlation analysis demonstrated that a positive correlation was identified between susceptibility value of all the positive brain regions and VAS score. Conclusion The current study demonstrated increased cerebral iron deposition presented in chronic patients, which suggested that increased cerebral iron deposition might play a role in the migraine chronicization.
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Affiliation(s)
- Zhiye Chen
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Wei Dai
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoyan Chen
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mengqi Liu
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China.,Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lin Ma
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
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46
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Huang J, Zhang Z, Gambeta E, Chen L, Zamponi GW. An orbitofrontal cortex to midbrain projection modulates hypersensitivity after peripheral nerve injury. Cell Rep 2021; 35:109033. [PMID: 33910011 DOI: 10.1016/j.celrep.2021.109033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 02/01/2021] [Accepted: 04/02/2021] [Indexed: 12/28/2022] Open
Abstract
Neuropathic pain is a debilitating condition that is often refractory to treatment. The network of neural substrates for pain transmission and control within the brain is complex and remains poorly understood. Through a combination of neuronal tracing, optogenetics, chemogenetics, electrophysiological recordings, and behavioral assessment, we demonstrate that activation of layer 5 pyramidal neurons in the ventrolateral orbitofrontal cortex (vlOFC) attenuates mechanical and thermal hypersensitivity and cold allodynia in mice with neuropathic pain induced by spared nerve injury (SNI). These vlOFC output neurons project to the posterior ventrolateral periaqueductal gray (vlPAG) region and receive inputs from the ventromedial thalamus (VM). Specific optogenetic and chemogenetic activation of the vlOFC-vlPAG and the VM-vlOFC circuits inhibits hypersensitivity associated with neuropathy. Thus, we reveal a modulatory role of the vlOFC and its projections to the vlPAG circuit in the processing of hypersensitive nociception.
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Affiliation(s)
- Junting Huang
- Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong 510080, China; Department of Physiology and Pharmacology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Zizhen Zhang
- Department of Physiology and Pharmacology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Eder Gambeta
- Department of Physiology and Pharmacology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Lina Chen
- Department of Physiology and Pharmacology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Gerald W Zamponi
- Department of Physiology and Pharmacology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
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47
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Uran C, Giojelli A. A "sneaky" symptom of aortic dissection. Brief literature review, physiopathology and diagnostic tools management. Monaldi Arch Chest Dis 2021; 91. [PMID: 33792232 DOI: 10.4081/monaldi.2021.1662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
Aortic diseases cover a large spectrum of conditions, such as aortic aneurysm and acute aortic syndromes (i.e., dissections, intramural hematoma, penetrating atherosclerotic ulcer, traumatic aortic injuries, and pseudoaneurysms), genetic diseases (e.g., Marfan syndrome) and congenital abnormalities, such as coarctation of the aorta. These conditions may have an acute presentation; thus, if the acute aortic syndrome is the first sign of the disease, the prognosis is extremely poor. Prompt diagnosis and timely therapy are therefore mandatory. In this paper, we discuss a deceptive symptom of painless aortic dissection and its physiopathology. Furthermore, we briefly review the literature and discuss the management of diagnostic tools.
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Affiliation(s)
- Carlo Uran
- Cardiology and Intensive Care Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy.
| | - Angela Giojelli
- Diagnostic Imaging Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy.
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Draguhn A, Mallatt JM, Robinson DG. Anesthetics and plants: no pain, no brain, and therefore no consciousness. PROTOPLASMA 2021; 258:239-248. [PMID: 32880005 PMCID: PMC7907021 DOI: 10.1007/s00709-020-01550-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/26/2020] [Indexed: 05/05/2023]
Abstract
Plants have a rich variety of interactions with their environment, including adaptive responses mediated by electrical signaling. This has prompted claims that information processing in plants is similar to that in animals and, hence, that plants are conscious, intelligent organisms. In several recent reports, the facts that general anesthetics cause plants to lose their sensory responses and behaviors have been taken as support for such beliefs. These lipophilic substances, however, alter multiple molecular, cellular, and systemic functions in almost every organism. In humans and other animals with complex brains, they eliminate the experience of pain and disrupt consciousness. The question therefore arises: do plants feel pain and have consciousness? In this review, we discuss what can be learned from the effects of anesthetics in plants. For this, we describe the mechanisms and structural prerequisites for pain sensations in animals and show that plants lack the neural anatomy and all behaviors that would indicate pain. By explaining the ubiquitous and diverse effects of anesthetics, we discuss whether these substances provide any empirical or logical evidence for "plant consciousness" and whether it makes sense to study the effects of anesthetics on plants for this purpose. In both cases, the answer is a resounding no.
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Affiliation(s)
- Andreas Draguhn
- Institute for Physiology and Pathophysiology, Medical Faculty, University of Heidelberg, 69120, Heidelberg, Germany
| | - Jon M Mallatt
- The University of Washington WWAMI Medical Education Program, The University of Idaho, Moscow, ID, 83844, USA
| | - David G Robinson
- Centre for Organismal Studies, University of Heidelberg, Im Neuenheimer Feld 230, D-69120, Heidelberg, Germany.
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Fatigue development and perceived response during self-paced endurance exercise: state-of-the-art review. Eur J Appl Physiol 2021. [PMID: 33389141 DOI: 10.1007/s00421-020-04549-] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Performance in self-paced endurance exercises results from continuous fatigue symptom management. While it is suggested that perceived responses and neuromuscular fatigue development may determine variations in exercise intensity, it is uncertain how these fatigue components interact throughout the task. To address the fatigue development in self-paced endurance exercises, the following topics were addressed in the present review: (1) fatigue development during constant-load vs. self-paced endurance exercises; (2) central and peripheral fatigue and perceived exertion interconnections throughout the self-paced endurance exercises; and (3) future directions and recommendations. Based on the available literature, it is suggested (1) the work rate variations during a self-paced endurance exercise result in transitions between exercise intensity domains, directly impacting the end-exercise central and peripheral fatigue level when compared to constant-load exercise mode; (2) central and peripheral fatigue, as well as perceived exertion response contribute to exercise intensity regulation at the different stages of the trial. It seems that while neuromuscular fatigue development might be relevant at beginning of the trial, the perceived exertion might interfere in the remaining parts to achieve maximal values only at the finish line; (3) future studies should focus on the mechanisms underpinning fatigue components interactions throughout the task and its influence on exercise intensity variations.
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50
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Azevedo RDA, Silva-Cavalcante MD, Lima-Silva AE, Bertuzzi R. Fatigue development and perceived response during self-paced endurance exercise: state-of-the-art review. Eur J Appl Physiol 2021; 121:687-696. [PMID: 33389141 DOI: 10.1007/s00421-020-04549-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Abstract
Performance in self-paced endurance exercises results from continuous fatigue symptom management. While it is suggested that perceived responses and neuromuscular fatigue development may determine variations in exercise intensity, it is uncertain how these fatigue components interact throughout the task. To address the fatigue development in self-paced endurance exercises, the following topics were addressed in the present review: (1) fatigue development during constant-load vs. self-paced endurance exercises; (2) central and peripheral fatigue and perceived exertion interconnections throughout the self-paced endurance exercises; and (3) future directions and recommendations. Based on the available literature, it is suggested (1) the work rate variations during a self-paced endurance exercise result in transitions between exercise intensity domains, directly impacting the end-exercise central and peripheral fatigue level when compared to constant-load exercise mode; (2) central and peripheral fatigue, as well as perceived exertion response contribute to exercise intensity regulation at the different stages of the trial. It seems that while neuromuscular fatigue development might be relevant at beginning of the trial, the perceived exertion might interfere in the remaining parts to achieve maximal values only at the finish line; (3) future studies should focus on the mechanisms underpinning fatigue components interactions throughout the task and its influence on exercise intensity variations.
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Affiliation(s)
- Rafael de Almeida Azevedo
- Endurance Sports Research Group (GEDAE-USP), School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65 - Cidade Universitária, São Paulo, SP, 05508-030, Brazil
| | - Marcos David Silva-Cavalcante
- Endurance Sports Research Group (GEDAE-USP), School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65 - Cidade Universitária, São Paulo, SP, 05508-030, Brazil.,Sport Science Research Group, Post-Graduation Program Nutrition, Physical Activity and Phenotypic Plasticity, Academic Center of Vitoria, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Adriano Eduardo Lima-Silva
- Human Performance Research Group, Federal University of Technology - Parana (UTFPR), Curitiba, Parana, Brazil
| | - Romulo Bertuzzi
- Endurance Sports Research Group (GEDAE-USP), School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65 - Cidade Universitária, São Paulo, SP, 05508-030, Brazil.
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