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Uragami S, Osumi M, Sumitani M, Fuyuki M, Igawa Y, Iki S, Koga M, Tanaka Y, Sato G, Morioka S. Prognosis of Pain After Stroke During Rehabilitation Depends on the Pain Quality. Phys Ther 2024; 104:pzae055. [PMID: 38567849 DOI: 10.1093/ptj/pzae055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 04/01/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE Pain after a stroke interferes with daily life and the rehabilitation process. This study aimed to clarify the prognosis of pain in subgroups of patients with pain after a stroke using pain quality data. METHODS The study included 85 patients with pain after stroke undergoing exercise-based rehabilitation. Items of the Neuropathic Pain Symptom Inventory (NPSI) were used, and patients with pain after stroke were clustered according to their scores of NPSI. Other clinical assessments, such as physical and psychological conditions, were assessed by interviews and questionnaires, and then these were compared among subgroups in a cross-sectional analysis. Longitudinal pain intensity in each subgroup was recorded during 12 weeks after the stroke and the patients' pain prognoses were compared between subgroups. RESULTS Four distinct subgroups were clustered: cluster 1 (cold-evoked pain and tingling), cluster 2 (tingling only), cluster 3 (pressure-evoked pain), and cluster 4 (deep muscle pain with a squeezing and pressure sensation). The cross-sectional analysis showed varying clinical symptoms among the subgroups, with differences in the prevalence of joint pain, limited range of motion, somatosensory dysfunction, and allodynia. There were no significant differences in pain intensity at baseline among the subgroups. A longitudinal analysis showed divergent prognoses of pain intensity among the subgroups. The pain intensity in cluster 4 was significantly alleviated, which suggested that musculoskeletal pain could be reduced with conventional exercise-based rehabilitation. However, the pain intensity of patients in clusters 1 and 2 remained over 12 weeks. CONCLUSION The study classified patients into clinically meaningful subgroups using pain quality data and provided insight into their prognosis of pain. The findings could be useful for guiding personalized rehabilitation strategies for pain management. IMPACT Assessment of pain quality in patients with pain after stroke leads to personalized rehabilitation for pain management.
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Affiliation(s)
- Shinji Uragami
- Graduate School of Health Science, Kio University, Nara, Japan
- Department of Rehabilitation, Hoshigaoka Medical Center, Osaka, Japan
| | - Michihiro Osumi
- Graduate School of Health Science, Kio University, Nara, Japan
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Masahiko Sumitani
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masanori Fuyuki
- Graduate School of Health Science, Kio University, Nara, Japan
| | - Yuki Igawa
- Graduate School of Health Science, Kio University, Nara, Japan
| | - Shinya Iki
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Kawaguchi Neurosurgery Rehabilitation Clinic, Osaka, Japan
| | - Masayuki Koga
- Graduate School of Health Science, Kio University, Nara, Japan
| | - Yoichi Tanaka
- School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan
| | - Gosuke Sato
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Shu Morioka
- Graduate School of Health Science, Kio University, Nara, Japan
- Neurorehabilitation Research Center, Kio University, Nara, Japan
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Rajamanickam G, Lee ATH, Liao P. Role of Brain Derived Neurotrophic Factor and Related Therapeutic Strategies in Central Post-Stroke Pain. Neurochem Res 2024:10.1007/s11064-024-04175-z. [PMID: 38856889 DOI: 10.1007/s11064-024-04175-z] [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: 02/05/2024] [Revised: 04/08/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
Brain-derived neurotrophic factor (BDNF) is vital for synaptic plasticity, cell persistence, and neuronal development in peripheral and central nervous systems (CNS). Numerous intracellular signalling pathways involving BDNF are well recognized to affect neurogenesis, synaptic function, cell viability, and cognitive function, which in turn affects pathological and physiological aspects of neurons. Stroke has a significant psycho-socioeconomic impact globally. Central post-stroke pain (CPSP), also known as a type of chronic neuropathic pain, is caused by injury to the CNS following a stroke, specifically damage to the somatosensory system. BDNF regulates a broad range of functions directly or via its biologically active isoforms, regulating multiple signalling pathways through interactions with different types of receptors. BDNF has been shown to play a major role in facilitating neuroplasticity during post-stroke recovery and a pro-nociceptive role in pain development in the nervous system. BDNF-tyrosine kinase receptors B (TrkB) pathway promotes neurite outgrowth, neurogenesis, and the prevention of apoptosis, which helps in stroke recovery. Meanwhile, BDNF overexpression plays a role in CPSP via the activation of purinergic receptors P2X4R and P2X7R. The neuronal hyperexcitability that causes CPSP is linked with BDNF-TrkB interactions, changes in ion channels and inflammatory reactions. This review provides an overview of BDNF synthesis, interactions with certain receptors, and potential functions in regulating signalling pathways associated with stroke and CPSP. The pathophysiological mechanisms underlying CPSP, the role of BDNF in CPSP, and the challenges and current treatment strategies targeting BDNF are also discussed.
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Affiliation(s)
- Gayathri Rajamanickam
- Calcium Signalling Laboratory, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Andy Thiam Huat Lee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Ping Liao
- Calcium Signalling Laboratory, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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3
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Guo F, Lin SD, Du Y, Hu TT, Wang Y, Chen Z, Zhang SH. Secondary somatosensory cortex glutamatergic innervation of the thalamus facilitates pain. Pain 2024; 165:1142-1153. [PMID: 38112733 DOI: 10.1097/j.pain.0000000000003117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/27/2023] [Indexed: 12/21/2023]
Abstract
ABSTRACT Although the secondary somatosensory cortex (SII) is known to be involved in pain perception, its role in pain modulation and neuropathic pain is yet unknown. In this study, we found that glutamatergic neurons in deep layers of the SII (SII Glu ) responded to bilateral sensory inputs by changing their firing with most being inhibited by contralateral noxious stimulation. Optical inhibition and activation of unilateral SII Glu reduced and enhanced bilateral nociceptive sensitivity, respectively, without affecting mood status. Tracing experiments revealed that SII Glu sent dense monosynaptic projections to the posterolateral nucleus (VPL) and the posterior nucleus (Po) of the thalamus. Optical inhibition and activation of projection terminals of SII Glu in the unilateral VPL and Po inhibited and facilitated pain on the contralateral side, respectively. After partial sciatic nerve ligation, SII Glu became hyperactive as evidenced by higher frequency of spontaneous firing, but the response patterns to peripheral stimulation remained. Optical inhibition of SII Glu alleviated not only bilateral mechanical allodynia and thermal hyperalgesia but also the negative affect associated with spontaneous pain. Inhibition of SII Glu terminals in the VPL and Po also relieved neuropathic pain. This study revealed that SII Glu and the circuits to the VPL and Po constitute a part of the endogenous pain modulatory network. These corticothalamic circuits became hyperactive after peripheral nerve injury, hence contributes to neuropathic pain. These results justify proper inhibition of SII Glu and associated neural circuits as a potential clinical strategy for neuropathic pain treatment.
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Affiliation(s)
- Fang Guo
- Department of Pharmacology and Department of Anesthesiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shi-Da Lin
- Department of Pharmacology and Department of Anesthesiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Du
- Department of Pharmacology and Department of Anesthesiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ting-Ting Hu
- Department of Pharmacology and Department of Anesthesiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhong Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shi-Hong Zhang
- Department of Pharmacology and Department of Anesthesiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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4
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Kollenburg L, Kurt E, Arnts H, Vinke S. Cingulotomy: the last man standing in the battle against medically refractory poststroke pain. Pain Rep 2024; 9:e1149. [PMID: 38529477 PMCID: PMC10962879 DOI: 10.1097/pr9.0000000000001149] [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: 10/21/2023] [Revised: 12/29/2023] [Accepted: 01/20/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Central poststroke pain (CPSP) places a huge burden on patient lives because patients are often refractory to conventional strategies and have little chance for spontaneous recovery. A subset of patients is even given approval for euthanasia and is without any perspective. Because the anterior cingulate cortex historically seems to be a promising target for patients with both mental and chronic pain disorders, lesioning of this central "hub" with cingulotomy may be a useful strategy for medically refractory CPSP. However, limited research is available on cingulotomy for central pain. Hence, we represent a rare case in which cingulotomy is performed on a patient with CPSP. Objectives To describe the potential of cingulotomy in a case with CPSP. Methods The case presented in this study concerns a 60-year-old woman who experienced CPSP, caused by a hemorrhagic stroke in the basal ganglia and thalamus. The patient visited several centers and tried multiple off-label treatments; however, she was told nothing else could be done and was even given approval for euthanasia. Hence, anterior cingulotomy was performed. Results After surgery, no transient adverse events occurred, except for vocabulary disturbances post stroke, which disappeared after several weeks. After 14 weeks, changes in pain behavior were observed, followed by a decreased pain intensity. At a later follow-up, the pain had completely disappeared. Conclusion Anterior cingulotomy seems to be a suitable "last-resort" option for patients with CPSP. Future research, including homogenous groups, to define the best location for lesioning is required to allow the revival of this "old" technique in the current era.
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Affiliation(s)
- Linda Kollenburg
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erkan Kurt
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hisse Arnts
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saman Vinke
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Center for Brain, Cognition and Behaviour, Department of Neurosurgery
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Matsuda S, Igawa Y, Uchisawa H, Iki S, Osumi M. Thermal Grill Illusion in Post-Stroke Patients: Analysis of Clinical Features and Lesion Areas. J Pain Res 2023; 16:3895-3904. [PMID: 38026455 PMCID: PMC10656876 DOI: 10.2147/jpr.s433309] [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: 08/03/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose In the thermal grill illusion, participants experience a feeling similar to burning pain. The illusion is induced by simultaneously touching warm and cool stimuli in alternating positions. In post-stroke pain, central sensitization is caused by a variety of factors, including damage to the spinothalamic tract and shoulder pain. Because the thermal grill illusion depends on central mechanisms, it has recently been suggested that it may be a useful indicator of central sensitization. Therefore, we hypothesized that post-stroke patients who are more likely to experience central sensitization may also be more likely to experience a thermal grill sensation of pain and discomfort than the likelihood among those who are less likely to experience central sensitization. However, the effects of the thermal grill illusion in post-stroke patients have not yet been reported. In this pilot study, we conducted the thermal grill illusion procedure in post-stroke patients and analyzed the relationship between clinical somatosensory functions and thermal grill sensations. We also conducted brain imaging analysis to identify brain lesion areas that were associated with thermal grill sensations. Patients and Methods Twenty patients (65.7 ± 11.9 years old) with post-stroke patients participated in this study. The thermal grill illusion procedure was performed as follows: patients simultaneously touched eight water-filled copper bars, with the water temperature adjusted to provide alternate warm (40°C) and cold (20°C) stimuli. Results Thermal grill sensation of pain and discomfort tended to be associated with the wind-up phenomenon in bedside quantitative sensory testing and thermal grill sensation of discomfort was also related to damage to the thalamic lateral nucleus. Conclusion These findings suggest that the thermal grill illusion might measure central sensitization, and that secondary brain hyperactivity might lead to increased thermal grill sensations.
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Affiliation(s)
| | - Yuki Igawa
- Graduate School of Health Sciences, Kio University, Nara, Japan
- Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Hidekazu Uchisawa
- Graduate School of Health Sciences, Kio University, Nara, Japan
- Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Shinya Iki
- Department of Rehabilitation, Kawaguchi Neurosurgery Rehabilitation Clinic, Osaka, Japan
| | - Michihiro Osumi
- Graduate School of Health Sciences, Kio University, Nara, Japan
- Neurorehabilitation Research Center, Kio University, Nara, Japan
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6
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Liang T, Chen XF, Yang Y, Yang F, Yu Y, Yang F, Wang XL, Wang JL, Sun W, Chen J. Secondary damage and neuroinflammation in the spinal dorsal horn mediate post-thalamic hemorrhagic stroke pain hypersensitivity: SDF1-CXCR4 signaling mediation. Front Mol Neurosci 2022; 15:911476. [PMID: 36034499 PMCID: PMC9416701 DOI: 10.3389/fnmol.2022.911476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Central post-stroke pain (CPSP) is an intractable neuropathic pain, which can be caused by primary lesion of central somatosensory system. It is also a common sequelae of the thalamic hemorrhagic stroke (THS). So far, the underlying mechanisms of CPSP remain largely unknown. Our previous studies have demonstrated that SDF1-CXCR4 signaling in the hemorrhagic region contributes to the maintenance of the THS pain hypersensitivity via mediation of the thalamic neuroinflammation. But whether the spinal dorsal horn, an initial point of spinothalamic tract (STT), suffers from retrograde axonal degeneration from the THS region is still unknown. In this study, neuronal degeneration and loss in the spinal dorsal horn were detected 7 days after the THS caused by intra-thalamic collagenase (ITC) injection by immunohistochemistry, TUNEL staining, electron microscopy, and extracellular multi-electrode array (MEA) recordings, suggesting the occurrence of secondary apoptosis and death of the STT projecting neuronal cell bodies following primary THS via retrograde axonal degeneration. This retrograde degeneration was accompanied by secondary neuroinflammation characterized by an activation of microglial and astrocytic cells and upregulation of SDF1-CXCR4 signaling in the spinal dorsal horn. As a consequence, central sensitization was detected by extracellular MEA recordings of the spinal dorsal horn neurons, characterized by hyperexcitability of both wide dynamic range and nociceptive specific neurons to suprathreshold mechanical stimuli. Finally, it was shown that suppression of spinal neuroinflammation by intrathecal administration of inhibitors of microglia (minocycline) and astrocytes (fluorocitrate) and antagonist of CXCR4 (AMD3100) could block the increase in expression levels of Iba-1, GFAP, SDF1, and CXCR4 proteins in the dorsal spinal cord and ameliorate the THS-induced bilateral mechanical pain hypersensitivity, implicating that, besides the primary damage at the thalamus, spinal secondary damage and neuroinflammation also play the important roles in maintaining the central post-THS pain hypersensitivity. In conclusion, secondary neuronal death and neuroinflammation in the spinal dorsal horn can be induced by primary thalamic neural damage via retrograde axonal degeneration process. SDF1-CXCR4 signaling is involved in the mediation of secondary spinal neuroinflammation and THS pain hypersensitivity. This finding would provide a new therapeutic target for treatment of CPSP at the spinal level.
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Affiliation(s)
- Ting Liang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xue-Feng Chen
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Yan Yang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Fei Yang
- Department of Anesthesiology and Perioperative Medicine, Clinical Medical College (900 Hospital of the Joint Logistic Support Force), Fujian Medical University, Fuzhou, China
| | - Yang Yu
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Fan Yang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Xiao-Liang Wang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Jiang-Lin Wang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Department of Pain Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Wei Sun
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
- Wei Sun,
| | - Jun Chen
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
- *Correspondence: Jun Chen, ,
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7
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Nagasaka K, Takashima I, Matsuda K, Higo N. Pharmacological inactivation of the primate posterior insular/secondary somatosensory cortices attenuates thermal hyperalgesia. Eur J Pain 2022; 26:1723-1731. [PMID: 35762263 DOI: 10.1002/ejp.1996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/21/2022] [Accepted: 06/26/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND We previously established a macaque model of central post-stroke pain (CPSP) and confirmed the involvement of increased activity of the posterior insular cortex (PIC) and secondary somatosensory cortex (SII) to somatosensory stimuli in mechanical allodynia by a combination of imaging techniques with local pharmacological inactivation. However, it is unclear whether the same intervention would be effective for thermal hyperalgesia. Therefore, using the macaque model, we examined behavioral responses to thermal stimuli following pharmacological inactivation of the PIC/SII. METHODS Two CPSP model macaques were established based on collagenase-induced unilateral hemorrhagic lesions in the ventral posterolateral nucleus of the thalamus. To evaluate pain perception, withdrawal latencies to thermal stimuli of 37, 45, 50, 52, and 55 °C to hands were measured. Several weeks after the lesion induction, pharmacological inactivation of the PIC/SII by microinjection of muscimol was performed. The effect of inactivation on withdrawal latency was assessed by comparison with withdrawal latency after vehicle injection. RESULTS Several weeks after induction of the thalamic lesions, both macaques demonstrated a reduction in withdrawal latencies to thermal stimulation (<50 °C) on the contralesional hand, indicating the occurrence of thermal hyperalgesia. When the PIC/SII were inactivated by muscimol, the withdrawal latencies to thermal stimuli of 50 and 52 °C were significantly increased compared to those after vehicle injection. CONCLUSIONS Our data emphasize that increased activity in the PIC/SII after appearance of thalamic lesions can contribute to abnormal pain of multiple modalities, and the modulation of PIC/SII activity may be a therapeutic approach for thermal hyperalgesia.
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Affiliation(s)
- K Nagasaka
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - I Takashima
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - K Matsuda
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan
| | - N Higo
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan
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8
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Meng X, Yue L, Liu A, Tao W, Shi L, Zhao W, Wu Z, Zhang Z, Wang L, Zhang X, Zhou W. Distinct basolateral amygdala excitatory inputs mediate the somatosensory and aversive-affective components of pain. J Biol Chem 2022; 298:102207. [PMID: 35772494 PMCID: PMC9304789 DOI: 10.1016/j.jbc.2022.102207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/03/2022] [Accepted: 06/17/2022] [Indexed: 01/28/2023] Open
Abstract
Pain is a multidimensional perception that includes unpleasant somatosensory and affective experiences; however, the underlying neural circuits that mediate different components of pain remain elusive. Although hyperactivity of basolateral amygdala glutamatergic (BLAGlu) neurons is required for the somatosensory and emotional processing of pain, the precise excitatory inputs to BLAGlu neurons and their roles in mediating different aspects of pain are unclear. Here, we identified two discrete glutamatergic neuronal circuits in male mice: a projection from the insular cortex glutamatergic (ICGlu) to BLAGlu neurons, which modulates both the somatosensory and affective components of pain, and a projection from the mediodorsal thalamic nucleus (MDGlu) to BLAGlu neurons, which modulates only the aversive-affective component of pain. Using whole-cell recording and fiber photometry, we found that neurons within the IC→BLA and MD→BLA pathways were activated in mice upon inflammatory pain induced by injection of complete Freund's adjuvant (CFA) into their paws. Optical inhibition of the ICGlu→BLA pathway increased the nociceptive threshold and induced behavioral place preference in CFA mice. In contrast, optical inhibition of the MDGlu→BLA pathway did not affect the nociceptive threshold but still induced place preference in CFA mice. In normal mice, optical activation of the ICGlu→BLA pathway decreased the nociceptive threshold and induced place aversion, while optical activation of the MDGlu→BLA pathway only evoked aversion. Taken together, our results demonstrate that discrete ICGlu→BLA and MDGlu→BLA pathways are involved in modulating different components of pain, provide insights into its circuit basis, and better our understanding of pain perception.
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Affiliation(s)
- Xiaojing Meng
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Lingxiao Yue
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China; Department of Pathology, Anhui Medical College, Hefei, China
| | - An Liu
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Wenjuan Tao
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Li Shi
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Wan Zhao
- Department of Otolaryngology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Zhongmin Wu
- Department of Anatomy, Medical College of Taizhou University, Taizhou, China
| | - Zhi Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale, CAS Key laboratory of Brain Function and Disease, University of Science and Technology of China, Hefei, China
| | - Liecheng Wang
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.
| | - Xulai Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China.
| | - Wenjie Zhou
- Hefei National Laboratory for Physical Sciences at the Microscale, CAS Key laboratory of Brain Function and Disease, University of Science and Technology of China, Hefei, China.
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9
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Barbosa LM, da Silva VA, de Lima Rodrigues AL, Mendes Fernandes DTR, de Oliveira RAA, Galhardoni R, Yeng LT, Junior JR, Conforto AB, Lucato LT, Lemos MD, Peyron R, Garcia-Larrea L, Teixeira MJ, de Andrade DC. Dissecting central post-stroke pain: a controlled symptom-psychophysical characterization. Brain Commun 2022; 4:fcac090. [PMID: 35528229 PMCID: PMC9070496 DOI: 10.1093/braincomms/fcac090] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/21/2021] [Accepted: 03/31/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Central post-stroke pain affects up to 12% of stroke survivors and is notoriously refractory to treatment. However, stroke patients often suffer from other types of pain of non- neuropathic nature (musculoskeletal, inflammatory, complex regional) and no head-to-head comparison of their respective clinical and somatosensory profiles has been performed so far.
We compared 39 patients with definite central neuropathic post-stroke pain with two matched- control groups: 32 patients with exclusively non-neuropathic pain developed after stroke and 31 stroke patients not complaining of pain. Patients underwent deep phenotyping via a comprehensive assessment including clinical exam, questionnaires and quantitative sensory testing to dissect central post-stroke pain from chronic pain in general and stroke.
While central post-stroke pain was mostly located in the face and limbs, non-neuropathic pain was predominantly axial and located in neck, shoulders and knees (p<0.05). Neuropathic Pain Symptom Inventory clusters burning (82.1%, n=32, p<0.001), tingling (66.7%, n= 26, p<0.001) and evoked by cold (64.1%, n=25, p<0.001) occurred more frequently in central post-stroke pain. Hyperpathia, thermal and mechanical allodynia also occurred more commonly in this group (p<0.001), which also presented higher levels of deafferentation (p<0.012) with more asymmetric cold and warm detection thresholds compared to controls. In particular, cold hypoesthesia (considered when the threshold of the affected side was less than 41% of the contralateral threshold) odds ratio was 12 (95%CI: 3.8-41.6) for neuropathic pain. Additionally, cold detection threshold/ warm detection threshold ratio correlated with the presence of neuropathic pain (ρ=-0.4, p< 0.001). Correlations were found between specific neuropathic pain symptom clusters and quantitative sensory testing: paroxysmal pain with cold (ρ=-0.4; p=0.008) and heat pain thresholds (ρ=0.5; p=0.003), burning pain with mechanical detection (ρ= -0.4; p=0.015) and mechanical pain thresholds (ρ=-0.4, p<0.013), evoked pain with mechanical pain threshold (ρ= -0.3; p=0.047). Logistic regression showed that the combination of cold hypoesthesia on quantitative sensory testing, the Neuropathic Pain Symptom Inventory, and the allodynia intensity on bedside examination explained 77% of the occurrence of neuropathic pain.
These findings provide insights into the clinical-psychophysics relationships in central post-stroke pain and may assist more precise distinction of neuropathic from non-neuropathic post-stroke pain in clinical practice and in future trials.
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Affiliation(s)
| | | | | | | | | | - Ricardo Galhardoni
- Pain Center, Discipline of Neurosurgery HC-FMUSP, LIM-62, University of São Paulo, Brazil
| | - Lin Tchia Yeng
- Pain Center, Discipline of Neurosurgery HC-FMUSP, LIM-62, University of São Paulo, Brazil
| | - Jefferson Rosi Junior
- Pain Center, Discipline of Neurosurgery HC-FMUSP, LIM-62, University of São Paulo, Brazil
| | | | | | - Marcelo Delboni Lemos
- Department of Radiology, LIM-44, University of São Paulo, 05403-900, São Paulo, Brazil
| | - Roland Peyron
- NeuroPain team, Lyon Neuroscience Research Center (CRNL), Inserm U1028, CNRS UMR5292, UCBL1, UJM, F-6900, Lyon, France
| | - Luis Garcia-Larrea
- NeuroPain team, Lyon Neuroscience Research Center (CRNL), Inserm U1028, CNRS UMR5292, UCBL1, UJM, F-6900, Lyon, France
| | - Manoel Jacobsen Teixeira
- Pain Center, Discipline of Neurosurgery HC-FMUSP, LIM-62, University of São Paulo, Brazil
- Department of Neurology, LIM-62, University of São Paulo, 05403-900, São Paulo, Brazil
| | - Daniel Ciampi de Andrade
- Pain Center, Discipline of Neurosurgery HC-FMUSP, LIM-62, University of São Paulo, Brazil
- Center for Neuroplasticity and Pain, Department of Health Sciences and Technology, Faculty of Medicine, Aalborg University, DK-9220, Aalborg, Denmark
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10
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Higo N. Non-human Primate Models to Explore the Adaptive Mechanisms After Stroke. Front Syst Neurosci 2021; 15:760311. [PMID: 34819842 PMCID: PMC8606408 DOI: 10.3389/fnsys.2021.760311] [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] [Received: 08/18/2021] [Accepted: 10/20/2021] [Indexed: 01/15/2023] Open
Abstract
The brain has the ability to reconstruct neural structures and functions to compensate for the brain lesions caused by stroke, although it is highly limited in primates including humans. Animal studies in which experimental lesions were induced in the brain have contributed to the current understanding of the neural mechanisms underlying functional recovery. Here, I have highlighted recent advances in non-human primate models using primate species such as macaques and marmosets, most of which have been developed to study the mechanisms underlying the recovery of motor functions after stroke. Cortical lesion models have been used to investigate motor recovery after lesions to the cortical areas involved in movements of specific body parts. Models of a focal stroke at the posterior internal capsule have also been developed to bridge the gap between the knowledge obtained by cortical lesion models and the development of intervention strategies because the severity and outcome of motor deficits depend on the degree of lesions to the region. This review will also introduce other stroke models designed to study the plastic changes associated with development and recovery from cognitive and sensory impairments. Although further validation and careful interpretation are required, considering the differences between non-human primate brains and human brains, studies using brain-lesioned non-human primates offer promise for improving translational outcomes.
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Affiliation(s)
- Noriyuki Higo
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
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11
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Hirabayashi T, Nagai Y, Hori Y, Inoue KI, Aoki I, Takada M, Suhara T, Higuchi M, Minamimoto T. Chemogenetic sensory fMRI reveals behaviorally relevant bidirectional changes in primate somatosensory network. Neuron 2021; 109:3312-3322.e5. [PMID: 34672984 DOI: 10.1016/j.neuron.2021.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/01/2021] [Accepted: 08/26/2021] [Indexed: 01/28/2023]
Abstract
Concurrent genetic neuromodulation and functional magnetic resonance imaging (fMRI) in primates has provided a valuable opportunity to assess the modified brain-wide operation in the resting state. However, its application to link the network operation with behavior still remains challenging. Here, we combined chemogenetic silencing of the primary somatosensory cortex (SI) with tactile fMRI and related behaviors in macaques. Focal chemogenetic silencing of functionally identified SI hand region impaired grasping behavior. The same silencing also attenuated hand stimulation-evoked fMRI signal at both the local silencing site and the anatomically and/or functionally connected downstream grasping network, suggesting altered network operation underlying the induced behavioral impairment. Furthermore, the hand region silencing unexpectedly disinhibited foot representation with accompanying behavioral hypersensitization. These results demonstrate that focal chemogenetic silencing with sensory fMRI in macaques unveils bidirectional network changes to generate multifaceted behavioral impairments, thereby opening a pivotal window toward elucidating the causal network operation underpinning higher brain functions in primates.
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Affiliation(s)
- Toshiyuki Hirabayashi
- Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan.
| | - Yuji Nagai
- Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan
| | - Yukiko Hori
- Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan
| | - Ken-Ichi Inoue
- Systems Neuroscience Section, Primate Research Institute, Kyoto University, Inuyama, Aichi 484-8506, Japan; PRESTO, Japan Science and Technology Agency, Kawaguchi, Saitama, Japan
| | - Ichio Aoki
- Department of Molecular Imaging and Theranostics, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan
| | - Masahiko Takada
- Systems Neuroscience Section, Primate Research Institute, Kyoto University, Inuyama, Aichi 484-8506, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan
| | - Takafumi Minamimoto
- Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, Chiba, Japan
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12
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Nagasaka K, Nemoto K, Takashima I, Bando D, Matsuda K, Higo N. Structural Plastic Changes of Cortical Gray Matter Revealed by Voxel-Based Morphometry and Histological Analyses in a Monkey Model of Central Post-Stroke Pain. Cereb Cortex 2021; 31:4439-4449. [PMID: 33861857 DOI: 10.1093/cercor/bhab098] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/17/2021] [Accepted: 03/25/2021] [Indexed: 12/16/2022] Open
Abstract
Central post-stroke pain (CPSP) is a chronic pain caused by stroke lesions of somatosensory pathways. Several brain imaging studies among patients with CPSP demonstrate that the pathophysiological mechanism underlying this condition is the maladaptive plasticity of pain-related brain regions. However, the temporal profile of the regional plastic changes, as suggested by brain imaging of CPSP patients, as well as their cellular basis, is unknown. To investigate these issues, we performed voxel-based morphometry (VBM) using T1-weighted magnetic resonance imaging and immunohistochemical analysis with our established CPSP monkey model. From 8 weeks after a hemorrhagic lesion to the unilateral ventral posterolateral nucleus of the thalamus, the monkeys exhibited significant behavioral changes that were interpreted as reflecting allodynia. The present VBM results revealed a decrease in gray matter volume in the pain-related areas after several weeks following the lesion. Furthermore, immunohistochemical staining in the ipsilesional posterior insular cortex (ipsi-PIC) and secondary somatosensory cortex (ipsi-SII), where the significant reduction in gray matter volume was observed in the VBM result, displayed a significant reduction in both excitatory and inhibitory synaptic terminals compared to intact monkeys. Our results suggest that progressive changes in neuronal morphology, including synaptic loss in the ipsi-PIC/SII, are involved in theCPSP.
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Affiliation(s)
- Kazuaki Nagasaka
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki 305-8568, Japan.,Institute for Human Movement and Medical Science, Niigata University of Health and Welfare, Niigata 950-3198, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan
| | - Ichiro Takashima
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki 305-8568, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Daigo Bando
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki 305-8568, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Keiji Matsuda
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki 305-8568, Japan
| | - Noriyuki Higo
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki 305-8568, Japan
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13
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Repetitive transcranial magnetic stimulation restores altered functional connectivity of central poststroke pain model monkeys. Sci Rep 2021; 11:6126. [PMID: 33731766 PMCID: PMC7969937 DOI: 10.1038/s41598-021-85409-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/25/2021] [Indexed: 11/14/2022] Open
Abstract
Central poststroke pain (CPSP) develops after a stroke around the somatosensory pathway. CPSP is hypothesized to be caused by maladaptive reorganization between various brain regions. The treatment for CPSP has not been established; however, repetitive transcranial magnetic stimulation (rTMS) to the primary motor cortex has a clinical effect. To verify the functional reorganization hypothesis for CPSP development and rTMS therapeutic mechanism, we longitudinally pursued the structural and functional changes of the brain by using two male CPSP model monkeys (Macaca fuscata) developed by unilateral hemorrhage in the ventral posterolateral nucleus of the thalamus. Application of rTMS to the ipsilesional primary motor cortex relieved the induced pain of the model monkeys. A tractography analysis revealed a decrease in the structural connectivity in the ipsilesional thalamocortical tract, and rTMS had no effect on the structural connectivity. A region of interest analysis using resting-state functional magnetic resonance imaging revealed inappropriately strengthened functional connectivity between the ipsilesional mediodorsal nucleus of the thalamus and the amygdala, which are regions associated with emotion and memory, suggesting that this may be the cause of CPSP development. Moreover, rTMS normalizes this strengthened connectivity, which may be a possible therapeutic mechanism of rTMS for CPSP.
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14
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Abboud C, Duveau A, Bouali-Benazzouz R, Massé K, Mattar J, Brochoire L, Fossat P, Boué-Grabot E, Hleihel W, Landry M. Animal models of pain: Diversity and benefits. J Neurosci Methods 2020; 348:108997. [PMID: 33188801 DOI: 10.1016/j.jneumeth.2020.108997] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 12/15/2022]
Abstract
Chronic pain is a maladaptive neurological disease that remains a major health problem. A deepening of our knowledge on mechanisms that cause pain is a prerequisite to developing novel treatments. A large variety of animal models of pain has been developed that recapitulate the diverse symptoms of different pain pathologies. These models reproduce different pain phenotypes and remain necessary to examine the multidimensional aspects of pain and understand the cellular and molecular basis underlying pain conditions. In this review, we propose an overview of animal models, from simple organisms to rodents and non-human primates and the specific traits of pain pathologies they model. We present the main behavioral tests for assessing pain and investing the underpinning mechanisms of chronic pathological pain. The validity of animal models is analysed based on their ability to mimic human clinical diseases and to predict treatment outcomes. Refine characterization of pathological phenotypes also requires to consider pain globally using specific procedures dedicated to study emotional comorbidities of pain. We discuss the limitations of pain models when research findings fail to be translated from animal models to human clinics. But we also point to some recent successes in analgesic drug development that highlight strategies for improving the predictive validity of animal models of pain. Finally, we emphasize the importance of using assortments of preclinical pain models to identify pain subtype mechanisms, and to foster the development of better analgesics.
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Affiliation(s)
- Cynthia Abboud
- Univ. Bordeaux, CNRS, Interdisciplinary Institute for Neuroscience, IINS, UMR 5297, F-33000 Bordeaux, France; Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France; Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Lebanon
| | - Alexia Duveau
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Rabia Bouali-Benazzouz
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Karine Massé
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Joseph Mattar
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Lebanon
| | - Louison Brochoire
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Pascal Fossat
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Eric Boué-Grabot
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Walid Hleihel
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Lebanon; Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Lebanon
| | - Marc Landry
- Univ. Bordeaux, CNRS, Institute for Neurodegenerative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France.
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15
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Dezawa S, Nagasaka K, Watanabe Y, Takashima I. Lesions of the nucleus basalis magnocellularis (Meynert) induce enhanced somatosensory responses and tactile hypersensitivity in rats. Exp Neurol 2020; 335:113493. [PMID: 33011194 DOI: 10.1016/j.expneurol.2020.113493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
We used the immunotoxin 192 immunoglobulin G-saporin to produce a selective cholinergic lesion in the nucleus basalis of Meynert (NBM) of rats and investigated whether the NBM lesion led to tactile hypersensitivity in the forepaw. The paw mechanical threshold test showed that the lesioned rats had a decreased threshold compared to the control. Surprisingly, there was a significant positive correlation between mechanical threshold and survival rate of NBM cholinergic neurons. Furthermore, using local field potential (LFP) recordings and voltage-sensitive dye (VSD) imaging, we found that the forepaw-evoked response in the primary somatosensory cortex (S1) was significantly enhanced in both amplitude and spatial extent in the NBM-lesioned rats. The neurophysiological measures of S1 response, such as LFP amplitude and maximal activated cortical area depicted by VSD, were also correlated with withdrawal behavior. Additional pharmacological experiments demonstrated that forepaw-evoked responses were increased in naive rats by blocking S1 cholinergic receptors with mecamylamine and scopolamine, while the response decreased in NBM-lesioned rats with the cholinergic agonist carbachol. In addition, NBM burst stimulation, which facilitates acetylcholine release in the S1, suppressed subsequent sensory responses to forepaw stimulation. Taken together, these results suggest that neuronal loss in the NBM diminishes acetylcholine actions in the S1, thereby enhancing the cortical representation of sensory stimuli, which may in turn lead to behavioral hypersensitivity.
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Affiliation(s)
- Shinnosuke Dezawa
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8568, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Kazuaki Nagasaka
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8568, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata 950-3198, Japan
| | - Yumiko Watanabe
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8568, Japan
| | - Ichiro Takashima
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8568, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8577, Japan.
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