1
|
Graeme-Drury TJ, Worthen SF, Maden M, Raphael JH, Khan S, Vreugdenhil M, Duarte RV. Contact Heat in Magnetoencephalography: A Systematic Review. Can J Neurol Sci 2024; 51:179-186. [PMID: 36803520 DOI: 10.1017/cjn.2023.25] [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: 02/23/2023]
Abstract
BACKGROUND Contact heat is commonly used in experimental research to evoke brain activity, most frequently acquired with electroencephalography (EEG). Although magnetoencephalography (MEG) improves spatial resolution, using some contact heat stimulators with MEG can present methodological challenges. This systematic review assesses studies that utilise contact heat in MEG, their findings and possible directions for further research. METHODS Eight electronic databases were searched for relevant studies, in addition to the selected papers' reference lists, citations and ConnectedPapers maps. Best practice recommendations for systematic reviews were followed. Papers met inclusion criteria if they used MEG to record brain activity in conjunction with contact heat, regardless of stimulator equipment or paradigm. RESULTS Of 646 search results, seven studies met the inclusion criteria. Studies demonstrated effective electromagnetic artefact removal from MEG data, the ability to elicit affective anticipation and differences in deep brain stimulation responders. We identify contact heat stimulus parameters that should be reported in publications to ensure comparisons between data outcomes are consistent. CONCLUSIONS Contact heat is a viable alternative to laser or electrical stimulation in experimental research, and methods exist to successfully mitigate any electromagnetic noise generated by PATHWAY CHEPS equipment - though there is a dearth of literature exploring the post-stimulus time window.
Collapse
Affiliation(s)
| | - Siân F Worthen
- Aston Institute of Health and Neurodevelopment, Birmingham, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group; University of Liverpool, Liverpool, UK
| | - Jon H Raphael
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Salim Khan
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | | | - Rui V Duarte
- Liverpool Reviews and Implementation Group; University of Liverpool, Liverpool, UK
| |
Collapse
|
2
|
Jones SE, Lempka SF, Gopalakrishnan R, Baker KB, Beall EB, Bhattacharyya P, Huang X, Lin J, Chen J, Lowe MJ, Malone DA, Machado AG. Functional Magnetic Resonance Imaging Correlates of Ventral Striatal Deep Brain Stimulation for Poststroke Pain. Neuromodulation 2020; 24:259-264. [PMID: 32744789 DOI: 10.1111/ner.13247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/12/2020] [Accepted: 06/23/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Deep brain stimulation (DBS) for pain has largely been implemented in an uncontrolled manner to target the somatosensory component of pain, with research leading to mixed results. We have previously shown that patients with poststroke pain syndrome who were treated with DBS targeting the ventral striatum/anterior limb of the internal capsule (VS/ALIC) demonstrated a significant improvement in measures related to the affective sphere of pain. In this study, we sought to determine how DBS targeting the VS/ALIC modifies brain activation in response to pain. MATERIALS AND METHODS Five patients with poststroke pain syndrome who were blinded to DBS status (ON/OFF) and six age- and sex-matched healthy controls underwent functional magnetic resonance imaging (fMRI) measuring blood oxygen level-dependent activation in a block design. In this design, each participant received heat stimuli to the affected or unaffected wrist area. Statistical comparisons were performed using fMRI z-maps. RESULTS In response to pain, patients in the DBS OFF state showed significant activation (p < 0.001) in the same regions as healthy controls (thalamus, insula, and operculum) and in additional regions (orbitofrontal and superior convexity cortical areas). DBS significantly reduced activation of these additional regions and introduced foci of significant inhibitory activation (p < 0.001) in the hippocampi when painful stimulation was applied to the affected side. CONCLUSIONS These findings suggest that DBS of the VS/ALIC modulates affective neural networks.
Collapse
Affiliation(s)
- Stephen E Jones
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Scott F Lempka
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Raghavan Gopalakrishnan
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Kenneth B Baker
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Erik B Beall
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Xuemei Huang
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jian Lin
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jacqueline Chen
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mark J Lowe
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Donald A Malone
- Department of Psychiatry, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Andre G Machado
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
3
|
STIPRESOFT: an alternative stimuli presentation software synchronizing with current acquisition systems in EEG experiments. SN APPLIED SCIENCES 2019. [DOI: 10.1007/s42452-019-1683-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
4
|
Vasil'ev YL, Rabinovich SA, Dydykin SS, Toropina GG, Demyanenko SA. [Objective assessment of mental nerve local anesthesia]. STOMATOLOGIIA 2019; 98:99-103. [PMID: 31701937 DOI: 10.17116/stomat20199805199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM To study the reaction of the mental nerve to selective stimulation of thin nerve fibers by thermal stimuli during conduction anesthesia. MATERIAL AND METHOD The pilot study involved 24 healthy volunteers: 13 subjects were injected with a 4% solution of articaine-containing anesthetic with a vasoconstrictor in a ratio of 1:200 000 (pH 4.8-5.4) and 11 subjects - a 3% solution of mepivacaine-containing local anesthetic without a vasoconstrictor (pH value 5.8-6.4). The registration of evoked potentials was performed twice: before local anesthesia and 5 minutes after anesthesia. With the help of disposable carpal dental injectors, local anesthesia was performed near the mental foramen in order to anesthetize the innervation region of the mental nerve through a conductive type. The evoked potentials (VP) were recorded on a Nicolet instrument (USA) with Bravo evoked potentials software. The study of thermal EPs was performed using a Contact heat evoked potential stimulator (CHEPS) device ('Medoc Ltd, Ramat Yishai', Israel). The base and peak temperature were set at 33 and 54 °C, correspondingly. RESULTS The evoked potentials for thermal stimulation demonstrated a significant decrease in the amplitude of all components and the elongation of the LP of the main negative-positive N2-P2 complex after anesthesia compared with the initial thermal EP. The complete disappearance of thermal responses was observed in 14 (58%) of 24 study participants, minor changes were seen in 3 (12.5%) cases only. The total response disappearance was observed in 10 (77%) of 13 participants after articaine and in 3 (27%) of 11 - after mepivacaine (p<0.05), weak changes were registered in 2 (15%) cases in the articaine group and in 1 (9%) case in the mepivacaine group. CONCLUSION A 4% solution of articaine is somewhat more effective for pain relief of teeth and bone since it often causes deeper anesthesia, and a 3% solution of mepivacaine without a vasoconstrictor is physiologically more suitable for working with soft tissues.
Collapse
Affiliation(s)
- Yu L Vasil'ev
- First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - S A Rabinovich
- Moscow State University of Medicine and Dentistry named after A.I. Evdakimov, Moscow, Russia
| | - S S Dydykin
- First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - G G Toropina
- First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - S A Demyanenko
- S.I. Georgievsky Crimean Federal University, Simferopol, Russia
| |
Collapse
|
5
|
Fernández Rodríguez A, de Santiago Rodrigo L, López Guillén E, Rodríguez Ascariz JM, Miguel Jiménez JM, Boquete L. Coding Prony's method in MATLAB and applying it to biomedical signal filtering. BMC Bioinformatics 2018; 19:451. [PMID: 30477444 PMCID: PMC6260881 DOI: 10.1186/s12859-018-2473-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 11/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The response of many biomedical systems can be modelled using a linear combination of damped exponential functions. The approximation parameters, based on equally spaced samples, can be obtained using Prony's method and its variants (e.g. the matrix pencil method). This paper provides a tutorial on the main polynomial Prony and matrix pencil methods and their implementation in MATLAB and analyses how they perform with synthetic and multifocal visual-evoked potential (mfVEP) signals. This paper briefly describes the theoretical basis of four polynomial Prony approximation methods: classic, least squares (LS), total least squares (TLS) and matrix pencil method (MPM). In each of these cases, implementation uses general MATLAB functions. The features of the various options are tested by approximating a set of synthetic mathematical functions and evaluating filtering performance in the Prony domain when applied to mfVEP signals to improve diagnosis of patients with multiple sclerosis (MS). RESULTS The code implemented does not achieve 100%-correct signal approximation and, of the methods tested, LS and MPM perform best. When filtering mfVEP records in the Prony domain, the value of the area under the receiver-operating-characteristic (ROC) curve is 0.7055 compared with 0.6538 obtained with the usual filtering method used for this type of signal (discrete Fourier transform low-pass filter with a cut-off frequency of 35 Hz). CONCLUSIONS This paper reviews Prony's method in relation to signal filtering and approximation, provides the MATLAB code needed to implement the classic, LS, TLS and MPM methods, and tests their performance in biomedical signal filtering and function approximation. It emphasizes the importance of improving the computational methods used to implement the various methods described above.
Collapse
Affiliation(s)
- A Fernández Rodríguez
- Grupo de Ingeniería Biomédica, Departamento de Electrónica, Universidad de Alcalá, Plaza de S. Diego, s/n, 28801, Alcalá de Henares, Spain
| | - L de Santiago Rodrigo
- Grupo de Ingeniería Biomédica, Departamento de Electrónica, Universidad de Alcalá, Plaza de S. Diego, s/n, 28801, Alcalá de Henares, Spain
| | - E López Guillén
- Grupo de Ingeniería Biomédica, Departamento de Electrónica, Universidad de Alcalá, Plaza de S. Diego, s/n, 28801, Alcalá de Henares, Spain
| | - J M Rodríguez Ascariz
- Grupo de Ingeniería Biomédica, Departamento de Electrónica, Universidad de Alcalá, Plaza de S. Diego, s/n, 28801, Alcalá de Henares, Spain
| | - J M Miguel Jiménez
- Grupo de Ingeniería Biomédica, Departamento de Electrónica, Universidad de Alcalá, Plaza de S. Diego, s/n, 28801, Alcalá de Henares, Spain
| | - Luciano Boquete
- Grupo de Ingeniería Biomédica, Departamento de Electrónica, Universidad de Alcalá, Plaza de S. Diego, s/n, 28801, Alcalá de Henares, Spain.
| |
Collapse
|
6
|
Hari R, Baillet S, Barnes G, Burgess R, Forss N, Gross J, Hämäläinen M, Jensen O, Kakigi R, Mauguière F, Nakasato N, Puce A, Romani GL, Schnitzler A, Taulu S. IFCN-endorsed practical guidelines for clinical magnetoencephalography (MEG). Clin Neurophysiol 2018; 129:1720-1747. [PMID: 29724661 PMCID: PMC6045462 DOI: 10.1016/j.clinph.2018.03.042] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/18/2018] [Accepted: 03/24/2018] [Indexed: 12/22/2022]
Abstract
Magnetoencephalography (MEG) records weak magnetic fields outside the human head and thereby provides millisecond-accurate information about neuronal currents supporting human brain function. MEG and electroencephalography (EEG) are closely related complementary methods and should be interpreted together whenever possible. This manuscript covers the basic physical and physiological principles of MEG and discusses the main aspects of state-of-the-art MEG data analysis. We provide guidelines for best practices of patient preparation, stimulus presentation, MEG data collection and analysis, as well as for MEG interpretation in routine clinical examinations. In 2017, about 200 whole-scalp MEG devices were in operation worldwide, many of them located in clinical environments. Yet, the established clinical indications for MEG examinations remain few, mainly restricted to the diagnostics of epilepsy and to preoperative functional evaluation of neurosurgical patients. We are confident that the extensive ongoing basic MEG research indicates potential for the evaluation of neurological and psychiatric syndromes, developmental disorders, and the integrity of cortical brain networks after stroke. Basic and clinical research is, thus, paving way for new clinical applications to be identified by an increasing number of practitioners of MEG.
Collapse
Affiliation(s)
- Riitta Hari
- Department of Art, Aalto University, Helsinki, Finland.
| | - Sylvain Baillet
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Gareth Barnes
- Wellcome Centre for Human Neuroimaging, University College of London, London, UK
| | - Richard Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Nina Forss
- Clinical Neuroscience, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Joachim Gross
- Centre for Cognitive Neuroimaging, University of Glasgow, Glasgow, UK; Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Germany
| | - Matti Hämäläinen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA; NatMEG, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ole Jensen
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Ryusuke Kakigi
- Department of Integrative Physiology, National Institute of Physiological Sciences, Okazaki, Japan
| | - François Mauguière
- Department of Functional Neurology and Epileptology, Neurological Hospital & University of Lyon, Lyon, France
| | | | - Aina Puce
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Gian-Luca Romani
- Department of Neuroscience, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Samu Taulu
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA; Department of Physics, University of Washington, Seattle, WA, USA
| |
Collapse
|
7
|
Khan PF, Sengottuvel S, Patel R, Gireesan K, Baskaran R, Mani A. Design and Implementation of a Discrete-Time Proportional Integral (PI) Controller for the Temperature Control of a Heating Pad. SLAS Technol 2018; 23:614-623. [PMID: 29746801 DOI: 10.1177/2472630318773697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Contact heat evoked potentials (CHEPs) are recorded from the brain by giving thermal stimulations through heating pads kept on the surface of the skin. CHEP signals have crucial diagnostic implications in human pain activation studies. This work proposes a novel design of a digital proportional integral (PI) controller based on Arduino microcontroller with a view to explore the suitability of an electric heating pad for use as a thermode in a custom-made, cost-effective CHEP stimulator. The purpose of PI controller is to set, regulate, and deliver desired temperatures on the surface of the heating pad in a user-defined pattern. The transfer function of the heating system has been deduced using the parametric system identification method, and the design parameters of the controller have been identified using the root locus technique. The efficiency of the proposed PI controller in circumventing the well-known integrator windup problem (error in the integral term builds excessively, leading to large transients in the controller output) in tracking the reference input and the controller effort (CE) in rejecting output disturbances to maintain the set temperature of the heating pad have been found to be superior compared with the conventional PI controller and two of the existing anti-windup models.
Collapse
Affiliation(s)
- Pathan Fayaz Khan
- 1 Condensed Matter Physics Division, Materials Science Group, Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, India
| | - S Sengottuvel
- 1 Condensed Matter Physics Division, Materials Science Group, Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, India
| | - Rajesh Patel
- 1 Condensed Matter Physics Division, Materials Science Group, Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, India
| | - K Gireesan
- 1 Condensed Matter Physics Division, Materials Science Group, Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, India
| | - R Baskaran
- 1 Condensed Matter Physics Division, Materials Science Group, Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, India
| | - Awadhesh Mani
- 1 Condensed Matter Physics Division, Materials Science Group, Indira Gandhi Centre for Atomic Research, Homi Bhabha National Institute, Kalpakkam, India
| |
Collapse
|
8
|
Vinik AI, Casellini C, Névoret ML. Alternative Quantitative Tools in the Assessment of Diabetic Peripheral and Autonomic Neuropathy. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2016; 127:235-85. [PMID: 27133153 DOI: 10.1016/bs.irn.2016.03.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Here we review some seldom-discussed presentations of diabetic neuropathy, including large fiber dysfunction and peripheral autonomic dysfunction, emphasizing the impact of sympathetic/parasympathetic imbalance. Diabetic neuropathy is the most common complication of diabetes and contributes additional risks in the aging adult. Loss of sensory perception, loss of muscle strength, and ataxia or incoordination lead to a risk of falling that is 17-fold greater in the older diabetic compared to their young nondiabetic counterparts. A fall is accompanied by lacerations, tears, fractures, and worst of all, traumatic brain injury, from which more than 60% do not recover. Autonomic neuropathy has been hailed as the "Prophet of Doom" for good reason. It is conducive to increased risk of myocardial infarction and sudden death. An imbalance in the autonomic nervous system occurs early in the evolution of diabetes, at a stage when active intervention can abrogate the otherwise relentless progression. In addition to hypotension, many newly recognized syndromes can be attributed to cardiac autonomic neuropathy such as orthostatic tachycardia and bradycardia. Ultimately, this constellation of features of neuropathy conspire to impede activities of daily living, especially in the patient with pain, anxiety, depression, and sleep disorders. The resulting reduction in quality of life may worsen prognosis and should be routinely evaluated and addressed. Early neuropathy detection can only be achieved by assessment of both large and small- nerve fibers. New noninvasive sudomotor function technologies may play an increasing role in identifying early peripheral and autonomic neuropathy, allowing rapid intervention and potentially reversal of small-fiber loss.
Collapse
Affiliation(s)
- A I Vinik
- Eastern Virginia Medical School, Strelitz Diabetes and Neuroendocrine Center, Norfolk, VA, United States.
| | - C Casellini
- Eastern Virginia Medical School, Strelitz Diabetes and Neuroendocrine Center, Norfolk, VA, United States
| | - M-L Névoret
- Impeto Medical Inc., San Diego, CA, United States
| |
Collapse
|
9
|
Gopalakrishnan R, Burgess RC, Plow EB, Floden DP, Machado AG. Early event related fields during visually evoked pain anticipation. Clin Neurophysiol 2015; 127:1855-63. [PMID: 26733321 DOI: 10.1016/j.clinph.2015.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/02/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Pain experience is not only a function of somatosensory inputs. Rather, it is strongly influenced by cognitive and affective pathways. Pain anticipatory phenomena, an important limitation to rehabilitative efforts in the chronic state, are processed by associative and limbic networks, along with primary sensory cortices. Characterization of neurophysiological correlates of pain anticipation, particularly during very early stages of neural processing is critical for development of therapeutic interventions. METHODS Here, we utilized magnetoencephalography to study early event-related fields (ERFs) in healthy subjects exposed to a 3 s visual countdown task that preceded a painful stimulus, a non-painful stimulus or no stimulus. RESULTS We found that the first countdown cue, but not the last cue, evoked critical ERFs signaling anticipation, attention and alertness to the noxious stimuli. Further, we found that P2 and N2 components were significantly different in response to first-cues that signaled incoming painful stimuli when compared to non-painful or no stimuli. CONCLUSIONS The findings indicate that early ERFs are relevant neural substrates of pain anticipatory phenomena and could be potentially serve as biomarkers. SIGNIFICANCE These measures could assist in the development of neurostimulation approaches aimed at curbing the negative effects of pain anticipation during rehabilitation.
Collapse
Affiliation(s)
- Raghavan Gopalakrishnan
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Richard C Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Ela B Plow
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Darlene P Floden
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Andre G Machado
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
| |
Collapse
|
10
|
Gopalakrishnan R, Burgess RC, Plow EB, Floden DP, Machado AG. A magnetoencephalography study of multi-modal processing of pain anticipation in primary sensory cortices. Neuroscience 2015. [PMID: 26210576 DOI: 10.1016/j.neuroscience.2015.07.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pain anticipation plays a critical role in pain chronification and results in disability due to pain avoidance. It is important to understand how different sensory modalities (auditory, visual or tactile) may influence pain anticipation as different strategies could be applied to mitigate anticipatory phenomena and chronification. In this study, using a countdown paradigm, we evaluated with magnetoencephalography the neural networks associated with pain anticipation elicited by different sensory modalities in normal volunteers. When encountered with well-established cues that signaled pain, visual and somatosensory cortices engaged the pain neuromatrix areas early during the countdown process, whereas the auditory cortex displayed delayed processing. In addition, during pain anticipation, the visual cortex displayed independent processing capabilities after learning the contextual meaning of cues from associative and limbic areas. Interestingly, cross-modal activation was also evident and strong when visual and tactile cues signaled upcoming pain. Dorsolateral prefrontal cortex and mid-cingulate cortex showed significant activity during pain anticipation regardless of modality. Our results show pain anticipation is processed with great time efficiency by a highly specialized and hierarchical network. The highest degree of higher-order processing is modulated by context (pain) rather than content (modality) and rests within the associative limbic regions, corroborating their intrinsic role in chronification.
Collapse
Affiliation(s)
- R Gopalakrishnan
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
| | - R C Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - E B Plow
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
| | - D P Floden
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - A G Machado
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| |
Collapse
|
11
|
Machado AG, Gopalakrishnan R, Plow EB, Burgess RC, Mosher JC. A magnetoencephalography study of visual processing of pain anticipation. J Neurophysiol 2014; 112:276-86. [PMID: 24790165 DOI: 10.1152/jn.00193.2014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Anticipating pain is important for avoiding injury; however, in chronic pain patients, anticipatory behavior can become maladaptive, leading to sensitization and limiting function. Knowledge of networks involved in pain anticipation and conditioning over time could help devise novel, better-targeted therapies. With the use of magnetoencephalography, we evaluated in 10 healthy subjects the neural processing of pain anticipation. Anticipatory cortical activity elicited by consecutive visual cues that signified imminent painful stimulus was compared with cues signifying nonpainful and no stimulus. We found that the neural processing of visually evoked pain anticipation involves the primary visual cortex along with cingulate and frontal regions. Visual cortex could quickly and independently encode and discriminate between visual cues associated with pain anticipation and no pain during preconscious phases following object presentation. When evaluating the effect of task repetition on participating cortical areas, we found that activity of prefrontal and cingulate regions was mostly prominent early on when subjects were still naive to a cue's contextual meaning. Visual cortical activity was significant throughout later phases. Although visual cortex may precisely and time efficiently decode cues anticipating pain or no pain, prefrontal areas establish the context associated with each cue. These findings have important implications toward processes involved in pain anticipation and maladaptive pain conditioning.
Collapse
Affiliation(s)
- Andre G Machado
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Raghavan Gopalakrishnan
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ela B Plow
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Richard C Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - John C Mosher
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|