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Gilliam JR, Sahu PK, Vendemia JMC, Silfies SP. Association between seated trunk control and cortical sensorimotor white matter brain changes in patients with chronic low back pain. PLoS One 2024; 19:e0309344. [PMID: 39208294 PMCID: PMC11361694 DOI: 10.1371/journal.pone.0309344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024] Open
Abstract
Trunk control involves integration of sensorimotor information in the brain. Individuals with chronic low back pain (cLBP) have impaired trunk control and show differences in brain structure and function in sensorimotor areas compared with healthy controls (HC). However, the relationship between brain structure and trunk control in this group is not well understood. This cross-sectional study aimed to compare seated trunk control and sensorimotor white matter (WM) structure in people with cLBP and HC and explore relationships between WM properties and trunk control in each group. Thirty-two people with cLBP and 35 HC were tested sitting on an unstable chair to isolate trunk control; performance was measured using the 95% confidence ellipse area (CEA95) of center-of-pressure tracing. A WM network between cortical sensorimotor regions of interest was derived using probabilistic tractography. WM microstructure and anatomical connectivity between cortical sensorimotor regions were assessed. A mixed-model ANOVA showed that people with cLBP had worse trunk control than HC (F = 12.96; p < .001; ηp2 = .091). There were no differences in WM microstructure or anatomical connectivity between groups (p = 0.564 to 0.940). In the cLBP group, WM microstructure was moderately correlated (|r| = .456 to .565; p ≤ .009) with trunk control. Additionally, the cLBP group demonstrated stronger relationships between anatomical connectivity and trunk control (|r| = .377 to .618 p < .034) compared to the HC group. Unique to the cLBP group, WM connectivity between right somatosensory and left motor areas highlights the importance of interhemispheric information exchange for trunk control. Parietal areas associated with attention and spatial reference frames were also relevant to trunk control. These findings suggest that people with cLBP adopt a more cortically driven sensorimotor integration strategy for trunk control. Future research should replicate these findings and identify interventions to effectively modulate this strategy.
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Affiliation(s)
- John R. Gilliam
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Pradeep K. Sahu
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Jennifer M. C. Vendemia
- Department of Psychology, University of South Carolina, Columbia, SC, United States of America
| | - Sheri P. Silfies
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
- Physical Therapy Program, University of South Carolina, Columbia, SC, United States of America
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Han SY, Shim L, Lee HJ, Park MK. Transcutaneous auricular vagus nerve stimulation can modulate fronto-parietal brain networks. Front Neurosci 2024; 18:1368754. [PMID: 39091347 PMCID: PMC11292796 DOI: 10.3389/fnins.2024.1368754] [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: 01/11/2024] [Accepted: 06/24/2024] [Indexed: 08/04/2024] Open
Abstract
Objective Recent studies have shown that transcutaneous vagal nerve stimulation (tVNS) holds promise as a treatment for neurological or psychiatric disease through the ability to modulate neural activity in some brain regions without an invasive procedure. The objective of this study was to identify the neural correlates underlying the effects of tVNS. Methods Twenty right-handed healthy subjects with normal hearing participated in this study. An auricle-applied tVNS device (Soricle, Neurive Co., Ltd., Gyeongsangnam-do, Republic of Korea) was used to administer tVNS stimulation. A session consisted of 14 blocks, including 7 blocks of tVNS stimulation or sham stimulation and 7 blocks of rest, and lasted approximately 7 min (1 block = 30 s). Functional magnetic resonance imaging (fMRI) was performed during the stimulation. Results No activated regions were observed in the fMRI scans following both sham stimulation and tVNS after the first session. After the second session, tVNS activated two clusters of brain regions in the right frontal gyrus. A comparison of the activated regions after the second session of each stimulation revealed that the fMRI following tVNS exhibited four surviving clusters. Additionally, four clusters were activated in the overall stimulated area during both the first and second sessions. When comparing the fMRI results after each type of stimulation, the fMRI following tVNS showed four surviving clusters compared to the fMRI after sham stimulation. Conclusion tVNS could stimulate some brain regions, including the fronto-parietal network. Stimulating these regions for treating neurological or psychiatric disease might require applying tVNS for at least 3.5 min.
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Affiliation(s)
- Sang-Yoon Han
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Leeseul Shim
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang-si, Republic of Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine, Hallym University Medical Center, Anyang-si, Republic of Korea
| | - Hyo-Jeong Lee
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang-si, Republic of Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine, Hallym University Medical Center, Anyang-si, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon-si, Republic of Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
- Sensory Organ Research Institute, Seoul National University, Medical Research Center, Seoul, Republic of Korea
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Murillo C, López-Sola M, Cagnie B, Suñol M, Smeets RJEM, Coppieters I, Cnockaert E, Meeus M, Timmers I. Gray Matter Adaptations to Chronic Pain in People with Whiplash-Associated Disorders are Partially Reversed After Treatment: A Voxel-based Morphometry Study. THE JOURNAL OF PAIN 2024; 25:104471. [PMID: 38232862 DOI: 10.1016/j.jpain.2024.01.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
Gray matter (GM) changes are often observed in people with chronic spinal pain, including those with chronic whiplash-associated disorders (CWAD). These GM adaptations may be reversed with treatment, at least partially. Pain neuroscience education combined with exercise (PNE+Exercise) is an effective treatment, but its neural underlying mechanisms still remain unexplored in CWAD. Here, we performed both cross-sectional and longitudinal voxel-based morphometry to 1) identify potential GM alterations in people with CWAD (n = 63) compared to age- and sex-matched pain-free controls (n = 32), and 2) determine whether these GM alterations might be reversed following PNE+Exercise (compared to conventional physiotherapy). The cross-sectional whole-brain analysis revealed that individuals with CWAD had less GM volume in the right and left dorsolateral prefrontal cortex and left inferior temporal gyrus which was, in turn, associated with higher pain vigilance. Fifty individuals with CWAD and 29 pain-free controls were retained in the longitudinal analysis. GM in the right dorsolateral prefrontal cortex increased after treatment in people with CWAD. Moreover, the longitudinal whole-brain analysis revealed that individuals with CWAD had decreases in GM volumes of the left and right central operculum and supramarginal after treatment. These changes were not specific to treatment modality and some were not observed in pain-free controls over time. Herewith, we provide the first evidence on how GM adaptations to CWAD respond to treatment. PERSPECTIVE: This article presents which gray matter adaptations are present in people with chronic pain after whiplash injuries. Then, we examine the treatment effect on these alterations as well as whether other neuroplastic effects on GM following treatment occur.
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Affiliation(s)
- Carlos Murillo
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium
| | - Marina López-Sola
- Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, Spain
| | - Barbara Cagnie
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium
| | - María Suñol
- Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, Spain
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Science, Maastricht University, the Netherlands
| | - Iris Coppieters
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Department of chronic diseases and metabolism, Faculty of Medicine, KU Leuven, Belgium; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - Elise Cnockaert
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium; MOVANT research group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Health Sciences and Medicine, University of Antwerp, Belgium
| | - Inge Timmers
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium; Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Science, Maastricht University, the Netherlands; Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
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Sacca V, Chai-Zhang TC, Hodges S, Amores J, Guler S, Todorova N, McDonald CM, Ge T, Kong J. Morphological changes of the limbic system associated with acute and chronic low-back pain: A UK biobank imaging study. Eur J Pain 2024; 28:608-619. [PMID: 38009393 PMCID: PMC10947961 DOI: 10.1002/ejp.2206] [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: 05/01/2023] [Revised: 09/29/2023] [Accepted: 11/01/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Low back pain (LBP) is a major public health issue that influences physical and emotional factors integral to the limbic system. This study aims to investigate the association between LBP and brain morphometry alterations as the duration of LBP increases (acute vs. chronic). METHODS We used the UK Biobank data to investigate the morphological features of the limbic system in acute LBP (N = 115), chronic LBP (N = 243) and controls (N = 358), and tried to replicate our findings with an independent dataset composed of 45 acute LBP participants evaluated at different timepoints throughout 1 year from the OpenPain database. RESULTS We found that in comparison with chronic LBP and pain-free controls, acute LBP was associated with increased volumes of the nucleus accumbens, amygdala, hippocampus, and thalamus, and increased grey matter volumes in the hippocampus and posterior cingulate gyrus. In the replication cohort, we found non-significantly larger hippocampus and thalamus volumes in the 3-month visit (acute LBP) compared to the 1-year visit (chronic LBP), with similar effect sizes as the UK Biobank dataset. CONCLUSIONS Our results suggest that acute LBP is associated with dramatic morphometric increases in the limbic system and mesolimbic pathway, which may reflect an active brain response and self-regulation in the early stage of LBP. SIGNIFICANCE Our study suggests that LBP in the acute phase is associated with the brain morphometric changes (increase) in some limbic areas, indicating that the acute phase of LBP may represent a crucial stage of self-regulation and active response to the disease's onset.
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Affiliation(s)
- Valeria Sacca
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Thalia Celeste Chai-Zhang
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Sierra Hodges
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Judith Amores
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Seyhmus Guler
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Nevyana Todorova
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Caroline Merritt McDonald
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Tian Ge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, United States
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van Gool R, Far A, Drenthen GS, Jansen JFA, Goijen CP, Backes WH, Linden DEJ, Merkies ISJ, Faber CG, Upadhyay J, Hoeijmakers JGJ. Peripheral Pain Captured Centrally: Altered Brain Morphology on MRI in Small Fiber Neuropathy Patients With and Without an SCN9A Gene Variant. THE JOURNAL OF PAIN 2024; 25:730-741. [PMID: 37921732 DOI: 10.1016/j.jpain.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023]
Abstract
The current study aims to characterize brain morphology of pain as reported by small fiber neuropathy (SFN) patients with or without a gain-of-function variant involving the SCN9A gene and compare these with findings in healthy controls without pain. The Neuropathic Pain Scale was used in patients with idiopathic SFN (N = 20) and SCN9A-associated SFN (N = 12) to capture pain phenotype. T1-weighted, structural magnetic resonance imaging (MRI) data were collected in patients and healthy controls (N = 21) to 1) compare cortical thickness and subcortical volumes and 2) quantify the association between severity, quality, and duration of pain with morphological properties. SCN9A-associated SFN patients showed significant (P < .017, Bonferroni corrected) higher cortical thickness in sensorimotor regions, compared to idiopathic SFN patients, while lower cortical thickness was found in more functionally diverse regions (eg, posterior cingulate cortex). SFN patient groups combined demonstrated a significant (Spearman's ρ = .44-.55, P = .005-.049) correlation among itch sensations (Neuropathic Pain Scale-7) and thickness of the left precentral gyrus, and midcingulate cortices. Significant associations were found between thalamic volumes and duration of pain (left: ρ = -.37, P = .043; right: ρ = -.40, P = .025). No associations were found between morphological properties and other pain qualities. In conclusion, in SCN9A-associated SFN, profound morphological alterations anchored within the pain matrix are present. The association between itch sensations of pain and sensorimotor and midcingulate structures provides a novel basis for further examining neurobiological underpinnings of itch in SFN. PERSPECTIVE: Cortical thickness and subcortical volume alterations in SFN patients were found in pain hubs, more profound in SCN9A-associated neuropathy, and correlated with itch and durations of pain. These findings contribute to our understanding of the pathophysiological pathways underlying chronic neuropathic pain and symptoms of itch in SFN.
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Affiliation(s)
- Raquel van Gool
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Amir Far
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands
| | - Gerhard S Drenthen
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, North Brabant, The Netherlands
| | - Celine P Goijen
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands
| | - David E J Linden
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Ingemar S J Merkies
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands; Department of Neurology, Curaçao Medical Center, Willemstad, Kingdom of the Netherlands, Curaçao
| | - Catharina G Faber
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands
| | - Jaymin Upadhyay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Janneke G J Hoeijmakers
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, Limburg, The Netherlands
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Niddam DM, Lai KL, Hsiao YT, Wang YF, Wang SJ. Grey matter structure within the visual networks in migraine with aura: multivariate and univariate analyses. Cephalalgia 2024; 44:3331024231222637. [PMID: 38170950 DOI: 10.1177/03331024231222637] [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: 01/05/2024]
Abstract
BACKGROUND The visual cortex is involved in the generation of migraine aura. Voxel-based multivariate analyses applied to this region may provide complementary information about aura mechanisms relative to the commonly used mass-univariate analyses. METHODS Structural images constrained within the functional resting-state visual networks were obtained in migraine patients with (n = 50) and without (n = 50) visual aura and healthy controls (n = 50). The masked images entered a multivariate analysis in which Gaussian process classification was used to generate pairwise models. Generalizability was assessed by five-fold cross-validation and non-parametric permutation tests were used to estimate significance levels. A univariate voxel-based morphometry analysis was also performed. RESULTS A multivariate pattern of grey matter voxels within the ventral medial visual network contained significant information related to the diagnosis of migraine with visual aura (aura vs. healthy controls: classification accuracy = 78%, p < 0.001; area under the curve = 0.84, p < 0.001; migraine with aura vs. without aura: classification accuracy = 71%, p < 0.001; area under the curve = 0.73, p < 0.003). Furthermore, patients with visual aura exhibited increased grey matter volume in the medial occipital cortex compared to the two other groups. CONCLUSIONS Migraine with visual aura is characterized by multivariate and univariate patterns of grey matter changes within the medial occipital cortex that have discriminative power and may reflect pathological mechanisms.
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Affiliation(s)
- David M Niddam
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Ting Hsiao
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Szabo E, Ashina S, Melo-Carrillo A, Bolo NR, Borsook D, Burstein R. Peripherally acting anti-CGRP monoclonal antibodies alter cortical gray matter thickness in migraine patients: A prospective cohort study. Neuroimage Clin 2023; 40:103531. [PMID: 37866119 PMCID: PMC10623369 DOI: 10.1016/j.nicl.2023.103531] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Migraine is underpinned by central nervous system neuroplastic alterations thought to be caused by the repetitive peripheral afferent barrage the brain receives during the headache phase (cortical hyperexcitability). Calcitonin gene-related peptide monoclonal antibodies (anti-CGRP-mAbs) are highly effective migraine preventative treatments. Their ability to alter brain morphometry in treatment-responders vs. non-responders is not well understood. Our aim was to determine the effects of the anti-CGRP-mAb galcanezumab on cortical thickness after 3-month treatment of patients with high-frequency episodic or chronic migraine. High-resolution magnetic resonance imaging was performed pre- and post-treatment in 36 migraine patients. In this group, 19 patients were classified responders (≥50 % reduction in monthly migraine days) and 17 were considered non-responders (<50 % reduction in monthly migraine days). Following cross-sectional processing to analyze the baseline differences in cortical thickness, two-stage longitudinal processing and symmetrized percent change were conducted to investigate treatment-related brain changes. At baseline, no significant differences were found between the responders and non-responders. After 3-month treatment, decreased cortical thickness (compared to baseline) was observed in the responders in regions of the somatosensory cortex, anterior cingulate cortex, medial frontal cortex, superior frontal gyrus, and supramarginal gyrus. Non-responders demonstrated decreased cortical thickness in the left dorsomedial cortex and superior frontal gyrus. We interpret the cortical thinning seen in the responder group as suggesting that reduction in head pain could lead to changes in neural swelling and dendritic complexity and that such changes reflect the recovery process from maladaptive neural activity. This conclusion is further supported by our recent study showing that 3 months after treatment initiation, the incidence of premonitory symptoms and prodromes that are followed by headache decreases but not the incidence of the premonitory symptoms or prodromes themselves (that is, cortical thinning relates to reductions in the nociceptive signals in the responders). We speculate that a much longer recovery period is required to allow the brain to return to a more 'normal' functioning state whereby prodromes and premonitory symptoms no longer occur.
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Affiliation(s)
- Edina Szabo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA
| | - Sait Ashina
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Agustin Melo-Carrillo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA
| | - Nicolas R Bolo
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - David Borsook
- Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Rami Burstein
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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Estévez-López F, Kim HH, López-Vicente M, Legerstee JS, Hillegers MHJ, Tiemeier H, Muetzel RL. Physical symptoms and brain morphology: a population neuroimaging study in 12,286 pre-adolescents. Transl Psychiatry 2023; 13:254. [PMID: 37438345 DOI: 10.1038/s41398-023-02528-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/14/2023] Open
Abstract
Physical symptoms, also known as somatic symptoms, are those for which medical examinations do not reveal a sufficient underlying root cause (e.g., pain and fatigue). The extant literature of the neurobiological underpinnings of physical symptoms is largely inconsistent and primarily comprises of (clinical) case-control studies with small sample sizes. In this cross-sectional study, we studied the association between dimensionally measured physical symptoms and brain morphology in pre-adolescents from two population-based cohorts; the Generation R Study (n = 2649, 10.1 ± 0.6 years old) and ABCD Study (n = 9637, 9.9 ± 0.6 years old). Physical symptoms were evaluated using continuous scores from the somatic complaints syndrome scale from the parent-reported Child Behavior Checklist (CBCL). High-resolution structural magnetic resonance imaging (MRI) was collected using 3-Tesla MRI systems. Linear regression models were fitted for global brain metrics (cortical and subcortical grey matter and total white matter volume) and surface-based vertex-wise measures (surface area and cortical thickness). Results were meta-analysed. Symptoms of anxiety/depression were studied as a contrasting comorbidity. In the meta-analyses across cohorts, we found negative associations between physical symptoms and surface area in the (i) left hemisphere; in the lateral orbitofrontal cortex and pars triangularis and (ii) right hemisphere; in the pars triangularis, the pars orbitalis, insula, middle temporal gyrus and caudal anterior cingulate cortex. However, only a subset of regions (left lateral orbitofrontal cortex and right pars triangularis) were specifically associated with physical symptoms, while others were also related to symptoms of anxiety/depression. No significant associations were observed for cortical thickness. This study in preadolescents, the most representative and well-powered to date, showed that more physical symptoms are modestly related to less surface area of the prefrontal cortex mostly. While these effects are subtle, future prospective research is warranted to understand the longitudinal relationship of physical symptoms and brain changes over time. Particularly, to elucidate whether physical symptoms are a potential cause or consequence of distinct neurodevelopmental trajectories.
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Affiliation(s)
- Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
- Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024) and CERNEP Research Center, University of Almería, Almería, Spain.
| | - Hannah H Kim
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mónica López-Vicente
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Büchel C. The role of expectations, control and reward in the development of pain persistence based on a unified model. eLife 2023; 12:81795. [PMID: 36972108 PMCID: PMC10042542 DOI: 10.7554/elife.81795] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Chronic, or persistent pain affects more than 10% of adults in the general population. This makes it one of the major physical and mental health care problems. Although pain is an important acute warning signal that allows the organism to take action before tissue damage occurs, it can become persistent and its role as a warning signal thereby inadequate. Although per definition, pain can only be labeled as persistent after 3 months, the trajectory from acute to persistent pain is likely to be determined very early and might even start at the time of injury. The biopsychosocial model has revolutionized our understanding of chronic pain and paved the way for psychological treatments for persistent pain, which routinely outperform other forms of treatment. This suggests that psychological processes could also be important in shaping the very early trajectory from acute to persistent pain and that targeting these processes could prevent the development of persistent pain. In this review, we develop an integrative model and suggest novel interventions during early pain trajectories, based on predictions from this model.
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Affiliation(s)
- Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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10
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Han P, Su T, Chen H, Hummel T. Regional brain morphology of the primary somatosensory cortex correlates with spicy food consumption and capsaicin sensitivity. Nutr Neurosci 2023; 26:208-216. [PMID: 35156563 DOI: 10.1080/1028415x.2022.2031495] [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: 02/02/2023]
Abstract
Objective: Habitual spicy food consumption leads to altered perception of capsaicin. Little is known about the neural morphological correlates of habitual spicy food intake and related trigeminal perceptions. In this study, we used voxel-based morphometry to identify brain regions where regional gray matter volume (GMV) correlates to spicy food consumption. Methods: Fifty-two participants were surveyed for their spicy food dietary habit by a composite score of spicy diet duration, frequency of spicy food consumption, and preferred degree of spiciness. Forty-two participants were further assessed for oral sensitivity and intensity ratings of capsaicin-induced irritation, and intranasal sensitivity and intensity of trigeminal odors. Results: We found that the composite spicy score was positively correlated to GMV of the primary somatosensory area (SI), and the primary (M1), supplementary motor areas (SMA) and the putamen. It was negatively correlated to GMV of the anterior insula, orbitofrontal cortex, frontal gyrus and angular gyrus. The GMV of the SI area was negatively correlated to capsaicin sensitivity; the GMV of the right middle frontal gyrus was positively correlated to the irritative intensity for capsaicin at high concentration (70 μM). However, we observed no correlation between the intranasal trigeminal sensitivity and spicy food consumption or the regional GMV. Discussion: Collectively our findings suggest a central neuroanatomical reflection of altered capsaicin perception in relation to habitual spicy food consumption. Future longitudinal studies should elucidate the possible causal relationship of dietary habit and brain structural plasticity.
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Affiliation(s)
- Pengfei Han
- Faculty of Psychology, Southwest University, Chongqing, People's Republic of China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, People's Republic of China
| | - Tao Su
- Faculty of Psychology, Southwest University, Chongqing, People's Republic of China
| | - Hong Chen
- Faculty of Psychology, Southwest University, Chongqing, People's Republic of China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, People's Republic of China
| | - Thomas Hummel
- Interdisciplinary Centre Smell and Taste, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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11
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Su Q, Li J, Chu X, Zhao R. Preoperative pain hypersensitivity is associated with axial pain after posterior cervical spinal surgeries in degenerative cervical myelopathy patients: a preliminary resting-state fMRI study. Insights Imaging 2023; 14:16. [PMID: 36690763 PMCID: PMC9871135 DOI: 10.1186/s13244-022-01332-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/11/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To test whether preoperative pain sensitivity is associated with the postoperative axial pain (PAP) in degenerative cervical myelopathy (DCM) and to explore its underlying brain mechanism. METHODS Clinical data and resting-state fMRI data of 62 DCM patients along with 60 age/gender matched healthy participants were collected and analysed. Voxel-wise amplitude of low frequency fluctuation (ALFF) was computed and compared between DCM patients and healthy controls. Correlation analyses were performed to reveal the association between the clinical metrics and brain alterations. Clinical data and ALFF were also compared between DCM patients with PAP and without PAP. RESULTS (1) Relative to healthy participants, DCM patients exhibited significantly lower preoperative pain threshold which is associated with the PAP intensity; (2) Relative to patients without PAP, PAP patients exhibited increased ALFF in mid-cingulate cortex (MCC) and lower preoperative pain threshold; (3) Further, multivariate pattern analysis revealed that MCC ALFF provide additional value for PAP vs. non-PAP classification. CONCLUSION In conclusion, our findings suggest that preoperative pain hypersensitivity may be associated with postoperative axial pain in degenerative cervical myelopathy patients. This finding may inspire new therapeutic ideas for patients with preoperative axial pain.
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Affiliation(s)
- Qian Su
- grid.411918.40000 0004 1798 6427Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for China, Tianjin, 300060 China
| | - Jie Li
- grid.265021.20000 0000 9792 1228Graduate School, Tianjin Medical University, Tianjin, 300203 China ,grid.33763.320000 0004 1761 2484Department of Minimally Invasive Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, 300211 China
| | - Xu Chu
- grid.43169.390000 0001 0599 1243Department of Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Rui Zhao
- grid.412645.00000 0004 1757 9434Department of Orthopedics Surgery, Tianjin Medical University General Hospital, Tianjin, 300052 China
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12
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Zhou Z, Hui ES, Kranz GS, Chang JR, de Luca K, Pinto SM, Chan WW, Yau SY, Chau BK, Samartzis D, Jensen MP, Wong AYL. Potential mechanisms underlying the accelerated cognitive decline in people with chronic low back pain: A scoping review. Ageing Res Rev 2022; 82:101767. [PMID: 36280211 DOI: 10.1016/j.arr.2022.101767] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/13/2022] [Accepted: 10/20/2022] [Indexed: 01/31/2023]
Abstract
A growing body of evidence has shown that people with chronic low back pain (CLBP) demonstrate significantly greater declines in multiple cognitive domains than people who do not have CLBP. Given the high prevalence of CLBP in the ever-growing aging population that may be more vulnerable to cognitive decline, it is important to understand the mechanisms underlying the accelerated cognitive decline observed in this population, so that proper preventive or treatment approaches can be developed and implemented. The current scoping review summarizes what is known regarding the potential mechanisms underlying suboptimal cognitive performance and cognitive decline in people with CLBP and discusses future research directions. Five potential mechanisms were identified based on the findings from 34 included studies: (1) altered activity in the cortex and neural networks; (2) grey matter atrophy; (3) microglial activation and neuroinflammation; (4) comorbidities associated with CLBP; and (5) gut microbiota dysbiosis. Future studies should deepen the understanding of mechanisms underlying this association so that proper prevention and treatment strategies can be developed.
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Affiliation(s)
- Zhixing Zhou
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Edward S Hui
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; The State Key Laboratory of Brain and Cognitive Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Jeremy R Chang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Katie de Luca
- School of Health, Medical and Applied Sciences, CQ University, Brisbane, Australia
| | - Sabina M Pinto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Winnie Wy Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Suk-Yu Yau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China; Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Bolton Kh Chau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Centre, Chicago, IL, USA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China; Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong Special Adminstrative Region, China.
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13
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Lee JHA, Chen Q, Zhuo M. Synaptic Plasticity in the Pain-Related Cingulate and Insular Cortex. Biomedicines 2022; 10:2745. [PMID: 36359264 PMCID: PMC9687873 DOI: 10.3390/biomedicines10112745] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 09/23/2023] Open
Abstract
Cumulative animal and human studies have consistently demonstrated that two major cortical regions in the brain, namely the anterior cingulate cortex (ACC) and insular cortex (IC), play critical roles in pain perception and chronic pain. Neuronal synapses in these cortical regions of adult animals are highly plastic and can undergo long-term potentiation (LTP), a phenomenon that is also reported in brain areas for learning and memory (such as the hippocampus). Genetic and pharmacological studies show that inhibiting such cortical LTP can help to reduce behavioral sensitization caused by injury as well as injury-induced emotional changes. In this review, we will summarize recent progress related to synaptic mechanisms for different forms of cortical LTP and their possible contribution to behavioral pain and emotional changes.
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Affiliation(s)
- Jung-Hyun Alex Lee
- Department of Physiology, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Qiyu Chen
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266199, China
- Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Min Zhuo
- Department of Physiology, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266199, China
- Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou 325000, China
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14
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Medrano-Escalada Y, Plaza-Manzano G, Fernández-de-las-Peñas C, Valera-Calero JA. Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain. Tomography 2022; 8:2153-2163. [PMID: 36136876 PMCID: PMC9498382 DOI: 10.3390/tomography8050180] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 12/19/2022] Open
Abstract
Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal disorders, being one of the leading contributors to disability worldwide and involving an important economic and social burden. Up to 90% of CLBP is non-specific (not associated with specific injuries), with a chronicity expectation estimated at 10%. Currently, motivational and emotional central circuits are being investigated due to their role in CLBP persistency and chronification. Therefore, this narrative review aimed to summarize the evidence regarding the cortical brain changes described for proposing novel multidisciplinary approaches. Novel advances in neuroimaging techniques demonstrated structural (e.g., decrease in the grey matter located at the dorsolateral prefrontal cortex), functional (e.g., connectivity impairments in those areas involved in pain processing), and neurochemical changes (e.g., decrease in cerebral metabolites). In addition, significant changes were found in the primary somatosensory and motor cortex, contributing to the alteration of low back muscles activation and function.
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Affiliation(s)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913-941-545
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Clínica e Investigación en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
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15
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Suñol M, Payne MF, Tong H, Maloney TC, Ting TV, Kashikar-Zuck S, Coghill RC, López-Solà M. Brain Structural Changes during Juvenile Fibromyalgia: Relationships with Pain, Fatigue and Functional Disability. Arthritis Rheumatol 2022; 74:1284-1294. [PMID: 35076177 PMCID: PMC9247027 DOI: 10.1002/art.42073] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/03/2021] [Accepted: 01/21/2022] [Indexed: 11/17/2022]
Abstract
Objective Juvenile fibromyalgia (FM) is a prevalent chronic pain condition affecting children and adolescents worldwide during a critical period of brain development. To date, no published studies have addressed the pathophysiology of juvenile FM. This study was undertaken to characterize gray matter volume (GMV) alterations in juvenile FM patients for the first time, and to investigate their functional and clinical relevance. Methods Thirty‐four female adolescents with juvenile FM and 38 healthy adolescents underwent a structural magnetic resonance imaging examination and completed questionnaires assessing core juvenile FM symptoms. Using voxel‐based morphometry, we assessed between‐group GMV differences and associations between GMV and functional disability, fatigue, and pain interference in juvenile FM. We also studied whether validated brain patterns predicting pain, cognitive control, or negative emotion were amplified/attenuated in juvenile FM patients and whether structural alterations reported in adult FM were replicated in adolescents with juvenile FM. Results Compared to controls, juvenile FM patients showed GMV reductions in the anterior midcingulate cortex (aMCC) region (family‐wise error corrected P [PFWE‐corr] = 0.04; estimated with threshold‐free cluster enhancement [TFCE]; n = 72) associated with pain. Within the juvenile FM group, patients reporting higher functional disability had larger GMV in inferior frontal regions (PFWE‐corr = 0.006; TFCE estimated; n = 34) linked to affective, self‐referential, and language‐related processes. Last, GMV reductions in juvenile FM showed partial overlap with findings in adult FM, specifically for the anterior/posterior cingulate cortices (P = 0.02 and P = 0.03, respectively; n = 72). Conclusion Pain‐related aMCC reductions may be a structural hallmark of juvenile FM, whereas alterations in regions involved in emotional, self‐referential, and language‐related processes may predict disease impact on patients’ well‐being. The partial overlap between juvenile and adult FM findings strengthens the importance of early symptom identification and intervention to prevent the transition to adult forms of the disease.
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Affiliation(s)
- Maria Suñol
- Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Michael F Payne
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Han Tong
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Thomas C Maloney
- Department of Radiology, University of Cincinnati, Cincinnati, OH, USA
| | - Tracy V Ting
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Susmita Kashikar-Zuck
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert C Coghill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marina López-Solà
- Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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16
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Barazanji N, Paul Hamilton J, Icenhour A, Simon RA, Bednarska O, Tapper S, Tisell A, Lundberg P, Engström M, Walter S. Irritable bowel syndrome in women: Association between decreased insular subregion volumes and gastrointestinal symptoms. NEUROIMAGE: CLINICAL 2022; 35:103128. [PMID: 36002966 PMCID: PMC9421502 DOI: 10.1016/j.nicl.2022.103128] [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: 02/15/2022] [Revised: 07/09/2022] [Accepted: 07/23/2022] [Indexed: 12/04/2022] Open
Abstract
All insular subregions are smaller in IBS compared to healthy women. Insular volume associates with GI symptoms independent of psychiatric comorbidity. GI symptoms associate with anterior but not posterior insular volume. More nausea associated with smaller dorsal anterior insula bilaterally. Insula in major depression is not significantly smaller than in healthy women.
Objective Irritable bowel syndrome (IBS) is a chronic pain disorder characterized by disturbed interactions between the gut and the brain with depression as a common comorbidity. In both IBS and depression, structural brain alterations of the insular cortices, key structures for pain processing and interoception, have been demonstrated but the specificity of these findings remains unclear. We compared the gray matter volume (GMV) of insular cortex (IC) subregions in IBS women and healthy controls (HC) and examined relations to gastrointestinal (GI) symptoms and glutamate + glutamine (Glx) concentrations. We further analyzed GMV of IC subregions in women with major depression (MDD) compared to HC and addressed possible differences between depression, IBS, IBS with depression and HC. Design Women with IBS (n = 75), MDD (n = 41) and their respective HC (n = 39 and n = 43) underwent structural brain MRI. IC subregion volumes were estimated using statistical parametric mapping software. General linear model approaches were applied to IC volumetric data and FDR-corrected partial correlation analyses assessed relations between GMV, GI symptoms and Glx concentrations. Results IBS patients had significantly smaller IC subregions than HC in both hemispheres but there was no significant difference between MDD compared with IBS and HC for any insular subregion. In IBS, the dorsal anterior insular volumes were negatively correlated with symptoms of nausea and pain, and the left ventral subregion showed a positive correlation with straining to defecate, while the posterior subregion volumes showed no relation to symptoms. In the anterior insula, concentration of Glx showed positive correlations with GMV bilaterally in HC and with GMV of the right anterior insula in IBS. Conclusion As the interoceptive cortex, the insula shows substantial and disease-specific structural differences in patients with chronic interoceptive visceral pain. Particularly changes in the anterior proportions might be related to chronic exposure to or enhanced salience towards adverse interoceptive visceral signals and could be linked to biochemical changes, calling for further multimodal and longitudinal work.
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17
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Acupuncture Treatment Associated with Functional Connectivity Changes in Primary Dysmenorrhea: A Resting State fMRI Study. J Clin Med 2021; 10:jcm10204731. [PMID: 34682857 PMCID: PMC8537009 DOI: 10.3390/jcm10204731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Primary dysmenorrhea (PDM) is the most commonly encountered gynecological problem in reproductive-age women. Acupuncture has been suggested as an effective treatment of PDM that may modulate descending pain modulation systems. In the present study, we used resting-state functional magnetic resonance imaging to investigate possible changes in descending pain modulation systems after acupuncture treatment in women with PDM. Thirty-four right-handed adult women with PDM participated in this randomized, single-blinded, sham-controlled study. Each patient was randomly allocated to an 8-week verum or sham acupuncture intervention on the bilateral Sanyinjiao (SP6). Resting-state functional magnetic resonance imaging was conducted before, during, and after the intervention to measure the spontaneous activity in brain. After the 8-week intervention, both verum and sham groups reported decreased menstrual pain. However, the cessation of decreased functional connectivity (FC) between periaqueductal gray matter and the regions associated with affective pain modulation and attention-related pain modulation were found in the verum but not in the sham group after the 8-week intervention. More decreased FC has been found in the region associated with non-specific effects of acupuncture intervention after the early stage of acupuncture intervention. These results indicated that verum acupuncture may intercept the altered FC in descending pain modulation systems in PDM.
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18
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Watanabe H, Kojima S, Nagasaka K, Ohno K, Sakurai N, Kodama N, Otsuru N, Onishi H. Gray Matter Volume Variability in Young Healthy Adults: Influence of Gender Difference and Brain-Derived Neurotrophic Factor Genotype. Cereb Cortex 2021; 32:2635-2643. [PMID: 34635909 PMCID: PMC9201594 DOI: 10.1093/cercor/bhab370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022] Open
Abstract
Although brain gray matter (GM) plastically changes during short-term training, it is still unclear whether brain structures are stable for short periods (several months). Therefore, this study aimed to re-test the short-term variability of GM volumes and to clarify the effect of factors (gender and BDNF-genotype) expected to contribute to such variability. The subjects comprised 41 young healthy adults. T1-weighted images were acquired twice with an interval of approximately 4 months using a 3 T-MRI scanner. Voxel-based morphometry (VBM) was used to calculate GM volumes in 47 regions. The intraclass correlation coefficient (ICC) and Test–retest variability (%TRV) were used as indices of variability. As a result, the ICCs in 43 regions were excellent (ICC > 0.90) and those in 3 regions were good (ICC > 0.80), whereas the ICC in the thalamus was moderate (ICC = 0.694). Women had a higher %TRV than men in 5 regions, and %TRV of the Val66Val group was higher than that of the Met carrier group in 2 regions. Moreover, the Female-Val66Val group had a higher %TRV than the Male-Met carrier group in 3 regions. These results indicate that although the short-term variability of GM volumes is small, it is affected by within-subject factors.
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Affiliation(s)
- Hiraku Watanabe
- Address correspondence to Hiraku Watanabe, Graduate School, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan. Tel: +81-25-257-4445; Fax: +81-25-257-4445.
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Ken Ohno
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Noriko Sakurai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Naoki Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
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19
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Kim SK, Nikolova S, Schwedt TJ. Structural aberrations of the brain associated with migraine: A narrative review. Headache 2021; 61:1159-1179. [PMID: 34407215 DOI: 10.1111/head.14189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To summarize major results from imaging studies investigating brain structure in migraine. BACKGROUND Neuroimaging studies, using several different imaging and analysis techniques, have demonstrated aberrations in brain structure associated with migraine. This narrative review summarizes key imaging findings and relates imaging findings with clinical features of migraine. METHODS We searched PubMed for English language articles using the key words "neuroimaging" AND/OR "MRI" combined with "migraine" through August 20, 2020. The titles and abstracts of resulting articles were reviewed for their possible inclusion in this manuscript, followed by examination of the full texts and reference lists of relevant articles. RESULTS Migraine is associated with structural brain aberrations within regions that participate in pain processing, the processing of other sensory stimuli, multisensory integration, and in white matter fiber tracts. Furthermore, migraine is associated with magnetic resonance imaging T2/fluid-attenuated inversion recovery white matter hyperintensities. Some structural aberrations are correlated with the severity and clinical features of migraine, whereas others are not. These findings suggest that some structural abnormalities are associated with or amplified by recurrent migraine attacks, whereas others are intrinsic to the migraine brain. CONCLUSIONS Migraine is associated with aberrant brain structure. Structural neuroimaging studies contribute to understanding migraine pathophysiology and identification of brain regions associated with migraine and its individual symptoms. Additional work is needed to determine the extent to which structural aberrations are a result of recurrent migraine attacks, and perhaps reversible with effective treatment or migraine resolution, versus being intrinsic traits of the migraine brain.
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Affiliation(s)
- Soo-Kyoung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
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20
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Neumann L, Wulms N, Witte V, Spisak T, Zunhammer M, Bingel U, Schmidt-Wilcke T. Network properties and regional brain morphology of the insular cortex correlate with individual pain thresholds. Hum Brain Mapp 2021; 42:4896-4908. [PMID: 34296487 PMCID: PMC8449096 DOI: 10.1002/hbm.25588] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/15/2021] [Accepted: 06/20/2021] [Indexed: 12/16/2022] Open
Abstract
Pain thresholds vary considerably across individuals and are influenced by a number of behavioral, genetic and neurobiological factors. However, the neurobiological underpinnings that account for individual differences remain to be fully elucidated. In this study, we used voxel‐based morphometry (VBM) and graph theory, specifically the local clustering coefficient (CC) based on resting‐state connectivity, to identify brain regions, where regional gray matter volume and network properties predicted individual pain thresholds. As a main finding, we identified a cluster in the left posterior insular cortex (IC) reaching into the left parietal operculum, including the secondary somatosensory cortex, where both regional gray matter volume and the local CC correlated with individual pain thresholds. We also performed a resting‐state functional connectivity analysis using the left posterior IC as seed region, demonstrating that connectivity to the pre‐ as well as postcentral gyrus bilaterally; that is, to the motor and primary sensory cortices were correlated with individual pain thresholds. To our knowledge, this is the first study that applied VBM in combination with voxel‐based graph theory in the context of pain thresholds. The co‐location of the VBM and the local CC cluster provide first evidence that both structure and function map to the same brain region while being correlated with the same behavioral measure; that is, pain thresholds. The study highlights the importance of the posterior IC, not only for pain perception in general, but also for the determination of individual pain thresholds.
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Affiliation(s)
- Lynn Neumann
- Medizinische Klinik I, Klinik für Innere Medizin, Nephrologie und Dialyse, Osteologie und Rheumatologie, St. Franziskus-Hospital Münster, Münster, Germany
| | - Niklas Wulms
- Institut für Epidemiologie und Sozialmedizin, Universitätsklinikum Münster, Münster, Germany
| | - Vanessa Witte
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital Bochum, Ruhr-Universität Bochum, Bochum, Germany
| | - Tamas Spisak
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Germany
| | | | - Ulrike Bingel
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Germany
| | - Tobias Schmidt-Wilcke
- Institut für Klinische Neurowissenschaften und Medizinische Psychologie, Heinrich Heine Universität, Düsseldorf, Germany.,Neurologisches Zentrum, Bezirksklinikum Mainkofen, Deggendorf, Germany
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21
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De Martino E, Gregoret L, Zandalasini M, Graven-Nielsen T. Slowing in Peak-Alpha Frequency Recorded After Experimentally-Induced Muscle Pain is not Significantly Different Between High and Low Pain-Sensitive Subjects. THE JOURNAL OF PAIN 2021; 22:1722-1732. [PMID: 34182105 DOI: 10.1016/j.jpain.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Peak alpha frequency (PAF) reduces during cutaneous pain, but no studies have investigated PAF during movement-related muscle pain. Whether high-pain sensitive (HPS) individuals exhibit a more pronounced PAF response to pain than low-pain sensitive (LPS) individuals is unclear. As a pain model, twenty-four participants received nerve growth factor injections into a wrist extensor muscle at Day 0, Day 2, and Day 4. At Day 4, a subgroup of twelve participants also undertook eccentric wrist exercise to induce additional pain. Pain numerical rating scale (NRS) scores and electroencephalography were recorded at Day 0 (before injection), Day 4, and Day 6 for 3 minutes (eyes closed) with wrist at rest (Resting-state) and extension (Contraction-state). The average pain NRS scores in contraction-state across Days were used to divide participants into HPS (NRS-scores≥2) and LPS groups. PAF was calculated by frequency decomposition of electroencephalographic recordings. Compared with Day 0, contraction NRS-scores only increased in HPS-group at Day 4 and Day 6 (P < .001). PAF in Contraction-state decreased in both groups at Day 6 compared with Day 0 (P = .011). Across days, HPS-group showed faster PAF than LPS-group during Resting-state and Contraction-state (P < .04). Average pain NRS-scores across days during Contraction-states correlated with PAF at Day 0 (P = .012). Pain NRS-scores were associated with PAF during Contraction-state at Day 4 and Day 6 (P < .05). PERSPECTIVE: PAF was slowed during long-lasting movement-related pain in both groups, suggesting a widespread change in cortical excitability independent of the pain sensitivity. Moreover, HPS individuals showed faster PAF than LPS individuals during muscle pain, which may reflect a different cognitive, emotional, or attentional response to muscle pain among individuals.
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Affiliation(s)
- Enrico De Martino
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Aerospace Medicine and Rehabilitation Laboratory, Department of Sport, Exercise & Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Luisina Gregoret
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Matteo Zandalasini
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Spinal Unit and Intensive Rehabilitation Medicine. A.U.S.L. Piacenza, Italy
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
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22
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Kashanian A, Tsolaki E, Pouratian N, Bari AA. Deep Brain Stimulation of the Subgenual Cingulate Cortex for the Treatment of Chronic Low Back Pain. Neuromodulation 2021; 25:202-210. [PMID: 33872423 DOI: 10.1111/ner.13388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/12/2021] [Accepted: 02/24/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Despite converging basic scientific and clinical evidence of the link between chronic pain and depression, existing therapies do not often take advantage of this overlap. Here, we provide a critical review of the literature that highlights the intersection in brain networks between chronic low back pain (CLBP) and depression and discuss findings from previous deep brain stimulation (DBS) studies for pain. Based on a multidimensional model of pain processing and the connectivity of the subgenual cingulate cortex (SCC) with areas that are implicated in both CLBP and depression, we propose a novel approach to the treatment of CLBP using DBS of the SCC. MATERIALS AND METHODS A narrative review with literature assessment. RESULTS CLBP is associated with a shift away from somatosensory representation toward brain regions that mediate emotional processes. There is a high degree of overlap between these regions and those involved in depression, including the anterior cingulate cortex, medial prefrontal cortex, nucleus accumbens, and amygdala. Whereas targets sites from previous DBS trials for pain were not anatomically positioned to engage these areas and their associated networks, the SCC is structurally connected to all of these regions and as well as others involved in mediating sensory, cognitive, and affective processing in CLBP. CONCLUSIONS CLBP and depression share a common underlying brain network interconnected by the SCC. Current data and novel technology provide an optimal opportunity to develop clinically effective trials of SCC DBS for CLBP.
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Affiliation(s)
- Alon Kashanian
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Evangelia Tsolaki
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Nader Pouratian
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Ausaf A Bari
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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23
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Grinsvall C, Ryu HJ, Van Oudenhove L, Labus JS, Gupta A, Ljungberg M, Törnblom H, Mayer EA, Simrén M. Association between pain sensitivity and gray matter properties in the sensorimotor network in women with irritable bowel syndrome. Neurogastroenterol Motil 2021; 33:e14027. [PMID: 33174312 PMCID: PMC8047895 DOI: 10.1111/nmo.14027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/26/2020] [Accepted: 10/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Enhanced perception of visceral stimuli is an important feature of Irritable Bowel Syndrome (IBS), but it is not known whether visceral sensitivity is associated with regional structural brain properties in IBS. METHODS Structural brain magnetic resonance imaging data from 216 women with IBS and 138 healthy women were parcellated with FreeSurfer to define regional gray matter morphometry (volume, cortical thickness, surface area and mean curvature) in the sensorimotor network. General linear models were used to detect group differences between IBS and health. In a second set of 48 female IBS patients, pain threshold, pain intensity ratings during rectal balloon distension, and reported levels of abdominal pain and bloating were correlated with brain regions that showed differences between IBS and health in the first data set. KEY RESULTS Several statistically significant differences between IBS patients and healthy controls were found, mainly higher gray matter volume and cortical thickness in primary somatosensory cortex, secondary somatosensory cortex, and subcortical regions, and lesser gray matter volume, surface area and cortical thickness in posterior insula and superior frontal gyrus. Pain intensity ratings during rectal distension were associated with left primary somatosensory cortical thickness, and pain threshold was associated with right nucleus accumbens volume. CONCLUSIONS AND INFERENCES Regional gray matter differences in sensorimotor network are associated with visceral sensitivity and may represent neuroplastic changes in female IBS patients.
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Affiliation(s)
- Cecilia Grinsvall
- Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Hyo Jin Ryu
- Vatche and Tamar Manoukian Division of Digestive DiseasesDavid Geffen School at UCLALos AngelesCAUSA
| | - Lukas Van Oudenhove
- Translational Research Center for Gastrointestinal Disorders (TARGID)KU LeuvenLeuvenBelgium
| | - Jennifer S. Labus
- Vatche and Tamar Manoukian Division of Digestive DiseasesDavid Geffen School at UCLALos AngelesCAUSA
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive DiseasesDavid Geffen School at UCLALos AngelesCAUSA
| | - Maria Ljungberg
- Department of Radiation PhysicsInstitute of Clinical SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Medical Physics and Biomedical EngineeringDiagnostic ImagingSahlgrenska University HospitalMR CentreGothenburgSweden
| | - Hans Törnblom
- Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Emeran A. Mayer
- Vatche and Tamar Manoukian Division of Digestive DiseasesDavid Geffen School at UCLALos AngelesCAUSA
| | - Magnus Simrén
- Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Center for Functional Gastrointestinal and Motility DisordersUniversity of North Carolina at Chapel HillChapel HillNCUSA
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24
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Wuyts E, De Neef N, Coppens V, Schuerwegen A, de Zeeuw-Jans I, Van Der Pol M, Morrens M. Beyond Pain: A Study on the Variance of Pain Thresholds Within BDSM Interactions in Dominants and Submissives. J Sex Med 2021; 18:556-564. [PMID: 33642237 DOI: 10.1016/j.jsxm.2021.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/29/2020] [Accepted: 01/02/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND BDSM is an acronym describing bondage and discipline, dominance and submission, and sadism and masochism. Afflicting or receiving pain is usually an important part of the BDSM interaction. AIM This research will focus on better understanding the aspect of pain within a BDSM interaction. METHODS Submissive and dominant counterparts of 35 couples were recruited to participate in a BDSM interaction, of which 34 dominants and 33 submissives were included in the analyses. A non-BDSM interested control group (n = 27) was included to control for social interaction, of which 24 were included in the analyses. OUTCOMES This research investigates the differences in (i) baseline pain thresholds, (ii) the impact of a BDSM interaction on those thresholds, and (iii) threshold moderating factors like pain cognition between submissive and dominant BDSM participants and control individuals. RESULTS BDSM practitioners have a higher pain threshold overall and a BSDM interaction will result in a temporary elevation of pain thresholds for submissives. Additionally, pain thresholds in dominants will be dependent upon their fear of pain and tendency to catastrophize pain and submissives will experience less fear of pain than the control group. CLINICAL IMPLICATIONS By further enhancing our understanding of the mechanisms behind a BDSM interaction in this way, we aspire to relieve the stigma these practitioners still endure. STRENGTHS & LIMITATIONS This is one of the first studies of its kind with a large sample size compared to similar research, which makes it a significant contribution to the field. It must be mentioned that there is a possible selection bias because recruitment was only done through the Flemish BDSM community and specifically those who visit clubs. Additionally, pain threshold remains a subjective measurement, which must be taken into account. CONCLUSION This study helps shed further light on the biological processes behind a BDSM interaction through pain threshold measurements. Wuyts E, De Neef N, Coppens V, et al. Beyond Pain: A Study on the Variance of Pain Thresholds Within BDSM Interactions in Dominants and Submissives. J Sex Med 2021;18:556-564.
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Affiliation(s)
- Elise Wuyts
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium.
| | - Nele De Neef
- Europe Hospitals, Campus St Michel, Brussels, Belgium
| | - Violette Coppens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium; University Department of Psychiatry, Campus Duffel, Duffel, Belgium
| | - Alana Schuerwegen
- University Forensic Centre, University Hospital Antwerp, Antwerp, Belgium
| | - Ilona de Zeeuw-Jans
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium; Department of Psychology, University of Tilburg, Tilburg, Netherlands
| | | | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium; University Department of Psychiatry, Campus Duffel, Duffel, Belgium
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25
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Tu CH, Lin CL, Yang ST, Shen WC, Chen YH. Hormonal Contraceptive Treatment May Reduce the Risk of Fibromyalgia in Women with Dysmenorrhea: A Cohort Study. J Pers Med 2020; 10:jpm10040280. [PMID: 33327434 PMCID: PMC7768424 DOI: 10.3390/jpm10040280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/15/2022] Open
Abstract
Dysmenorrhea is the most common gynecological disorder for women in the reproductive age. Study has indicated that dysmenorrhea might be a general risk factor of chronic pelvic pain and even chronic non-pelvic pain, such as fibromyalgia. We used the Longitudinal Health Insurance Database 2000 from the Taiwan National Health Research Institutes Database to investigate whether women with dysmenorrhea have a higher risk of fibromyalgia and whether treatment of dysmenorrhea reduced the risk of fibromyalgia. The dysmenorrhea cohort was matched with a non-dysmenorrhea cohort at a 1:1 ratio based on gender, age, and the year of entry study by frequency matching. Multivariable Cox proportional hazard regression models were used to assess the risk of fibromyalgia, with controlling for potential confounding variables such as age, comorbidities, and medication use. After controlling confounding variables, results revealed that women with dysmenorrhea have a significantly higher risk of fibromyalgia than women without dysmenorrhea. However, only treatment of dysmenorrhea with hormonal contraceptives reduce the risk of fibromyalgia. These results indicated that dysmenorrhea may be a risk factor of fibromyalgia, whereas personalized medicine for treatment of dysmenorrhea may be the key to reduce the risk of fibromyalgia. Future studies are needed to identify the causes and prevention strategies in detail.
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Affiliation(s)
- Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
- Correspondence: (C.-H.T.); (Y.-H.C.); Tel.: +886-4-22053366 (C.-H.T.) (ext. 3336)
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 404332, Taiwan;
| | - Su-Tso Yang
- Department of Medical Imaging, China Medical University Hospital, Taichung 404332, Taiwan;
- School of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
| | - Wei-Chih Shen
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404332, Taiwan;
- Department of Computer Science and Information Engineering, Asia University, Taichung 413305, Taiwan
| | - Yi-Hung Chen
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
- Traditional Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan
- Department of Photonics and Communication Engineering, Asia University, Taichung 41354, Taiwan
- Correspondence: (C.-H.T.); (Y.-H.C.); Tel.: +886-4-22053366 (C.-H.T.) (ext. 3336)
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26
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Multi-modal biomarkers of low back pain: A machine learning approach. NEUROIMAGE-CLINICAL 2020; 29:102530. [PMID: 33338968 PMCID: PMC7750450 DOI: 10.1016/j.nicl.2020.102530] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/12/2022]
Abstract
Widespread differences in cortical thickness (CT) were observed in patients with low back pain. Changes in CT correlated with self-reported clinical scores of pain and emotion. Changes in resting state fMRI metrics of functional networks. Support vector machines separated low back pain patients from controls with a high performance. Multi-modal biomarkers can be useful when identifying personalized treatments for low back pain.
Chronic low back pain (LBP) is a very common health problem worldwide and a major cause of disability. Yet, the lack of quantifiable metrics on which to base clinical decisions leads to imprecise treatments, unnecessary surgery and reduced patient outcomes. Although, the focus of LBP has largely focused on the spine, the literature demonstrates a robust reorganization of the human brain in the setting of LBP. Brain neuroimaging holds promise for the discovery of biomarkers that will improve the treatment of chronic LBP. In this study, we report on morphological changes in cerebral cortical thickness (CT) and resting-state functional connectivity (rsFC) measures as potential brain biomarkers for LBP. Structural MRI scans, resting state functional MRI scans and self-reported clinical scores were collected from 24 LBP patients and 27 age-matched healthy controls (HC). The results suggest widespread differences in CT in LBP patients relative to HC. These differences in CT are correlated with self-reported clinical summary scores, the Physical Component Summary and Mental Component Summary scores. The primary visual, secondary visual and default mode networks showed significant age-corrected increases in connectivity with multiple networks in LBP patients. Cortical regions classified as hubs based on their eigenvector centrality (EC) showed differences in their topology within motor and visual processing regions. Finally, a support vector machine trained using CT to classify LBP subjects from HC achieved an average classification accuracy of 74.51%, AUC = 0.787 (95% CI: 0.66–0.91). The findings from this study suggest widespread changes in CT and rsFC in patients with LBP while a machine learning algorithm trained using CT can predict patient group. Taken together, these findings suggest that CT and rsFC may act as potential biomarkers for LBP to guide therapy.
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27
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Torrecillas-Martínez L, Catena A, O'Valle F, Solano-Galvis C, Padial-Molina M, Galindo-Moreno P. On the Relationship Between White Matter Structure and Subjective Pain. Lessons From an Acute Surgical Pain Model. Front Hum Neurosci 2020; 14:558703. [PMID: 33328926 PMCID: PMC7732636 DOI: 10.3389/fnhum.2020.558703] [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: 05/03/2020] [Accepted: 10/26/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Pain has been associated with structural changes of the brain. However, evidence regarding white matter changes in response to acute pain protocols is still scarce. In the present study, we assess the existence of differences in brain white matter related to pain intensity reported by patients undergoing surgical removal of a mandibular impacted third molar using diffusion tensor imaging (DTI) analysis. Methods: 30 participants reported their subjective pain using a visual analog scale at three postsurgical stages: under anesthesia, in pain, and after the administration of an analgesic. The diffusion data were acquired prior to surgery. Results: DTI analysis yielded significant positive associations of fractional anisotropy in white matter areas related to pain processing (corticospinal tract, corona radiata, corpus callosum) with the differences in pain between the three postsurgery stages. Extent and location of these associations depended on the magnitude of the subjective pain differences. Tractography analysis indicated that some pain–tract associations are significant only when pain stage is involved in the contrast (posterior corona radiata), while others (middle cerebellar peduncle, pontine crossing) are only when anesthesia is involved in the contrast. Conclusions: The association of white matter fractional anisotropy and connectivity, measured before the pain stages, with subjective pain depends on the magnitude of the differences in pain scores.
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Affiliation(s)
- Laura Torrecillas-Martínez
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Andrés Catena
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Francisco O'Valle
- Department of Pathology, School of Medicine and Instituto de Biopatología y Medicina Reparativa, University of Granada, Granada, Spain
| | - César Solano-Galvis
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
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28
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Niu X, Bai L, Sun Y, Wang Y, Bai G, Yin B, Wang S, Gan S, Jia X, Liu H. Mild traumatic brain injury is associated with effect of inflammation on structural changes of default mode network in those developing chronic pain. J Headache Pain 2020; 21:135. [PMID: 33228537 PMCID: PMC7684719 DOI: 10.1186/s10194-020-01201-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/10/2020] [Indexed: 02/09/2023] Open
Abstract
Background Mild traumatic brain injury (mTBI) has a higher prevalence (more than 50%) of developing chronic posttraumatic headache (CPTH) compared with moderate or severe TBI. However, the underlying neural mechanism for CPTH remains unclear. This study aimed to investigate the inflammation level and cortical volume changes in patients with acute PTH (APTH) and further examine their potential in identifying patients who finally developed CPTH at follow-up. Methods Seventy-seven mTBI patients initially underwent neuropsychological measurements, 9-plex panel of serum cytokines and MRI scans within 7 days post-injury (T-1) and 54 (70.1%) of patients completed the same protocol at a 3-month follow-up (T-2). Forty-two matched healthy controls completed the same protocol at T-1 once. Results At baseline, mTBI patients with APTH presented significantly increased GM volume mainly in the right dorsal anterior cingulate cortex (dACC) and dorsal posterior cingulate cortex (dPCC), of which the dPCC volume can predict much worse impact of headache on patients’ lives by HIT-6 (β = 0.389, P = 0.007) in acute stage. Serum levels of C-C motif chemokine ligand 2 (CCL2) were also elevated in these patients, and its effect on the impact of headache on quality of life was partially mediated by the dPCC volume (mean [SE] indirect effect, 0.088 [0.0462], 95% CI, 0.01–0.164). Longitudinal analysis showed that the dACC and dPCC volumes as well as CCL2 levels had persistently increased in patients developing CPTH 3 months postinjury. Conclusion The findings suggested that structural remodelling of DMN brain regions were involved in the progression from acute to chronic PTH following mTBI, which also mediated the effect of inflammation processes on pain modulation. Trial registration ClinicalTrial.gov ID: NCT02868684; registered 16 August 2016. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-020-01201-7.
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Affiliation(s)
- Xuan Niu
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Yingxiang Sun
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuan Wang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guanghui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Shuoqiu Gan
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Xiaoyan Jia
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Hongjuan Liu
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Archibald J, MacMillan EL, Enzler A, Jutzeler CR, Schweinhardt P, Kramer JL. Excitatory and inhibitory responses in the brain to experimental pain: A systematic review of MR spectroscopy studies. Neuroimage 2020; 215:116794. [DOI: 10.1016/j.neuroimage.2020.116794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 01/21/2023] Open
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30
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Cerebral cortical dimensions in headache sufferers aged 50 to 66 years: a population-based imaging study in the Nord-Trøndelag Health Study (HUNT-MRI). Pain 2020; 160:1634-1643. [PMID: 30839431 DOI: 10.1097/j.pain.0000000000001550] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Based on previous clinic-based magnetic resonance imaging studies showing regional differences in the cerebral cortex between those with and without headache, we hypothesized that headache sufferers have a decrease in volume, thickness, or surface area in the anterior cingulate cortex, prefrontal cortex, and insula. In addition, exploratory analyses on volume, thickness, and surface area across the cerebral cortical mantle were performed. A total of 1006 participants (aged 50-66 years) from the general population were selected to an imaging study of the head at 1.5 T (HUNT-MRI). Two hundred eighty-three individuals suffered from headache, 80 with migraine, and 87 with tension-type headache, whereas 309 individuals did not suffer from headache and were used as controls. T1-weighted 3D scans of the brain were analysed with voxel-based morphometry and FreeSurfer. The association between cortical volume, thickness, and surface area and questionnaire-based headache diagnoses was evaluated, taking into consideration evolution of headache and frequency of attacks. There were no significant differences in cortical volume, thickness, or surface area between headache sufferers and nonsufferers in the anterior cingulate cortex, prefrontal cortex, or insula. Similarly, the exploratory analyses across the cortical mantle demonstrated no significant differences in volume, thickness, or surface area between any of the headache groups and the nonsufferers. Maps of effect sizes showed small differences in the cortical measures between headache sufferers and nonsufferers. Hence, there are probably no or only very small differences in volume, thickness, or surface area of the cerebral cortex between those with and without headache in the general population.
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Najafi P, Ben Salem D, Carré JL, Misery L, Dufor O. Functional and anatomical brain connectivity in psoriasis patients and healthy controls: a pilot brain imaging study after exposure to mentally induced itch. J Eur Acad Dermatol Venereol 2020; 34:2557-2565. [PMID: 32267024 DOI: 10.1111/jdv.16441] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Despite the prevalence of psoriasis, the processing of itch in psoriasis and its impact on the central nervous system (CNS) remain unclear. OBJECTIVE We studied the influence of psoriasis on the CNS using magnetic resonance imaging techniques (fMRI and DTI, respectively) to investigate whether mentally induced itch can modify the functional connectivity or the white matter microstructure of the brain. METHODS Fourteen patients with chronic psoriasis and 15 healthy controls were recruited. Itch was mentally induced in subjects by videos showing others scratching themselves. RESULTS The observation of functional connectivity during the viewing the video revealed an interconnected network of brain regions that are more strongly coupled in psoriasis patients than in healthy controls. This network links the cerebellum, the thalami, the anteroposterior cingulum, the inferior parietal lobules, the middle temporal poles and the parahippocampal, hippocampal, lingual and supramarginal gyri. We also found connections with the right precuneus and both left insula and superior temporal gyrus. The DTI analysis showed that chronic itch affects the microstructure of white matter, including the anterior thalamic radiations, the superior and inferior longitudinal fasciculi, the corticospinal tracts, the cingulum, the external capsules, the inferior frontal-occipital fasciculi and both minor and major forceps. CONCLUSION Our results indicate that there could exist a network which is more interconnected in psoriasis patients. Among two building blocks of this network, the subnetwork encoding the perception and control of itch sensation is more affected than the subnetwork representing mentalizing and empathy. With an approach consisting of measuring microstructural changes at a local level in the brain, we also contradict the findings obtained with global measures which stated that chronic psoriasis cannot alter the anatomy of the brain. This confirms that itchy pathophysiological conditions have similar effects on functional and structural connectivity as those observed in chronic pain.
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Affiliation(s)
| | - D Ben Salem
- Univ Brest, LATIM, Brest, France.,University Hospital of Brest, Brest, France
| | - J-L Carré
- Univ Brest, LIEN, Brest, France.,University Hospital of Brest, Brest, France
| | - L Misery
- Univ Brest, LIEN, Brest, France.,University Hospital of Brest, Brest, France
| | - O Dufor
- Univ Brest, LIEN, Brest, France
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32
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Telkes L, Hancu M, Paniccioli S, Grey R, Briotte M, McCarthy K, Raviv N, Pilitsis JG. Differences in EEG patterns between tonic and high frequency spinal cord stimulation in chronic pain patients. Clin Neurophysiol 2020; 131:1731-1740. [PMID: 32504934 DOI: 10.1016/j.clinph.2020.03.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/20/2020] [Accepted: 03/22/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the differences in neural patterns between spinal cord stimulation (SCS) waveforms (60-Hz tonic vs 10-KHz high frequency stimulation, HFS) and their correlation to stimulation-induced pain relief. METHODS We recorded 10-channel electroencephalogram (EEG) in response to stimulation ON and OFF in 9 chronic pain patients (4 women, 5 men) during SCS surgery and examined the intraoperative spatio-spectral EEG features. RESULTS We discovered stronger relative alpha power in the somatosensory region and higher trend in alpha/theta peak power ratio in frontal cortex with HFS. We also observed a shift in peak frequency from theta to alpha rhythms in HFS as compared to baseline and tonic stimulation, where slower theta activity was maintained. Further, a positive correlation was found between changes in Oswestry disability index (ODI) scores (from preoperative to postoperative) and HFS-induced alpha/theta peak power ratio in frontal and somatosensory regions. CONCLUSIONS Altogether, our findings suggest that dynamic spectral interactions in theta-alpha band and their spatial distributions might be the first intraoperative neural signatures of pain relief induced by HFS in chronic pain. SIGNIFICANCE Examining electrophysiological changes intraoperatively has a potential to elucidate response to SCS therapy prior to device selection, reducing the healthcare expenditures associated with failed implants.
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Affiliation(s)
- Llknur Telkes
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, NY, USA
| | - Maria Hancu
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, NY, USA
| | | | | | | | | | - Nataly Raviv
- Department of Neurosurgery, Albany Medical Center, NY, USA
| | - Julie G Pilitsis
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, NY, USA; Department of Neurosurgery, Albany Medical Center, NY, USA.
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33
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Lussier D, Cruz-Almeida Y, Ebner NC. Musculoskeletal Pain and Brain Morphology: Oxytocin's Potential as a Treatment for Chronic Pain in Aging. Front Aging Neurosci 2019; 11:338. [PMID: 31920621 PMCID: PMC6923678 DOI: 10.3389/fnagi.2019.00338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/22/2019] [Indexed: 11/13/2022] Open
Abstract
Chronic pain disproportionately affects older adults, severely impacting quality of life and independent living, with musculoskeletal pain most prevalent. Chronic musculoskeletal pain is associated with specific structural alterations in the brain and interindividual variability in brain structure is likely an important contributor to susceptibility for the development of chronic pain. However, understanding of age-related structural changes in the brain and their associations with chronic musculoskeletal pain is currently limited. Oxytocin (OT), a neuropeptide present in the periphery and central nervous system, has been implicated in pain attenuation. Variation of the endogenous OT system (e.g., OT receptor genotype, blood, saliva, and cerebrospinal fluid OT levels) is associated with morphology in brain regions involved in pain processing and modulation. Intranasal OT administration has been shown to attenuate pain. Yet, studies investigating the efficacy of OT for management of chronic musculoskeletal pain are lacking, including among older individuals who are particularly susceptible to the development of chronic musculoskeletal pain. The goal of this focused narrative review was to synthesize previously parallel lines of work on the relationships between chronic pain, brain morphology, and OT in the context of aging. Based on the existing evidence, we propose that research on the use of intranasal OT administration as an intervention for chronic pain in older adults is needed and constitutes a promising future direction for this field. The paper concludes with suggestions for future research in the emerging field, guided by our proposed Model of Oxytocin’s Anagelsic and Brain Structural Effects in Aging.
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Affiliation(s)
- Désirée Lussier
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States.,Claude D. Pepper Older American Independence Center, Institute on Aging, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, United States.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States.,Departments of Aging & Geriatric Research, Epidemiology and Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Natalie C Ebner
- Department of Psychology, University of Florida, Gainesville, FL, United States.,Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States.,Claude D. Pepper Older American Independence Center, Institute on Aging, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, United States.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States
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Kincses ZT, Veréb D, Faragó P, Tóth E, Kocsis K, Kincses B, Király A, Bozsik B, Párdutz Á, Szok D, Tajti J, Vécsei L, Tuka B, Szabó N. Are Migraine With and Without Aura Really Different Entities? Front Neurol 2019; 10:982. [PMID: 31632329 PMCID: PMC6783501 DOI: 10.3389/fneur.2019.00982] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/28/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Migraine research is booming with the rapidly developing neuroimaging tools. Structural and functional alterations of the migrainous brain were detected with MRI. The outcome of a research study largely depends on the working hypothesis, on the chosen measurement approach and also on the subject selection. Against all evidence from the literature that migraine subtypes are different, most of the studies handle migraine with and without aura as one disease. Methods: Publications from PubMed database were searched for terms of "migraine with aura," "migraine without aura," "interictal," "MRI," "diffusion weighted MRI," "functional MRI," "compared to," "atrophy" alone and in combination. Conclusion: Only a few imaging studies compared the two subforms of the disease, migraine with aura, and without aura, directly. Functional imaging investigations largely agree that there is an increased activity/activation of the brain in migraine with aura as compared to migraine without aura. We propose that this might be the signature of cortical hyperexcitability. However, structural investigations are not equivocal. We propose that variable contribution of parallel, competing mechanisms of maladaptive plasticity and neurodegeneration might be the reason behind the variable results.
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Affiliation(s)
- Zsigmond Tamás Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- Department of Radiology, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Péter Faragó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - András Király
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- Brain and Mind Research, Central European Institute of Technology, Brno, Czechia
| | - Bence Bozsik
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Árpád Párdutz
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Délia Szok
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - János Tajti
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- MTA-SZTE, Neuroscience Research Group, Szeged, Hungary
| | - Bernadett Tuka
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- MTA-SZTE, Neuroscience Research Group, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- Brain and Mind Research, Central European Institute of Technology, Brno, Czechia
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Sundermann B, Dehghan Nayyeri M, Pfleiderer B, Stahlberg K, Jünke L, Baie L, Dieckmann R, Liem D, Happe T, Burgmer M. Subtle changes of gray matter volume in fibromyalgia reflect chronic musculoskeletal pain rather than disease-specific effects. Eur J Neurosci 2019; 50:3958-3967. [PMID: 31448468 DOI: 10.1111/ejn.14558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 12/17/2022]
Abstract
Fibromyalgia syndrome (FMS) is a chronic pain syndrome. Neuroimaging studies provided evidence of altered gray matter volume (GMV) in FMS but, similarly, in chronic pain of other origin as well. Therefore, the purpose of this study was to evaluate the disease specificity of GMV alterations in FMS by direct comparison. Structural MRI data of the brain were acquired in 25 females with FMS and two different control groups: 21 healthy subjects and 23 patients with osteoarthritis. Regional GMVs were compared by voxel-based morphometry and additional ROI-analyses. In conclusion, we did not identify significant GMV alterations in either FMS or OA patients compared to healthy controls when adopting a conservative statistical approach with multiple comparison correction. However, even under a more liberal approach no FMS-specific GMV changes were found because both pain groups presented increased gray matter volumes in the precentral gyrus and decreased GMV in the angular gyrus/middle occipital gyrus and middle temporal gyrus in comparison with healthy controls. Since no differences between both pain groups could be detected cortical GMV changes in FMS should not be interpreted as FMS-specific but might rather reflect changes in chronic pain in general. This previously held notion is confirmed in this study by direct comparison with a control group consisting of another pain disorder.
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Affiliation(s)
- Benedikt Sundermann
- Department of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Münster, Germany
| | - Mahboobeh Dehghan Nayyeri
- Department of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Münster, Germany.,Department of Psychosomatic Medicine and Psychotherapy, LVR Clinic, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Bettina Pfleiderer
- Department of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Münster, Germany
| | - Kim Stahlberg
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Leonie Jünke
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Lara Baie
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Ralf Dieckmann
- Department of General Orthopaedics and Tumororthopaedics, University Hospital Münster, Münster, Germany
| | - Dennis Liem
- Department of General Orthopaedics and Tumororthopaedics, University Hospital Münster, Münster, Germany
| | | | - Markus Burgmer
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
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36
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Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth 2019; 123:e273-e283. [PMID: 31079836 PMCID: PMC6676152 DOI: 10.1016/j.bja.2019.03.023] [Citation(s) in RCA: 736] [Impact Index Per Article: 147.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/22/2019] [Indexed: 12/18/2022] Open
Abstract
Chronic pain is a common, complex, and distressing problem that has a profound impact on individuals and society. It frequently presents as a result of a disease or an injury; however, it is not merely an accompanying symptom, but rather a separate condition in its own right, with its own medical definition and taxonomy. Studying the distribution and determinants of chronic pain allows us to understand and manage the problem at the individual and population levels. Targeted and appropriate prevention and management strategies need to take into account the biological, psychological, socio-demographic, and lifestyle determinants and outcomes of pain. We present a narrative review of the current understanding of these factors.
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Affiliation(s)
- Sarah E E Mills
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
| | - Karen P Nicolson
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK
| | - Blair H Smith
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK
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37
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Diffusion tensor imaging in middle-aged headache sufferers in the general population: a cross-sectional population-based imaging study in the Nord-Trøndelag health study (HUNT-MRI). J Headache Pain 2019; 20:78. [PMID: 31291903 PMCID: PMC6734377 DOI: 10.1186/s10194-019-1028-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies have investigated white matter with diffusion tensor imaging (DTI) in those suffering from headache, but so far only in clinic based samples and with conflicting results. METHODS In the present study, 1006 individuals (50-66 years) from the general population (Nord-Trøndelag Health Study) participated in an imaging study of the head at 1.5 T (HUNT-MRI). Hundred and ninety-six individuals were excluded because of errors in the data acquisition or brain pathology. Two hundred and forty-six of the remaining participants reported suffering from headache (69 from migraine and 76 from tension-type headache) the year prior to the scanning. DTI data were analysed with Tract-Based Spatial Statistics and automated tractography. Type of headache, frequency of attacks and evolution of headache were investigated for an association with white matter fractional anisotropy (FA), mean diffusivity (MD), axonal diffusivity (AD), radial diffusivity (RD) and tract volume. Correction for various demographical and clinical variables were performed. RESULTS Headache sufferers had widespread higher white matter MD, AD and RD compared to headache free individuals (n = 277). The effect sizes were mostly small with the largest seen in those with middle-age onset headache, who also had lower white matter FA. There were no associations between white matter microstructure and attack frequency or type of headache. CONCLUSION Middle-age onset headache may be related to a widespread process in the white matter leading to altered microstructure.
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38
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Bhatt RR, Gupta A, Rapkin A, Kilpatrick LA, Hamadani K, Pazmany E, Van Oudenhove L, Stains J, Aerts L, Enzlin P, Tillisch K, Mayer EA, Labus JS. Altered gray matter volume in sensorimotor and thalamic regions associated with pain in localized provoked vulvodynia: a voxel-based morphometry study. Pain 2019; 160:1529-1540. [PMID: 30817440 PMCID: PMC6586504 DOI: 10.1097/j.pain.0000000000001532] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Multimodal neuroimaging studies provide support for a role of alterations in sensory processing circuits and endogenous pain modulatory systems in provoked vestibulodynia (PVD). In this study, we tested the hypotheses that PVD compared with healthy controls (HCs) would demonstrate gray matter volume (GMV) alterations in regions associated with sensorimotor, corticothalamic, and basal ganglia circuits. We also tested the replicability of previously reported gray matter increases in basal ganglia and hippocampal volumes in PVD vs HCs. In addition, disease specificity of GMV alterations were examined by comparing PVD with another chronic pain disorder. Finally, we examine whether GMV alterations are correlated with symptom measures. Structural magnetic resonance imaging was obtained in 119 premenopausal women (45 PVD, 45 HCs, and 29 irritable bowel syndrome [IBS]). A voxel-based morphometry analysis was applied to determine group differences in the hypothesized regions of interest. Compared with HCs, PVD women exhibited greater GMV in the basal ganglia, hippocampus, and sensorimotor cortices. Compared to patients with IBS, women with PVD had greater GMV in the hippocampus, and sensorimotor network, but lower GMV in the thalamus and precentral gyrus. Regional GMV alterations were associated with patient reports of pain during intercourse and muscle tenderness. The current findings provide further evidence that GMV is increased in PVD compared with HCs in several regions of the sensorimotor network and the hippocampus in patients with PVD. In addition, GMV distinct alterations in the sensorimotor network were identified between 2 pelvic pain disorders, PVD compared with IBS.
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Affiliation(s)
- Ravi R. Bhatt
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- Pediatric Pain and Palliative Care Program, UCLA
| | - Arpana Gupta
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- David Geffen School of Medicine, UCLA
- UCLA Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA
| | - Andrea Rapkin
- David Geffen School of Medicine, UCLA
- Department of Obstetrics and Gynecology, UCLA
| | - Lisa A. Kilpatrick
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- David Geffen School of Medicine, UCLA
- UCLA Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA
| | - Kareem Hamadani
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
| | - Els Pazmany
- Institute for Family and Sexuality Studies, KU Leuven
| | - Lukas Van Oudenhove
- Translational Research Center for Gastrointestinal Disorders, University of Leuven
| | - Jean Stains
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- David Geffen School of Medicine, UCLA
- UCLA Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA
| | - Leen Aerts
- Institute for Family and Sexuality Studies, KU Leuven
- Geneva University Hospitals
| | - Paul Enzlin
- Institute for Family and Sexuality Studies, KU Leuven
| | - Kirsten Tillisch
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- David Geffen School of Medicine, UCLA
- UCLA Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA
| | - Emeran A. Mayer
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- David Geffen School of Medicine, UCLA
- UCLA Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA
- Brain Research Institute, UCLA
| | - Jennifer S. Labus
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, UCLA
- David Geffen School of Medicine, UCLA
- UCLA Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA
- Brain Research Institute, UCLA
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39
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Vaculik MF, Noorani A, Hung PSP, Hodaie M. Selective hippocampal subfield volume reductions in classic trigeminal neuralgia. Neuroimage Clin 2019; 23:101911. [PMID: 31491821 PMCID: PMC6616529 DOI: 10.1016/j.nicl.2019.101911] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/24/2019] [Accepted: 06/25/2019] [Indexed: 12/26/2022]
Abstract
Trigeminal Neuralgia (TN) is a chronic neuropathic pain syndrome characterized by paroxysmal unilateral shock-like pains in the trigeminal territory most frequently attributed to neurovascular compression of the trigeminal nerve at its root entry zone. Recent advances in the study of TN suggest a possible central nervous system (CNS) role in modulation and maintenance of pain. TN and other chronic pain patients commonly experience alterations in cognition and affect, as well as abnormalities in CNS volume and microstructure in regions associated with pain perception, emotional modulation, and memory consolidation. However, the microstructural changes in the hippocampus, an important structure within the limbic system, have not been previously studied in TN patients. Here, we use grey matter analysis to assess whether TN pain is associated with altered hippocampal subfield volume in patients with classic TN. Anatomical magnetic resonance (MR) images of twenty-two right-sided TN patients and matched healthy controls underwent automated segmentation of hippocampal subfields using FreeSurfer v6.0. Right-sided TN patients had significant volumetric reductions in ipsilateral cornu ammois 1 (CA1), CA4, dentate gyrus, molecular layer, and hippocampus-amygdala transition area - resulting in decreased whole ipsilateral hippocampal volume, compared to healthy controls. Overall, we demonstrate selective hippocampal subfield volume reduction in patients with classic TN. These changes occur in subfields implicated as neural circuits for chronic pain processing. Selective subfield volume reduction suggests aberrant processes and circuitry reorganization, which may contribute to development and/or maintenance of TN symptoms.
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Affiliation(s)
- Michael Frantisek Vaculik
- Dalhousie Medical School, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Alborz Noorani
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada
| | - Peter Shih-Ping Hung
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada
| | - Mojgan Hodaie
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada; Division of Neurosurgery, Toronto Western Hospital, University Health Network, Ontario, Canada.
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Torrecillas-Martínez L, Catena A, O'Valle F, Padial-Molina M, Galindo-Moreno P. Does experienced pain affects local brain volumes? Insights from a clinical acute pain model. Int J Clin Health Psychol 2019; 19:115-123. [PMID: 31193130 PMCID: PMC6517646 DOI: 10.1016/j.ijchp.2019.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/23/2019] [Indexed: 12/04/2022] Open
Abstract
Background/Objective:To study pain-brain morphometry associations as a function of post-surgery stages (anesthesia, pain and analgesia) in an acute pain model. Method:Impacted mandible third molar were extracted. Before surgery, an anatomical T1 scan was obtained. Regional brain volumen and subcortical nuclei shapes were obtained. Statistical analyses were done using multiple regression, being pain scores the predictors and voxel volumes, subcortical nuclei volumes and subcortical nuclei shapes, the outcomes. Results:Pain was significantly larger at pain than at anesthesia and analgesia stages, and was higher during anesthesia than during analgesia. Pain intensity was related to grey matter in several cortical (Insula, Mid Frontal and Temporal Gyruses, Precuneus, Anterior Cingulate), and subcortical nuclei (Hippocampus, Thalamus, Putamen, Amygdala), depending of the post-surgical stage. A larger number of brain areas showed significance at pain that at anesthesia and analgesia stages. Conclusions:The relationships of regional brain volumes and subcortical nuclei shapes with pain scores seemed to be unsteady, as they changed with the patient's actual pain stage.
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Affiliation(s)
| | - Andrés Catena
- Mind, Brain and Behavior Research Center, University of Granada, Spain
| | - Francisco O'Valle
- Department of Pathology, School of Medicine & IBIMER, University of Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Spain
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41
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Li T, Zhang S, Kurata J. Suppressed descending pain modulatory and enhanced sensorimotor networks in patients with chronic low back pain. J Anesth 2018; 32:831-843. [PMID: 30264383 DOI: 10.1007/s00540-018-2561-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/22/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE Although cerebral structural and functional changes were uncovered by neuroimaging in patients with chronic low back pain (CLBP), their associations remain to be clarified. We co-analyzed anatomical and functional magnetic resonance imaging data in those patients and tested whether cortical gray matter volume changes are associated with altered pain modulatory networks underlying chronification of pain. METHODS In 16 patients with CLBP and 16 heathy controls, we performed functional magnetic resonance imaging during mechanical pain stimulation on the lower back followed by anatomical imaging. We performed voxel-based morphometry and functional connectivity analysis from the seeds with altered gray matter volume, and examined correlations between imaging and psychophysical parameters. RESULTS Patients showed decreases in gray matter volume at the right dorsolateral prefrontal cortex, middle occipital gyrus, and cerebellum, and showed increases at the bilateral primary sensorimotor cortices, left fusiform gyrus, and right cerebellum compared with controls (P < 0.001). Dorsolateral prefrontal and fusiform volumes showed negative associations with affective comorbidity, whereas motor cortex volume with impaired daily activity (P < 0.05). Connectivity was decreased between the cerebellar and limbic, and increased between the bilateral sensorimotor regions (PFDR < 0.05). Higher pain intensity and unpleasantness correlated with enhanced bilateral sensorimotor and dorsolateral-medial prefrontal networks, respectively (P < 0.05). CONCLUSION Patients showed a decreased volume of cortical center for descending pain modulation and an increased volume of sensorimotor network, in association with suppressed descending pain modulatory and cerebellum-limbic networks and enhanced sensorimotor network during pain. Such structural and functional alterations might be part of cerebral pathophysiology of CLBP.
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Affiliation(s)
- Tianjiao Li
- Department of Anesthesiology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Shuo Zhang
- Department of Anesthesiology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Jiro Kurata
- Department of Anesthesiology and Pain Clinic, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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42
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Ayoub LJ, Seminowicz DA, Moayedi M. A meta-analytic study of experimental and chronic orofacial pain excluding headache disorders. NEUROIMAGE-CLINICAL 2018; 20:901-912. [PMID: 30292089 PMCID: PMC6176551 DOI: 10.1016/j.nicl.2018.09.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 01/08/2023]
Abstract
Chronic orofacial pain (COFP) disorders are prevalent and debilitating pain conditions affecting the head, neck and face areas. Neuroimaging studies have reported functional and grey matter abnormalities, but not all the studies have reported consistent findings. Identifying convergent abnormalities across COFPs provides a basis for future hypothesis-driven research aimed at elucidating common CNS mechanisms. Here, we perform three coordinate-based meta-analyses according to PRISMA guidelines to elucidate the central mechanisms of orofacial pain disorders. Specifically, we investigated consistent patterns of: (1) brain function to experimental orofacial pain in healthy subjects, (2) structural and (3) functional brain abnormalities in COFP. We computed our coordinate-based meta-analyses using GingerALE. The experimental pain meta-analysis revealed increased brain activity in bilateral thalami, posterior mid-cingulate cortices, and secondary somatosensory cortices, the right posterior parietal cortex extending to the orofacial region of the right primary somatosensory cortex and the right insula, and decreased activity in the right somatomotor regions. The structural COFP meta-analysis identified consistent higher grey matter volume/concentration in the right ventral thalamus and posterior putamen of COFP patients compared to healthy controls. The functional COFP meta-analysis identified a consistent increase in brain activity in the left medial and posterior thalamus and lesser activity in the left posterior insula in COFP, compared to healthy controls. Overall, these findings provide evidence of brain abnormalities in pain-related regions, namely the thalamus and insula, across different COFP disorders. The convergence of thalamic abnormalities in both structure and function suggest a key role for this region in COFP pathophysiology. Identifying convergent abnormalities in COFP can elucidate novel therapeutic targets. Experimental orofacial pain is associated with activity in nociceptive processing brain areas. Chronic orofacial pain (COFP) is associated with abnormal thalamic activity and grey matter. Our review highlights the need for more high quality COFP brain imaging studies.
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Affiliation(s)
- Lizbeth J Ayoub
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada
| | - David A Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, United States; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
| | - Massieh Moayedi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada.
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43
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Zhao L, Wang Y, Zhang Y. Microstructural changes in the brain in elderly patients with irritable bowel syndrome. Aging Med (Milton) 2018; 1:141-148. [PMID: 31942491 PMCID: PMC6880712 DOI: 10.1002/agm2.12034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/02/2018] [Accepted: 08/02/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE It is unclear how alterations in gray matter volume and white matter density affect elderly patients with irritable bowel syndrome (IBS). This study aimed to investigate the relationship between structural changes in the brain and psychological stress in elderly IBS patients. METHODS Eighteen IBS patients and 12 healthy controls underwent structural magnetic resonance imaging. Voxel-based morphometry and diffusion tensor imaging analysis were used to identify abnormalities in cortical regions and white matter, respectively. RESULTS The IBS group showed a significant GMV reduction in the cingulate gyrus, occipital lobe, hippocampus, frontal lobe, medial frontal gyrus, superior frontal gyrus, and limbic lobe as well as a higher GMV in the insula, superior temporal gyrus, angular gyrus, and supramarginal gyrus. Diffusion tensor imaging indicated that the IBS group had lower fractional anisotropy in the corpus callosum, upper corona, fornix, internal capsule, and brainstem. Additionally, IBS patients showed higher mean diffusivity in the cingulate gyrus, corpus callosum, upper corona, internal capsule, external capsule, fornix, and superior longitudinal fasciculus. CONCLUSION Structural changes in the brain play a role in the condition of elderly IBS patients. Psychological stress is an important factor for developing IBS via the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- Lanlan Zhao
- Department of GerontologyHuashan HospitalShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Yuezhi Wang
- Department of GerontologyHuashan HospitalShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Yu Zhang
- Department of GerontologyHuashan HospitalShanghai Medical CollegeFudan UniversityShanghaiChina
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Husøy AK, Pintzka C, Eikenes L, Håberg AK, Hagen K, Linde M, Stovner LJ. Volume and shape of subcortical grey matter structures related to headache: A cross-sectional population-based imaging study in the Nord-Trøndelag Health Study. Cephalalgia 2018; 39:173-184. [PMID: 29848110 DOI: 10.1177/0333102418780632] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The relationship between subcortical nuclei and headache is unclear. Most previous studies were conducted in small clinical migraine samples. In the present population-based MRI study, we hypothesized that headache sufferers exhibit reduced volume and deformation of the nucleus accumbens compared to non-sufferers. In addition, volume and deformation of the amygdala, caudate, hippocampus, pallidum, putamen and thalamus were examined. METHODS In all, 1006 participants (50-66 years) from the third Nord-Trøndelag Health Survey, were randomly selected to undergo a brain MRI at 1.5 T. Volume and shape of the subcortical nuclei from T1 weighted 3D scans were obtained in FreeSurfer and FSL. The association with questionnaire-based headache categories (migraine and tension-type headache included) was evaluated using analysis of covariance. Individuals not suffering from headache were used as controls. Age, sex, intracranial volume and Hospital Anxiety and Depression Scale were used as covariates. RESULTS No effect of headache status on accumbens volume and shape was present. Exploratory analyses showed significant but small differences in volume of caudate and putamen and in putamen shape between those with non-migrainous headache and the controls. A post hoc analysis showed that caudate volume was strongly associated with white matter hyperintensities. CONCLUSION We did not confirm our hypothesis that headache sufferers have smaller volume and different shape of the accumbens compared to non-sufferers. No or only small differences in volume and shape of subcortical nuclei between headache sufferers and non-sufferers appear to exist in the general population.
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Affiliation(s)
- Andreas Kattem Husøy
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Carl Pintzka
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,2 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Live Eikenes
- 2 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asta K Håberg
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,3 Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Knut Hagen
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,4 Norwegian Advisory Unit on Headache, St. Olav's University Hospital, Trondheim, Norway
| | - Mattias Linde
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,4 Norwegian Advisory Unit on Headache, St. Olav's University Hospital, Trondheim, Norway
| | - Lars Jacob Stovner
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,4 Norwegian Advisory Unit on Headache, St. Olav's University Hospital, Trondheim, Norway
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Bido-Medina R, Wirsich J, Rodríguez M, Oviedo J, Miches I, Bido P, Tusen L, Stoeter P, Sadaghiani S. Impact of Zika Virus on adult human brain structure and functional organization. Ann Clin Transl Neurol 2018; 5:752-762. [PMID: 29928658 PMCID: PMC5989769 DOI: 10.1002/acn3.575] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 01/11/2023] Open
Abstract
Objective To determine the impact of Zika virus (ZIKV) infection on brain structure and functional organization of severely affected adult patients with neurological complications that extend beyond Guillain–Barré Syndrome (GBS)‐like manifestations and include symptoms of the central nervous system (CNS). Methods In this first case–control neuroimaging study, we obtained structural and functional magnetic resonance images in nine rare adult patients in the subacute phase, and healthy age‐ and sex‐matched controls. ZIKV patients showed atypical descending and rapidly progressing peripheral nervous system (PNS) manifestations, and importantly, additional CNS presentations such as perceptual deficits. Voxel‐based morphometry was utilized to evaluate gray matter volume, and resting state functional connectivity and Network Based Statistics were applied to assess the functional organization of the brain. Results Gray matter volume was decreased bilaterally in motor areas (supplementary motor cortex, specifically Frontal Eye Fields) and beyond (left inferior frontal sulcus). Additionally, gray matter volume increased in right middle frontal gyrus. Functional connectivity increased in a widespread network within and across temporal lobes. Interpretation We provide preliminary evidence for a link between ZIKV neurological complications and changes in adult human brain structure and functional organization, comprising both motor‐related regions potentially secondary to prolonged PNS weakness, and nonsomatomotor regions indicative of PNS‐independent alternations. The latter included the temporal lobes, particularly vulnerable in a range of neurological conditions. While future studies into the ZIKV‐related neuroinflammatory mechanisms in adults are urgently needed, this study indicates that ZIKV infection can lead to an impact on the brain.
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Affiliation(s)
- Richard Bido-Medina
- Beckman Institute for Advanced Science and Technology University of Illinois at Urbana-Champaign Urbana Illinois 61801.,Neuroscience Program University of Illinois at Urbana-Champaign Urbana Illinois 61801
| | - Jonathan Wirsich
- Beckman Institute for Advanced Science and Technology University of Illinois at Urbana-Champaign Urbana Illinois 61801
| | | | - Jairo Oviedo
- Centro Diagnostico de Medicina Avanzada y Telemedicina (CEDIMAT) Santo Domingo Dominican Republic
| | - Isidro Miches
- Neuroscience Program University of Illinois at Urbana-Champaign Urbana Illinois 61801
| | - Pamela Bido
- Hospital Salvador B. Gautier Santo Domingo Dominican Republic
| | - Luis Tusen
- Hospital Salvador B. Gautier Santo Domingo Dominican Republic
| | - Peter Stoeter
- Centro Diagnostico de Medicina Avanzada y Telemedicina (CEDIMAT) Santo Domingo Dominican Republic
| | - Sepideh Sadaghiani
- Beckman Institute for Advanced Science and Technology University of Illinois at Urbana-Champaign Urbana Illinois 61801.,Psychology Department University of Illinois at Urbana-Champaign Urbana Illinois 61801
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Szabó N, Faragó P, Király A, Veréb D, Csete G, Tóth E, Kocsis K, Kincses B, Tuka B, Párdutz Á, Szok D, Tajti J, Vécsei L, Kincses ZT. Evidence for Plastic Processes in Migraine with Aura: A Diffusion Weighted MRI Study. Front Neuroanat 2018; 11:138. [PMID: 29387002 PMCID: PMC5776127 DOI: 10.3389/fnana.2017.00138] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/26/2017] [Indexed: 01/03/2023] Open
Abstract
Background: Formerly white matter abnormalities in a mixed group of migraine patients with and without aura were shown. Here, we aimed to explore white matter alterations in a homogeneous group of migraineurs with aura and to delineate possible relationships between white matter changes and clinical variables. Methods: Eighteen patients with aura, 25 migraine patients without aura and 28 controls were scanned on a 1.5T MRI scanner. Diffusivity parameters of the white matter were estimated and compared between patients’ groups and controls using whole-brain tract-based spatial statistics. Results: Decreased radial diffusivity (p < 0.036) was found bilaterally in the parieto-occipital white matter, the corpus callosum, and the cingular white matter of migraine with aura (MwA) patients compared to controls. Migraine without aura (MwoA) patients showed no alteration compared to controls. MwA compared to MwoA showed increased fractional anisotropy (p < 0.048) in the left parieto-occipital white matter. In MwA a negative correlation was found between axial diffusivity and disease duration in the left superior longitudinal fascicle (left parieto-occipital region) and in the left corticospinal tract (p < 0.036) and with the number of the attacks in the right superior longitudinal fascicle (p < 0.048). Conclusion: We showed for the first time that there are white matter microstructural differences between these two subgroups of migraine and hence it is important to handle the two groups separately in further researches. We propose that degenerative and maladaptive plastic changes coexist in the disease and the diffusion profile is a result of these processes.
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Affiliation(s)
- Nikoletta Szabó
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Péter Faragó
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - András Király
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Dániel Veréb
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergő Csete
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | | | - Árpád Párdutz
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Délia Szok
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - János Tajti
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond T Kincses
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Taylor KS, Millar PJ, Murai H, Haruki N, Kimmerly DS, Bradley TD, Floras JS. Cortical autonomic network gray matter and sympathetic nerve activity in obstructive sleep apnea. Sleep 2017; 41:4773854. [PMID: 29309669 DOI: 10.1093/sleep/zsx208] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/08/2017] [Indexed: 01/08/2023] Open
Abstract
The sympathetic excitation elicited acutely by obstructive apnea during sleep (OSA) carries over into wakefulness. We hypothesized that OSA induces structural changes in the insula and cingulate, key central autonomic network elements with projections to brainstem sympathetic premotor regions. The aims of this study were to (1) apply two distinct but complementary methods (cortical thickness analysis [CTA] and voxel-based morphometry [VBM]) to compare insula and cingulate gray matter thickness in participants without and with OSA; (2) determine whether oxygen desaturation index (ODI) relates to cortical thickness; and (3) determine whether cortical thickness or volume in these regions predicts muscle sympathetic nerve activity (MSNA) burst incidence (BI). Overnight polysomnography, anatomical magnetic resonance imaging, and MSNA data were acquired in 41 participants with no or mild OSA (n = 19; 59 ± 2 years [Mean ± SE]; six females; apnea-hypopnea index [AHI] 7 ± 1 events per hour) or moderate-to-severe OSA (n = 22; 59 ± 2 years; five females; AHI 31 ± 4 events per hour). Between-group CTA analyses identified cortical thinning within the left dorsal posterior insula and thickening within the left mid-cingulate cortex (LMCC), whereas VBM identified thickening within bilateral thalami (all [p < .05]). CTA revealed inverse relationships between ODI and bilateral dpIC and left posterior cingulate cortex (LPCC) or precuneus thickness. Positive correlations between BI and LMCC gray matter thickness or volume were evident with both methods and between BI and left posterior thalamus volume using VBM. In OSA, the magnitude of insular thinning, although a function of hypoxia severity, does not influence MSNA, whereas cingulate and thalamic thickening relate directly to the intensity of sympathetic discharge during wakefulness.
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Affiliation(s)
- Keri S Taylor
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Philip J Millar
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Hisayoshi Murai
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nobuhiko Haruki
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Derek S Kimmerly
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia, Canada
| | - T Douglas Bradley
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John S Floras
- Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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Wurthmann S, Naegel S, Schulte Steinberg B, Theysohn N, Diener HC, Kleinschnitz C, Obermann M, Holle D. Cerebral gray matter changes in persistent postural perceptual dizziness. J Psychosom Res 2017; 103:95-101. [PMID: 29167054 DOI: 10.1016/j.jpsychores.2017.10.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Persistent postural perceptual dizziness (PPPD) is the most common vestibular syndrome in middle-aged patients. Multisensory maladjustment involving alterations of sensory response pattern including vestibular, visual and motion stimuli is thought to be a key pathophysiological correlate of this disorder. OBJECTIVE We aimed to identify regional gray matter changes in PPPD patients that might be involved in the underlying pathophysiology of this disorder. METHODS 42 PPPD patients and healthy age and gender matched controls were investigated using magnetic resonance imaging-based voxel-based morphometry. All patients fulfilled the current diagnostic criteria for PPPD, established by the Bárány-Society based on previous criteria for chronic subjective dizziness and phobic postural vertigo. RESULTS PPPD patients showed gray matter volume decrease in the temporal cortex, cingulate cortex, precentral gyrus, hippocampus, dorsolateral prefrontal cortex, caudate nucleus and the cerebellum. A negative correlation of disease duration and gray matter volume was observed in the visual cortex, supplementary motor area and somatosensory processing structures. CONCLUSIONS In patients with PPPD areas involved in multisensory vestibular processing show gray matter volume decrease. These brain regions resemble those previously described for other vestibular disorders. Longer duration of disease leads to a more pronounced gray matter alteration, which might represent maladaptive mechanisms within the course of disease.
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Affiliation(s)
- Sebastian Wurthmann
- Department of Neurology and Dizziness, Vertigo Center Essen, University of Duisburg-Essen, Germany.
| | - Steffen Naegel
- Department of Neurology and Dizziness, Vertigo Center Essen, University of Duisburg-Essen, Germany.
| | | | - Nina Theysohn
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Germany.
| | - Hans-Christoph Diener
- Department of Neurology and Dizziness, Vertigo Center Essen, University of Duisburg-Essen, Germany.
| | - Christoph Kleinschnitz
- Department of Neurology and Dizziness, Vertigo Center Essen, University of Duisburg-Essen, Germany.
| | - Mark Obermann
- Department of Neurology and Dizziness, Vertigo Center Essen, University of Duisburg-Essen, Germany; Center for Neurology, Asklepios Hospitals Schildautal, Karl-Herold-Straße 1, 38723 Seesen, Germany.
| | - Dagny Holle
- Department of Neurology and Dizziness, Vertigo Center Essen, University of Duisburg-Essen, Germany.
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Paquet A, Plansont B, Labrunie A, Malauzat D, Girard M. Past Pain Experience and Experimentally induced Pain Perception. Issues Ment Health Nurs 2017; 38:1013-1021. [PMID: 28766994 DOI: 10.1080/01612840.2017.1354103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
UNLABELLED Many intercurrent factors may be involved in the modulation of the pain message and its expression, such as the previous experience of pain built along the life. In this study, we aimed to determine whether susceptibility to experimentally induced pain is differentially influenced by the individual previous painful experience in subjects with schizophrenia (SC) major depression (MD), and controls (C). METHODS The SC (30), MD (32) and C (30) groups participated in experimental pain tests (application of pressure and induction of ischemia) after a semi-structured interview to make an inventory of the previous painful experiences, and the evaluation of anxiety either with autonomic (heart rate, blood pressure) or psychological (Hospital Anxiety Depression scale HAD) measures, and catastrophism. RESULTS The reported pain intensities, severities, duration, of the previous pain events, and the number of previous painful events were equivalent in the three groups, except for the number of painful events experimented before the last six months which was lower in the MD group. Experimental pain sensitivity was influenced by the diagnosis, the HAD scores or the number and intensities of previous lived painful events. CONCLUSION The lack of a past experience of pain was comparable for the different groups, suggesting that psychiatric disorders do not affect the experience of pain associated with daily life or past events. For each subject, the reported previous experience of pain influences the present feeling of pain.
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Affiliation(s)
- Aude Paquet
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
| | - Brigitte Plansont
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
| | - Anaïs Labrunie
- b INSERM, U1094 , Neuroépidémiologie Tropicale , Limoges , France ; CHU Limoges , Centre d'Epidémiologie, de Biostatistique et de Méthodologie de la Recherche , Limoges , France
| | - Dominique Malauzat
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
| | - Murielle Girard
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
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50
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Characterization of a novel capsaicin/heat ongoing pain model. Eur J Pain 2017; 22:370-384. [DOI: 10.1002/ejp.1126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2017] [Indexed: 12/27/2022]
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