1
|
Chouchou F, Fauchon C, Perchet C, Garcia-Larrea L. An approach to the detection of pain from autonomic and cortical correlates. Clin Neurophysiol 2024; 166:152-165. [PMID: 39178550 DOI: 10.1016/j.clinph.2024.07.018] [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: 04/14/2023] [Revised: 06/04/2024] [Accepted: 07/26/2024] [Indexed: 08/26/2024]
Abstract
OBJECTIVE To assess the value of combining brain and autonomic measures to discriminate the subjective perception of pain from other sensory-cognitive activations. METHODS 20 healthy individuals received 2 types of tonic painful stimulation delivered to the hand: electrical stimuli and immersion in 10 Celsius degree (°C) water, which were contrasted with non-painful immersion in 15 °C water, and stressful cognitive testing. High-density electroencephalography (EEG) and autonomic measures (pupillary, electrodermal and cardiovascular) were continuously recorded, and the accuracy of pain detection based on combinations of electrophysiological features was assessed using machine learning procedures. RESULTS Painful stimuli induced a significant decrease in contralateral EEG alpha power. Cardiac, electrodermal and pupillary reactivities occurred in both painful and stressful conditions. Classification models, trained on leave-one-out cross-validation folds, showed low accuracy (61-73%) of cortical and autonomic features taken independently, while their combination significantly improved accuracy to 93% in individual reports. CONCLUSIONS Changes in cortical oscillations reflecting somatosensory salience and autonomic changes reflecting arousal can be triggered by many activating signals other than pain; conversely, the simultaneous occurrence of somatosensory activation plus strong autonomic arousal has great probability of reflecting pain uniquely. SIGNIFICANCE Combining changes in cortical and autonomic reactivities appears critical to derive accurate indexes of acute pain perception.
Collapse
Affiliation(s)
- F Chouchou
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - Inserm U 1028/CNRS UMR 5292, University of Saint-Etienne, University of Lyon, France; IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France.
| | - C Fauchon
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - Inserm U 1028/CNRS UMR 5292, University of Saint-Etienne, University of Lyon, France; Neuro-Dol, Inserm 1107, University Hospital of Clermont-Ferrand, University of Clermont-Auvergne, Clermont-Ferrand, France
| | - C Perchet
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - Inserm U 1028/CNRS UMR 5292, University of Saint-Etienne, University of Lyon, France
| | - L Garcia-Larrea
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - Inserm U 1028/CNRS UMR 5292, University of Saint-Etienne, University of Lyon, France
| |
Collapse
|
2
|
Quesada C, Fauchon C, Pommier B, Bergandi F, Peyron R, Mertens P, Garcia-Larrea L. Field recordings of transcranial magnetic stimulation in human brain postmortem models. Pain Rep 2024; 9:e1134. [PMID: 38375090 PMCID: PMC10876241 DOI: 10.1097/pr9.0000000000001134] [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: 07/21/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 02/21/2024] Open
Abstract
Introduction The ability of repetitive transcranial magnetic stimulation (rTMS) to deliver a magnetic field (MF) in deep brain targets is debated and poorly documented. Objective To quantify the decay of MF in the human brain. Methods Magnetic field was generated by single pulses of TMS delivered at maximum intensity using a flat or angulated coil. Magnetic field was recorded by a 3D-magnetic probe. Decay was measured in the air using both coils and in the head of 10 postmortem human heads with the flat coil being positioned tangential to the scalp. Magnetic field decay was interpreted as a function of distance to the coil for 6 potential brain targets of noninvasive brain stimulation: the primary motor cortex (M1, mean depth: 28.5 mm), dorsolateral prefrontal cortex (DLPFC: 28 mm), secondary somatosensory cortex (S2: 35.5 mm), posterior and anterior insulae (PI: 38.5 mm; AI: 43.5 mm), and midcingulate cortex (MCC: 57.5 mm). Results In air, the maximal MF intensities at coil center were 0.88 and 0.77 T for the flat and angulated coils, respectively. The maximal intracranial MF intensity in the cadaver model was 0.34 T, with a ∼50% decay at 15 mm and a ∼75% MF decay at 30 mm. The decay of the MF in air was similar for the flat coil and significantly less attenuated with the angulated coil (a ∼50% decay at 20 mm and a ∼75% MF decay at 45 mm). Conclusions Transcranial magnetic stimulation coil MFs decay in brain structures similarly as in air, attenuation with distance being significantly lower with angulated coils. Reaching brain targets deeper than 20 mm such as the insula or Antérior Cingulate Cortex seems feasible only when using angulated coils. The abacus of MF attenuation provided here can be used to adjust modalities of deep brain stimulation with rTMS in future research protocols.
Collapse
Affiliation(s)
- Charles Quesada
- NeuroPain Team, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, UJM & UCBL, Lyon, France
- Physiotherapy Department, Sciences of Rehabilitation Institute (ISTR), University Claude Bernard Lyon 1, Lyon, France
| | - Camille Fauchon
- NeuroPain Team, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, UJM & UCBL, Lyon, France
| | - Benjamin Pommier
- NeuroPain Team, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, UJM & UCBL, Lyon, France
| | - Florian Bergandi
- University of Medecine Jacques Lisfranc, Anatomy Laboratory, UJM, Saint-Etienne, France
| | - Roland Peyron
- NeuroPain Team, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, UJM & UCBL, Lyon, France
- Neurological Department & CETD, University Hospital, CHU Saint-Etienne, Saint-Etienne, France
| | - Patrick Mertens
- NeuroPain Team, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, UJM & UCBL, Lyon, France
- Laboratory of Anatomy, Faculté de Médecine Lyon-est, Université Claude Bernard Lyon 1, Saint-Etienne and Lyon, France
- CETD Neurological Hospital Lyon, Hospices Civils de Lyon, Lyon, France
| | - Luis Garcia-Larrea
- NeuroPain Team, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, UJM & UCBL, Lyon, France
- CETD Neurological Hospital Lyon, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
3
|
Mandonnet V, Obaid S, Descoteaux M, St-Onge E, Devaux B, Levé C, Froelich S, Rheault F, Mandonnet E. Electrostimulation of the white matter of the posterior insula and medial operculum: perception of vibrations, heat, and pain. Pain 2024; 165:565-572. [PMID: 37862047 DOI: 10.1097/j.pain.0000000000003069] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/02/2023] [Indexed: 10/21/2023]
Abstract
ABSTRACT This study aimed to characterize the sensory responses observed when electrically stimulating the white matter surrounding the posterior insula and medial operculum (PIMO). We reviewed patients operated on under awake conditions for a glioma located in the temporoparietal junction. Patients' perceptions were retrieved from operative reports. Stimulation points were registered in the Montreal Neurological Institute template. A total of 12 stimulation points in 8 patients were analyzed. Painful sensations in the contralateral leg were reported (5 sites in 5 patients) when stimulating the white matter close to the parcel OP2/3 of the Glasser atlas. Pain had diverse qualities: burning, tingling, crushing, or electric shock. More laterally, in the white matter of OP1, pain and heat sensations in the upper part of the body were described (5 sites in 2 patients). Intermingled with these sites, vibration sensations were also reported (3 sites in 2 patients). Based on the tractograms of 44 subjects from the Human Connectome Project data set, we built a template of the pathways linking the thalamus to OP2/3 and OP1. Pain sites were located in the thalamo-OP2/3 and thalamo-OP1 tracts. Heat sites were located in the thalamo-OP1 tract. In the 227 awake surgeries performed for a tumor located outside of the PIMO region, no patients ever reported pain or heat sensations when stimulating the white matter. Thus, we propose that the thalamo-PIMO connections constitute the main cortical inputs for nociception and thermoception and emphasize that preserving these fibers is of utmost importance to prevent the postoperative onset of a debilitating insulo-opercular pain syndrome.
Collapse
Affiliation(s)
- Valéry Mandonnet
- Frontlab, Paris Brain Institute, CNRS UMR 7225, INSERM U1127, Paris, France
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| | - Sami Obaid
- Division of Neurosurgery, Department of Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada
- Department of Neurosciences, University of Montreal, Montreal, QC, Canada
- Neuroscience Research Axis, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Imeka Solutions, Sherbrooke, QC, Canada
| | - Etienne St-Onge
- Neuroimaging and Surgical Technologies Laboratory (NIST), Montreal Neurological Institute (MNI), Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Department of Computer Science and Engineering, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
| | - Bertrand Devaux
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| | - Charlotte Levé
- Department of Anesthesiology, Lariboisière Hospital, Paris, France
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| | - François Rheault
- Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Emmanuel Mandonnet
- Frontlab, Paris Brain Institute, CNRS UMR 7225, INSERM U1127, Paris, France
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| |
Collapse
|
4
|
Jafari M, Shaabani M, Hosseini SR, Ashayeri H, Bakhshi E, Haghgoo HA. Modification of cortical electrical activity in stroke survivors with abnormal subjective visual vertical: An eLORETA study. Heliyon 2023; 9:e22194. [PMID: 38027645 PMCID: PMC10661540 DOI: 10.1016/j.heliyon.2023.e22194] [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: 05/31/2022] [Revised: 09/16/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Balance impairment is among the main complications of stroke. The gravity-based subjective vertical (SV) is considered an important reference for upright posture and navigation affected by stroke. The correlation between injury location and pathological perception of verticality remains controversial. This study aimed to evaluate the cortico-cortical network of vertical perception among patients with the right hemisphere stroke and abnormal visual-vertical perception compared with healthy individuals. Materials and methods This observational cross-sectional study included 40 patients with the right hemisphere stroke and 35 healthy participants. All patients had abnormal visual-vertical perception. The EEG connectivity analysis was conducted through the exact low-resolution brain electromagnetic tomography analysis (eLORETA). Results Stroke survivors manifested a power spectral density that reduced within the beta-2 frequency band in the left hemisphere and increased within the beta-3 frequency band in the right hemisphere compared with controls (p < 0.01). The lagged-phase synchronization was increased within alpha-1, beta-2, and beta-3 bands and decreased in stroke survivors compared with controls in the vestibular network involved in visual-vertical perception (p < 0.01). Conclusion The results of this study demonstrated variations in the function and functional connectivity of cortical areas involved in the visual-vertical perception that are mainly located in the vestibular cortex.
Collapse
Affiliation(s)
- Meymaneh Jafari
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Moslem Shaabani
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ruhollah Hosseini
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hassan Ashayeri
- Rehabilitation Research Center, Department of Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Enayatollah Bakhshi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hojjat Allah Haghgoo
- Department of Occupational Therapy. University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
5
|
Rohel A, Desmons M, Leonard G, Desgagnés A, da Silva R, Simoneau M, Mercier C, Massé-Alarie H. The influence of experimental low back pain on neural networks involved in the control of lumbar erector spinae muscles. J Neurophysiol 2022; 127:1593-1605. [PMID: 35608262 DOI: 10.1152/jn.00030.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) often modifies spine motor control, but the neural origin of these motor control changes remains largely unexplored. This study aimed to determine the impact of experimental low back pain on the excitability of cortical, subcortical, and spinal networks involved in the control of back muscles. METHOD Thirty healthy subjects were recruited and allocated to Pain (capsaicin and heat) or Control (heat) groups. Corticospinal excitability (motor-evoked potential-MEP) and intracortical networks were assessed by single- and paired-pulse transcranial magnetic stimulation, respectively. Electrical vestibular stimulation was applied to assess vestibulospinal excitability (vestibular MEP-VMEP), and the stretch reflex for excitability of the spinal or supraspinal loop (R1 and R2, respectively). Evoked back motor responses were measured before, during and after pain induction. Nonparametric rank-based ANOVA determined if pain modulated motor neural networks. RESULTS A decrease of R1 amplitude was present after the pain disappearance (p=0.01) whereas an increase was observed in the control group (p=0.03) compared to the R1 amplitude measured at pre-pain and pre-heat period, respectively (Group x Time interaction - p<0.001). No difference in MEP and VMEP amplitude was present during and after pain (p>0.05). CONCLUSION During experimental LBP, no change in cortical, subcortical, or spinal networks was observed. After pain disappearance, the reduction of the R1 amplitude without modification of MEP and VMEP amplitude suggest a reduction in spinal excitability potentially combined with an increase in descending drives. The absence of effect during pain needs to be further explored.
Collapse
Affiliation(s)
- Antoine Rohel
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Mikaël Desmons
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Guillaume Leonard
- Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Canada
| | - Amélie Desgagnés
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Rubens da Silva
- BioNR Research Lab, Université du Québec à Chicoutimi, Chicoutimi, Quebec, Canada
| | - Martin Simoneau
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Catherine Mercier
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Hugo Massé-Alarie
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| |
Collapse
|
6
|
Loued-Khenissi L, Martin-Brevet S, Schumacher L, Corradi-Dell'Acqua C. The Effect of Uncertainty on Pain Decisions for Self and Others. Eur J Pain 2022; 26:1163-1175. [PMID: 35290697 PMCID: PMC9322544 DOI: 10.1002/ejp.1940] [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] [Indexed: 11/30/2022]
Abstract
Background Estimating others’ pain is a challenging inferential process, associated with a high degree of uncertainty. While much is known about uncertainty’s effect on self‐regarding actions, its impact on other‐regarding decisions for pain have yet to be characterized. Aim The present study exploited models of probabilistic decision‐making to investigate how uncertainty influences the valuation and assessment of another’s pain. Materials & Methods We engaged 63 dyads (43 strangers and 20 romantic couples) in a task where individual choices affected the pain delivered to either oneself (the agent) or the other member of the dyad. At each trial, agents were presented with cues predicting a given pain intensity with an associated probability of occurrence. Agents either chose a sure (mild decrease of pain) or risky (50% chance of avoiding pain altogether) management option, before bidding on their choice. A heat stimulation was then issued to the target (self or other). Decision‐makers were then asked to rate the pain administered to the target. Results We found that the higher the expected pain, the more risk‐averse agents became, in line with findings in value‐based decision‐making. Furthermore, agents gambled less on another individual’s pain (especially strangers) and placed higher bids on pain relief than they did for themselves. Most critically, the uncertainty associated with expected pain dampened ratings made for strangers’ pain. This contrasted with the effect on an agent’s own pain, for which risk had a marginal hyperalgesic effect. Discussion & Conclusion Overall, our results suggested that risk selectively affects decision‐making on a stranger’s suffering, both at the level of assessment and treatment selection, by (1) leading to underestimation, (2) privileging sure options and (3) altruistically allocating more money to insure the treatment’s success. Significance Uncertainty biases decision‐making but it is unclear if it affects choice behavior on pain for others. In examining this question, we found individuals were generally risk‐seeking when faced with looming pain, but more so for self; and assigned higher monetary values and subjective ratings on another’s pain. However, uncertainty dampened agents’ assessment of a stranger’s pain, suggesting latent variables may contradict overt altruism. This bias may underlie pain underestimation in clinical settings.
Collapse
Affiliation(s)
- Leyla Loued-Khenissi
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland.,Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | | | - Luis Schumacher
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland
| | - Corrado Corradi-Dell'Acqua
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland.,Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
| |
Collapse
|
7
|
Ngo TT, Barsdell WN, Law PCF, Arnold CA, Chou MJ, Nunn AK, Brown DJ, Fitzgerald PB, Gibson SJ, Miller SM. Tolerability of caloric vestibular stimulation in a persistent pain cohort. Brain Stimul 2020; 13:1446-1448. [PMID: 32693181 DOI: 10.1016/j.brs.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Trung T Ngo
- UQ Diamantina Institute, University of Queensland Faculty of Medicine & Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia.
| | - Wendy N Barsdell
- Neuropsychology Service, Psychology Department, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Phillip C F Law
- Monash Biomedicine Discovery Institute, Department of Physiology, Monash University, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and the Alfred Hospital, Melbourne, VIC, Australia
| | - Carolyn A Arnold
- Caulfield Pain Management & Research Centre, Caulfield Hospital and Alfred Health, Melbourne, VIC, Australia; Department of Anaesthesia & Perioperative Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael J Chou
- Amputee Clinic, Caulfield Hospital, Melbourne, VIC, Australia
| | - Andrew K Nunn
- Amputee Clinic, Caulfield Hospital, Melbourne, VIC, Australia; Victorian Spinal Cord Service, Austin Health, Melbourne, VIC, Australia; Department of Electrical & Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
| | - Douglas J Brown
- Spinal Research Institute, Austin Health, Melbourne, VIC, Australia
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University, Department of Psychiatry, Melbourne, VIC, Australia
| | - Stephen J Gibson
- Caulfield Pain Management & Research Centre, Caulfield Hospital and Alfred Health, Melbourne, VIC, Australia; National Ageing Research Institute, Melbourne, VIC, Australia
| | - Steven M Miller
- Monash Biomedicine Discovery Institute, Department of Physiology, Monash University, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and the Alfred Hospital, Melbourne, VIC, Australia.
| |
Collapse
|
8
|
Daniel A, Barker L, Martini M. Pain modulation by illusory body rotation: A new way to disclose the interaction between the vestibular system and pain processing. Eur J Pain 2020; 24:1119-1129. [DOI: 10.1002/ejp.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Aster Daniel
- School of Psychology University of East London London UK
| | - Leon Barker
- School of Arts and Digital Industries University of East London London UK
| | - Matteo Martini
- School of Psychology University of East London London UK
| |
Collapse
|