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Santos Cuevas DC, Campos Ruiz RE, Collina DD, Tierra Criollo CJ. Effective brain connectivity related to non-painful thermal stimuli using EEG. Biomed Phys Eng Express 2024; 10:045044. [PMID: 38834037 DOI: 10.1088/2057-1976/ad53ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/04/2024] [Indexed: 06/06/2024]
Abstract
Understanding the brain response to thermal stimuli is crucial in the sensory experience. This study focuses on non-painful thermal stimuli, which are sensations induced by temperature changes without causing discomfort. These stimuli are transmitted to the central nervous system through specific nerve fibers and are processed in various regions of the brain, including the insular cortex, the prefrontal cortex, and anterior cingulate cortex. Despite the prevalence of studies on painful stimuli, non-painful thermal stimuli have been less explored. This research aims to bridge this gap by investigating brain functional connectivity during the perception of non-painful warm and cold stimuli using electroencephalography (EEG) and the partial directed coherence technique (PDC). Our results demonstrate a clear contrast in the direction of information flow between warm and cold stimuli, particularly in the theta and alpha frequency bands, mainly in frontal and temporal regions. The use of PDC highlights the complexity of brain connectivity during these stimuli and reinforces the existence of different pathways in the brain to process different types of non-painful warm and cold stimuli.
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Affiliation(s)
| | | | - Denny Daniel Collina
- Department of Electronics and Biomedical Engineering, Federal Center for Technological Education of Minas Gerais, Belo Horizonte, 30510-000, Brazil
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2
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Nichols NM, Ezzat B, Waters AC, Panov F, Yong RL, Germano IM. What is the cognitive footprint of insular glioma? Front Hum Neurosci 2024; 18:1382380. [PMID: 38859993 PMCID: PMC11163043 DOI: 10.3389/fnhum.2024.1382380] [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: 02/05/2024] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
Cognitive impairment has a profound deleterious impact on long-term outcomes of glioma surgery. The human insula, a deep cortical structure covered by the operculum, plays a role in a wide range of cognitive functions including interceptive thoughts and salience processing. Both low-grade (LGG) and high-grade gliomas (HGG) involve the insula, representing up to 25% of LGG and 10% of HGG. Surgical series from the past 30 years support the role of primary cytoreductive surgery for insular glioma patients; however, reported cognitive outcomes are often limited to speech and language function. The breath of recent neuroscience literature demonstrates that the insula plays a broader role in cognition including interoceptive thoughts and salience processing. This article summarizes the vast functional role of the healthy human insula highlighting how this knowledge can be leveraged to improve the care of patients with insular gliomas.
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Affiliation(s)
- Noah M Nichols
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, United States
| | - Bahie Ezzat
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, United States
- School of Medicine, Mount Sinai School of Medicine, New York, NY, United States
| | - Allison C Waters
- Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, United States
| | - Fedor Panov
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, United States
| | - Raymund L Yong
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, United States
| | - Isabelle M Germano
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, United States
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3
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Islam J, Rahman MT, Kc E, Park YS. Deciphering the functional role of insular cortex stratification in trigeminal neuropathic pain. J Headache Pain 2024; 25:76. [PMID: 38730344 PMCID: PMC11084050 DOI: 10.1186/s10194-024-01784-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
Trigeminal neuropathic pain (TNP) is a major concern in both dentistry and medicine. The progression from normal to chronic TNP through activation of the insular cortex (IC) is thought to involve several neuroplastic changes in multiple brain regions, resulting in distorted pain perception and associated comorbidities. While the functional changes in the insula are recognized contributors to TNP, the intricate mechanisms underlying the involvement of the insula in TNP processing remain subjects of ongoing investigation. Here, we have overviewed the most recent advancements regarding the functional role of IC in regulating TNP alongside insights into the IC's connectivity with other brain regions implicated in trigeminal pain pathways. In addition, the review examines diverse modulation strategies that target the different parts of the IC, thereby suggesting novel diagnostic and therapeutic management of chronic TNP in the future.
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Affiliation(s)
- Jaisan Islam
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Md Taufiqur Rahman
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Elina Kc
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Young Seok Park
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Korea.
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea.
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Funk AT, Hassan AAO, Waugh JL. In humans, insulo-striate structural connectivity is largely biased toward either striosome-like or matrix-like striatal compartments. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.07.588409. [PMID: 38645229 PMCID: PMC11030402 DOI: 10.1101/2024.04.07.588409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The insula is an integral component of sensory, motor, limbic, and executive functions, and insular dysfunction is associated with numerous human neuropsychiatric disorders. Insular afferents project widely, but insulo-striate projections are especially numerous. The targets of these insulo-striate projections are organized into tissue compartments, the striosome and matrix. These striatal compartments have distinct embryologic origins, afferent and efferent connectivity, dopamine pharmacology, and susceptibility to injury. Striosome and matrix appear to occupy separate sets of cortico-striato-thalamo-cortical loops, so a bias in insulo-striate projections towards one compartment may also embed an insular subregion in distinct regulatory and functional networks. Compartment-specific mapping of insulo-striate structural connectivity is sparse; the insular subregions are largely unmapped for compartment-specific projections. In 100 healthy adults, we utilized probabilistic diffusion tractography to map and quantify structural connectivity between 19 structurally-defined insular subregions and each striatal compartment. Insulo-striate streamlines that reached striosome-like and matrix-like voxels were concentrated in distinct insular zones (striosome: rostro- and caudoventral; matrix: caudodorsal) and followed different paths to reach the striatum. Though tractography was generated independently in each hemisphere, the spatial distribution and relative bias of striosome-like and matrix-like streamlines were highly similar in the left and right insula. 16 insular subregions were significantly biased towards one compartment: seven toward striosome-like voxels and nine toward matrix-like voxels. Striosome-favoring bundles had significantly higher streamline density, especially from rostroventral insular subregions. The biases in insulo-striate structural connectivity we identified mirrored the compartment-specific biases identified in prior studies that utilized injected tract tracers, cytoarchitecture, or functional MRI. Segregating insulo-striate structural connectivity through either striosome or matrix may be an anatomic substrate for functional specialization among the insular subregions.
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Affiliation(s)
- AT Funk
- Division of Pediatric Neurology, Department of Pediatrics, University of Texas Southwestern, Dallas, TX
| | - AAO Hassan
- Department of Natural Sciences and Mathematics, University of Texas at Dallas
| | - JL Waugh
- Division of Pediatric Neurology, Department of Pediatrics, University of Texas Southwestern, Dallas, TX
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
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5
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Mammadkhanli O, Kehaya S, Solak S, Yağmurlu K. Insular cortex involvement in migraine patients with chronic pain: A volumetric radiological and clinical study. J Clin Neurosci 2024; 123:157-161. [PMID: 38579522 DOI: 10.1016/j.jocn.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/24/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND This study aimed to assess abnormalities in the insular cortex of individuals suffering from migraines and examine their associations with pain duration, medication usage, and clinical symptoms. METHODS We analyzed radiological data from 38 migraine patients who had undergone 3D iso T1-weighted brain MRI at our university hospital between 2019 and 2023. Structured questionnaires were used to collect information on participants' age, migraine type, disease duration, clinical symptoms, and medication use. Volumetric analysis was performed on the insular regions using Volbrain and 3DSlicer. The results were statistically analyzed. RESULTS Comparing groups with chronic pain to normal groups revealed significant differences in several insular regions, including the posterior insula (p = 0.034), parietal operculum (p = 0.04), and the entire insular cortex (p = 0.023). Further group comparisons (Group 1, 2, and 3) showed significant differences in specific insular regions. For instance, the anterior insula (p = 0.032) was associated with taste changes, the posterior insula (p = 0.010) with smell-related changes, and the central operculum (p = 0.046) with sensations of nausea. Additionally, significant changes were observed in the parietal operculum concerning nausea, photophobia, phonophobia, and changes in smell. CONCLUSION To the best of our knowledge, there have been no studies investigating the relationship between clinical manifestations and volumetric correlation. This study provides insights into abnormalities in the insular cortex among migraine patients and their potential relevance to pain duration, severity, and migraine type. The results suggest that understanding alterations in insular regions possibly linked to pain could contribute to the development of innovative approaches to managing chronic pain.
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Affiliation(s)
- Orkhan Mammadkhanli
- Trakya University, Department of Neurosurgery, Edirne, Turkey; Hacettepe University, Department of Anatomy, Ankara, Turkey.
| | - Sezgin Kehaya
- Trakya University, Department of Neurology, Edirne, Turkey
| | - Serdar Solak
- Trakya University, Department of Radiology, Edirne, Turkey
| | - Kaan Yağmurlu
- University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, Tennessee, USA
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Zhu H, Tao Y, Wang S, Zhu X, Lin K, Zheng N, Chen LM, Xu F, Wu R. fMRI, LFP, and anatomical evidence for hierarchical nociceptive routing pathway between somatosensory and insular cortices. Neuroimage 2024; 289:120549. [PMID: 38382864 DOI: 10.1016/j.neuroimage.2024.120549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
The directional organization of multiple nociceptive regions, particularly within obscure operculoinsular areas, underlying multidimensional pain processing remains elusive. This study aims to establish the fundamental organization between somatosensory and insular cortices in routing nociceptive information. By employing an integrated multimodal approach of high-field fMRI, intracranial electrophysiology, and transsynaptic viral tracing in rats, we observed a hierarchically organized connection of S1/S2 → posterior insula → anterior insula in routing nociceptive information. The directional nociceptive pathway determined by early fMRI responses was consistent with that examined by early evoked LFP, intrinsic effective connectivity, and anatomical projection, suggesting fMRI could provide a valuable facility to discern directional neural circuits in animals and humans non-invasively. Moreover, our knowledge of the nociceptive hierarchical organization of somatosensory and insular cortices and the interface role of the posterior insula may have implications for the development of targeted pain therapies.
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Affiliation(s)
- Hongyan Zhu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200032, China
| | - Yan Tao
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200032, China
| | - Siqi Wang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430071, China
| | - Xutao Zhu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Kunzhang Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Ning Zheng
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430071, China
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science and Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA.
| | - Fuqiang Xu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430071, China.
| | - Ruiqi Wu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200032, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 200031, China.
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7
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Mehnert J, Tinnermann A, Basedau H, May A. Functional representation of trigeminal nociceptive input in the human periaqueductal gray. SCIENCE ADVANCES 2024; 10:eadj8213. [PMID: 38507498 PMCID: PMC10954197 DOI: 10.1126/sciadv.adj8213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/13/2024] [Indexed: 03/22/2024]
Abstract
The periaqueductal gray (PAG) is located in the mesencephalon in the upper brainstem and, as part of the descending pain modulation, is considered a crucial structure for pain control. Its modulatory effect on painful sensation is often seen as a systemic function affecting the whole body similarly. However, recent animal data suggest some kind of somatotopy in the PAG. This would make the PAG capable of dermatome-specific analgesic function. We electrically stimulated the three peripheral dermatomes of the trigemino-cervical complex and the greater occipital nerve in 61 humans during optimized brainstem functional magnetic resonance imaging. We provide evidence for a fine-grained and highly specific somatotopic representation of nociceptive input in the PAG in humans and a functional connectivity between the individual representations of the peripheral nerves in the PAG and the brainstem nuclei of these nerves. Our data suggest that the downstream antinociceptive properties of the PAG may be rather specific down to the level of individual dermatomes.
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Affiliation(s)
| | | | - Hauke Basedau
- Department of Systems Neuroscience, University Medical Center Eppendorf, 20146 Hamburg, Germany
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8
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Kadakia F, Khadka A, Yazell J, Davidson S. Chemogenetic Modulation of Posterior Insula CaMKIIa Neurons Alters Pain and Thermoregulation. THE JOURNAL OF PAIN 2024; 25:766-780. [PMID: 37832899 PMCID: PMC10922377 DOI: 10.1016/j.jpain.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
The posterior insular cortex (PIC) is well positioned to perform somatosensory-limbic integration; yet, the function of neuronal subsets within the PIC in processing the sensory and affective dimensions of pain remains unclear. Here, we employ bidirectional chemogenetic modulation to characterize the function of PIC CaMKIIa-expressing excitatory neurons in a comprehensive array of sensory, affective, and thermoregulatory behaviors. Excitatory pyramidal neurons in the PIC were found to be sensitized under inflammatory pain conditions. Chemogenetic activation of excitatory CaMKIIa-expressing PIC neurons in non-injured conditions produced an increase in reflexive and affective pain- and anxiety-like behaviors. Moreover, activation of PIC CaMKIIa-expressing neurons during inflammatory pain conditions exacerbated hyperalgesia and decreased pain tolerance. However, Chemogenetic activation did not alter heat nociception via hot plate latency or body temperature. Conversely, inhibiting CaMKIIa-expressing neurons did not alter either sensory or affective pain-like behaviors in non-injured or under inflammatory pain conditions, but it did decrease body temperature and decreased hot plate latency. Our findings reveal that PIC CaMKIIa-expressing neurons are a critical hub for producing both sensory and affective pain-like behaviors and important for thermoregulatory processing. PERSPECTIVE: The present study reveals that activation of the posterior insula produces hyperalgesia and negative affect, and has a role in thermal tolerance and thermoregulation. These findings highlight the insula as a key player in contributing to the multidimensionality of pain.
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Affiliation(s)
- Feni Kadakia
- Neuroscience Graduate Program, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
- Department of Anesthesiology and Pain Research Center, University of Cincinnati, College of Medicine, Cincinnati, OH, United States
| | - Akansha Khadka
- Department of Anesthesiology and Pain Research Center, University of Cincinnati, College of Medicine, Cincinnati, OH, United States
| | - Jake Yazell
- Department of Anesthesiology and Pain Research Center, University of Cincinnati, College of Medicine, Cincinnati, OH, United States
| | - Steve Davidson
- Neuroscience Graduate Program, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
- Department of Anesthesiology and Pain Research Center, University of Cincinnati, College of Medicine, Cincinnati, OH, United States
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9
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Mandonnet V, Obaid S, Descoteaux M, St-Onge E, Devaux B, Levé C, Froelich S, Rheault F, Mandonnet E. Electrostimulation of the white matter of the posterior insula and medial operculum: perception of vibrations, heat, and pain. Pain 2024; 165:565-572. [PMID: 37862047 DOI: 10.1097/j.pain.0000000000003069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/02/2023] [Indexed: 10/21/2023]
Abstract
ABSTRACT This study aimed to characterize the sensory responses observed when electrically stimulating the white matter surrounding the posterior insula and medial operculum (PIMO). We reviewed patients operated on under awake conditions for a glioma located in the temporoparietal junction. Patients' perceptions were retrieved from operative reports. Stimulation points were registered in the Montreal Neurological Institute template. A total of 12 stimulation points in 8 patients were analyzed. Painful sensations in the contralateral leg were reported (5 sites in 5 patients) when stimulating the white matter close to the parcel OP2/3 of the Glasser atlas. Pain had diverse qualities: burning, tingling, crushing, or electric shock. More laterally, in the white matter of OP1, pain and heat sensations in the upper part of the body were described (5 sites in 2 patients). Intermingled with these sites, vibration sensations were also reported (3 sites in 2 patients). Based on the tractograms of 44 subjects from the Human Connectome Project data set, we built a template of the pathways linking the thalamus to OP2/3 and OP1. Pain sites were located in the thalamo-OP2/3 and thalamo-OP1 tracts. Heat sites were located in the thalamo-OP1 tract. In the 227 awake surgeries performed for a tumor located outside of the PIMO region, no patients ever reported pain or heat sensations when stimulating the white matter. Thus, we propose that the thalamo-PIMO connections constitute the main cortical inputs for nociception and thermoception and emphasize that preserving these fibers is of utmost importance to prevent the postoperative onset of a debilitating insulo-opercular pain syndrome.
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Affiliation(s)
- Valéry Mandonnet
- Frontlab, Paris Brain Institute, CNRS UMR 7225, INSERM U1127, Paris, France
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| | - Sami Obaid
- Division of Neurosurgery, Department of Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada
- Department of Neurosciences, University of Montreal, Montreal, QC, Canada
- Neuroscience Research Axis, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Imeka Solutions, Sherbrooke, QC, Canada
| | - Etienne St-Onge
- Neuroimaging and Surgical Technologies Laboratory (NIST), Montreal Neurological Institute (MNI), Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Department of Computer Science and Engineering, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
| | - Bertrand Devaux
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| | - Charlotte Levé
- Department of Anesthesiology, Lariboisière Hospital, Paris, France
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
| | - François Rheault
- Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Emmanuel Mandonnet
- Frontlab, Paris Brain Institute, CNRS UMR 7225, INSERM U1127, Paris, France
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- Université de Paris Cité, Paris, France
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10
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Fauchon C, Bastuji H, Peyron R, Garcia-Larrea L. Fractal Similarity of Pain Brain Networks. ADVANCES IN NEUROBIOLOGY 2024; 36:639-657. [PMID: 38468056 DOI: 10.1007/978-3-031-47606-8_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The conscious perception of pain is the result of dynamic interactions of neural activities from local brain regions to distributed brain networks. Mapping out the networks of functional connections between brain regions that form and disperse when an experimental participant received nociceptive stimulations allow to characterize the pattern of network connections related to the pain experience.Although the pattern of intra- and inter-areal connections across the brain are incredibly complex, they appear also largely scale free, with "fractal" connectivity properties reproducing at short and long-time scales. Our results combining intracranial recordings and functional imaging in humans during pain indicate striking similarities in the activity and topological representation of networks at different orders of temporality, with reproduction of patterns of activation from the millisecond to the multisecond range. The connectivity analyzed using graph theory on fMRI data was organized in four sets of brain regions matching those identified through iEEG (i.e., sensorimotor, default mode, central executive, and amygdalo-hippocampal).Here, we discuss similarities in brain network organization at different scales or "orders," in participants as they feel pain. Description of this fractal-like organization may provide clues about how our brain regions work together to create the perception of pain and how pain becomes chronic when its organization is altered.
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Affiliation(s)
- Camille Fauchon
- Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France.
- Université Jean Monnet, Inserm, CRNL, NeuroPain, Saint-Etienne, France.
| | - Hélène Bastuji
- Université Claude Bernard Lyon 1, UJM, Inserm, CRNL, NeuroPain, Bron, France
| | - Roland Peyron
- Université Jean Monnet, Inserm, CRNL, NeuroPain, Saint-Etienne, France
- CHU, centre de la douleur, Saint-Etienne, France
| | - Luis Garcia-Larrea
- Université Claude Bernard Lyon 1, UJM, Inserm, CRNL, NeuroPain, Bron, France
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11
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Yao D, Chen Y, Chen G. The role of pain modulation pathway and related brain regions in pain. Rev Neurosci 2023; 34:899-914. [PMID: 37288945 DOI: 10.1515/revneuro-2023-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/18/2023] [Indexed: 06/09/2023]
Abstract
Pain is a multifaceted process that encompasses unpleasant sensory and emotional experiences. The essence of the pain process is aversion, or perceived negative emotion. Central sensitization plays a significant role in initiating and perpetuating of chronic pain. Melzack proposed the concept of the "pain matrix", in which brain regions associated with pain form an interconnected network, rather than being controlled by a singular brain region. This review aims to investigate distinct brain regions involved in pain and their interconnections. In addition, it also sheds light on the reciprocal connectivity between the ascending and descending pathways that participate in pain modulation. We review the involvement of various brain areas during pain and focus on understanding the connections among them, which can contribute to a better understanding of pain mechanisms and provide opportunities for further research on therapies for improved pain management.
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Affiliation(s)
- Dandan Yao
- Department of Anesthesiology, School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Yeru Chen
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Gang Chen
- Department of Anesthesiology, School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
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12
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Islam J, Kc E, Kim S, Chung MY, Park KS, Kim HK, Park YS. Optogenetic Inhibition of Glutamatergic Neurons in the Dysgranular Posterior Insular Cortex Modulates Trigeminal Neuropathic Pain in CCI-ION Rat. Neuromolecular Med 2023; 25:516-532. [PMID: 37700212 DOI: 10.1007/s12017-023-08752-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023]
Abstract
In individuals with chronic neuropathic pain, the posterior insular cortex (PIC) has been found to exhibit increased glutamatergic activity, and the dysgranular portion of PIC (DPIC) has been investigated as a novel cortical target for pain modulation. However, the role of DPIC glutamatergic neurons (DPICg) in trigeminal neuropathic pain (TNP) remains unclear. Here, we examined the outcomes of DPICg inhibition in a rat model of chronic constriction injury of the infraorbital nerve (CCI-ION). Animals were randomly divided into TNP, sham, and control groups. TNP animals underwent CCI-ION surgery. Either optogenetic or null viruses were delivered to the contralateral DPICg of TNP and sham animals. In vivo single-unit extracellular recordings from the ipsilateral spinal trigeminal nucleus caudalis (TNC) and contralateral ventral posteromedial (VPM) thalamus were obtained under both "ON" and "OFF" stimulation states. Behavioral responses during the stimulation-OFF and stimulation-ON phases were examined. Expression of c-Fos, pERK, and CREB immunopositive neurons were also observed. Optogenetic inhibition of contralateral DPICg decreased the neural firing rate in both TNC and VPM thalamus, the expression of sensory-responsive cell bodies, and transcriptional factors in the DPIC of TNP group. Improvements in hyperalgesia, allodynia, and anxiety-like responses in TNP animals were also observed during stimulation-ON condition. In fine, descending pain processing is influenced by neuroanatomical projections from the DPIC to the pain matrix areas, and DPICg could play a necessary role in this neural circuitry. Therefore, the antinociceptive effect of DPICg inhibition in this study may provide evidence for the therapeutic potential of DPICg in TNP.
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Affiliation(s)
- Jaisan Islam
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Chungbuk, Korea
| | - Elina Kc
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Chungbuk, Korea
| | - Soochong Kim
- Department of Veterinary Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Moon Young Chung
- Department of Neurosurgery, Soonchunhyang University, Bucheon, Korea
| | - Ki Seok Park
- Department of Neurosurgery, Eulji University Hospital, Daejeon, Korea
| | - Hyong Kyu Kim
- Department of Medicine and Microbiology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Young Seok Park
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Chungbuk, Korea.
- Department of Neurosurgery, Chungbuk National University Hospital, 776, 1 Sunhwanro, Seowon-gu, Cheongju, 28644, Korea.
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13
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Filipescu C, Landré E, Turak B, Devaux B, Chassoux F. Towards a better identification of ictal semiology patterns in insular epilepsies: A stereo-EEG study. Clin Neurophysiol 2023; 155:32-43. [PMID: 37683325 DOI: 10.1016/j.clinph.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/26/2023] [Accepted: 08/12/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To describe pure insular ictal semiology and patterns of extra-insular spread demonstrated by stereoelectroencephalography (SEEG) according to a classification based on the insular cytoarchitecture. METHODS We investigated the ictal semiology in 17 patients undergoing SEEG for insular epilepsy. The insular cortex was divided into three regions roughly overlapping with the agranular, dysgranular and granular regions. Ictal semiology was described accordingly: anterior insula (AI, short anterior and middle gyri), middle insula (MI, short posterior and long anterior gyri) and posterior insula (PI, long posterior gyrus). RESULTS Awareness impairment occurred secondarily to extra-insular ictal spread. Subjective manifestations were constant. AI seizures (n = 3) presented with autonomic (increased heart rate [HR], respiratory changes), oropharyngeal (mainly throat sensations), emotional (fear, anguish) semiology and the "hand-to-throat" sign followed by frontal-like semiology. MI seizures (n = 8) presented with mainly non-painful paresthesia, some autonomic (respiratory, increased HR), oropharyngeal or thermic symptoms and early motor features with spread to the opercular cortex. PI seizures (n = 6) were characterized by somatosensory semiology, mainly paresthesia potentially painful, and cephalic sensations. CONCLUSIONS Cytoarchitectonic-based classification and the corresponding ictal features support the antero-posterior grading of insular seizures and highlight specific ictal symptoms. SIGNIFICANCE This refinement of insular semiology can help optimize the planning of SEEG for presumed insular epilepsy.
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Affiliation(s)
- Cristina Filipescu
- Surgical Epileptology Unit, Neurosurgery Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, France; Neurophysiology and Epileptology Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, France.
| | - Elisabeth Landré
- Surgical Epileptology Unit, Neurosurgery Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, France.
| | - Baris Turak
- Surgical Epileptology Unit, Neurosurgery Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, France.
| | - Bertrand Devaux
- Surgical Epileptology Unit, Neurosurgery Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, France; Paris-Cité University, Paris, France.
| | - Francine Chassoux
- Surgical Epileptology Unit, Neurosurgery Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, France.
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14
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Duong A, Quabs J, Kucyi A, Lusk Z, Buch V, Caspers S, Parvizi J. Subjective states induced by intracranial electrical stimulation matches the cytoarchitectonic organization of the human insula. Brain Stimul 2023; 16:1653-1665. [PMID: 37949296 PMCID: PMC10893903 DOI: 10.1016/j.brs.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/23/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
Functions of the human insula have been explored extensively with neuroimaging methods and intracranial electrical stimulation studies that have highlighted a functional segregation across its subregions. A recently developed cytoarchitectonic map of the human insula has also segregated this brain region into various areas. Our knowledge of the functional organization of this brain region at the level of these fine-parceled microstructural areas remains only partially understood. We address this gap of knowledge by applying a multimodal approach linking direct electrical stimulation and task-evoked intracranial EEG recordings with microstructural subdivisions of the human insular cortex. In 17 neurosurgical patients with 142 implanted electrodes, stimulation of 40 % of the sites induced a reportable change in the conscious experience of the subjects in visceral/autonomic, anxiety, taste/olfactory, pain/temperature as well as somatosensory domains. These subjective responses showed a topographical allocation to microstructural areas defined by probabilistic cytoarchitectonic parcellation maps of the human insula. We found the pain and thermal responses to be located in areas lg2/ld2, while non-painful/non-thermal somatosensory responses corresponded to area ld3 and visceroceptive responses to area Id6. Lastly, the stimulation of area Id7 in the dorsal anterior insula, failed to induce reportable changes to subjective experience even though intracranial EEG recordings from this region captured significant time-locked high-frequency activity (HFA). Our results provide a multimodal map of functional subdivisions within the human insular cortex at the individual brain basis and characterize their anatomical association with fine-grained cytoarchitectonic parcellations of this brain structure.
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Affiliation(s)
- Anna Duong
- Laboratory of Behavioral and Cognitive Neuroscience, Human Intracranial Cognitive Electrophysiology Program, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Julian Quabs
- Institute for Anatomy I, Medical Faculty & University Hospital, Heinrich Heine University, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Germany
| | - Aaron Kucyi
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Zoe Lusk
- Laboratory of Behavioral and Cognitive Neuroscience, Human Intracranial Cognitive Electrophysiology Program, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Vivek Buch
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Svenja Caspers
- Institute for Anatomy I, Medical Faculty & University Hospital, Heinrich Heine University, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Germany
| | - Josef Parvizi
- Laboratory of Behavioral and Cognitive Neuroscience, Human Intracranial Cognitive Electrophysiology Program, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
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15
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Pelliccia V, Del Vecchio M, Avanzini P, Revay M, Sartori I, Caruana F. 70 Years of Human Cingulate Cortex Stimulation. Functions and Dysfunctions Through the Lens of Electrical Stimulation. J Clin Neurophysiol 2023; 40:491-500. [PMID: 36007014 DOI: 10.1097/wnp.0000000000000961] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY In this review, we retrace the results of 70 years of human cingulate cortex (CC) intracerebral electrical stimulation and discuss its contribution to our understanding of the anatomofunctional and clinical aspects of this wide cortical region. The review is divided into three main sections. In the first section, we report the results obtained by the stimulation of the anterior, middle, and posterior CC, in 30 studies conducted on approximately 1,000 patients from the 1950s to the present day. These studies show that specific manifestations can be reliably associated with specific cingulate subfields, with autonomic, interoceptive, and emotional manifestations clustered in the anterior cingulate, goal-oriented motor behaviors elicited from the anterior midcingulate and a variety of sensory symptoms characterizing the posterior cingulate regions. In the second section, we compare the effect of CC intracerebral electrical stimulation with signs and manifestations characterizing cingulate epilepsy, showing that the stimulation mapping of CC subfields provides precious information for understanding cingulate epileptic manifestations. The last section tackles the issue of the discrepancy emerging when comparing the results of clinical (electrical stimulation, epilepsy) studies-revealing the quintessential affective and motor nature of the CC-with that reported by neuroimaging studies-which focus on high-level cognitive functions. Particular attention will be paid to the hypothesis that CC hosts a "Pain Matrix" specifically involved in pain perception, which we will discuss in the light of the fact that the stimulation of CC (as well as cingulate epileptic seizures) does not induce nociceptive effects.
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Affiliation(s)
- Veronica Pelliccia
- "Claudio Munari" Epilepsy Surgery Center, ASST GOM Niguarda, Milano, Italy; and
| | - Maria Del Vecchio
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| | - Pietro Avanzini
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| | - Martina Revay
- "Claudio Munari" Epilepsy Surgery Center, ASST GOM Niguarda, Milano, Italy; and
| | - Ivana Sartori
- "Claudio Munari" Epilepsy Surgery Center, ASST GOM Niguarda, Milano, Italy; and
| | - Fausto Caruana
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
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16
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Tsai CG, Fu YF, Li CW. Prediction errors arising from switches between major and minor modes in music: An fMRI study. Brain Cogn 2023; 169:105987. [PMID: 37126951 DOI: 10.1016/j.bandc.2023.105987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
The major and minor modes in Western music have positive and negative connotations, respectively. The present fMRI study examined listeners' neural responses to switches between major and minor modes. We manipulated the final chords of J. S. Bach's keyboard pieces so that each major-mode passage ended with either the major (Major-Major) or minor (Major-Minor) tonic chord, and each minor-mode passage ended with either the minor (Minor-Minor) or major (Minor-Major) tonic chord. If the final major and minor chords have positive and negative reward values respectively, the Major-Minor and Minor-Major stimuli would cause negative and positive reward prediction errors (RPEs) respectively in a listener's brain. We found that activity in a frontoparietal network was significantly higher for Major-Minor than for Major-Major. Based on previous research, these results support the idea that a major-to-minor switch causes negative RPE. The contrast of Minor-Major minus Minor-Minor yielded activation in the ventral insula and visual cortex, speaking against the idea that a minor-to-major switch causes positive RPE. We discuss our results in relation to executive functions and the emotional connotations of major versus minor modes.
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Affiliation(s)
- Chen-Gia Tsai
- Graduate Institute of Musicology, National Taiwan University, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Yi-Fan Fu
- Department of Bio-Industry Communication and Development, National Taiwan University, Taipei, Taiwan
| | - Chia-Wei Li
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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17
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Marinelli S, Coccurello R. From the Gender Gap to Neuroactive Steroids: Exploring Multiple Cases to Further Understand Neuropathic Pain. Int J Mol Sci 2023; 24:ijms24108577. [PMID: 37239924 DOI: 10.3390/ijms24108577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Neuropathic pain (NeuP) is still an intractable form of highly debilitating chronic pain, resulting from a lesion or disease of the somatosensory nervous system [...].
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Affiliation(s)
- Sara Marinelli
- National Council of Research (CNR), Institute of Biochemistry and Cell Biology, 00015 Monterotondo, Italy
| | - Roberto Coccurello
- Institute for Complex Systems (ISC), National Council of Research (CNR), 00185 Rome, Italy
- European Center for Brain Research/Santa Lucia Foundation IRCCS, 00143 Rome, Italy
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18
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Labrakakis C. The Role of the Insular Cortex in Pain. Int J Mol Sci 2023; 24:ijms24065736. [PMID: 36982807 PMCID: PMC10056254 DOI: 10.3390/ijms24065736] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
The transition from normal to chronic pain is believed to involve alterations in several brain areas that participate in the perception of pain. These plastic changes are then responsible for aberrant pain perception and comorbidities. The insular cortex is consistently found activated in pain studies of normal and chronic pain patients. Functional changes in the insula contribute to chronic pain; however, the complex mechanisms by which the insula is involved in pain perception under normal and pathological conditions are still not clear. In this review, an overview of the insular function is provided and findings on its role in pain from human studies are summarized. Recent progress on the role of the insula in pain from preclinical experimental models is reviewed, and the connectivity of the insula with other brain regions is examined to shed new light on the neuronal mechanisms of the insular cortex’s contribution to normal and pathological pain sensation. This review underlines the need for further studies on the mechanisms underlying the involvement of the insula in the chronicity of pain and the expression of comorbid disorders.
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Affiliation(s)
- Charalampos Labrakakis
- Department of Biological Applications and Technology, University of Ioannina, 45110 Ioannina, Greece;
- Institute of Biosciences, University Research Center of Ioannina (URCI), 45110 Ioannina, Greece
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19
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Solanki C, Williams J, Andrews C, Fayed I, Wu C. Insula in epilepsy - "untying the gordian knot": A systematic review. Seizure 2023; 106:148-161. [PMID: 36878050 DOI: 10.1016/j.seizure.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023] Open
Abstract
PURPOSE Despite significant advances in epileptology, there are still many uncertainties about the role of the insula in epilepsy. Until recently, most insular onset seizures were wrongly attributed to the temporal lobe. Further, there are no standardised approaches to the diagnosis and treatment of insular onset seizures. This systematic review gathers the available information about insular epilepsy and synthesizes current knowledge as a basis for future research. METHOD Adhering to the PRISMA guidelines, studies were meticulously extracted from the PubMed database. The empirical data pertaining to the semiology of insular seizures, insular networks in epilepsy, techniques of mapping the insula, and the surgical intricacies of non-lesional insular epilepsy were reviewed from published studies. The corpus of information available was then subjected to a process of concise summarization and astute synthesis. RESULTS Out of 235 studies identified for full-text review, 86 studies were included in the systematic review. The insula emerges as a brain region with a number of functional subdivisions. The semiology of insular seizures is diverse and depends on the involvement of particular subdivisions. The semiological heterogeneity of insular seizures is explained by the extensive connectivity of the insula and its subdivisions with all four lobes of the brain, deep grey matter structures, and remote brainstem areas. The mainstay of the diagnosis of seizure onset in the insula is stereoelectroencephalography (SEEG). The surgical resection of the insular epileptogenic zone (when possible) is the most effective treatment. Open surgery on the insula is challenging but magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) also holds promise. CONCLUSION The physiological and functional roles of the insula in epilepsy have remained obfuscated. The dearth of precisely defined diagnostic and therapeutic protocols acts as an impediment to scientific advancement. This review could potentially facilitate forthcoming research endeavours by establishing a foundational framework for uniform data collection protocols, thereby enhancing the feasibility of comparing findings across future studies and promoting progress in this domain.
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Affiliation(s)
- Chirag Solanki
- Consultant Neurosurgeon, Department of Neurosurgery, Sterling Hospital, Ahmedabad, Gujarat, India.
| | - Justin Williams
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, United States.
| | - Carrie Andrews
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, United States.
| | - Islam Fayed
- Stereotactic and Functional Neurosurgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, United States.
| | - Chengyuan Wu
- Associate Professor of Neurosurgery and Radiology, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, United States.
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20
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Strath LJ, Hernandez PV, Nodarse CL, Johnson AJ, Edberg JD, Fillingim RB, Cruz-Almeida Y. Clinical vitamin D levels are associated with insular volume and inferior temporal gyrus white matter surface area in community-dwelling individuals with knee pain. Front Neurosci 2022; 16:882322. [PMID: 36117614 PMCID: PMC9470941 DOI: 10.3389/fnins.2022.882322] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
Context Vitamin D is an essential, fat soluble micronutrient long-known for its effects on calcium homeostasis and bone health. With advances in technology, it is being discovered that Vitamin D exerts its effects beyond the musculoskeletal system. Vitamin D has since been noted in nervous system health and functioning, and is becoming a target of interest in brain health, aging, and chronic pain outcomes. Objectives We and others have previously shown that deficient Vitamin D status is associated with greater pain severity across a variety of conditions, however the reason as to why this relationship exists is still being understood. Here, we sought to examine associations between Vitamin D status and brain structure in those with chronic knee pain. Methods Structural MRI imaging techniques and whole brain analyses were employed and serum Vitamin D were collected on 140 participants with chronic pain. Covariates included age, sex, race and site, as these data were collected at two separate institutions. ANOVAs using the clinical cut points for Vitamin D status (deficient, insufficient, and optimal) as well as continuous regression-based Vitamin D effects were employed to observe differences in brain volume. P-value was set to 0.017 after correction for multiple comparisons. Results We discovered that individuals in our sample (age = 50+; 63.6% female; 52.1% Non-Hispanic Black) who were either clinically deficient (<20 ng/mL) or insufficient (20-30 ng/mL) in serum Vitamin D had significant differences in the gray matter of the left circular insular cortex, left inferior temporal gyrus, right middle temporal gyrus, as well as decreased white matter surface area in the right inferior temporal gyrus compared to those considered to have optimal levels (>30 ng/mL) of serum Vitamin D. Conclusion Evidence from these data suggests that Vitamin D, or lack thereof, may be associated with pain outcomes by mediating changes in regions of the brain known to process and interpret pain. More research understanding this phenomenon as well as the effects of Vitamin D supplementation is warranted.
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Affiliation(s)
- Larissa J. Strath
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Pedro Valdes Hernandez
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Chavier Laffitte Nodarse
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Alisa J. Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Jeffrey D. Edberg
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States,*Correspondence: Yenisel Cruz-Almeida,
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21
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Jaroszynski C, Amorim-Leite R, Deman P, Perrone-Bertolotti M, Chabert F, Job-Chapron AS, Minotti L, Hoffmann D, David O, Kahane P. Brain mapping of auditory hallucinations and illusions induced by direct intracortical electrical stimulation. Brain Stimul 2022; 15:1077-1087. [PMID: 35952963 DOI: 10.1016/j.brs.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The exact architecture of the human auditory cortex remains a subject of debate, with discrepancies between functional and microstructural studies. In a hierarchical framework for sensory perception, simple sound perception is expected to take place in the primary auditory cortex, while the processing of complex, or more integrated perceptions is proposed to rely on associative and higher-order cortices. OBJECTIVES We hypothesize that auditory symptoms induced by direct electrical stimulation (DES) offer a window into the architecture of the brain networks involved in auditory hallucinations and illusions. The intracranial recordings of these evoked perceptions of varying levels of integration provide the evidence to discuss the theoretical model. METHODS We analyzed SEEG recordings from 50 epileptic patients presenting auditory symptoms induced by DES. First, using the Juelich cytoarchitectonic parcellation, we quantified which regions induced auditory symptoms when stimulated (ROI approach). Then, for each evoked auditory symptom type (illusion or hallucination), we mapped the cortical networks showing concurrent high-frequency activity modulation (HFA approach). RESULTS Although on average, illusions were found more laterally and hallucinations more posteromedially in the temporal lobe, both perceptions were elicited in all levels of the sensory hierarchy, with mixed responses found in the overlap. The spatial range was larger for illusions, both in the ROI and HFA approaches. The limbic system was specific to the hallucinations network, and the inferior parietal lobule was specific to the illusions network. DISCUSSION Our results confirm a network-based organization underlying conscious sound perception, for both simple and complex components. While symptom localization is interesting from an epilepsy semiology perspective, the hallucination-specific modulation of the limbic system is particularly relevant to tinnitus and schizophrenia.
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Affiliation(s)
- Chloé Jaroszynski
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France.
| | - Ricardo Amorim-Leite
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Pierre Deman
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Marcela Perrone-Bertolotti
- Univ. Grenoble Alpes, CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNC, 38000, Grenoble, France
| | - Florian Chabert
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Anne-Sophie Job-Chapron
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Lorella Minotti
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Dominique Hoffmann
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France; Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
| | - Philippe Kahane
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France.
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22
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Zhang G, Ma J, Lu W, Zhan H, Zhang X, Wang K, Hu Y, Wang X, Peng W, Yue S, Cai Q, Liang W, Wu W. Comorbid depressive symptoms can aggravate the functional changes of the pain matrix in patients with chronic back pain: A resting-state fMRI study. Front Aging Neurosci 2022; 14:935242. [PMID: 35923542 PMCID: PMC9340779 DOI: 10.3389/fnagi.2022.935242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The purposes of this study are to explore (1) whether comorbid depressive symptoms in patients with chronic back pain (CBP) affect the pain matrix. And (2) whether the interaction of depression and CBP exacerbates impaired brain function. Methods Thirty-two patients with CBP without comorbid depressive symptoms and thirty patients with CBP with comorbid depressive symptoms were recruited. All subjects underwent functional magnetic resonance imaging (fMRI) scans. The graph theory analysis, mediation analysis, and functional connectivity (FC) analysis were included in this study. All subjects received the detection of clinical depressive symptoms and pain-related manifestations. Result Compared with the CBP group, subjects in the CBP with comorbid depressive symptoms (CBP-D) group had significantly increased FC in the left medial prefrontal cortex and several parietal cortical regions. The results of the graph theory analyses showed that the area under the curve of small-world property (t = −2.175, p = 0.034), gamma (t = −2.332, p = 0.023), and local efficiency (t = −2.461, p = 0.017) in the CBP-D group were significantly lower. The nodal efficiency in the ventral posterior insula (VPI) (t = −3.581, p = 0.0007), and the network efficiency values (t = −2.758, p = 0.008) in the pain matrix were significantly lower in the CBP-D group. Both the topological properties and the FC values of these brain regions were significantly correlated with self-rating depression scale (SDS) scores (all FDR corrected) but not with pain intensity. Further mediation analyses demonstrated that pain intensity had a mediating effect on the relationship between SDS scores and Pain Disability Index scores. Likewise, the SDS scores mediated the relationship between pain intensity and PDI scores. Conclusion Our study found that comorbid depressive symptoms can aggravate the impairment of pain matrix function of CBP, but this impairment cannot directly lead to the increase of pain intensity, which may be because some brain regions of the pain matrix are the common neural basis of depression and CBP.
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Affiliation(s)
- Guangfang Zhang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Pain, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Junqin Ma
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Weirong Lu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hongrui Zhan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Physical Medicine and Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xuefei Zhang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Kangling Wang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yingxuan Hu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xianglong Wang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Shouwei Yue
- Department of Rehabilitation Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Qingxiang Cai
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Qingxiang Cai,
| | - Wen Liang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Wen Liang,
| | - Wen Wu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Wen Wu,
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Meng X, Yue L, Liu A, Tao W, Shi L, Zhao W, Wu Z, Zhang Z, Wang L, Zhang X, Zhou W. Distinct basolateral amygdala excitatory inputs mediate the somatosensory and aversive-affective components of pain. J Biol Chem 2022; 298:102207. [PMID: 35772494 PMCID: PMC9304789 DOI: 10.1016/j.jbc.2022.102207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/03/2022] [Accepted: 06/17/2022] [Indexed: 01/28/2023] Open
Abstract
Pain is a multidimensional perception that includes unpleasant somatosensory and affective experiences; however, the underlying neural circuits that mediate different components of pain remain elusive. Although hyperactivity of basolateral amygdala glutamatergic (BLAGlu) neurons is required for the somatosensory and emotional processing of pain, the precise excitatory inputs to BLAGlu neurons and their roles in mediating different aspects of pain are unclear. Here, we identified two discrete glutamatergic neuronal circuits in male mice: a projection from the insular cortex glutamatergic (ICGlu) to BLAGlu neurons, which modulates both the somatosensory and affective components of pain, and a projection from the mediodorsal thalamic nucleus (MDGlu) to BLAGlu neurons, which modulates only the aversive-affective component of pain. Using whole-cell recording and fiber photometry, we found that neurons within the IC→BLA and MD→BLA pathways were activated in mice upon inflammatory pain induced by injection of complete Freund's adjuvant (CFA) into their paws. Optical inhibition of the ICGlu→BLA pathway increased the nociceptive threshold and induced behavioral place preference in CFA mice. In contrast, optical inhibition of the MDGlu→BLA pathway did not affect the nociceptive threshold but still induced place preference in CFA mice. In normal mice, optical activation of the ICGlu→BLA pathway decreased the nociceptive threshold and induced place aversion, while optical activation of the MDGlu→BLA pathway only evoked aversion. Taken together, our results demonstrate that discrete ICGlu→BLA and MDGlu→BLA pathways are involved in modulating different components of pain, provide insights into its circuit basis, and better our understanding of pain perception.
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Affiliation(s)
- Xiaojing Meng
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Lingxiao Yue
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China; Department of Pathology, Anhui Medical College, Hefei, China
| | - An Liu
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Wenjuan Tao
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Li Shi
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Wan Zhao
- Department of Otolaryngology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Zhongmin Wu
- Department of Anatomy, Medical College of Taizhou University, Taizhou, China
| | - Zhi Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale, CAS Key laboratory of Brain Function and Disease, University of Science and Technology of China, Hefei, China
| | - Liecheng Wang
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.
| | - Xulai Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China.
| | - Wenjie Zhou
- Hefei National Laboratory for Physical Sciences at the Microscale, CAS Key laboratory of Brain Function and Disease, University of Science and Technology of China, Hefei, China.
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A psychophysical and neuroimaging analysis of genital hedonic sensation in men. Sci Rep 2022; 12:10181. [PMID: 35715453 PMCID: PMC9205885 DOI: 10.1038/s41598-022-14020-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/31/2022] [Indexed: 11/08/2022] Open
Abstract
Current understanding of human genital-brain interactions relates primarily to neuroendocrine and autonomic control, whereas interactions during sexual stimulation remain largely unexplored. Here we present a systematic approach towards identifying how the human brain encodes sensory genital information. Using a validated affective touch paradigm and functional magnetic resonance imaging, we found that hedonic responses to discriminatory versus affective tactile stimulation were distinctly different for both penile shaft and forearm. This suggests that, as with other body sites, genital skin contains small diameter mechanoreceptive nerve fibres that signal pleasant touch. In the brain, secondary somatosensory cortex (S2) distinguished between affective and discriminative touch for the penile shaft, but not for the forearm. Frenulum stimulation induced the greatest reports of subjective pleasure and led to the greatest deactivation of the default-mode network. This study represents a first pass at investigating, in humans, the relationship between innervation of genital surfaces, hedonic feelings, and brain mechanisms, in a systematic way.
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25
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Kim KI, Jung WH, Woo CW, Kim H. Neural signatures of individual variability in context-dependent perception of ambiguous facial expression. Neuroimage 2022; 258:119355. [PMID: 35660000 DOI: 10.1016/j.neuroimage.2022.119355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
How do we incorporate contextual information to infer others' emotional state? Here we employed a naturalistic context-dependent facial expression estimation task where participants estimated pleasantness levels of others' ambiguous expression faces when sniffing different contextual cues (e.g., urine, fish, water, and rose). Based on their pleasantness rating data, we placed participants on a context-dependency continuum and mapped the individual variability in the context-dependency onto the neural representation using a representational similarity analysis. We found that the individual variability in the context-dependency of facial expression estimation correlated with the activity level of the pregenual anterior cingulate cortex (pgACC) and the amygdala and was also decoded by the neural representation of the ventral anterior insula (vAI). A dynamic causal modeling revealed that those with higher context-dependency exhibited a greater degree of the modulation from vAI to the pgACC. These findings provide novel insights into the neural circuitry associated with the individual variability in context-dependent facial expression estimation and the first empirical evidence for individual variability in the predictive accounts of affective states.
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Affiliation(s)
- Kun Il Kim
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Wi Hoon Jung
- Department of Psychology, Gachon University, Seongnam, Republic of Korea
| | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Sungkyunkwan University, Suwon, Republic of Korea; Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
| | - Hackjin Kim
- School of Psychology, Korea University, Seoul, Republic of Korea.
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Fermin ASR, Friston K, Yamawaki S. An insula hierarchical network architecture for active interoceptive inference. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220226. [PMID: 35774133 PMCID: PMC9240682 DOI: 10.1098/rsos.220226] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/09/2022] [Indexed: 05/05/2023]
Abstract
In the brain, the insular cortex receives a vast amount of interoceptive information, ascending through deep brain structures, from multiple visceral organs. The unique hierarchical and modular architecture of the insula suggests specialization for processing interoceptive afferents. Yet, the biological significance of the insula's neuroanatomical architecture, in relation to deep brain structures, remains obscure. In this opinion piece, we propose the Insula Hierarchical Modular Adaptive Interoception Control (IMAC) model to suggest that insula modules (granular, dysgranular and agranular), forming parallel networks with the prefrontal cortex and striatum, are specialized to form higher order interoceptive representations. These interoceptive representations are recruited in a context-dependent manner to support habitual, model-based and exploratory control of visceral organs and physiological processes. We discuss how insula interoceptive representations may give rise to conscious feelings that best explain lower order deep brain interoceptive representations, and how the insula may serve to defend the body and mind against pathological depression.
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Affiliation(s)
- Alan S. R. Fermin
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Karl Friston
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, England
| | - Shigeto Yamawaki
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, Hiroshima, Japan
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27
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Glutamatergic synapses from the insular cortex to the basolateral amygdala encode observational pain. Neuron 2022; 110:1993-2008.e6. [PMID: 35443154 DOI: 10.1016/j.neuron.2022.03.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/30/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023]
Abstract
Empathic pain has attracted the interest of a substantial number of researchers studying the social transfer of pain in the sociological, psychological, and neuroscience fields. However, the neural mechanism of empathic pain remains elusive. Here, we establish a long-term observational pain model in mice and find that glutamatergic projection from the insular cortex (IC) to the basolateral amygdala (BLA) is critical for the formation of observational pain. The selective activation or inhibition of the IC-BLA projection pathway strengthens or weakens the intensity of observational pain, respectively. The synaptic molecules are screened, and the upregulated synaptotagmin-2 and RIM3 are identified as key signals in controlling the increased synaptic glutamate transmission from the IC to the BLA. Together, these results reveal the molecular and synaptic mechanisms of a previously unidentified neural pathway that regulates observational pain in mice.
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da Cunha PHM, Dongyang L, Fernandes AM, Thibes RB, Sato J, Tanaka H, Dale C, Lapa JDDS, de Morais ADS, Soares FHC, da Silva VA, Graven-Nielsen T, Teixeira MJ, de Andrade DC. Non-invasive insular stimulation for peripheral neuropathic pain: Influence of target or symptom? Neurophysiol Clin 2022; 52:109-116. [DOI: 10.1016/j.neucli.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 10/18/2022] Open
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Cardinale V, Demirakca T, Gradinger T, Sack M, Ruf M, Kleindienst N, Schmitz M, Schmahl C, Baumgärtner U, Ende G. Cerebral processing of sharp mechanical pain measured with arterial spin labeling. Brain Behav 2022; 12:e2442. [PMID: 34878219 PMCID: PMC8785639 DOI: 10.1002/brb3.2442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/27/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Arterial spin labeling (ASL) is a functional neuroimaging technique that has been frequently used to investigate acute pain states. A major advantage of ASL as opposed to blood-oxygen-level-dependent functional neuroimaging is its applicability for low-frequency designs. As such, ASL represents an interesting option for studies in which repeating an experimental event would reduce its ecological validity. Whereas most ASL pain studies so far have used thermal stimuli, to our knowledge, no ASL study so far has investigated pain responses to sharp mechanical pain. METHODS As a proof of concept, we investigated whether ASL has the sensitivity to detect brain activation within core areas of the nociceptive network in healthy controls following a single stimulation block based on 96 s of mechanical painful stimulation using a blunt blade. RESULTS We found significant increases in perfusion across many regions of the nociceptive network such as primary and secondary somatosensory cortices, premotor cortex, posterior insula, inferior parietal cortex, parietal operculum, temporal gyrus, temporo-occipital lobe, putamen, and the cerebellum. Contrary to our hypothesis, we did not find any significant increase within ACC, thalamus, or PFC. Moreover, we were able to detect a significant positive correlation between pain intensity ratings and pain-induced perfusion increase in the posterior insula. CONCLUSION We demonstrate that ASL is suited to investigate acute pain in a single event paradigm, although to detect activation within some regions of the nociceptive network, the sensitivity of our paradigm seemed to be limited. Regarding the posterior insula, our paradigm was sensitive enough to detect a correlation between pain intensity ratings and pain-induced perfusion increase. Previous experimental pain studies have proposed that intensity coding in this region may be restricted to thermal stimulation. Our result demonstrates that the posterior insula encodes intensity information for mechanical stimuli as well.
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Affiliation(s)
- Vita Cardinale
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Traute Demirakca
- Department of Neuroimaging and Core Facility ZIPP, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Gradinger
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Markus Sack
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias Ruf
- Department of Neuroimaging and Core Facility ZIPP, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nikolaus Kleindienst
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulf Baumgärtner
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience (MTCN), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Institute of Cognitive and Affective Neuroscience (ICAN), Medical School Hamburg, Hamburg, Germany
| | - Gabriele Ende
- Department of Neuroimaging and Core Facility ZIPP, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Lubejko ST, Graham RD, Livrizzi G, Schaefer R, Banghart MR, Creed MC. The role of endogenous opioid neuropeptides in neurostimulation-driven analgesia. Front Syst Neurosci 2022; 16:1044686. [PMID: 36591324 PMCID: PMC9794630 DOI: 10.3389/fnsys.2022.1044686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022] Open
Abstract
Due to the prevalence of chronic pain worldwide, there is an urgent need to improve pain management strategies. While opioid drugs have long been used to treat chronic pain, their use is severely limited by adverse effects and abuse liability. Neurostimulation techniques have emerged as a promising option for chronic pain that is refractory to other treatments. While different neurostimulation strategies have been applied to many neural structures implicated in pain processing, there is variability in efficacy between patients, underscoring the need to optimize neurostimulation techniques for use in pain management. This optimization requires a deeper understanding of the mechanisms underlying neurostimulation-induced pain relief. Here, we discuss the most commonly used neurostimulation techniques for treating chronic pain. We present evidence that neurostimulation-induced analgesia is in part driven by the release of endogenous opioids and that this endogenous opioid release is a common endpoint between different methods of neurostimulation. Finally, we introduce technological and clinical innovations that are being explored to optimize neurostimulation techniques for the treatment of pain, including multidisciplinary efforts between neuroscience research and clinical treatment that may refine the efficacy of neurostimulation based on its underlying mechanisms.
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Affiliation(s)
- Susan T. Lubejko
- Department of Neurobiology, School of Biological Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Robert D. Graham
- Department of Anesthesiology, Pain Center, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Giulia Livrizzi
- Department of Neurobiology, School of Biological Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Robert Schaefer
- Department of Anesthesiology, Pain Center, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Matthew R. Banghart
- Department of Neurobiology, School of Biological Sciences, University of California, San Diego, La Jolla, CA, United States
- *Correspondence: Matthew R. Banghart,
| | - Meaghan C. Creed
- Department of Anesthesiology, Pain Center, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
- Department of Neuroscience, Washington University in St. Louis, St. Louis, MO, United States
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
- Meaghan C. Creed,
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31
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Rachidi I, Minotti L, Martin G, Hoffmann D, Bastin J, David O, Kahane P. The Insula: A Stimulating Island of the Brain. Brain Sci 2021; 11:1533. [PMID: 34827532 PMCID: PMC8615692 DOI: 10.3390/brainsci11111533] [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: 10/08/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Direct cortical stimulation (DCS) in epilepsy surgery patients has a long history of functional brain mapping and seizure triggering. Here, we review its findings when applied to the insula in order to map the insular functions, evaluate its local and distant connections, and trigger seizures. Clinical responses to insular DCS are frequent and diverse, showing a partial segregation with spatial overlap, including a posterior somatosensory, auditory, and vestibular part, a central olfactory-gustatory region, and an anterior visceral and cognitive-emotional portion. The study of cortico-cortical evoked potentials (CCEPs) has shown that the anterior (resp. posterior) insula has a higher connectivity rate with itself than with the posterior (resp. anterior) insula, and that both the anterior and posterior insula are closely connected, notably between the homologous insular subdivisions. All insular gyri show extensive and complex ipsilateral and contralateral extra-insular connections, more anteriorly for the anterior insula and more posteriorly for the posterior insula. As a rule, CCEPs propagate first and with a higher probability around the insular DCS site, then to the homologous region, and later to more distal regions with fast cortico-cortical axonal conduction delays. Seizures elicited by insular DCS have rarely been specifically studied, but their rate does not seem to differ from those of other DCS studies. They are mainly provoked from the insular seizure onset zone but can also be triggered by stimulating intra- and extra-insular early propagation zones. Overall, in line with the neuroimaging studies, insular DCS studies converge on the view that the insula is a multimodal functional hub with a fast propagation of information, whose organization helps understand where insular seizures start and how they propagate.
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Affiliation(s)
- Inès Rachidi
- CHU Grenoble Alpes, 38000 Grenoble, France; (L.M.); (G.M.); (D.H.); (P.K.)
| | - Lorella Minotti
- CHU Grenoble Alpes, 38000 Grenoble, France; (L.M.); (G.M.); (D.H.); (P.K.)
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (J.B.); (O.D.)
| | - Guillaume Martin
- CHU Grenoble Alpes, 38000 Grenoble, France; (L.M.); (G.M.); (D.H.); (P.K.)
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (J.B.); (O.D.)
| | - Dominique Hoffmann
- CHU Grenoble Alpes, 38000 Grenoble, France; (L.M.); (G.M.); (D.H.); (P.K.)
| | - Julien Bastin
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (J.B.); (O.D.)
| | - Olivier David
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (J.B.); (O.D.)
| | - Philippe Kahane
- CHU Grenoble Alpes, 38000 Grenoble, France; (L.M.); (G.M.); (D.H.); (P.K.)
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (J.B.); (O.D.)
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Marcati E, Ferrari E, Fava E, Talamonti G, D'Aliberti GA. Clinical considerations on a right operculo-insular cavernous angioma: an illustrative case. Acta Neurochir (Wien) 2021; 163:2755-2759. [PMID: 34363126 DOI: 10.1007/s00701-021-04947-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/17/2021] [Indexed: 11/30/2022]
Abstract
The insular cortex is considered one of the most complex regions of the brain, defined as the "hub" of somatosensory areas. Here, we examine the case of a surgically treated haemorrhagic cavernoma involving the middle and posterior insular cortex, presenting both sensory, gustative and speech symptoms. By reviewing the recent findings in humans' and primates' basic research, we illustrated clinical and radiological correlations of the reported case, confirming insular role in sensitive and gustatory functions.
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Affiliation(s)
- Eleonora Marcati
- Department of Neurosurgery, ASST Niguarda Metropolitan Hospital, P.Le Ospedale Maggiore, 3, 20162, Milano, Italy.
| | - Erika Ferrari
- Department of Neurosurgery, ASST Niguarda Metropolitan Hospital, P.Le Ospedale Maggiore, 3, 20162, Milano, Italy
| | - Enrica Fava
- Department of Neurosurgery, ASST Niguarda Metropolitan Hospital, P.Le Ospedale Maggiore, 3, 20162, Milano, Italy
| | - Giuseppe Talamonti
- Department of Neurosurgery, ASST Niguarda Metropolitan Hospital, P.Le Ospedale Maggiore, 3, 20162, Milano, Italy
| | - Giuseppe A D'Aliberti
- Department of Neurosurgery, ASST Niguarda Metropolitan Hospital, P.Le Ospedale Maggiore, 3, 20162, Milano, Italy
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Brideau-Duquette M, Boucher O, Tremblay J, Robert M, Bouthillier A, Lepore F, Nguyen DK. Insular Cortex Response to Static Visual Sexual Stimuli. J PSYCHOPHYSIOL 2021. [DOI: 10.1027/0269-8803/a000285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. According to previous research, the insula is important for processing salient and emotional stimuli, but its precise role remains elusive. By combining high spatial and temporal resolution, intracranial electroencephalography (iEEG) might contribute to filling this gap. Four drug-resistant epileptic patients with intracranial electrodes in the insula were instructed to watch and rate pictures with sexual content and neutral pictures. Event-related potentials (ERPs) were computed separately for both types of stimuli. Ninety-three percent of the anterior insula (AI) and 85% of the posterior insula (PI) contacts showed differences between ERPs. AI-positive deflections tended to have an earlier onset than PI-positive deflections. The results suggest that the AI generates a P300-like response and contributes to the early phase of the late positive potential, both components found enhanced while viewing emotional stimuli in the ERP literature. The present findings are interpreted as congruent with the role of the AI in maintaining attention to salient stimuli.
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Affiliation(s)
- Mathieu Brideau-Duquette
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- Département de Psychologie, Université de Montréal, Canada
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Montréal, Canada
| | - Olivier Boucher
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- Département de Psychologie, Université de Montréal, Canada
- CHUM, Service de Psychologie, Montréal, Canada
| | - Julie Tremblay
- Centre de recherche du CHU Sainte-Justine, Montréal, Canada
| | - Manon Robert
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
| | | | - Franco Lepore
- Département de Psychologie, Université de Montréal, Canada
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Montréal, Canada
| | - Dang Khoa Nguyen
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- CHUM, Service de Neurologie, Montréal, Canada
- Département de Neurosciences, Université de Montréal, Canada
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34
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Terrier LM, Fontaine D. Intracranial nociception. Rev Neurol (Paris) 2021; 177:765-772. [PMID: 34384629 DOI: 10.1016/j.neurol.2021.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Understanding intracranial nociceptive innervation is essential to understand the pathophysiology of headaches. Our knowledge about human intracranial nociception comes from sparse observations during neurosurgical procedures performed in awake patients, from human anatomical studies and from experimental studies in animals. In this article we review the anatomical and functional organization underlying nociceptive innervation. Intracranial nociception is mainly mediated by the trigeminal system, except in the posterior cranial fossa that is innervated by the first cervical roots. For decades, the dura mater, its vessels and major cerebral blood vessels were considered as the only intracranial pain-sensitive structures. Recent animal and human studies have suggested that smaller brain arteries and potentially pia mater might also be pain sensitive. Nociceptive neurons innervating intracranial blood vessels project via the ophthalmic division (V1) to the trigeminal ganglion and store several neurotransmitters including glutamate, substance P and calcitonin gene-related peptide (CGRP). The trigeminal ganglion, root and brainstem nuclei have a specific topographic and functional somatotopy. Progressive transition between the trigeminal spinal nucleus and the dorsal horn of the cervical spinal cord, and convergence of nociceptive inputs from the face, intracranial structures and the occipital area on the so-called "trigemino-cervical complex" may explain some headache features, relations between facial and occipital pain, and efficacy of occipital nerve stimulation in headache. The specific anatomic organization of the trigeminal system, from the primary-order neuron in the trigeminal ganglion, to the second-order neuron is the trigeminal nuclei, may explain a part of the various characteristics of headaches.
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Affiliation(s)
- L-M Terrier
- Department of Neurosurgery, CHRU de Tours, U1253, 10, Boulevard Tonnellé, 37032 Tours, France; UMR 1253, ibrain, Université de Tours, Inserm, Tours, France.
| | - D Fontaine
- Department of Neurosurgery, CHU de Nice, Université Cote d'Azur, Nice, France; Université Cote d'Azur, FHU INOVPAIN, CHU de Nice, Nice, France
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35
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Mariani V, Balestrini S, Gozzo F, Pelliccia V, Mai R, Francione S, Sartori I, Cardinale F, Tassi L. Intracerebral electrical stimulations of the temporal lobe: A stereoelectroencephalography study. Eur J Neurosci 2021; 54:5368-5383. [PMID: 34192818 DOI: 10.1111/ejn.15377] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/06/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
The functional anatomy of the anteromesial portion of the temporal lobe and its involvement in epilepsy can be explored by means of intracerebral electrical stimulations. Here, we aimed to expand the knowledge of its physiological and pathophysiological symptoms by conducting the first large-sample systematic analysis of 1529 electrical stimulations of this anatomical region. We retrospectively analysed all clinical manifestations induced by intracerebral electrical stimulations in 173 patients with drug-resistant focal epilepsy with at least one electrode implanted in this area. We found that high-frequency stimulations were more likely to evoke electroclinical manifestations (p < .0001) and also provoked 'false positive' seizures. Multimodal symptoms were associated with EEG electrical modification (after discharge) (p < .0001). Visual symptoms were not associated with after discharge (p = .0002) and were mainly evoked by stimulation of the hippocampus (p = .009) and of the parahippocampal gyrus (p = .0212). 'False positive seizures' can be evoked by stimulation of the hippocampus, parahippocampal gyrus and amygdala, likely due to their intrinsic low epileptogenic threshold. Visual symptoms evoked in the hippocampus and parahippocampal gyrus, without EEG changes, are physiological symptoms and suggest involvement of these areas in the visual ventral stream. Our findings provide meaningful guidance in the interpretation of intracranial EEG studies of the temporal lobe.
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Affiliation(s)
- Valeria Mariani
- Neurology and Stroke Unit Divison, Circolo Hospital ASST Settelaghi University of Insubria, Varese, Italy.,"Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
| | - Simona Balestrini
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology and Chalfont Centre for Epilepsy, London, UK.,Neuroscience Department, Meyer Children's Hospital-University of Florence, Florence, Italy
| | - Francesca Gozzo
- "Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
| | - Veronica Pelliccia
- "Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
| | - Roberto Mai
- "Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
| | - Stefano Francione
- "Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
| | - Ivana Sartori
- "Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
| | | | - Laura Tassi
- "Claudio Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Milan, Italy
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36
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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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37
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Hewitt D, Byrne A, Henderson J, Newton-Fenner A, Tyson-Carr J, Fallon N, Brown C, Stancak A. Inhibition of cortical somatosensory processing during and after low frequency peripheral nerve stimulation in humans. Clin Neurophysiol 2021; 132:1481-1495. [PMID: 34023628 DOI: 10.1016/j.clinph.2021.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Transcutaneous low-frequency stimulation (LFS) elicits long-term depression-like effects on human pain perception. However, the neural mechanisms underlying LFS are poorly understood. We investigated cortical activation changes occurring during LFS and if changes were associated with reduced nociceptive processing and increased amplitude of spontaneous cortical oscillations post-treatment. METHODS LFS was applied to the radial nerve of 25 healthy volunteers over two sessions using active (1 Hz) or sham (0.02 Hz) frequencies. Changes in resting electroencephalography (EEG) and laser-evoked potentials (LEPs) were investigated before and after LFS. Somatosensory-evoked potentials were recorded during LFS and source analysis was carried out. RESULTS Ipsilateral midcingulate and operculo-insular cortex source activity declined linearly during LFS. Active LFS was associated with attenuated long-latency LEP amplitude in ipsilateral frontocentral electrodes and increased resting alpha (8-12 Hz) and beta (16-24 Hz) band power in electrodes overlying operculo-insular, sensorimotor and frontal cortical regions. Reduced ipsilateral operculo-insular cortex source activity during LFS correlated with a smaller post-treatment alpha-band power increase. CONCLUSIONS LFS attenuated somatosensory processing both during and after stimulation. SIGNIFICANCE Results further our understanding of the attenuation of somatosensory processing both during and after LFS.
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Affiliation(s)
- Danielle Hewitt
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
| | - Adam Byrne
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK; Institute for Risk and Uncertainty, University of Liverpool, Liverpool, UK
| | - Jessica Henderson
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Alice Newton-Fenner
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK; Institute for Risk and Uncertainty, University of Liverpool, Liverpool, UK
| | - John Tyson-Carr
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Nicholas Fallon
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Christopher Brown
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Andrej Stancak
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK; Institute for Risk and Uncertainty, University of Liverpool, Liverpool, UK
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Bergeron D, Obaid S, Fournier-Gosselin MP, Bouthillier A, Nguyen DK. Deep Brain Stimulation of the Posterior Insula in Chronic Pain: A Theoretical Framework. Brain Sci 2021; 11:brainsci11050639. [PMID: 34063367 PMCID: PMC8156413 DOI: 10.3390/brainsci11050639] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION To date, clinical trials of deep brain stimulation (DBS) for refractory chronic pain have yielded unsatisfying results. Recent evidence suggests that the posterior insula may represent a promising DBS target for this indication. METHODS We present a narrative review highlighting the theoretical basis of posterior insula DBS in patients with chronic pain. RESULTS Neuroanatomical studies identified the posterior insula as an important cortical relay center for pain and interoception. Intracranial neuronal recordings showed that the earliest response to painful laser stimulation occurs in the posterior insula. The posterior insula is one of the only regions in the brain whose low-frequency electrical stimulation can elicit painful sensations. Most chronic pain syndromes, such as fibromyalgia, had abnormal functional connectivity of the posterior insula on functional imaging. Finally, preliminary results indicated that high-frequency electrical stimulation of the posterior insula can acutely increase pain thresholds. CONCLUSION In light of the converging evidence from neuroanatomical, brain lesion, neuroimaging, and intracranial recording and stimulation as well as non-invasive stimulation studies, it appears that the insula is a critical hub for central integration and processing of painful stimuli, whose high-frequency electrical stimulation has the potential to relieve patients from the sensory and affective burden of chronic pain.
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Affiliation(s)
- David Bergeron
- Service de Neurochirurgie, Université de Montréal, Montréal, QC H3T 1L5, Canada; (S.O.); (M.-P.F.-G.); (A.B.)
- Correspondence:
| | - Sami Obaid
- Service de Neurochirurgie, Université de Montréal, Montréal, QC H3T 1L5, Canada; (S.O.); (M.-P.F.-G.); (A.B.)
| | | | - Alain Bouthillier
- Service de Neurochirurgie, Université de Montréal, Montréal, QC H3T 1L5, Canada; (S.O.); (M.-P.F.-G.); (A.B.)
| | - Dang Khoa Nguyen
- Service de Neurologie, Université de Montréal, Montréal, QC H3T 1L5, Canada;
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Taesler P, Rose M. The modulation of neural insular activity by a brain computer interface differentially affects pain discrimination. Sci Rep 2021; 11:9795. [PMID: 33963226 PMCID: PMC8105353 DOI: 10.1038/s41598-021-89206-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/11/2021] [Indexed: 11/20/2022] Open
Abstract
The experience of pain is generated by activations throughout a complex pain network with the insular cortex as a central processing area. The state of ongoing oscillatory activity can influence subsequent processing throughout this network. In particular the ongoing theta-band power can be relevant for later pain processing, however a direct functional relation to post-stimulus processing or behaviour is missing. Here, we used a non-invasive brain-computer interface to either increase or decrease ongoing theta-band power originating in the insular cortex. Our results show a differential modulation of oscillatory power and even more important a transfer to independently measured pain processing and sensation. Pain evoked neural power and subjective pain discrimination were differentially affected by the induced modulations of the oscillatory state. The results demonstrate a functional relevance of insular based theta-band oscillatory states for the processing and subjective discrimination of nociceptive stimuli and offer the perspective for clinical applications.
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Affiliation(s)
- Philipp Taesler
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W34, 20251, Hamburg, Germany
| | - Michael Rose
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W34, 20251, Hamburg, Germany.
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40
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Zhang X, Li L, Huang G, Zhang L, Liang Z, Shi L, Zhang Z. A Multisensory fMRI Investigation of Nociceptive-Preferential Cortical Regions and Responses. Front Neurosci 2021; 15:635733. [PMID: 33935632 PMCID: PMC8079658 DOI: 10.3389/fnins.2021.635733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 11/13/2022] Open
Abstract
The existence of nociceptive-specific brain regions has been a controversial issue for decades. Multisensory fMRI studies, which examine fMRI activities in response to various types of sensory stimulation, could help identify nociceptive-specific brain regions, but previous studies are limited by sample size and they did not differentiate nociceptive-specific regions and nociceptive-preferential regions, which have significantly larger responses to nociceptive input. In this study, we conducted a multisensory fMRI experiment on 80 healthy participants, with the aim to determine whether there are certain brain regions that specifically or preferentially respond to nociceptive stimulation. By comparing the evoked fMRI responses across four sensory modalities, we found a series of brain regions specifically or preferentially involved in nociceptive sensory input. Particularly, we found different parts of some cortical regions, such as insula and cingulate gyrus, play different functional roles in the processing of nociceptive stimulation. Hence, this multisensory study improves our understanding of the functional integrations and segregations of the nociceptive-related regions.
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Affiliation(s)
- Xiaoxia Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Linling Li
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Gan Huang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Li Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Zhen Liang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Li Shi
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Zhiguo Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Peng Cheng Laboratory, Shenzhen, China
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41
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Abend R, Bajaj MA, Harrewijn A, Matsumoto C, Michalska KJ, Necka E, Palacios-Barrios EE, Leibenluft E, Atlas LY, Pine DS. Threat-anticipatory psychophysiological response is enhanced in youth with anxiety disorders and correlates with prefrontal cortex neuroanatomy. J Psychiatry Neurosci 2021; 46:E212-E221. [PMID: 33703868 PMCID: PMC8061736 DOI: 10.1503/jpn.200110] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/27/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022] Open
Abstract
Background Threat anticipation engages neural circuitry that has evolved to promote defensive behaviours; perturbations in this circuitry could generate excessive threat-anticipation response, a key characteristic of pathological anxiety. Research into such mechanisms in youth faces ethical and practical limitations. Here, we use thermal stimulation to elicit pain-anticipatory psychophysiological response and map its correlates to brain structure among youth with anxiety and healthy youth. Methods Youth with anxiety (n = 25) and healthy youth (n = 25) completed an instructed threat-anticipation task in which cues predicted nonpainful or painful thermal stimulation; we indexed psychophysiological response during the anticipation and experience of pain using skin conductance response. High-resolution brain-structure imaging data collected in another visit were available for 41 participants. Analyses tested whether the 2 groups differed in their psychophysiological cue-based pain-anticipatory and pain-experience responses. Analyses then mapped psychophysiological response magnitude to brain structure. Results Youth with anxiety showed enhanced psychophysiological response specifically during anticipation of painful stimulation (b = 0.52, p = 0.003). Across the sample, the magnitude of psychophysiological anticipatory response correlated negatively with the thickness of the dorsolateral prefrontal cortex (pFWE < 0.05); psychophysiological response to the thermal stimulation correlated positively with the thickness of the posterior insula (pFWE < 0.05). Limitations Limitations included the modest sample size and the cross-sectional design. Conclusion These findings show that threat-anticipatory psychophysiological response differentiates youth with anxiety from healthy youth, and they link brain structure to psychophysiological response during pain anticipation and experience. A focus on threat anticipation in research on anxiety could delineate relevant neural circuitry.
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Affiliation(s)
- Rany Abend
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Mira A Bajaj
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Anita Harrewijn
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Chika Matsumoto
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Kalina J Michalska
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Elizabeth Necka
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Esther E Palacios-Barrios
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Ellen Leibenluft
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Lauren Y Atlas
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Daniel S Pine
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
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Najafi P, Misery L, Carré JL, Ben Salem D, Dufor O. Itch Matrixes. Front Med (Lausanne) 2021; 8:636904. [PMID: 33718409 PMCID: PMC7943862 DOI: 10.3389/fmed.2021.636904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peyman Najafi
- Univ Brest, LIEN, Brest, France.,Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique/Université Paris-Saclay, Gif-sur-Yvette, France
| | - Laurent Misery
- Univ Brest, LIEN, Brest, France.,University Hospital of Brest, Department of Dermatology, Brest, France
| | | | - Douraied Ben Salem
- Univ Brest, LATIM, INSERM UMR, Brest, France.,University Hospital of Brest, Department of Radiology, Brest, France
| | - Olivier Dufor
- Univ Brest, LIEN, Brest, France.,L@bISEN Yncréa Ouest, ISEN, Brest, France
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43
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Lemaître H, Augé P, Saitovitch A, Vinçon-Leite A, Tacchella JM, Fillon L, Calmon R, Dangouloff-Ros V, Lévy R, Grévent D, Brunelle F, Boddaert N, Zilbovicius M. Rest Functional Brain Maturation during the First Year of Life. Cereb Cortex 2021; 31:1776-1785. [PMID: 33230520 PMCID: PMC7869100 DOI: 10.1093/cercor/bhaa325] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 11/28/2022] Open
Abstract
The first year of life is a key period of brain development, characterized by dramatic structural and functional modifications. Here, we measured rest cerebral blood flow (CBF) modifications throughout babies’ first year of life using arterial spin labeling magnetic resonance imaging sequence in 52 infants, from 3 to 12 months of age. Overall, global rest CBF significantly increased during this age span. In addition, we found marked regional differences in local functional brain maturation. While primary sensorimotor cortices and insula showed early maturation, temporal and prefrontal region presented great rest CBF increase across the first year of life. Moreover, we highlighted a late and remarkably synchronous maturation of the prefrontal and posterior superior temporal cortices. These different patterns of regional cortical rest CBF modifications reflect a timetable of local functional brain maturation and are consistent with baby’s cognitive development within the first year of life.
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Affiliation(s)
- Hervé Lemaître
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives (CNRS UMR 5293), Université de Bordeaux, Bordeaux 33000, France
| | - Pierre Augé
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Ana Saitovitch
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Alice Vinçon-Leite
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Jean-Marc Tacchella
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Ludovic Fillon
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Raphael Calmon
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Volodia Dangouloff-Ros
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Raphaël Lévy
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - David Grévent
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Francis Brunelle
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Nathalie Boddaert
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Monica Zilbovicius
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
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Lötsch J, Oertel BG, Felden L, Nöth U, Deichmann R, Hummel T, Walter C. Central encoding of the strength of intranasal chemosensory trigeminal stimuli in a human experimental pain setting. Hum Brain Mapp 2020; 41:5240-5254. [PMID: 32870583 PMCID: PMC7670645 DOI: 10.1002/hbm.25190] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/29/2022] Open
Abstract
An important measure in pain research is the intensity of nociceptive stimuli and their cortical representation. However, there is evidence of different cerebral representations of nociceptive stimuli, including the fact that cortical areas recruited during processing of intranasal nociceptive chemical stimuli included those outside the traditional trigeminal areas. Therefore, the aim of this study was to investigate the major cerebral representations of stimulus intensity associated with intranasal chemical trigeminal stimulation. Trigeminal stimulation was achieved with carbon dioxide presented to the nasal mucosa. Using a single-blinded, randomized crossover design, 24 subjects received nociceptive stimuli with two different stimulation paradigms, depending on the just noticeable differences in the stimulus strengths applied. Stimulus-related brain activations were recorded using functional magnetic resonance imaging with event-related design. Brain activations increased significantly with increasing stimulus intensity, with the largest cluster at the right Rolandic operculum and a global maximum in a smaller cluster at the left lower frontal orbital lobe. Region of interest analyses additionally supported an activation pattern correlated with the stimulus intensity at the piriform cortex as an area of special interest with the trigeminal input. The results support the piriform cortex, in addition to the secondary somatosensory cortex, as a major area of interest for stimulus strength-related brain activation in pain models using trigeminal stimuli. This makes both areas a primary objective to be observed in human experimental pain settings where trigeminal input is used to study effects of analgesics.
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Affiliation(s)
- Jörn Lötsch
- Institute of Clinical PharmacologyGoethe – UniversityFrankfurt am MainGermany
- Fraunhofer Institute for Molecular Biology and Applied Ecology IMEBranch for Translational Medicine and Pharmacology TMPFrankfurt am MainGermany
| | - Bruno G. Oertel
- Institute of Clinical PharmacologyGoethe – UniversityFrankfurt am MainGermany
| | - Lisa Felden
- Institute of Clinical PharmacologyGoethe – UniversityFrankfurt am MainGermany
| | - Ulrike Nöth
- Brain Imaging CenterGoethe – UniversityFrankfurt am MainGermany
| | - Ralf Deichmann
- Brain Imaging CenterGoethe – UniversityFrankfurt am MainGermany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
| | - Carmen Walter
- Institute of Clinical PharmacologyGoethe – UniversityFrankfurt am MainGermany
- Fraunhofer Institute for Molecular Biology and Applied Ecology IMEBranch for Translational Medicine and Pharmacology TMPFrankfurt am MainGermany
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45
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Tinnermann A, Büchel C, Cohen-Adad J. Cortico-spinal imaging to study pain. Neuroimage 2020; 224:117439. [PMID: 33039624 DOI: 10.1016/j.neuroimage.2020.117439] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 12/15/2022] Open
Abstract
Functional magnetic resonance imaging of the brain has helped to reveal mechanisms of pain perception in health and disease. Recently, imaging approaches have been developed that allow recording neural activity simultaneously in the brain and in the spinal cord. These approaches offer the possibility to examine pain perception in the entire central pain system and in addition, to investigate cortico-spinal interactions during pain processing. Although cortico-spinal imaging is a promising technique, it bears challenges concerning data acquisition and data analysis strategies. In this review, we discuss studies that applied simultaneous imaging of the brain and spinal cord to explore central pain processing. Furthermore, we describe different MR-related acquisition techniques, summarize advantages and disadvantages of approaches that have been implemented so far and present software that has been specifically developed for the analysis of spinal fMRI data to address challenges of spinal data analysis.
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Affiliation(s)
- Alexandra Tinnermann
- Department for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Max Planck School of Cognition, Leipzig, Germany.
| | - Christian Büchel
- Department for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Max Planck School of Cognition, Leipzig, Germany
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, Quebec, Canada.
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Cerritelli F, Chiacchiaretta P, Gambi F, Perrucci MG, Barassi G, Visciano C, Bellomo RG, Saggini R, Ferretti A. Effect of manual approaches with osteopathic modality on brain correlates of interoception: an fMRI study. Sci Rep 2020; 10:3214. [PMID: 32081945 PMCID: PMC7035282 DOI: 10.1038/s41598-020-60253-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/10/2020] [Indexed: 01/17/2023] Open
Abstract
The present randomised placebo controlled trial explored the extent to which osteopathic manipulative treatment (OMT) affects brain activity, particularly the insula, during both an “interoceptive awareness” and “exteroceptive awareness” task in a sample of 32 right-handed adults with chronic Low Back Pain (CLBP) randomly assigned to either the OMT or sham group. Patients received 4 weekly sessions and fMRI was performed at enrolment (T0), immediately after the first session (T1) and at 1 month (T2). The results revealed that the OMT produced a distinct and specific reduction in BOLD response in specific brain areas related to interoception, i.e., bilateral insula, ACC, left striatum and rMFG. The observed trend across the three time points appears uncharacteristic. At T1, a marginal increase of the BOLD response was observed in all the above-mentioned areas except the rMFG, which showed a decrease in BOLD response. At T2, the response was the opposite: areas related to interoception (bilateral insula and ACC) as well as the rMFG and left striatum demonstrated significant decreased in BOLD response. The findings of this study provide an insight into the effects of manual therapies on brain activity and have implications for future research in the field.
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Affiliation(s)
- Francesco Cerritelli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Clinical-Based Human Research Department-C.O.M.E. Collaboration ONLUS, Pescara, Italy
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy. .,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Francesco Gambi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Barassi
- Department of Medical Oral and Biotechnological Science, "Gabriele d'Annunzio" University, Chieti-Pescara, Italy
| | - Christian Visciano
- Department of Medical Oral and Biotechnological Science, "Gabriele d'Annunzio" University, Chieti-Pescara, Italy
| | | | - Raoul Saggini
- Department of Medical Oral and Biotechnological Science, "Gabriele d'Annunzio" University, Chieti-Pescara, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Lee IS, Necka EA, Atlas LY. Distinguishing pain from nociception, salience, and arousal: How autonomic nervous system activity can improve neuroimaging tests of specificity. Neuroimage 2020; 204:116254. [PMID: 31604122 PMCID: PMC6911655 DOI: 10.1016/j.neuroimage.2019.116254] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 12/16/2022] Open
Abstract
Pain is a subjective, multidimensional experience that is distinct from nociception. A large body of work has focused on whether pain processing is supported by specific, dedicated brain circuits. Despite advances in human neuroscience and neuroimaging analysis, dissociating acute pain from other sensations has been challenging since both pain and non-pain stimuli evoke salience and arousal responses throughout the body and in overlapping brain circuits. In this review, we discuss these challenges and propose that brain-body interactions in pain can be leveraged in order to improve tests for pain specificity. We review brain and bodily responses to pain and nociception and extant efforts toward identifying pain-specific brain networks. We propose that autonomic nervous system activity should be used as a surrogate measure of salience and arousal to improve these efforts and enable researchers to parse out pain-specific responses in the brain, and demonstrate the feasibility of this approach using example fMRI data from a thermal pain paradigm. This new approach will improve the accuracy and specificity of functional neuroimaging analyses and help to overcome current difficulties in assessing pain specific responses in the human brain.
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Affiliation(s)
- In-Seon Lee
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth A Necka
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
| | - Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA; National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
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48
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Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, Filipović SR, Grefkes C, Hasan A, Hummel FC, Jääskeläinen SK, Langguth B, Leocani L, Londero A, Nardone R, Nguyen JP, Nyffeler T, Oliveira-Maia AJ, Oliviero A, Padberg F, Palm U, Paulus W, Poulet E, Quartarone A, Rachid F, Rektorová I, Rossi S, Sahlsten H, Schecklmann M, Szekely D, Ziemann U. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clin Neurophysiol 2020; 131:474-528. [PMID: 31901449 DOI: 10.1016/j.clinph.2019.11.002] [Citation(s) in RCA: 938] [Impact Index Per Article: 234.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/21/2019] [Accepted: 11/02/2019] [Indexed: 02/08/2023]
Abstract
A group of European experts reappraised the guidelines on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) previously published in 2014 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]. These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018. Level A evidence (definite efficacy) was reached for: high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the painful side for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) using a figure-of-8 or a H1-coil for depression; low-frequency (LF) rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke. Level B evidence (probable efficacy) was reached for: HF-rTMS of the left M1 or DLPFC for improving quality of life or pain, respectively, in fibromyalgia; HF-rTMS of bilateral M1 regions or the left DLPFC for improving motor impairment or depression, respectively, in Parkinson's disease; HF-rTMS of ipsilesional M1 for promoting motor recovery at the post-acute stage of stroke; intermittent theta burst stimulation targeted to the leg motor cortex for lower limb spasticity in multiple sclerosis; HF-rTMS of the right DLPFC in posttraumatic stress disorder; LF-rTMS of the right inferior frontal gyrus in chronic post-stroke non-fluent aphasia; LF-rTMS of the right DLPFC in depression; and bihemispheric stimulation of the DLPFC combining right-sided LF-rTMS (or continuous theta burst stimulation) and left-sided HF-rTMS (or intermittent theta burst stimulation) in depression. Level A/B evidence is not reached concerning efficacy of rTMS in any other condition. The current recommendations are based on the differences reached in therapeutic efficacy of real vs. sham rTMS protocols, replicated in a sufficient number of independent studies. This does not mean that the benefit produced by rTMS inevitably reaches a level of clinical relevance.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France; Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France.
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - David H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Jérôme Brunelin
- PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Saša R Filipović
- Department of Human Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Christian Grefkes
- Department of Neurology, Cologne University Hospital, Cologne, Germany; Institute of Neurosciences and Medicine (INM3), Jülich Research Centre, Jülich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Friedhelm C Hummel
- Defitech Chair in Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Defitech Chair in Clinical Neuroengineering, Swiss Federal Institute of Technology (EPFL) Valais and Clinique Romande de Réadaptation, Sion, Switzerland; Clinical Neuroscience, University of Geneva Medical School, Geneva, Switzerland
| | - Satu K Jääskeläinen
- Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Letizia Leocani
- Department of Neurorehabilitation and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Alain Londero
- Department of Otorhinolaryngology - Head and Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Paris, France
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | - Jean-Paul Nguyen
- Multidisciplinary Pain Center, Clinique Bretéché, ELSAN, Nantes, France; Multidisciplinary Pain, Palliative and Supportive Care Center, UIC22-CAT2-EA3826, University Hospital, CHU Nord-Laënnec, Nantes, France
| | - Thomas Nyffeler
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Albino J Oliveira-Maia
- Champalimaud Research & Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Medical Park Chiemseeblick, Bernau, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Emmanuel Poulet
- PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France; Department of Emergency Psychiatry, Edouard Herriot Hospital, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Angelo Quartarone
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Irena Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience, Si-BIN Lab Human Physiology Section, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy
| | - Hanna Sahlsten
- ENT Clinic, Mehiläinen and University of Turku, Turku, Finland
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - David Szekely
- Department of Psychiatry, Princess Grace Hospital, Monaco
| | - Ulf Ziemann
- Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
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Abstract
Supplemental Digital Content is Available in the Text. Hub topology is altered in fibromyalgia, and disruption of the excitatory tone within the insula influences hub status and is associated with clinical pain intensity. A critical component of brain network architecture is a robust hub structure, wherein hub regions facilitate efficient information integration by occupying highly connected and functionally central roles in the network. Across a wide range of neurological disorders, hub brain regions seem to be disrupted, and the character of this disruption can yield insights into the pathophysiology of these disorders. We applied a brain network–based approach to examine hub topology in fibromyalgia, a chronic pain condition with prominent central nervous system involvement. Resting state functional magnetic resonance imaging data from 40 fibromyalgia patients and 46 healthy volunteers, and a small validation cohort of 11 fibromyalgia patients, were analyzed using graph theoretical techniques to model connections between 264 brain regions. In fibromyalgia, the anterior insulae functioned as hubs and were members of the rich club, a highly interconnected nexus of hubs. In fibromyalgia, rich-club membership varied with the intensity of clinical pain: the posterior insula, primary somatosensory, and motor cortices belonged to the rich club only in patients with the highest pain intensity. Furthermore, the eigenvector centrality (a measure of how connected a region is to other highly connected regions) of the posterior insula positively correlated with clinical pain and mediated the relationship between glutamate + glutamine (assessed by proton magnetic resonance spectroscopy) within this structure and the patient's clinical pain report. Together, these findings reveal altered hub topology in fibromyalgia and demonstrate, for the first time to our knowledge, a neurochemical basis for altered hub strength and its relationship to the perception of pain.
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