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Nichols SJ, Yanes JA, Reid MA, Robinson JL. 7 T characterization of excitatory and inhibitory systems of acute pain in healthy female participants. NMR IN BIOMEDICINE 2024; 37:e5088. [PMID: 38140895 DOI: 10.1002/nbm.5088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023]
Abstract
Current understanding of the physiological underpinnings of normative pain processing is incomplete. Enhanced knowledge of these systems is necessary to advance our understanding of pain processes as well as to develop effective therapeutic interventions. Previous neuroimaging research suggests a network of interrelated brain regions that seem to be implicated in the processing and experience of pain. Among these, the dorsal anterior cingulate cortex (dACC) plays an important role in the affective aspects of pain signals. The current study leveraged functional MRS to investigate the underlying dynamic shifts in the neurometabolic signature of the human dACC at rest and during acute pain. Results provide support for increased glutamate levels following acute pain administration. Specifically, a 4.6% increase in glutamate was observed during moderate pressure pain compared with baseline. Exploratory analysis also revealed meaningful changes in dACC gamma aminobutyric acid in response to pain stimulation. These data contribute toward the characterization of neurometabolic shifts, which lend insight into the role of the dACC in the pain network. Further research in this area with larger sample sizes could contribute to the development of novel therapeutics or other advances in pain-related outcomes.
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Affiliation(s)
- Steven J Nichols
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Julio A Yanes
- Exponent Inc., Washington, District of Columbia, USA
| | - Meredith A Reid
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
| | - Jennifer L Robinson
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
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2
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Wen J, Gao Y, Li M, Hu S, Zhao M, Su C, Wang Q, Xi H, Zhan L, Lv Y, Antwi CO, Ren J, Jia X. Regional abnormalities of spontaneous brain activity in migraine: A coordinate‐based meta‐analysis. J Neurosci Res 2023. [DOI: 10.1002/jnr.25191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023]
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3
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Choi JC, Park HJ, Park JA, Kang DR, Choi YS, Choi S, Lee HG, Choi JH, Choi IH, Yoon MW, Lee JM, Kim J. The increased analgesic efficacy of cold therapy after an unsuccessful analgesic experience is associated with inferior parietal lobule activation. Sci Rep 2022; 12:14687. [PMID: 36038625 PMCID: PMC9424269 DOI: 10.1038/s41598-022-18181-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/08/2022] [Indexed: 11/09/2022] Open
Abstract
Prior experiences of successful and failed treatments are known to influence the efficacy of a newly applied treatment. However, whether that carry-over effect applies to non-pharmacological treatments is unknown. This study investigated how a failed treatment history with placebo analgesic cream affected the therapeutic outcomes of cold-pack treatment. The neural correlates underlying those effects were also explored using functional magnetic resonance imaging. The effect of the placebo analgesic cream was induced using placebo conditioning with small (44.5 °C to 43.7 °C, negative experience) and large (44.5 °C to 40.0 °C, positive experience) thermal stimuli changes. After the placebo conditioning, brain responses and self-reported evaluations of the effect of subsequent treatment with a cold-pack were contrasted between the two groups. The negative experience group reported less pain and lower anxiety scores in the cold-pack condition than the positive experience group and exhibited significantly greater activation in the right inferior parietal lobule (IPL), which is known to be involved in pain relief. These findings suggest that an unsatisfying experience with an initial pain-relief treatment could increase the expectations for the complementary treatment outcome and improve the analgesic effect of the subsequent treatment. The IPL could be associated with this expectation-induced pain relief process.
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Affiliation(s)
- Jae Chan Choi
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea.,Cham Brain Health Institute, 08807, Seoul, Republic of Korea
| | - Hae-Jeong Park
- Department of Nuclear Medicine, Graduate School of Medical Science, BrainKorea21Project, Yonsei University College of Medicine, Seoul, 3722, Republic of Korea
| | - Jeong A Park
- Alzza Health Institute, Seoul, Republic of Korea
| | - Dae Ryong Kang
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju-si, 26426, Republic of Korea
| | - Young-Seok Choi
- Department of Electronics and Communications Engineering, Kwangwoon University, Seoul, 01897, Republic of Korea
| | - SoHyun Choi
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju-si, 26426, Republic of Korea
| | - Hong Gyu Lee
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju-si, 26426, Republic of Korea
| | - Jun-Ho Choi
- Department of Practical Arts Education, Chinju National University of Education, Jinju-si, 52673, Republic of Korea
| | - In-Ho Choi
- Department of Architectural Design, Kaywon University of Art and Design, Uiwang-si, 16038, Republic of Korea
| | - Min Woo Yoon
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, 4763, Republic of Korea
| | - Jinhee Kim
- School of Psychology, Korea University, Seoul, 2841, Republic of Korea.
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4
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Hewitt D, Newton-Fenner A, Henderson J, Fallon NB, Brown C, Stancak A. Intensity-dependent modulation of cortical somatosensory processing during external, low-frequency peripheral nerve stimulation in humans. J Neurophysiol 2022; 127:1629-1641. [PMID: 35611988 PMCID: PMC9190739 DOI: 10.1152/jn.00511.2021] [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] [Indexed: 01/20/2023] Open
Abstract
External low-frequency peripheral nerve stimulation (LFS) has been proposed as a novel method for neuropathic pain relief. Previous studies have reported that LFS elicits long-term depression-like effects on human pain perception when delivered at noxious intensities, whereas lower intensities are ineffective. To shed light on cortical regions mediating the effects of LFS, we investigated changes in somatosensory-evoked potentials (SEPs) during four LFS intensities. LFS was applied to the radial nerve (600 pulses, 1 Hz) of 24 healthy participants at perception (1 times), low (5 times), medium (10 times), and high intensities (15 times detection threshold). SEPs were recorded during LFS, and averaged SEPs in 10 consecutive 1-min epochs of LFS were analyzed using source dipole modeling. Changes in resting electroencephalography (EEG) were investigated after each LFS block. Source activity in the midcingulate cortex (MCC) decreased linearly during LFS, with greater attenuation at stronger LFS intensities, and in the ipsilateral operculo-insular cortex during the two lowest LFS stimulus intensities. Increased LFS intensities resulted in greater augmentation of contralateral primary sensorimotor cortex (SI/MI) activity. Stronger LFS intensities were followed by increased α (alpha, 9-11 Hz) band power in SI/MI and decreased θ (theta, 3-5 Hz) band power in MCC. Intensity-dependent attenuation of MCC activity with LFS is consistent with a state of long-term depression. Sustained increases in contralateral SI/MI activity suggests that effects of LFS on somatosensory processing may also be dependent on satiation of SI/MI. Further research could clarify if the activation of SI/MI during LFS competes with nociceptive processing in neuropathic pain.NEW & NOTEWORTHY Somatosensory-evoked potentials during low-frequency stimulation of peripheral nerves were examined at graded stimulus intensities. Low-frequency stimulation was associated with decreased responsiveness in the midcingulate cortex and increased responsiveness in primary sensorimotor cortex. Greater intensities were associated with increased midcingulate cortex θ band power and decreased sensorimotor cortex α band power. Results further previous evidence of an inhibition of somatosensory processing during and after low-frequency stimulation and point toward a potential augmentation of activity in somatosensory processing regions.
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Affiliation(s)
- Danielle Hewitt
- 1Department of Psychological Sciences, grid.10025.36University of Liverpool, Liverpool, United Kingdom
| | - Alice Newton-Fenner
- 1Department of Psychological Sciences, grid.10025.36University of Liverpool, Liverpool, United Kingdom,2Institute for Risk and Uncertainty, University of Liverpool, Liverpool, United Kingdom
| | - Jessica Henderson
- 1Department of Psychological Sciences, grid.10025.36University of Liverpool, Liverpool, United Kingdom
| | - Nicholas B. Fallon
- 1Department of Psychological Sciences, grid.10025.36University of Liverpool, Liverpool, United Kingdom
| | - Christopher Brown
- 1Department of Psychological Sciences, grid.10025.36University of Liverpool, Liverpool, United Kingdom
| | - Andrej Stancak
- 1Department of Psychological Sciences, grid.10025.36University of Liverpool, Liverpool, United Kingdom,2Institute for Risk and Uncertainty, University of Liverpool, Liverpool, United Kingdom
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5
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Corp DT, Bereznicki HGK, Clark GM, Youssef GJ, Fried PJ, Jannati A, Davies CB, Gomes-Osman J, Kirkovski M, Albein-Urios N, Fitzgerald PB, Koch G, Di Lazzaro V, Pascual-Leone A, Enticott PG. Large-scale analysis of interindividual variability in single and paired-pulse TMS data. Clin Neurophysiol 2021; 132:2639-2653. [PMID: 34344609 DOI: 10.1016/j.clinph.2021.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study brought together over 60 transcranial magnetic stimulation (TMS) researchers to create the largest known sample of individual participant single and paired-pulse TMS data to date, enabling a more comprehensive evaluation of factors driving response variability. METHODS Authors of previously published studies were contacted and asked to share deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to variability in response to single and paired-pulse TMS data. RESULTS 687 healthy participant's data were pooled across 35 studies. Target muscle, pulse waveform, neuronavigation use, and TMS machine significantly predicted an individual's single-pulse TMS amplitude. Baseline motor evoked potential amplitude, motor cortex hemisphere, and motor threshold (MT) significantly predicted short-interval intracortical inhibition response. Baseline motor evoked potential amplitude, test stimulus intensity, interstimulus interval, and MT significantly predicted intracortical facilitation response. Age, hemisphere, and TMS machine significantly predicted MT. CONCLUSIONS This large-scale analysis has identified a number of factors influencing participants' responses to single and paired-pulse TMS. We provide specific recommendations to minimise interindividual variability in single and paired-pulse TMS data. SIGNIFICANCE This study has used large-scale analyses to give clarity to factors driving variance in TMS data. We hope that this ongoing collaborative approach will increase standardisation of methods and thus the utility of single and paired-pulse TMS.
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Affiliation(s)
- Daniel T Corp
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Hannah G K Bereznicki
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Gillian M Clark
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - George J Youssef
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Peter J Fried
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ali Jannati
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charlotte B Davies
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Joyce Gomes-Osman
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Melissa Kirkovski
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Natalia Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Central Clinical School, Melbourne, Australia
| | - Giacomo Koch
- Non-invasive Brain Stimulation Unit, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedical and Specialty Surgical Sciences, Section of Human Physiology, University of Ferrara, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology and Neurobiology, Università Campus Bio-Medico, Rome, Italy
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
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Berry MP, Lutz J, Schuman-Olivier Z, Germer C, Pollak S, Edwards RR, Gardiner P, Desbordes G, Napadow V. Brief Self-Compassion Training Alters Neural Responses to Evoked Pain for Chronic Low Back Pain: A Pilot Study. PAIN MEDICINE 2021; 21:2172-2185. [PMID: 32783054 DOI: 10.1093/pm/pnaa178] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Self-compassion meditation, which involves compassion toward the self in moments of suffering, shows promise for improving pain-related functioning, but its underlying mechanisms are unknown. This longitudinal, exploratory pilot study investigated the effects of a brief (eight contact hours, two weeks of home practice) self-compassion training on pain-related brain processing in chronic low back pain (cLBP). METHODS We evaluated functional magnetic resonance imaging (fMRI) response to evoked pressure pain and its anticipation during a self-compassionate state and compared altered brain responses following training with changes on self-reported measures of self-compassion (Self-Compassion Scale [SCS]), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness [MAIA]), and clinical pain intensity. RESULTS In a sample of participants with cLBP (N = 20 total, N = 14 with complete longitudinal data) who underwent self-compassion training, we observed reduced clinical pain intensity and disability (P < 0.01) and increased trait self-compassion and interoceptive awareness (all P < 0.05) following training. Evoked pressure pain response in the right temporo-parietal junction (TPJ) was reduced following training, and decreases were associated with reduced clinical pain intensity. Further, increased fMRI responses to pain anticipation were observed in the right dorsolateral prefrontal cortex (dlPFC) and ventral posterior cingulate cortex (vPCC), and these increases were associated with mean post-training changes in SCS scores and scores from the body listening subscale of the MAIA. DISCUSSION These findings, though exploratory and lacking comparison with a control condition, suggest that self-compassion training supports regulation of pain through the involvement of self-referential (vPCC), salience-processing (TPJ), and emotion regulatory (dlPFC) brain areas. The results also suggest that self-compassion could be an important target in the psychotherapeutic treatment of cLBP, although further studies using controlled experimental designs are needed to determine the specificity of these effects.
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Affiliation(s)
- Michael P Berry
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Jacqueline Lutz
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.,Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Zev Schuman-Olivier
- Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Christopher Germer
- Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Susan Pollak
- Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Paula Gardiner
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gaelle Desbordes
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Vitaly Napadow
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
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7
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Turkheimer FE, Rosas FE, Dipasquale O, Martins D, Fagerholm ED, Expert P, Váša F, Lord LD, Leech R. A Complex Systems Perspective on Neuroimaging Studies of Behavior and Its Disorders. Neuroscientist 2021; 28:382-399. [PMID: 33593120 PMCID: PMC9344570 DOI: 10.1177/1073858421994784] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The study of complex systems deals with emergent behavior that arises as
a result of nonlinear spatiotemporal interactions between a large
number of components both within the system, as well as between the
system and its environment. There is a strong case to be made that
neural systems as well as their emergent behavior and disorders can be
studied within the framework of complexity science. In particular, the
field of neuroimaging has begun to apply both theoretical and
experimental procedures originating in complexity science—usually in
parallel with traditional methodologies. Here, we illustrate the basic
properties that characterize complex systems and evaluate how they
relate to what we have learned about brain structure and function from
neuroimaging experiments. We then argue in favor of adopting a complex
systems-based methodology in the study of neuroimaging, alongside
appropriate experimental paradigms, and with minimal influences from
noncomplex system approaches. Our exposition includes a review of the
fundamental mathematical concepts, combined with practical examples
and a compilation of results from the literature.
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Affiliation(s)
- Federico E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fernando E Rosas
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK.,Data Science Institute, Imperial College London, London, UK.,Centre for Complexity Science, Imperial College London, London, UK
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Erik D Fagerholm
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul Expert
- Global Digital Health Unit, School of Public Health, Imperial College London, London, UK
| | - František Váša
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Robert Leech
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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8
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Changes in Functional Connectivity of Specific Cerebral Regions in Patients with Toothache: A Resting-State Functional Magnetic Resonance Imaging Study. DISEASE MARKERS 2020; 2020:6683161. [PMID: 33456630 PMCID: PMC7785343 DOI: 10.1155/2020/6683161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/31/2022]
Abstract
Objective In order to further study the changes of cerebral functional connectivity in patients with toothache (TA), this study used the resting-state functional magnetic resonance imaging (rs-fMRI) technique and degree centrality (DC) analysis method. Methods Eighteen TA patients (8 males, 10 females) and 18 healthy individuals of similar age, sex, and educational levels were recruited as healthy controls (HCs) to take part in the study, and all underwent rs-fMRI examination. And DC technology was used to compare the state of their cerebral spontaneous functional activity. In order to compare the average DC values of the TA group and HC group, we used independent two-sample t-test and receiver operating characteristic (ROC) curve to compare the difference of DC values between the two groups, so as to distinguish the accuracy of TA diagnosis. Finally, we also carry out Pearson's linear regression analysis. Results The TA group showed higher DC values in the right lingual gyrus (RLG), right precentral gyrus, and left middle temporal gyrus (LMTG) than HCs. Moreover, ROC curve analysis indicated that the area under the curve (AUC) of each cerebral region studied had high accuracy. In addition, linear analysis indicated that the DC values of the RLG were positively correlated with the Hospital Anxiety and Depression Scale (HADS) (r = 0.844, p < 0.001), and the DC values of the LMTG were positively correlated with the visual analogue scale (VAS) (r = 0.723, p < 0.001). Conclusion TA generates abnormal changes in the intrinsic activity patterns of pain-related and vision-related areas of the cerebral cortex, which will be beneficial to reveal the underlying neuropathic mechanisms.
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The Instant Effects of Continuous Transcutaneous Auricular Vagus Nerve Stimulation at Acupoints on the Functional Connectivity of Amygdala in Migraine without Aura: A Preliminary Study. Neural Plast 2020; 2020:8870589. [PMID: 33381165 PMCID: PMC7759401 DOI: 10.1155/2020/8870589] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background A growing body of evidence suggests that both auricular acupuncture and transcutaneous auricular vagus nerve stimulation (taVNS) can induce antinociception and relieve symptoms of migraine. However, their instant effects and central treatment mechanism remain unclear. Many studies proved that the amygdalae play a vital role not only in emotion modulation but also in pain processing. In this study, we investigated the modulation effects of continuous taVNS at acupoints on the FC of the bilateral amygdalae in MwoA. Methods Thirty episodic migraineurs were recruited for the single-blind, crossover functional magnetic resonance imaging (fMRI) study. Each participant attended two kinds of eight-minute stimulations, taVNS and sham-taVNS (staVNS), separated by seven days in random order. Finally, 27 of them were included in the analysis of seed-to-voxel FC with the left/right amygdala as seeds. Results Compared with staVNS, the FC decreased during taVNS between the left amygdala and left middle frontal gyrus (MFG), left dorsolateral superior frontal gyrus, right supplementary motor area (SMA), bilateral paracentral lobules, bilateral postcingulum gyrus, and right frontal superior medial gyrus, so did the FC of the right amygdala and left MFG. A significant positive correlation was observed between the FC of the left amygdala and right SMA and the frequency/total time of migraine attacks during the preceding four weeks. Conclusion Continuous taVNS at acupoints can modulate the FC between the bilateral amygdalae and pain-related brain regions in MwoA, involving the limbic system, default mode network, and pain matrix, with obvious differences between the left amygdala and the right amygdala. The taVNS may produce treatment effects by modulating the abnormal FC of the amygdala and pain networks, possibly having the same central mechanism as auricular acupuncture.
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10
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Čeko M, Frangos E, Gracely J, Richards E, Wang B, Schweinhardt P, Catherine Bushnell M. Default mode network changes in fibromyalgia patients are largely dependent on current clinical pain. Neuroimage 2020; 216:116877. [PMID: 32344063 DOI: 10.1016/j.neuroimage.2020.116877] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 01/15/2023] Open
Abstract
Differences in fMRI resting-state connectivity of the default mode network (DMN) seen in chronic pain patients are often interpreted as brain reorganization due to the chronic pain condition. Nevertheless, patients' pain at the time of fMRI might influence the DMN because pain, like cognitive stimuli, engages attentional mechanisms and cognitive engagement is known to alter DMN activity. Here, we aimed to dissociate the influence of chronic pain condition (trait) from the influence of current pain experience (state) on DMN connectivity in patients with fibromyalgia (FM). We performed resting-state fMRI scans to test DMN connectivity in FM patients and matched healthy controls in two separate cohorts: (1) in a cohort not experiencing pain during scanning (27 FM patients and 27 controls), (2) in a cohort with current clinical pain during scanning (16 FM patients and 16 controls). In FM patients without pain during scanning, the connectivity of the DMN did not differ significantly from controls. By contrast, FM patients with current clinical pain during the scan had significantly increased DMN connectivity to bilateral anterior insula (INS) similar to previous studies. Regression analysis showed a positive relationship between DMN-midINS connectivity and current pain. We therefore suggest that transient DMN disruptions due to current clinical pain during scanning (current pain state) may be a substantial contributor to DMN connectivity disruptions observed in chronic pain patients.
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Affiliation(s)
- Marta Čeko
- Institute of Cognitive Science, University of Colorado, Boulder, CO, USA.
| | - Eleni Frangos
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
| | - John Gracely
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
| | - Emily Richards
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
| | - Binquan Wang
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
| | - Petra Schweinhardt
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada; Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Zurich, Switzerland
| | - M Catherine Bushnell
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
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11
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Jones SA, Cooke HE, Wilson AC, Nagel BJ, Holley AL. A Pilot Study Examining Neural Response to Pain in Adolescents With and Without Chronic Pain. Front Neurol 2020; 10:1403. [PMID: 32010053 PMCID: PMC6974673 DOI: 10.3389/fneur.2019.01403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/23/2019] [Indexed: 01/19/2023] Open
Abstract
Introduction: Chronic pain is common in adolescence and is associated with both pain and prevalence of mental illness later in life. While previous functional neuroimaging work has informed knowledge of neural alterations associated with chronic pain, these findings have been primarily limited to adult samples, and it is unclear if similar patterns of altered brain activation are present in the developing adolescent brain. Objectives: The purpose of this study was to pilot a noxious pressure task during functional neuroimaging to assess brain response to pain in adolescents with and without chronic pain. Methods: Adolescents (ages 11–16) with (n = 9, 7 females) and without (n = 9, 7 females) chronic pain, matched on age, sex, IQ, and parental history of chronic pain, completed a noxious mechanical pressure task to assess subjective pain thresholds. This was followed by randomized presentation of subjective equivalent pressure applications (adolescents' pain 4/0–10), and two objectively equivalent pressures (0.25 and 1.5 kg/cm2), during functional magnetic resonance imaging, using an event-related task design. Results: Findings revealed that adolescents with chronic pain demonstrated significantly greater activation in the posterior cingulate compared to controls. Further, all adolescents demonstrated significant pain-related brain response in brain regions implicated in pain neurocircuitry, as well as in several regions of the default mode network. Similar patterns of neural response were also noted during pain anticipation. Conclusion: These findings are important for not only understanding the neurocircuitry involved in adolescent chronic pain, but may prove beneficial to future pain treatment efforts that seek to alter pain neurocircuitry.
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Affiliation(s)
- Scott A Jones
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Holly E Cooke
- School of Graduate Psychology, Pacific University, Hillsboro, OR, United States
| | - Anna C Wilson
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Bonnie J Nagel
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States
| | - Amy L Holley
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
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12
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Horing B, Sprenger C, Büchel C. The parietal operculum preferentially encodes heat pain and not salience. PLoS Biol 2019; 17:e3000205. [PMID: 31404058 PMCID: PMC6705876 DOI: 10.1371/journal.pbio.3000205] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/22/2019] [Accepted: 07/18/2019] [Indexed: 01/10/2023] Open
Abstract
Substantial controversy exists as to which part of brain activity is genuinely attributable to pain-related percepts and which activity is due to general aspects of sensory stimulation, such as its salience, or the accompanying arousal. The challenge posed by this question rests largely in the fact that pain per se exhibits highly intense but unspecific characteristics. These therefore should be matched by potential control conditions. Here, we used a unique combination of functional magnetic resonance imaging (fMRI) and behavioral and autonomic measures to address this longstanding debate in pain research. Subjects rated perceived intensity in a sequence alternating between heat and sound stimuli. Neuronal activity was monitored using fMRI. Either modality was presented in 6 different intensities, 3 of which lay above the pain threshold (for heat) or the unpleasantness threshold (for sound). We performed our analysis on 26 volunteers in which psychophysiological responses (as per skin conductance responses [SCRs]) did not differ between the 2 stimulus modalities. Having thus ascertained a comparable amount of stimulation-related but unspecific activation, we analyzed stimulus-response functions (SRFs) after painful stimulation and contrasted them with those of the matched acoustic control condition. Furthermore, analysis of fMRI data was performed on the brain surface to circumvent blurring issues stemming from the close proximity of several regions of interest located in heavily folded cortical areas. We focused our analyses on insular and peri-insular regions that are strongly involved in processing of painful stimuli. We employed an axiomatic approach to determine areas showing higher activation in painful compared to nonpainful heat and, at the same time, showing a steeper SRF for painful heat compared to unpleasant sound. Intriguingly, an area in the posterior parietal operculum emerged, whose response showed a pain preference after satisfying all axiomatic constraints. This result has important implications for the interpretation of functional imaging findings in pain research, because it clearly demonstrates that there are areas where activity following painful stimulation is not due to general attributes or results of sensory stimulation, such as salience or arousal. Conversely, several areas did not conform to the formulated axioms to rule out general factors as explanations. The brain activity detected during pain could be due merely to the fact that pain is arousing and attention-grabbing, rather than being directly attributable to the pain itself. This study identifies an area of the brain — the parietal operculum — whose activity can only be explained by the painfulness of pain.
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Affiliation(s)
- Björn Horing
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Christian Sprenger
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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13
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Brainstem neuroimaging of nociception and pain circuitries. Pain Rep 2019; 4:e745. [PMID: 31579846 PMCID: PMC6727990 DOI: 10.1097/pr9.0000000000000745] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/22/2019] [Accepted: 03/24/2019] [Indexed: 01/09/2023] Open
Abstract
The brainstem is known to be an important brain area for nociception and pain processing, and both relaying and coordinating signaling between the cerebrum, cerebellum, and spinal cord. Although preclinical models of pain have characterized the many roles that brainstem nuclei play in nociceptive processing, the degree to which these circuitries extend to humans is not as well known. Unfortunately, the brainstem is also a very challenging region to evaluate in humans with neuroimaging. The challenges for human brainstem imaging arise from the location of this elongated brain structure, proximity to cardiorespiratory noise sources, and the size of its constituent nuclei. These challenges can require dedicated approaches to brainstem imaging, which should be adopted when study hypotheses are focused on brainstem processing of nociception or modulation of pain perception. In fact, our review will highlight many pain neuroimaging studies that have reported some brainstem involvement in nociceptive processing and chronic pain pathology. However, we note that with recent advances in neuroimaging leading to improved spatial and temporal resolution, more studies are needed that take advantage of data collection and analysis methods focused on the challenges of brainstem neuroimaging.
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14
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Delahunty ET, Bisset LM, Kavanagh JJ. Intracortical motor networks are affected in both the contralateral and ipsilateral hemisphere during single limb cold water immersion. Exp Physiol 2019; 104:1296-1305. [PMID: 31206866 DOI: 10.1113/ep087745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/14/2019] [Indexed: 12/24/2022]
Abstract
NEW FINDINGS What is the central question of this study? How does single limb cold water immersion affect corticomotor function and intracortical circuitry in the motor cortex of each cerebral hemisphere? What is the main finding and its importance? Immersion of a single limb in very cold water caused an increase in corticomotor excitability and intracortical facilitation, and a decrease in intracortical inhibition, in the motor cortex of both hemispheres. These findings provide evidence that intense sensory stimuli induce widespread changes in motor circuitry in the contralateral, as well as the ipsilateral, hemisphere. ABSTRACT Although responses to noxious stimuli have been extensively studied for the contralateral hemisphere, little is known about how the ipsilateral hemisphere may be affected. Therefore, this study examined how exposing a single limb to noxious cold stimuli affects motor output arising from both the contralateral and ipsilateral hemisphere. A total of 17 healthy adults participated in three experiments. Single- and paired-pulse TMS protocols were used to identify how immersing a single upper limb in cold water (4.0 ± 0.5 °C) affects inhibitory and facilitatory circuits in the primary motor cortex (M1) of the contralateral (experiment 1) and ipsilateral (experiment 2) hemisphere. The third experiment used a reaction time task to assess the functional consequences of acute adaptations in the ipsilateral M1. The target muscle in all experiments was the extensor carpi radialis brevis (ECRB). Immersion of a single limb in cold water increased self-perception of pain and temperature, and increased EMG amplitude of the immersed limb. During immersion, motor evoked potentials and intracortical facilitation increased, whereas short interval intracortical inhibition decreased, for both the ipsilateral M1 and contralateral M1. Activity in the ipsilateral hemisphere to the limb immersed in cold water also slowed reaction time for the non-immersed limb. Our findings suggest that altered motor responses from single limb cold water immersion are not restricted to a single hemisphere. Instead, widespread activation of somatosensory systems influences inhibitory and facilitatory circuits in the primary motor cortex of each hemisphere.
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Affiliation(s)
- Eden T Delahunty
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, Queensland, Australia
| | - Leanne M Bisset
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, Queensland, Australia
| | - Justin J Kavanagh
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, Queensland, Australia
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15
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Diverse Role of Biological Plasticity in Low Back Pain and Its Impact on Sensorimotor Control of the Spine. J Orthop Sports Phys Ther 2019; 49:389-401. [PMID: 31151376 DOI: 10.2519/jospt.2019.8716] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pain is complex. It is no longer acceptable to consider pain solely as a peripheral phenomenon involving activation of nociceptive neurons. The contemporary understanding of pain involves consideration of different underlying pain mechanisms and an increasing awareness of plasticity in all of the biological systems. Of note, recent advances in technology and understanding have highlighted the critical importance of neuroimmune interactions, both in the peripheral and central nervous systems, and the interaction between the nervous system and body tissues in the development and maintenance of pain, including low back pain (LBP). Further, the biology of many tissues changes when challenged by pain and injury, as reported in a growing body of literature on the biology of muscle, fat, and connective tissue. These advances in understanding of the complexity of LBP have implications for our understanding of pain and its interaction with the motor system, and may change how we consider motor control in the rehabilitation of LBP. This commentary provides a state-of-the-art overview of plasticity of biology in LBP. The paper is divided into 4 parts that address (1) biology of pain mechanisms, (2) neuroimmune interaction in the central nervous system, (3) neuroimmune interaction in the periphery, and (4) brain and peripheral tissue interaction. Each section considers the implications for clinical management of LBP. J Orthop Sports Phys Ther 2019;49(6):389-401. doi:10.2519/jospt.2019.8716.
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16
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Peng K, Yücel MA, Steele SC, Bittner EA, Aasted CM, Hoeft MA, Lee A, George EE, Boas DA, Becerra L, Borsook D. Morphine Attenuates fNIRS Signal Associated With Painful Stimuli in the Medial Frontopolar Cortex (medial BA 10). Front Hum Neurosci 2018; 12:394. [PMID: 30349466 PMCID: PMC6186992 DOI: 10.3389/fnhum.2018.00394] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/12/2018] [Indexed: 11/26/2022] Open
Abstract
Functional near infrared spectroscopy (fNIRS) is a non-invasive optical imaging method that provides continuous measure of cortical brain functions. One application has been its use in the evaluation of pain. Previous studies have delineated a deoxygenation process associated with pain in the medial anterior prefrontal region, more specifically, the medial Brodmann Area 10 (BA 10). Such response to painful stimuli has been consistently observed in awake, sedated and anesthetized patients. In this study, we administered oral morphine (15 mg) or placebo to 14 healthy male volunteers with no history of pain or opioid abuse in a crossover double blind design, and performed fNIRS scans prior to and after the administration to assess the effect of morphine on the medial BA 10 pain signal. Morphine is the gold standard for inhibiting nociceptive processing, most well described for brain effects on sensory and emotional regions including the insula, the somatosensory cortex (the primary somatosensory cortex, S1, and the secondary somatosensory cortex, S2), and the anterior cingulate cortex (ACC). Our results showed an attenuation effect of morphine on the fNIRS-measured pain signal in the medial BA 10, as well as in the contralateral S1 (although observed in a smaller number of subjects). Notably, the extent of signal attenuation corresponded with the temporal profile of the reported plasma concentration for the drug. No clear attenuation by morphine on the medial BA 10 response to innocuous stimuli was observed. These results provide further evidence for the role of medial BA 10 in the processing of pain, and also suggest that fNIRS may be used as an objective measure of drug-brain profiles independent of subjective reports.
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Affiliation(s)
- Ke Peng
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Meryem A. Yücel
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
| | - Sarah C. Steele
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Edward A. Bittner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Christopher M. Aasted
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Mark A. Hoeft
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Arielle Lee
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Edward E. George
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - David A. Boas
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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17
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Valenza G, Duggento A, Passamonti L, Diciotti S, Tessa C, Barbieri R, Toschi N. Resting-state brain correlates of instantaneous autonomic outflow. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2017:3325-3328. [PMID: 29060609 DOI: 10.1109/embc.2017.8037568] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A prominent pathway of brain-heart interaction is represented by autonomic nervous system (ANS) heartbeat modulation. While within-brain resting state networks have been the object of intense functional Magnetic Resonance Imaging (fMRI) research, technological and methodological limitations have hampered research on the central correlates of cardiovascular control dynamics. Here we combine the high temporal and spatial resolution as well as data volume afforded by the Human Connectome Project with a probabilistic model of heartbeat dynamics to characterize central correlates of sympathetic and parasympathetic ANS activity at rest. We demonstrate an involvement of a number of brain regions such as the Insular cortex, Frontal Gyrus, Lateral Occipital Cortex, Paracingulate and Cingulate Gyrus and Precuneous Cortex, as well as subcortical structures (Thalamus, Putamen, Pallidum, Brain-Stem, Hippocampus, Amygdala, and Right Caudate) in the modulation of ANS-mediated cardiovascular control, possibly indicating a broader definition of the central autonomic network (CAN). Our findings provide a basis for an informed neurobiological interpretation of the numerous studies which employ HRV-related measures as standalone biomarkers in health and disease.
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18
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Paquette T, Jeffrey-Gauthier R, Leblond H, PichÉ M. Functional Neuroimaging of Nociceptive and Pain-Related Activity in the Spinal Cord and Brain: Insights From Neurovascular Coupling Studies. Anat Rec (Hoboken) 2018; 301:1585-1595. [PMID: 29752872 DOI: 10.1002/ar.23854] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/22/2018] [Accepted: 03/31/2018] [Indexed: 12/12/2022]
Abstract
Spinal cord and brain processes underlie pain perception, which produces systemic cardiovascular changes. In turn, the autonomic nervous system regulates vascular function in the spinal cord and brain in order to adapt to these systemic changes, while neuronal activity induces local vascular changes. Thus, autonomic regulation and pain processes in the brain and spinal cord are tightly linked and interrelated. The objective of this topical review is to discuss work on neurovascular coupling during nociceptive processing in order to highlight supporting evidence and limitations for the use of cerebral and spinal fMRI to investigate pain mechanisms and spinal nociceptive processes. Work on functional neuroimaging of pain is presented and discussed in relation to available neurovascular coupling studies and related issues. Perspectives on future work are also discussed with an emphasis on differences between the brain and the spinal cord and on different approaches that may be useful to improve current methods, data analyses and interpretation. In summary, this review highlights the lack of data on neurovascular coupling during nociceptive stimulation and indicates that hemodynamic and BOLD responses measured with fMRI may be biased by nonspecific vascular changes. Future neuroimaging studies on nociceptive and pain-related processes would gain further understanding of neurovascular coupling in the brain and spinal cord and should take into account the effects of systemic vascular changes that may affect hemodynamic responses. Anat Rec, 301:1585-1595, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Thierry Paquette
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Renaud Jeffrey-Gauthier
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Hugues Leblond
- CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Mathieu PichÉ
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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19
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A novel and effective fMRI decoding approach based on sliced inverse regression and its application to pain prediction. Neurocomputing 2018. [DOI: 10.1016/j.neucom.2017.07.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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20
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Peng K, Yücel MA, Aasted CM, Steele SC, Boas DA, Borsook D, Becerra L. Using prerecorded hemodynamic response functions in detecting prefrontal pain response: a functional near-infrared spectroscopy study. NEUROPHOTONICS 2018; 5:011018. [PMID: 29057285 PMCID: PMC5641587 DOI: 10.1117/1.nph.5.1.011018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/26/2017] [Indexed: 05/03/2023]
Abstract
Currently, there is no method for providing a nonverbal objective assessment of pain. Recent work using functional near-infrared spectroscopy (fNIRS) has revealed its potential for objective measures. We conducted two fNIRS scans separated by 30 min and measured the hemodynamic response to the electrical noxious and innocuous stimuli over the anterior prefrontal cortex (aPFC) in 14 subjects. Based on the estimated hemodynamic response functions (HRFs), we first evaluated the test-retest reliability of using fNIRS in measuring the pain response over the aPFC. We then proposed a general linear model (GLM)-based detection model that employs the subject-specific HRFs from the first scan to detect the pain response in the second scan. Our results indicate that fNIRS has a reasonable reliability in detecting the hemodynamic changes associated with noxious events, especially in the medial portion of the aPFC. Compared with a standard HRF with a fixed shape, including the subject-specific HRFs in the GLM allows for a significant improvement in the detection sensitivity of aPFC pain response. This study supports the potential application of individualized analysis in using fNIRS and provides a robust model to perform objective determination of pain perception.
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Affiliation(s)
- Ke Peng
- Harvard Medical School, Center for Pain and the Brain, Boston, Massachusetts, United States
- Boston Children’s Hospital and Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts, United States
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Address all correspondence to: Ke Peng, E-mail: Ke.
| | - Meryem A. Yücel
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Christopher M. Aasted
- Harvard Medical School, Center for Pain and the Brain, Boston, Massachusetts, United States
- Boston Children’s Hospital and Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts, United States
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Sarah C. Steele
- Harvard Medical School, Center for Pain and the Brain, Boston, Massachusetts, United States
- Boston Children’s Hospital and Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts, United States
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - David A. Boas
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Boston University, Boston University Neurophotonics Center, Boston, Massachusetts, United States
| | - David Borsook
- Harvard Medical School, Center for Pain and the Brain, Boston, Massachusetts, United States
- Boston Children’s Hospital and Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts, United States
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Lino Becerra
- Harvard Medical School, Center for Pain and the Brain, Boston, Massachusetts, United States
- Boston Children’s Hospital and Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts, United States
- Massachusetts General Hospital and Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
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21
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Upadhyay J, Geber C, Hargreaves R, Birklein F, Borsook D. A critical evaluation of validity and utility of translational imaging in pain and analgesia: Utilizing functional imaging to enhance the process. Neurosci Biobehav Rev 2018; 84:407-423. [PMID: 28807753 PMCID: PMC5729102 DOI: 10.1016/j.neubiorev.2017.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/22/2017] [Accepted: 08/04/2017] [Indexed: 02/07/2023]
Abstract
Assessing clinical pain and metrics related to function or quality of life predominantly relies on patient reported subjective measures. These outcome measures are generally not applicable to the preclinical setting where early signs pointing to analgesic value of a therapy are sought, thus introducing difficulties in animal to human translation in pain research. Evaluating brain function in patients and respective animal model(s) has the potential to characterize mechanisms associated with pain or pain-related phenotypes and thereby provide a means of laboratory to clinic translation. This review summarizes the progress made towards understanding of brain function in clinical and preclinical pain states elucidated using an imaging approach as well as the current level of validity of translational pain imaging. We hypothesize that neuroimaging can describe the central representation of pain or pain phenotypes and yields a basis for the development and selection of clinically relevant animal assays. This approach may increase the probability of finding meaningful new analgesics that can help satisfy the significant unmet medical needs of patients.
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Affiliation(s)
| | - Christian Geber
- Department of Neurology, University Medical Centre Mainz, Mainz, Germany; DRK Schmerz-Zentrum Mainz, Mainz, Germany
| | - Richard Hargreaves
- Center for Pain and the Brain, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston Harvard Medical School, Boston, MA 02115, United States
| | - Frank Birklein
- Department of Neurology, University Medical Centre Mainz, Mainz, Germany
| | - David Borsook
- Center for Pain and the Brain, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston Harvard Medical School, Boston, MA 02115, United States.
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22
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Peng K, Steele SC, Becerra L, Borsook D. Brodmann area 10: Collating, integrating and high level processing of nociception and pain. Prog Neurobiol 2017; 161:1-22. [PMID: 29199137 DOI: 10.1016/j.pneurobio.2017.11.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/16/2017] [Accepted: 11/28/2017] [Indexed: 02/08/2023]
Abstract
Multiple frontal cortical brain regions have emerged as being important in pain processing, whether it be integrative, sensory, cognitive, or emotional. One such region, Brodmann Area 10 (BA 10), is the largest frontal brain region that has been shown to be involved in a wide variety of functions including risk and decision making, odor evaluation, reward and conflict, pain, and working memory. BA 10, also known as the anterior prefrontal cortex, frontopolar prefrontal cortex or rostral prefrontal cortex, is comprised of at least two cytoarchitectonic sub-regions, medial and lateral. To date, the explicit role of BA 10 in the processing of pain hasn't been fully elucidated. In this paper, we first review the anatomical pathways and functional connectivity of BA 10. Numerous functional imaging studies of experimental or clinical pain have also reported brain activations and/or deactivations in BA 10 in response to painful events. The evidence suggests that BA 10 may play a critical role in the collation, integration and high-level processing of nociception and pain, but also reveals possible functional distinctions between the subregions of BA 10 in this process.
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Affiliation(s)
- Ke Peng
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
| | - Sarah C Steele
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
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23
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Different Brain Circuitries Mediating Controllable and Uncontrollable Pain. J Neurosci 2017; 36:5013-25. [PMID: 27147654 DOI: 10.1523/jneurosci.1954-15.2016] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 03/17/2016] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Uncontrollable, compared with controllable, painful stimulation can lead to increased pain perception and activation in pain-processing brain regions, but it is currently unknown which brain areas mediate this effect. When pain is controllable, the lateral prefrontal cortex (PFC) seems to inhibit pain processing, although it is unclear how this is achieved. Using fMRI in healthy volunteers, we examined brain activation during controllable and uncontrollable stimulation to answer these questions. In the controllable task, participants self-adjusted temperatures applied to their hand of pain or warm intensities to provoke a constant sensation. In the uncontrollable task, the temperature time courses of the controllable task were replayed (yoked control) and participants rated their sensation continuously. During controllable pain trials, participants significantly downregulated the temperature to keep their sensation constant. Despite receiving the identical nociceptive input, intensity ratings increased during the uncontrollable pain trials. This additional sensitization was mirrored in increased activation of pain-processing regions such as insula, anterior cingulate cortex, and thalamus. Further, increased connectivity between the anterior insula and medial PFC (mPFC) in the uncontrollable and increased negative connectivity between dorsolateral PFC (dlPFC) and insula in the controllable task were observed. This suggests a pain-facilitating role of the mPFC during uncontrollable pain and a pain-inhibiting role of the dlPFC during controllable pain, both exerting their respective effects via the anterior insula. These results elucidate neural mechanisms of context-dependent pain modulation and their relation to subjective perception. SIGNIFICANCE STATEMENT Pain control is of uttermost importance and stimulus controllability is an important way to achieve endogenous pain modulation. Here, we show differential effects of controllability and uncontrollability on pain perception and cerebral pain processing. When pain was controllable, the dorsolateral prefrontal cortex downregulated pain-evoked activation in important pain-processing regions. In contrast, sensitization during uncontrollable pain was mediated by increased connectivity of the medial prefrontal cortex with the anterior insula and other pain-processing regions. These novel insights into cerebral pain modulation by stimulus controllability have the potential to improve treatment approaches in pain patients.
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Nickel MM, May ES, Tiemann L, Schmidt P, Postorino M, Ta Dinh S, Gross J, Ploner M. Brain oscillations differentially encode noxious stimulus intensity and pain intensity. Neuroimage 2017; 148:141-147. [PMID: 28069543 PMCID: PMC5349759 DOI: 10.1016/j.neuroimage.2017.01.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/31/2016] [Accepted: 01/05/2017] [Indexed: 12/29/2022] Open
Abstract
Noxious stimuli induce physiological processes which commonly translate into pain. However, under certain conditions, pain intensity can substantially dissociate from stimulus intensity, e.g. during longer-lasting pain in chronic pain syndromes. How stimulus intensity and pain intensity are differentially represented in the human brain is, however, not yet fully understood. We therefore used electroencephalography (EEG) to investigate the cerebral representation of noxious stimulus intensity and pain intensity during 10 min of painful heat stimulation in 39 healthy human participants. Time courses of objective stimulus intensity and subjective pain ratings indicated a dissociation of both measures. EEG data showed that stimulus intensity was encoded by decreases of neuronal oscillations at alpha and beta frequencies in sensorimotor areas. In contrast, pain intensity was encoded by gamma oscillations in the medial prefrontal cortex. Contrasting right versus left hand stimulation revealed that the encoding of stimulus intensity in contralateral sensorimotor areas depended on the stimulation side. In contrast, a conjunction analysis of right and left hand stimulation revealed that the encoding of pain in the medial prefrontal cortex was independent of the side of stimulation. Thus, the translation of noxious stimulus intensity into pain is associated with a change from a spatially specific representation of stimulus intensity by alpha and beta oscillations in sensorimotor areas to a spatially independent representation of pain by gamma oscillations in brain areas related to cognitive and affective-motivational processes. These findings extend the understanding of the brain mechanisms of nociception and pain and their dissociations during longer-lasting pain as a key symptom of chronic pain syndromes. Stimulus intensity is encoded by alpha/beta oscillations in sensorimotor areas. Pain intensity is encoded by gamma oscillations in the medial prefrontal cortex. The encoding of stimulus intensity depends on stimulation side. The encoding of pain is independent of stimulation side.
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Affiliation(s)
- Moritz M Nickel
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany
| | - Elisabeth S May
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany
| | - Laura Tiemann
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany
| | - Paul Schmidt
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany
| | - Martina Postorino
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany
| | - Son Ta Dinh
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany
| | - Joachim Gross
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Markus Ploner
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, 81675 Munich, Germany.
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Zhang J, Su J, Wang M, Zhao Y, Yao Q, Zhang Q, Lu H, Zhang H, Wang S, Li GF, Wu YL, Liu FD, Shi YH, Li J, Liu JR, Du X. Increased default mode network connectivity and increased regional homogeneity in migraineurs without aura. J Headache Pain 2016; 17:98. [PMID: 27771875 PMCID: PMC5075323 DOI: 10.1186/s10194-016-0692-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/15/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The precuneus/posterior cingulate cortex, which has been associated with pain sensitivity, plays a pivotal role in the default mode network. However, information regarding migraine-related alterations in resting-state brain functional connectivity in the default mode network and in local regional spontaneous neuronal activity is not adequate. METHODS This study used functional magnetic resonance imaging to acquire resting-state scans in 22 migraineurs without aura and in 22 healthy matched controls. Independent component analysis, a data-driven method, was used to calculate the resting-state functional connectivity of the default mode network in the patient and healthy control groups. Regional homogeneity (ReHo) was used to analyse the local features of spontaneous resting-state brain activity in the migraineurs without aura. RESULTS Compared with the healthy controls, migraineurs without aura showed increased functional connectivity in the left precuneus/posterior cingulate cortex within the default mode network and significant increase in ReHo values in the bilateral precuneus/posterior cingulate cortex, left pons and trigeminal nerve entry zone. In addition, functional connectivity was decreased between the areas with abnormal ReHo (using the peaks in the precuneus/posterior cingulate cortex) and other brain areas. CONCLUSIONS The abnormalities in the precuneus/posterior cingulate cortex suggest that migraineurs without aura may exhibit information transfer and multimodal integration dysfunction and that pain sensitivity and pian processing may also be affected.
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Affiliation(s)
- Jilei Zhang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Jingjing Su
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Mengxing Wang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Ying Zhao
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Qian Yao
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Qiting Zhang
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Haifeng Lu
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Hui Zhang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Shuo Wang
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Ge-Fei Li
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yi-Lan Wu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Feng-Di Liu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yan-Hui Shi
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Jian-Ren Liu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
| | - Xiaoxia Du
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China.
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Chen Z, Chen X, Liu M, Liu S, Shu S, Ma L, Yu S. Altered functional connectivity of the marginal division in migraine: a resting-state fMRI study. J Headache Pain 2016; 17:89. [PMID: 27670428 PMCID: PMC5037100 DOI: 10.1186/s10194-016-0682-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/22/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The marginal division of neostriatum (MrD) is a flat, pan-shaped zone between the neostriatum and the globus pallidus, and previous documents demonstrated that it was involved in the modulation of pain. The aim of this study is to investigate the roles of the MrD of the human brain in the chronicization migraine using resting state functional magnetic resonance imaging (rs-fMRI). METHODS Conventional MRI, 3D structure images, and rs-fMRI were performed in 18 patients with episodic migraines (EM), 16 patients with chronic migraine (CM), 44 patients with medication overuse headache plus chronic migraine (MOH + CM), and 32 normal controls (NC). MrD was defined using manual delineation on structural images, and was selected as the seed to calculate the functional connectivity (FC). RESULTS Compared with the NC group, the decreased FC of MrD was observed in the EM and CM groups, and increased FC of MrD was demonstrated in all patient groups. Compared with the EM group, the decreased FC of MrD was revealed in the CM and MOH + CM groups, and the increased FC occurred only in the CM group. Increased FC of MrD alone was observed in the MOH + CM group compared with that in the CM group. CONCLUSION This study confirmed the double neuromodulation network of MrD in pain modulation and migraine chronicization; however, the mechanism requires further investigation.
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Affiliation(s)
- Zhiye Chen
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mengqi Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shuangfeng Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Siyun Shu
- Institute of Cognitive Neuroscience, South China Normal University, Guangzhou, 510631, China
| | - Lin Ma
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.
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Tu Y, Tan A, Bai Y, Hung YS, Zhang Z. Decoding Subjective Intensity of Nociceptive Pain from Pre-stimulus and Post-stimulus Brain Activities. Front Comput Neurosci 2016; 10:32. [PMID: 27148029 PMCID: PMC4830829 DOI: 10.3389/fncom.2016.00032] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/28/2016] [Indexed: 01/07/2023] Open
Abstract
Pain is a highly subjective experience. Self-report is the gold standard for pain assessment in clinical practice, but it may not be available or reliable in some populations. Neuroimaging data, such as electroencephalography (EEG) and functional magnetic resonance imaging (fMRI), have the potential to be used to provide physiology-based and quantitative nociceptive pain assessment tools that complements self-report. However, existing neuroimaging-based nociceptive pain assessments only rely on the information in pain-evoked brain activities, but neglect the fact that the perceived intensity of pain is also encoded by ongoing brain activities prior to painful stimulation. Here, we proposed to use machine learning algorithms to decode pain intensity from both pre-stimulus ongoing and post-stimulus evoked brain activities. Neural features that were correlated with intensity of laser-evoked nociceptive pain were extracted from high-dimensional pre- and post-stimulus EEG and fMRI activities using partial least-squares regression (PLSR). Further, we used support vector machine (SVM) to predict the intensity of pain from pain-related time-frequency EEG patterns and BOLD-fMRI patterns. Results showed that combining predictive information in pre- and post-stimulus brain activities can achieve significantly better performance in classifying high-pain and low-pain and in predicting the rating of perceived pain than only using post-stimulus brain activities. Therefore, the proposed pain prediction method holds great potential in basic research and clinical applications.
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Affiliation(s)
- Yiheng Tu
- School of Data and Computer Science, Sun Yat-Sen UniversityGuangzhou, China; Department of Electrical and Electronic Engineering, The University of Hong KongHong Kong, China
| | - Ao Tan
- School of Data and Computer Science, Sun Yat-Sen UniversityGuangzhou, China; Department of Electrical and Electronic Engineering, The University of Hong KongHong Kong, China
| | - Yanru Bai
- School of Data and Computer Science, Sun Yat-Sen UniversityGuangzhou, China; School of Chemical and Biomedical Engineering, Nanyang Technological UniversitySingapore, Singapore
| | - Yeung Sam Hung
- Department of Electrical and Electronic Engineering, The University of Hong Kong Hong Kong, China
| | - Zhiguo Zhang
- School of Data and Computer Science, Sun Yat-Sen University Guangzhou, China
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28
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Prior exposure to extreme pain alters neural response to pain in others. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2016; 16:662-71. [DOI: 10.3758/s13415-016-0422-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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29
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Burns E, Chipchase L, Schabrun S. Primary sensory and motor cortex function in response to acute muscle pain: A systematic review and meta-analysis. Eur J Pain 2016; 20:1203-13. [DOI: 10.1002/ejp.859] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2016] [Indexed: 12/20/2022]
Affiliation(s)
- E. Burns
- Brain Rehabilitation and Neuroplasticity Unit; School of Science and Health; Western Sydney University; Australia
| | - L.S. Chipchase
- Brain Rehabilitation and Neuroplasticity Unit; School of Science and Health; Western Sydney University; Australia
| | - S.M. Schabrun
- Brain Rehabilitation and Neuroplasticity Unit; School of Science and Health; Western Sydney University; Australia
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30
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De Ridder D, Vanneste S, Gillett G, Manning P, Glue P, Langguth B. Psychosurgery Reduces Uncertainty and Increases Free Will? A Review. Neuromodulation 2016; 19:239-48. [DOI: 10.1111/ner.12405] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/20/2015] [Accepted: 12/17/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Dirk De Ridder
- Department of Surgical Sciences; Section of Neurosurgery, Dunedin School of Medicine, University of Otago; Dunedin New Zealand
| | - Sven Vanneste
- Laboratory for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences; University of Texas at Dallas; Dallas TX USA
| | - Grant Gillett
- Department of Philosophy; Section of Medical Ethics, Dunedin School of Medicine, University of Otago; Dunedin New Zealand
| | - Patrick Manning
- Department of Internal Medicine; Section of Endocrinology, Dunedin School of Medicine, University of Otago; Dunedin New Zealand
| | - Paul Glue
- Department of Psychological Medicine; Dunedin School of Medicine, University of Otago; Dunedin New Zealand
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy; Interdisciplinary Tinnitus Clinic, University of Regensburg; Regensburg Germany
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Abstract
Recent neuroimaging studies suggest that the brain adapts with pain, as well as imparts risk for developing chronic pain. Within this context, we revisit the concepts for nociception, acute and chronic pain, and negative moods relative to behavior selection. We redefine nociception as the mechanism protecting the organism from injury, while acute pain as failure of avoidant behavior, and a mesolimbic threshold process that gates the transformation of nociceptive activity to conscious pain. Adaptations in this threshold process are envisioned to be critical for development of chronic pain. We deconstruct chronic pain into four distinct phases, each with specific mechanisms, and outline current state of knowledge regarding these mechanisms: the limbic brain imparting risk, and the mesolimbic learning processes reorganizing the neocortex into a chronic pain state. Moreover, pain and negative moods are envisioned as a continuum of aversive behavioral learning, which enhance survival by protecting against threats.
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Affiliation(s)
- Marwan N Baliki
- Department of Physiology, Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL 60610, USA.
| | - A Vania Apkarian
- Department of Physiology, Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL 60610, USA; Department of Anesthesia, Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL 60610, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL 60610, USA.
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32
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Test–retest reliability of evoked heat stimulation BOLD fMRI. J Neurosci Methods 2015; 253:38-46. [DOI: 10.1016/j.jneumeth.2015.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 11/19/2022]
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Loggia ML, Berna C, Kim J, Cahalan CM, Martel MO, Gollub RL, Wasan AD, Napadow V, Edwards RR. The lateral prefrontal cortex mediates the hyperalgesic effects of negative cognitions in chronic pain patients. THE JOURNAL OF PAIN 2015; 16:692-9. [PMID: 25937162 PMCID: PMC4522376 DOI: 10.1016/j.jpain.2015.04.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/01/2015] [Accepted: 04/11/2015] [Indexed: 11/28/2022]
Abstract
UNLABELLED Although high levels of negative affect and cognitions have been associated with greater pain sensitivity in chronic pain conditions, the neural mechanisms mediating the hyperalgesic effect of psychological factors in patients with pain disorders are largely unknown. In this cross-sectional study, we hypothesized that 1) catastrophizing modulates brain responses to pain anticipation and 2) anticipatory brain activity mediates the hyperalgesic effect of different levels of catastrophizing in fibromyalgia (FM) patients. Using functional magnetic resonance imaging, we scanned the brains of 31 FM patients exposed to visual cues anticipating the onset of moderately intense deep-tissue pain stimuli. Our results indicated the existence of a negative association between catastrophizing and pain-anticipatory brain activity, including in the right lateral prefrontal cortex. A bootstrapped mediation analysis revealed that pain-anticipatory activity in the lateral prefrontal cortex mediates the association between catastrophizing and pain sensitivity. These findings highlight the role of the lateral prefrontal cortex in the pathophysiology of FM-related hyperalgesia and suggest that deficits in the recruitment of pain-inhibitory brain circuitry during pain-anticipatory periods may play an important contributory role in the association between various degrees of widespread hyperalgesia in FM and levels of catastrophizing, a well-validated measure of negative cognitions and psychological distress. PERSPECTIVE This article highlights the presence of alterations in pain-anticipatory brain activity in FM. These findings provide the rationale for the development of psychological or neurofeedback-based techniques aimed at modifying patients' negative affect and cognitions toward pain.
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Affiliation(s)
- Marco L Loggia
- Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts.
| | - Chantal Berna
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jieun Kim
- Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Christine M Cahalan
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts
| | - Marc-Olivier Martel
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts
| | - Randy L Gollub
- Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Ajay D Wasan
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts; Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Vitaly Napadow
- Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts; Department of Biomedical Engineering, Kyunghee University, Yongin, Korea
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts
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Čeko M, Shir Y, Ouellet JA, Ware MA, Stone LS, Seminowicz DA. Partial recovery of abnormal insula and dorsolateral prefrontal connectivity to cognitive networks in chronic low back pain after treatment. Hum Brain Mapp 2015; 36:2075-92. [PMID: 25648842 DOI: 10.1002/hbm.22757] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/20/2015] [Accepted: 01/26/2015] [Indexed: 01/02/2023] Open
Abstract
We previously reported that effective treatment of chronic low back pain (CLBP) reversed abnormal brain structure and functional MRI (fMRI) activity during cognitive task performance, particularly in the left dorsolateral prefrontal cortex (DLPFC). Here, we used resting-state fMRI to examine how chronic pain affects connectivity of brain networks supporting cognitive functioning and the effect of treatment in 14 CLBP patients and 16 healthy, pain-free controls (scans were acquired at baseline for all subjects and at 6-months post-treatment for patients and a matched time-point for 10 controls). The main networks activated during cognitive task performance, task-positive network (TPN) and task-negative network (TNN) (aka default mode) network, were identified in subjects' task fMRI data and used to define matching networks in resting-state data. The connectivity of these cognitive resting-state networks was compared between groups, and before and after treatment. Our findings converged on the bilateral insula (INS) as the region of aberrant cognitive resting-state connectivity in patients pretreatment versus controls. These findings were complemented by an independent, data-driven approach showing altered global connectivity of the INS. Detailed investigation of the INS confirmed reduced connectivity to widespread TPN and TNN areas, which was partially restored post-treatment. Furthermore, analysis of diffusion-tensor imaging (DTI) data revealed structural changes in white matter supporting these findings. The left DLPFC also showed aberrant connectivity that was restored post-treatment. Altogether, our findings implicate the bilateral INS and left DLPFC as key nodes of disrupted cognition-related intrinsic connectivity in CLBP, and the resulting imbalance between TPN and TNN function is partially restored with treatment.
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Affiliation(s)
- Marta Čeko
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Alan Edwards Centre for Research on Pain, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Perlaki G, Orsi G, Schwarcz A, Bodi P, Plozer E, Biczo K, Aradi M, Doczi T, Komoly S, Hejjel L, Kovacs N, Janszky J. Pain-related autonomic response is modulated by the medial prefrontal cortex: An ECG-fMRI study in men. J Neurol Sci 2015; 349:202-8. [PMID: 25623806 DOI: 10.1016/j.jns.2015.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our goal was to identify brain structures responsible for pain-related autonomic changes by the correlation of simultaneously acquired functional magnetic resonance imaging (fMRI) and electrocardiogram (ECG) data. METHODS Eighteen healthy men (age: 22.89 ± 1.96) were involved. Painful sensation was evoked by heat. Simultaneously recorded brain fMRI and ECG data during pain were compared to data acquired during a non-painful heat sensation. From the ECG data, time- and frequency domain parameters of heart rate variability (HRV) were extracted. RESULTS We found that: (1) among the common elements of both pain network and central autonomic network (CAN) only the medial prefrontal frontal cortex (MPFC) showed significant correlation with HRV; (2) the parasympathetic response to the painful stimuli showed a positive, while the sympathetic response a negative association with pain related BOLD-signal change observed in MPFC; (3) time domain parameters of HRV were negatively associated with MPFC activation. CONCLUSIONS The novelty of our study-compared to previous ECG-fMRI studies-is that we used pain as stimulus and investigated both frequency- and time-domain parameters of HRV. Compared to other stimuli used in earlier studies to activate the CAN, pain sensation can be standardized easier and might allow us to better understand the functional organization of CAN. The results of the current ECG-fMRI study may have direct clinical relevance in understanding the pathomechanisms of several clinical conditions. PERSPECTIVE There are some simultaneous ECG-fMRI and ECG-Positron Emission Tomography (PET) studies, but limited information is available about the pain-related brain function-HRV relations. The novelty of our study is that we used pain as stimulus to activate the central autonomic network and investigated both frequency- and time-domain parameters of HRV.
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Affiliation(s)
- Gabor Perlaki
- Department of Neurology, University of Pécs, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Gergely Orsi
- Department of Neurology, University of Pécs, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
| | - Attila Schwarcz
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | | | - Eniko Plozer
- Department of Neurology, University of Pécs, Pécs, Hungary
| | | | | | - Tamas Doczi
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Samuel Komoly
- Department of Neurology, University of Pécs, Pécs, Hungary
| | | | - Norbert Kovacs
- Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Jozsef Janszky
- Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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Loggia ML, Chonde DB, Akeju O, Arabasz G, Catana C, Edwards RR, Hill E, Hsu S, Izquierdo-Garcia D, Ji RR, Riley M, Wasan AD, Zürcher NR, Albrecht DS, Vangel MG, Rosen BR, Napadow V, Hooker JM. Evidence for brain glial activation in chronic pain patients. ACTA ACUST UNITED AC 2015; 138:604-15. [PMID: 25582579 DOI: 10.1093/brain/awu377] [Citation(s) in RCA: 337] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although substantial evidence has established that microglia and astrocytes play a key role in the establishment and maintenance of persistent pain in animal models, the role of glial cells in human pain disorders remains unknown. Here, using the novel technology of integrated positron emission tomography-magnetic resonance imaging and the recently developed radioligand (11)C-PBR28, we show increased brain levels of the translocator protein (TSPO), a marker of glial activation, in patients with chronic low back pain. As the Ala147Thr polymorphism in the TSPO gene affects binding affinity for (11)C-PBR28, nine patient-control pairs were identified from a larger sample of subjects screened and genotyped, and compared in a matched-pairs design, in which each patient was matched to a TSPO polymorphism-, age- and sex-matched control subject (seven Ala/Ala and two Ala/Thr, five males and four females in each group; median age difference: 1 year; age range: 29-63 for patients and 28-65 for controls). Standardized uptake values normalized to whole brain were significantly higher in patients than controls in multiple brain regions, including thalamus and the putative somatosensory representations of the lumbar spine and leg. The thalamic levels of TSPO were negatively correlated with clinical pain and circulating levels of the proinflammatory citokine interleukin-6, suggesting that TSPO expression exerts pain-protective/anti-inflammatory effects in humans, as predicted by animal studies. Given the putative role of activated glia in the establishment and or maintenance of persistent pain, the present findings offer clinical implications that may serve to guide future studies of the pathophysiology and management of a variety of persistent pain conditions.
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Affiliation(s)
- Marco L Loggia
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA
| | - Daniel B Chonde
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Oluwaseun Akeju
- 3 Department of Anesthesia, Critical Care and Pain Medicine, MGH/HMS, Boston, MA 02114, USA
| | - Grae Arabasz
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Ciprian Catana
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Robert R Edwards
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 4 Department of Psychiatry, Brigham and Women's Hospital, HMS, Boston, MA 02155, USA
| | - Elena Hill
- 5 Tufts University School of Medicine, Boston, MA 02111, USA
| | - Shirley Hsu
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - David Izquierdo-Garcia
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Ru-Rong Ji
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 6 Departments of Anesthesiology and Neurobiology, Duke University Medical Center, Durham, NC 27705, USA
| | - Misha Riley
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Ajay D Wasan
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 4 Department of Psychiatry, Brigham and Women's Hospital, HMS, Boston, MA 02155, USA 7 Departments of Anesthesiology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15206, USA
| | - Nicole R Zürcher
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Daniel S Albrecht
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Mark G Vangel
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Bruce R Rosen
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA 8 Division of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Vitaly Napadow
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 9 Department of Biomedical Engineering, Kyung Hee University, Seoul 130-872, Republic of Korea
| | - Jacob M Hooker
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy. NEUROIMAGE-CLINICAL 2014; 5:365-76. [PMID: 26958466 PMCID: PMC4749849 DOI: 10.1016/j.nicl.2014.07.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 07/01/2014] [Accepted: 07/17/2014] [Indexed: 11/25/2022]
Abstract
Chronic pain is a complex physiological and psychological phenomenon. Implicit learning mechanisms contribute to the development of chronic pain and to persistent changes in the central nervous system. We hypothesized that these central abnormalities can be remedied with Cognitive Behavioral Therapy (CBT). Specifically, since regions of the anterior Default Mode Network (DMN) are centrally involved in emotional regulation via connections with limbic regions, such as the amygdala, remediation of maladaptive behavioral and cognitive patterns as a result of CBT for chronic pain would manifest itself as a change in the intrinsic functional connectivity (iFC) between these prefrontal and limbic regions. Resting-state functional neuroimaging was performed in patients with chronic pain before and after 11-week CBT (n = 19), as well as a matched (ages 19–59, both sexes) active control group of patients who received educational materials (n = 19). Participants were randomized prior to the intervention. To investigate the differential impact of treatment on intrinsic functional connectivity (iFC), we compared pre–post differences in iFC between groups. In addition, we performed exploratory whole brain analyses of changes in fractional amplitude of low frequency fluctuations (fALFF). The course of CBT led to significant improvements in clinical measures of pain and self-efficacy for coping with chronic pain. Significant group differences in pre–post changes in both iFC and fALFF were correlated with clinical outcomes. Compared to control patients, iFC between the anterior DMN and the amygdala/periaqueductal gray decreased following CBT, whereas iFC between the basal ganglia network and the right secondary somatosensory cortex increased following CBT. CBT patients also had increased post-therapy fALFF in the bilateral posterior cingulate and the cerebellum. By delineating neuroplasticity associated with CBT-related improvements, these results add to mounting evidence that CBT is a valuable treatment option for chronic pain.
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Atlas LY, Lindquist MA, Bolger N, Wager TD. Brain mediators of the effects of noxious heat on pain. Pain 2014; 155:1632-1648. [PMID: 24845572 DOI: 10.1016/j.pain.2014.05.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 05/01/2014] [Accepted: 05/14/2014] [Indexed: 12/25/2022]
Abstract
Recent human neuroimaging studies have investigated the neural correlates of either noxious stimulus intensity or reported pain. Although useful, analyzing brain relationships with stimulus intensity and behavior separately does not address how sensation and pain are linked in the central nervous system. In this study, we used multi-level mediation analysis to identify brain mediators of pain--regions in which trial-by-trial responses to heat explained variability in the relationship between noxious stimulus intensity (across 4 levels) and pain. This approach has the potential to identify multiple circuits with complementary roles in pain genesis. Brain mediators of noxious heat effects on pain included targets of ascending nociceptive pathways (anterior cingulate, insula, SII, and medial thalamus) and also prefrontal and subcortical regions not associated with nociceptive pathways per se. Cluster analysis revealed that mediators were grouped into several distinct functional networks, including the following: somatosensory, paralimbic, and striatal-cerebellar networks that increased with stimulus intensity; and 2 networks co-localized with "default mode" regions in which stimulus intensity-related decreases mediated increased pain. We also identified "thermosensory" regions that responded to increasing noxious heat but did not predict pain reports. Finally, several regions did not respond to noxious input, but their activity predicted pain; these included ventromedial prefrontal cortex, dorsolateral prefrontal cortex, cerebellar regions, and supplementary motor cortices. These regions likely underlie both nociceptive and non-nociceptive processes that contribute to pain, such as attention and decision-making processes. Overall, these results elucidate how multiple distinct brain systems jointly contribute to the central generation of pain.
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Affiliation(s)
- Lauren Y Atlas
- Section on Affective Neuroscience and Pain, National Center for Complementary and Alternative Medicine, US National Institutes of Health, Bethesda, MD, USA Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA Department of Psychology, Columbia University, New York, NY, USA Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, USA
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Loggia ML, Berna C, Kim J, Cahalan CM, Gollub RL, Wasan AD, Harris RE, Edwards RR, Napadow V. Disrupted brain circuitry for pain-related reward/punishment in fibromyalgia. Arthritis Rheumatol 2014; 66:203-12. [PMID: 24449585 DOI: 10.1002/art.38191] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 09/03/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVE While patients with fibromyalgia (FM) are known to exhibit hyperalgesia, the central mechanisms contributing to this altered pain processing are not fully understood. This study was undertaken to investigate potential dysregulation of the neural circuitry underlying cognitive and hedonic aspects of the subjective experience of pain, such as anticipation of pain and anticipation of pain relief. METHODS Thirty-one FM patients and 14 controls underwent functional magnetic resonance imaging, while receiving cuff pressure pain stimuli on the leg calibrated to elicit a pain rating of ~50 on a 100-point scale. During the scan, subjects also received visual cues informing them of the impending onset of pain (pain anticipation) and the impending offset of pain (relief anticipation). RESULTS Patients exhibited less robust activation during both anticipation of pain and anticipation of relief within regions of the brain commonly thought to be involved in sensory, affective, cognitive, and pain-modulatory processes. In healthy controls, direct searches and region-of-interest analyses of the ventral tegmental area revealed a pattern of activity compatible with the encoding of punishment signals: activation during anticipation of pain and pain stimulation, but deactivation during anticipation of pain relief. In FM patients, however, activity in the ventral tegmental area during periods of pain and periods of anticipation (of both pain and relief) was dramatically reduced or abolished. CONCLUSION FM patients exhibit disrupted brain responses to reward/punishment. The ventral tegmental area is a source of reward-linked dopaminergic/γ-aminobutyric acid-releasing (GABAergic) neurotransmission in the brain, and our observations are compatible with reports of altered dopaminergic/GABAergic neurotransmission in FM. Reduced reward/punishment signaling in FM may be related to the augmented central processing of pain and reduced efficacy of opioid treatments in these patients.
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Affiliation(s)
- Marco L Loggia
- Massachusetts General Hospital, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
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Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks. Proc Natl Acad Sci U S A 2013; 110:18692-7. [PMID: 24167282 DOI: 10.1073/pnas.1312902110] [Citation(s) in RCA: 299] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Human minds often wander away from their immediate sensory environment. It remains unknown whether such mind wandering is unsystematic or whether it lawfully relates to an individual's tendency to attend to salient stimuli such as pain and their associated brain structure/function. Studies of pain-cognition interactions typically examine explicit manipulation of attention rather than spontaneous mind wandering. Here we sought to better represent natural fluctuations in pain in daily life, so we assessed behavioral and neural aspects of spontaneous disengagement of attention from pain. We found that an individual's tendency to attend to pain related to the disruptive effect of pain on his or her cognitive task performance. Next, we linked behavioral findings to neural networks with strikingly convergent evidence from functional magnetic resonance imaging during pain coupled with thought probes of mind wandering, dynamic resting state activity fluctuations, and diffusion MRI. We found that (i) pain-induced default mode network (DMN) deactivations were attenuated during mind wandering away from pain; (ii) functional connectivity fluctuations between the DMN and periaqueductal gray (PAG) dynamically tracked spontaneous attention away from pain; and (iii) across individuals, stronger PAG-DMN structural connectivity and more dynamic resting state PAG-DMN functional connectivity were associated with the tendency to mind wander away from pain. These data demonstrate that individual tendencies to mind wander away from pain, in the absence of explicit manipulation, are subserved by functional and structural connectivity within and between default mode and antinociceptive descending modulation networks.
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Alterations in regional homogeneity assessed by fMRI in patients with migraine without aura stratified by disease duration. J Headache Pain 2013; 14:85. [PMID: 24134520 PMCID: PMC3853130 DOI: 10.1186/1129-2377-14-85] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/04/2013] [Indexed: 12/23/2022] Open
Abstract
Background Advanced neuroimaging approaches have been employed to prove that migraine was a central nervous system disorder. This study aims to examine resting-state abnormalities in migraine without aura (MWoA) patients stratified by disease duration, and to explore the neuroimaging markers for reflecting the disease duration. Methods 40 eligible MWoA patients and 20 matched healthy volunteers were included in the study. Regional homogeneity (ReHo) analysis was used to identify the local features of spontaneous brain activity in MWoA patients stratified by disease duration, and analysis was performed to investigate the correlation of overlapped brain dysfunction in MWoA patients with different disease duration (long-term and short-term) and course of disease. Results Compared with healthy controls, MWoA patients with long-term disease duration showed comprehensive neuronal dysfunction than patients with short-term disease duration. In addition, increased average ReHo values in the thalamus, brain stem, and temporal pole showed significantly positive correlations with the disease duration. On the contrary, ReHo values were negatively correlated with the duration of disease in the anterior cingulate cortex, insula, posterior cingulate cortex and superior occipital gyrus. Conclusions Our findings of progressive brain damage in relation to increasing disease duration suggest that migraine without aura is a progressive central nervous disease, and the length of the disease duration was one of the key reasons to cause brain dysfunction in MwoA patients. The repeated migraine attacks over time result in resting-state abnormalities of selective brain regions belonging to the pain processing and cognition. We predict that these brain regions are sensitive neuroimaging markers for reflecting the disease duration of migraine patients without aura.
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Jeffrey-Gauthier R, Guillemot JP, Piché M. Neurovascular coupling during nociceptive processing in the primary somatosensory cortex of the rat. Pain 2013; 154:1434-41. [DOI: 10.1016/j.pain.2013.04.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/18/2013] [Accepted: 04/25/2013] [Indexed: 11/30/2022]
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Iannetti GD, Salomons TV, Moayedi M, Mouraux A, Davis KD. Beyond metaphor: contrasting mechanisms of social and physical pain. Trends Cogn Sci 2013; 17:371-8. [PMID: 23796880 DOI: 10.1016/j.tics.2013.06.002] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 06/05/2013] [Accepted: 06/06/2013] [Indexed: 12/22/2022]
Abstract
Physical pain can be clearly distinguished from other states of distress. In recent years, however, the notion that social distress is experienced as physically painful has permeated the scientific literature and popular media. This conclusion is based on the overlap of brain regions that respond to nociceptive input and sociocultural distress. Here we challenge the assumption that underlies this conclusion - that physical pain can be easily inferred from a particular pattern of activated brain regions - by showing that patterns of activation commonly presumed to constitute the 'pain matrix' are largely unspecific to pain. We then examine recent analytical advances that may improve the specificity of imaging for parsing pain from a broad range of perceptually unique human experiences.
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Affiliation(s)
- Gian Domenico Iannetti
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
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Sustained deep-tissue pain alters functional brain connectivity. Pain 2013; 154:1343-51. [PMID: 23718988 DOI: 10.1016/j.pain.2013.04.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 03/07/2013] [Accepted: 04/05/2013] [Indexed: 11/21/2022]
Abstract
Recent functional brain connectivity studies have contributed to our understanding of the neurocircuitry supporting pain perception. However, evoked-pain connectivity studies have employed cutaneous and/or brief stimuli, which induce sensations that differ appreciably from the clinical pain experience. Sustained myofascial pain evoked by pressure cuff affords an excellent opportunity to evaluate functional connectivity change to more clinically relevant sustained deep-tissue pain. Connectivity in specific networks known to be modulated by evoked pain (sensorimotor, salience, dorsal attention, frontoparietal control, and default mode networks: SMN, SLN, DAN, FCN, and DMN) was evaluated with functional-connectivity magnetic resonance imaging, both at rest and during a sustained (6-minute) pain state in healthy adults. We found that pain was stable, with no significant changes of subjects' pain ratings over the stimulation period. Sustained pain reduced connectivity between the SMN and the contralateral leg primary sensorimotor (S1/M1) representation. Such SMN-S1/M1 connectivity decreases were also accompanied by and correlated with increased SLN-S1/M1 connectivity, suggesting recruitment of activated S1/M1 from SMN to SLN. Sustained pain also increased DAN connectivity to pain processing regions such as mid-cingulate cortex, posterior insula, and putamen. Moreover, greater connectivity during pain between contralateral S1/M1 and posterior insula, thalamus, putamen, and amygdala was associated with lower cuff pressures needed to reach the targeted pain sensation. These results demonstrate that sustained pain disrupts resting S1/M1 connectivity by shifting it to a network known to process stimulus salience. Furthermore, increased connectivity between S1/M1 and both sensory and affective processing areas may be an important contribution to interindividual differences in pain sensitivity.
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