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Guo Z, Liu X, Yang Z, Huang C, Liu J, Liu L, Xu Y, Liu S, Xu D, Chen J. WITHDRAWN: Association between aberrant brain activity and pain in patients with primary osteoporotic pain: a resting-state fMRI study. Neuroscience 2024:S0306-4522(24)00134-9. [PMID: 38521479 DOI: 10.1016/j.neuroscience.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Zhijie Guo
- Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Liu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhaoxu Yang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chihuan Huang
- Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Liu
- Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lanying Liu
- Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Daoming Xu
- Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
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Metzger S, Horn-Hofmann C, Kunz M, Lautenbacher S. Counterirritation by pain inhibits the responsiveness to aversive loud tones: the role of state anxiety and state fear triggered in the NPU paradigm. Somatosens Mot Res 2024:1-9. [PMID: 38459928 DOI: 10.1080/08990220.2024.2322499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/19/2024] [Indexed: 03/11/2024]
Abstract
AIM OF THE STUDY The application of a noxious stimulus reduces the perception and responsiveness to other pain stimuli. This inhibition can be experimentally assessed with a method called 'counterirritation'. The question arises if counterirritation acts also on the perception and responsiveness to aversive but non-nociceptive stimuli (e.g., loud tones). Since aversive stimulation is often associated with state anxiety or state fear, we investigated in addition the modulatory effects of these emotions on counterirritation. MATERIAL AND METHODS 51 subjects participated in our study. We presented tones with aversive loudness (105 dB), first alone then during counterirritation (immersion of the hand in a hot water bath of 46 °C) to assess inhibition of loudness perception and responsiveness. Influences of state anxiety and state fear on counterirritation were investigated by using the Neutral-Predictable(fear)- Unpredictable(anxiety) Paradigm (NPU), which is based on classical conditioning. Loudness ratings (perception of the aversive tones) and startle reflex (defensive reaction to aversive tones) were assessed. RESULTS Counterirritation reduced startle reflex amplitudes, but not the loudness ratings. Although state anxiety and state fear were successfully induced, counterirritation remained unaffected. CONCLUSIONS Our study showed that pain inhibits the responsiveness to aversive stimuli (loud tones). Thus, the postulate that 'pain inhibits pain' might be better changed to 'pain inhibits aversiveness'. Consequently, our findings may also question the assumption of a clear pain specificity in inhibitory action as assumed by theoretical approaches like 'conditioned pain modulation' (CPM). Furthermore, counterirritation appeared one more time resistant to the influence of negative emotions.
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Affiliation(s)
- Silvia Metzger
- Physiological Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Claudia Horn-Hofmann
- Physiological Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Miriam Kunz
- Bamberger Living Lab Dementia, BamLiD, Otto-Friedrich-University of Bamberg, Bamberg, Germany
- Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Stefan Lautenbacher
- Physiological Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
- Bamberger Living Lab Dementia, BamLiD, Otto-Friedrich-University of Bamberg, Bamberg, Germany
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Freund-Azaria A, Bart O, Regev R, Bar-Shalita T. Breastfeeding-related Pain, Sensory Over-responsiveness, and Exclusive Breastfeeding at 6 Months: A Prospective Cohort Study. Womens Health Issues 2024; 34:80-89. [PMID: 37940508 DOI: 10.1016/j.whi.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Exclusive breastfeeding (EBF) is recommended for the first 6 months of life, yet EBF rates at 6 months (T3) in most developed countries are low. Painful and nonpainful sensory stimuli processing is linked, and while pain has been suggested to restrict breastfeeding, its coupling with sensory over-responsiveness (SOR) in relation to breastfeeding has not yet been reported. OBJECTIVE We aimed to explore whether breastfeeding-related pain, SOR, and general pain sensitivity predict nonexclusive breastfeeding (NEBF) at T3. STUDY DESIGN In this prospective study, participants were recruited at 2 days postpartum (enrollment). For the assessment of breastfeeding-related pain, participants completed the visual analogue scale and the Short-Form McGill Pain Questionnaire at enrollment, and at 6 weeks after birth. At T3, they completed the Pain Sensitivity Questionnaire and the Sensory Responsiveness Questionnaire-Intensity Scale and then provided information about their breastfeeding status. Participants were divided into two groups accordingly: EBF and NEBF. RESULTS A total of 164 participants were reached at T3: EBF (n = 105) and NEBF (n = 59). The incidence of SOR was significantly higher among NEBF compared with EBF participants (25.4% vs. 11.4%; p = .020). Between enrollment and 6 weeks after birth, 72.3% of the EBF participants had reported a ≥30% pain reduction, compared with 44.8% of the NEBF participants (p = .001). Logistic regression modeling revealed that both breastfeeding-related pain reduction and SOR predicted NEBF at T3 (p < .001), indicating a 3.2 times (p = .001) and 2.5 times (p = .041) odds ratio for NEBF, respectively. CONCLUSIONS SOR and sustained breastfeeding-related pain predict NEBF at T3 and may emerge as substantial breastfeeding barriers.
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Affiliation(s)
- Adi Freund-Azaria
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel; Department of Neonatology, Meir Medical Center, Kfar-Saba, Israel
| | - Orit Bart
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Rivka Regev
- Clalit Health Organization and Neonatal Follow-up Clinic, Meir Medical Center, Kfar-Saba, Israel
| | - Tami Bar-Shalita
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel.
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4
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Metzger S, Horn-Hofmann C, Lautenbacher S. Counterirritation by Pain Inhibits Responses to and Perception of Aversive Loud Tones. Percept Mot Skills 2023; 130:1801-1818. [PMID: 37340659 PMCID: PMC10552344 DOI: 10.1177/00315125231183604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
The application of a noxious stimulus reduces the perception of other noxious stimuli, which can be assessed by an experimental method called "counterirritation." The question arises whether this type of inhibition also affects the processing of other aversive (but not nociceptive) stimuli, such as loud tones. If aversiveness or, in other words, negative emotional valence qualifies a stimulus to be affected by counterirritation, the general emotional context may also play a role in modulating counterirritation effects. We involved 63 participants in this study (M age = 38.8, SD = 10.5 years; 33 males, 30 females). We tried to counterirritate their perceptual and startle reactions to aversively loud tones (105 db) by immersing the hand into a painful hot water bath (46°C) in two emotional valence conditions (i.e., a neutral and a negative valence block in which we showed either neutral pictures or pictures of burn wounds). We assessed Inhibition by loudness ratings and startle reflex amplitudes. Counterirritation significantly reduced both loudness ratings and startle reflex amplitudes. The emotional context manipulation did not affect this clear inhibitory effect, showing that counterirritation by a noxious stimulus affects aversive sensations not induced by nociceptive stimuli. Thus, the assumption that "pain inhibits pain" should be widened to "pain inhibits the processing of aversive stimuli." This broadened understanding of counterirritation leads to a questioning of the postulate of clear pain specificity in paradigms like "conditioned pain modulation" (CPM) or "diffuse noxious inhibitory controls" (DNIC).
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Affiliation(s)
- Silvia Metzger
- Department of Physiological Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Claudia Horn-Hofmann
- Department of Physiological Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Stefan Lautenbacher
- Department of Physiological Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
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5
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Seymour B, Crook RJ, Chen ZS. Post-injury pain and behaviour: a control theory perspective. Nat Rev Neurosci 2023; 24:378-392. [PMID: 37165018 PMCID: PMC10465160 DOI: 10.1038/s41583-023-00699-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/12/2023]
Abstract
Injuries of various types occur commonly in the lives of humans and other animals and lead to a pattern of persistent pain and recuperative behaviour that allows safe and effective recovery. In this Perspective, we propose a control-theoretic framework to explain the adaptive processes in the brain that drive physiological post-injury behaviour. We set out an evolutionary and ethological view on how animals respond to injury, illustrating how the behavioural state associated with persistent pain and recuperation may be just as important as phasic pain in ensuring survival. Adopting a normative approach, we suggest that the brain implements a continuous optimal inference of the current state of injury from diverse sensory and physiological signals. This drives the various effector control mechanisms of behavioural homeostasis, which span the modulation of ongoing motivation and perception to drive rest and hyper-protective behaviours. However, an inherent problem with this is that these protective behaviours may partially obscure information about whether injury has resolved. Such information restriction may seed a tendency to aberrantly or persistently infer injury, and may thus promote the transition to pathological chronic pain states.
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Affiliation(s)
- Ben Seymour
- Institute for Biomedical Engineering, University of Oxford, Oxford, UK.
- Wellcome Centre for Integrative Neuroimaging, John Radcliffe Hospital, Headington, Oxford, UK.
| | - Robyn J Crook
- Department of Biology, San Francisco State University, San Francisco, CA, USA.
| | - Zhe Sage Chen
- Departments of Psychiatry, Neuroscience and Physiology, Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA.
- Interdisciplinary Pain Research Program, NYU Langone Health, New York, NY, USA.
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Guerra-Armas J, Flores-Cortes M, Pineda-Galan C, Luque-Suarez A, La Touche R. Role of Immersive Virtual Reality in Motor Behaviour Decision-Making in Chronic Pain Patients. Brain Sci 2023; 13:brainsci13040617. [PMID: 37190582 DOI: 10.3390/brainsci13040617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Primary chronic pain is a major contributor to disability worldwide, with an estimated prevalence of 20-33% of the world's population. The high socio-economic impact of musculoskeletal pain justifies seeking an appropriate therapeutic strategy. Immersive virtual reality (VR) has been proposed as a first-line intervention for chronic musculoskeletal pain. However, the growing literature has not been accompanied by substantial progress in understanding how VR exerts its impact on the pain experience and what neurophysiological mechanisms might be involved in the clinical effectiveness of virtual reality interventions in chronic pain patients. The aim of this review is: (i) to establish the state of the art on the effects of VR on patients with chronic pain; (ii) to identify neuroplastic changes associated with chronic pain that may be targeted by VR intervention; and (iii) to propose a hypothesis on how immersive virtual reality could modify motor behavioral decision-making through an interactive experience in patients with chronic pain.
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Affiliation(s)
- Javier Guerra-Armas
- Faculty of Health Sciences, Universidad Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas, Spain
| | - Mar Flores-Cortes
- Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
| | | | - Alejandro Luque-Suarez
- Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de la Investigacion Biomedica de Malaga (IBIMA), 29071 Malaga, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), 28008 Madrid, Spain
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7
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Sensorial saturation improves infants' procedure-related pain behaviour in the cardiac intensive care unit: A quasi-experimental study. Aust Crit Care 2023; 36:232-238. [PMID: 35183430 DOI: 10.1016/j.aucc.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Painful procedures are unavoidable when providing critical care to infants in intensive care units. These adverse experiences during infancy can lead to later hyperalgesia and poor neurodevelopmental outcomes. Thus, appropriate interventions are required to relieve infant pain during these procedures. OBJECTIVES This study evaluated the effectiveness of sensorial saturation in reducing pain for infants during jugular central venous catheter removal procedures in intensive care units. METHODS This study involved a quasi-experimental, repeated-measures design. Data were collected from participants sequentially recruited from April to June 2019 (control period) and July to September 2019 (experimental period). Participants included 78 infants younger than 1 year with congenital heart disease. The control group (n = 38) received a general nursing intervention using swaddling, a common child-care practice that consists of wrapping infants to restrict movements, whereas the experimental group (n = 40) received sensorial saturation using oral sugar, body massage, and verbal interaction. Infants' physiological reactions to procedural pain were measured by changes in heart rate, oxygen saturation, and respiratory rate. Infants' procedural pain and behavioural indicators were measured using the Modified Behavioural Pain Scale. Data were analysed using descriptive statistics, independent t-tests, χ2 tests, and repeated-measures analysis of variance. RESULTS Compared with the control group, the experimental group had lower heart rates (F = 53.15, p < .001), respiratory rates (F = 15.19, p < .001), and behavioural pain scores (F = 45.21, p < .001), both during and after the procedure. CONCLUSIONS Sensorial saturation can be used as a nursing intervention in infants. Given the many invasive procedures that are part of infant clinical care, sensorial saturation may be a safe analgesic alternative. The findings of this study could lead to the development of evidence-based clinical practice guidelines for the nonpharmacological management of acute pain in infants.
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8
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Li SC, Fitzek FHP. Digitally embodied lifespan neurocognitive development and Tactile Internet: Transdisciplinary challenges and opportunities. Front Hum Neurosci 2023; 17:1116501. [PMID: 36845878 PMCID: PMC9950571 DOI: 10.3389/fnhum.2023.1116501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/26/2023] [Indexed: 02/12/2023] Open
Abstract
Mechanisms underlying perceptual processing and inference undergo substantial changes across the lifespan. If utilized properly, technologies could support and buffer the relatively more limited neurocognitive functions in the still developing or aging brains. Over the past decade, a new type of digital communication infrastructure, known as the "Tactile Internet (TI)," is emerging in the fields of telecommunication, sensor and actuator technologies and machine learning. A key aim of the TI is to enable humans to experience and interact with remote and virtual environments through digitalized multimodal sensory signals that also include the haptic (tactile and kinesthetic) sense. Besides their applied focus, such technologies may offer new opportunities for the research tapping into mechanisms of digitally embodied perception and cognition as well as how they may differ across age cohorts. However, there are challenges in translating empirical findings and theories about neurocognitive mechanisms of perception and lifespan development into the day-to-day practices of engineering research and technological development. On the one hand, the capacity and efficiency of digital communication are affected by signal transmission noise according to Shannon's (1949) Information Theory. On the other hand, neurotransmitters, which have been postulated as means that regulate the signal-to-noise ratio of neural information processing (e.g., Servan-Schreiber et al., 1990), decline substantially during aging. Thus, here we highlight neuronal gain control of perceptual processing and perceptual inference to illustrate potential interfaces for developing age-adjusted technologies to enable plausible multisensory digital embodiments for perceptual and cognitive interactions in remote or virtual environments.
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Affiliation(s)
- Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany,Centre for Tactile Internet With Human-in-the-Loop, Technische Universität Dresden, Dresden, Germany,*Correspondence: Shu-Chen Li,
| | - Frank H. P. Fitzek
- Centre for Tactile Internet With Human-in-the-Loop, Technische Universität Dresden, Dresden, Germany,Deutsche Telekom Chair of Communication Networks, Faculty of Electrical and Computer Engineering, Technische Universität Dresden, Dresden, Germany
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9
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Pinto CB, Bielefeld J, Barroso J, Yip B, Huang L, Schnitzer T, Apkarian AV. Chronic pain domains and their relationship to personality, abilities, and brain networks. Pain 2023; 164:59-71. [PMID: 35612403 PMCID: PMC9582040 DOI: 10.1097/j.pain.0000000000002657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/23/2022] [Indexed: 01/09/2023]
Abstract
Abstract
Chronic pain is a multidimensional pathological state. Recent evidence suggests that specific brain properties and patients' psychological and physical traits are distorted in chronic pain patients. However, the relationship between these alterations and pain dimensions remains poorly understood. Here, we first evaluated multiple dimensions of chronic pain by assessing a broad battery of pain-related questionnaire scores (23 outcomes) of 107 chronic low back pain patients and identified 3 distinct chronic pain domains: magnitude, affect & disability, and quality. Second, we investigated the pain domains relationship with measures of personality, social interaction, psychological traits, and ability traits (77 biopsychosocial & ability [biopsy&ab] outcomes). Pain magnitude (out-of-sample [OOS]
) is associated with emotional control, attention, and working memory, with higher pain scores showing lower capacity to regulate and adapt behaviorally. Pain affect & disability (OOS
associated with anxiety, catastrophizing and social relationships dysfunction. Pain quality did not relate significantly to biopsy&ab variables. Third, we mapped these 3 pain domains to brain functional connectivity. Pain magnitude mainly associated with the sensorimotor and the cingulo-opercular networks (OOS
). Pain affect & disability related to frontoparietal and default mode networks (OOS
. Pain quality integrated sensorimotor, auditory, and cingulo-opercular networks (OOS
). Mediation analysis could link functional connectivity and biopsy&ab models to respective pain domains. Our results provide a global overview of the complexity of chronic pain, showing how underlying distinct domains of the experience map to different biopsy&ab correlates and underlie unique brain network signatures.
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Affiliation(s)
- Camila Bonin Pinto
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jannis Bielefeld
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Joana Barroso
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Byron Yip
- Departments of Physical Medicine and Rehabilitation
| | - Lejian Huang
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Thomas Schnitzer
- Departments of Physical Medicine and Rehabilitation
- Anesthesiology, and
- Medicine (Rheumatology), Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - A Vania Apkarian
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Departments of Physical Medicine and Rehabilitation
- Anesthesiology, and
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Young EL, Mista CA, Jure FA, Andersen OK, Biurrun Manresa JA. An analytical method to separate modality-specific and nonspecific sensory components of event-related potentials. Eur J Neurosci 2022; 56:5090-5105. [PMID: 35983754 DOI: 10.1111/ejn.15798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 01/07/2023]
Abstract
Several models have been developed to analyse cortical activity in response to salient events constituted by multiple sensory modalities. In particular, additive models compare event-related potentials (ERPs) in response to stimuli from two or more concomitant sensory modalities with the ERPs evoked by unimodal stimuli, in order to study sensory interactions. In this approach, components that are not specific to a sensory modality are commonly disregarded, although they likely carry information about stimulus expectation and evaluation, attentional orientation and other cognitive processes. In this study, we present an analytical method to assess the contribution of modality-specific and nonspecific components to the ERP. We developed an experimental setup that recorded ERPs in response to four stimulus types (visual, auditory, and two somatosensory modalities to test for stimulus specificity) in three different conditions (unimodal, bimodal and trimodal stimulation) and recorded the saliency of these stimuli relative to the sensory background. Stimuli were delivered in pairs, in order to study the effects of habituation. To this end, spatiotemporal features (peak amplitudes and latencies at different scalp locations) were analysed using linear mixed models. Results showed that saliency relative to the sensory background increased with the number of concomitant stimuli. We also observed that the spatiotemporal features of modality-specific components derived from this method likely reflect the amount and type of sensory input. Furthermore, the nonspecific component reflected habituation occurring for the second stimulus in the pair. In conclusion, this method provides an alternative to study neural mechanisms of responses to multisensory stimulation.
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Affiliation(s)
- Elizabeth Loreley Young
- Institute for Research and Development in Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Argentina.,Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Argentina
| | - Christian Ariel Mista
- Institute for Research and Development in Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Argentina.,Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Argentina
| | - Fabricio Ariel Jure
- Neurorehabilitation Systems, Department of Health Science and Technology (HST), Aalborg University, Aalborg, Denmark
| | | | - José A Biurrun Manresa
- Institute for Research and Development in Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Argentina.,Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Argentina.,Centre for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
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11
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Efraim Kaufman A, Weissman-Fogel I, Rosenthal MZ, Kaplan Neeman R, Bar-Shalita T. Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain. Front Neurosci 2022; 16:907585. [PMID: 35992931 PMCID: PMC9381840 DOI: 10.3389/fnins.2022.907585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Misophonia and sensory over-responsiveness (SOR) share physiological and psychological symptoms. While individuals with SOR demonstrate pain perception alterations, these were not explored in misophonia. Methods This exploratory study comprised thirty healthy adults with (n = 15; based on the Misophonia Questionnaire) and without misophonia. The Sensory Responsiveness Questionnaire (SRQ) was used for evaluating sensory responsiveness. In addition, psychophysical tests were applied for quantification of: (i) stimulus-response function of painful stimuli, (ii) the individual perceived pain intensity, (iii) pain modulation efficiency, (iv) auditory intensity discrimination capability, and (v) painful and unpleasantness responses to six ecological daily sounds using the Battery of Aversiveness to Sounds (BAS). Results Individuals with misophonia reported higher scores in the SRQ-Aversive (p = 0.022) and SRQ-Hedonic (p = 0.029) scales as well as in auditory (p = 0.042) and smell (p = 0.006) sub-scales, indicating higher sensory responsiveness. Yet they were not identified with the SOR type of sensory modulation dysfunction. Groups did not differ in the pain psychophysical tests, and in auditory discrimination test scores (p > 0.05). However, in the misophonia group the BAS evoked higher pain intensity (p = 0.046) and unpleasantness (p <0.001) ratings in the apple biting sound, and higher unpleasantness rating in the scraping a dish sound (p = 0.007), compared to the comparison group. Conclusion Findings indicate increased sensory responsiveness in individuals with misophonia, yet not defined as SOR. Thus, this suggests that misophonia and SOR are two distinct conditions, differing in their behavioral responses to painful and non-painful stimuli.
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Affiliation(s)
- Adi Efraim Kaufman
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - M. Zachary Rosenthal
- Department of Psychiatry and Behavioral Sciences, Center for Misophonia and Emotion Regulation, Duke University Medical Center, Durham, NC, United States
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Kohoutová L, Atlas LY, Büchel C, Buhle JT, Geuter S, Jepma M, Koban L, Krishnan A, Lee DH, Lee S, Roy M, Schafer SM, Schmidt L, Wager TD, Woo CW. Individual variability in brain representations of pain. Nat Neurosci 2022; 25:749-759. [PMID: 35637368 PMCID: PMC9435464 DOI: 10.1038/s41593-022-01081-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 04/22/2022] [Indexed: 01/22/2023]
Abstract
Characterizing cerebral contributions to individual variability in pain processing is crucial for personalized pain medicine, but has yet to be done. In the present study, we address this problem by identifying brain regions with high versus low interindividual variability in their relationship with pain. We trained idiographic pain-predictive models with 13 single-trial functional MRI datasets (n = 404, discovery set) and quantified voxel-level importance for individualized pain prediction. With 21 regions identified as important pain predictors, we examined the interindividual variability of local pain-predictive weights in these regions. Higher-order transmodal regions, such as ventromedial and ventrolateral prefrontal cortices, showed larger individual variability, whereas unimodal regions, such as somatomotor cortices, showed more stable pain representations across individuals. We replicated this result in an independent dataset (n = 124). Overall, our study identifies cerebral sources of individual differences in pain processing, providing potential targets for personalized assessment and treatment of pain.
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Affiliation(s)
- Lada Kohoutová
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Jason T Buhle
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Stephan Geuter
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Marieke Jepma
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Leonie Koban
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM, CNRS, Sorbonne University, Paris, France
| | - Anjali Krishnan
- Department of Psychology, Brooklyn College of the City University of New York, New York, NY, USA
| | - Dong Hee Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Sungwoo Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Mathieu Roy
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Scott M Schafer
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Liane Schmidt
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM, CNRS, Sorbonne University, Paris, France
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea.
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea.
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13
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Basedau H, Peng KP, May A, Mehnert J. High-Density Electroencephalography-Informed Multiband Functional Magnetic Resonance Imaging Reveals Rhythm-Specific Activations Within the Trigeminal Nociceptive Network. Front Neurosci 2022; 16:802239. [PMID: 35651631 PMCID: PMC9149083 DOI: 10.3389/fnins.2022.802239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
The interest in exploring trigeminal pain processing has grown in recent years, mainly due to various pathologies (such as migraine) related to this system. However, research efforts have mainly focused on understanding molecular mechanisms or studying pathological states. On the contrary, non-invasive imaging studies are limited by either spatial or temporal resolution depending on the modality used. This can be overcome by using multimodal imaging techniques such as simultaneous functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). Although this technique has already been applied to neuroscientific research areas and consequently gained insights into diverse sensory systems and pathologies, only a few studies have applied EEG-fMRI in the field of pain processing and none in the trigeminal system. Focusing on trigeminal nociception, we used a trigeminal pain paradigm, which has been well-studied in either modality. For validation, we first acquired stand-alone measures with each imaging modality before fusing them in a simultaneous session. Furthermore, we introduced a new, yet simple, non-parametric correlation technique, which exploits trial-to-trial variance of both measurement techniques with Spearman’s correlations, to consolidate the results gained by the two modalities. This new technique does not presume a linear relationship and needs a few repetitions per subject. We also showed cross-validation by analyzing visual stimulations. Using these techniques, we showed that EEG power changes in the theta-band induced by trigeminal pain correlate with fMRI activation within the brainstem, whereas those of gamma-band oscillations correlate with BOLD signals in higher cortical areas.
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14
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Hamed R, Mizrachi L, Granovsky Y, Issachar G, Yuval-Greenberg S, Bar-Shalita T. Neurofeedback Therapy for Sensory Over-Responsiveness-A Feasibility Study. SENSORS 2022; 22:s22051845. [PMID: 35270991 PMCID: PMC8914621 DOI: 10.3390/s22051845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Background: Difficulty in modulating multisensory input, specifically the sensory over-responsive (SOR) type, is linked to pain hypersensitivity and anxiety, impacting daily function and quality of life in children and adults. Reduced cortical activity recorded under resting state has been reported, suggestive of neuromodulation as a potential therapeutic modality. This feasibility study aimed to explore neurofeedback intervention in SOR. Methods: Healthy women with SOR (n = 10) underwent an experimental feasibility study comprising four measurement time points (T1—baseline; T2—preintervention; T3—postintervention; T4—follow-up). Outcome measures included resting-state EEG recording, in addition to behavioral assessments of life satisfaction, attaining functional goals, pain sensitivity, and anxiety. Intervention targeted the upregulation of alpha oscillatory power over ten sessions. Results: No changes were detected in all measures between T1 and T2. Exploring the changes in brain activity between T2 and T4 revealed power enhancement in delta, theta, beta, and gamma oscillatory bands, detected in the frontal region (p = 0.03−<0.001; Cohen’s d = 0.637−1.126) but not in alpha oscillations. Furthermore, a large effect was found in enhancing life satisfaction and goal attainment (Cohen’s d = 1.18; 1.04, respectively), and reduced pain sensitivity and anxiety trait (Cohen’s d = 0.70). Conclusion: This is the first study demonstrating the feasibility of neurofeedback intervention in SOR.
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Affiliation(s)
- Ruba Hamed
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Limor Mizrachi
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Rambam Health Care Campus, Technion, Haifa 3109601, Israel;
| | - Gil Issachar
- Biomedical Engineering Department, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Shlomit Yuval-Greenberg
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel;
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-525437631
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15
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Risch N, Dubois J, M’bailara K, Cussac I, Etain B, Belzeaux R, Dubertret C, Haffen E, Schwan R, Samalin L, Roux P, Polosan M, Leboyer M, Courtet P, Olié E. Self-Reported Pain and Emotional Reactivity in Bipolar Disorder: A Prospective FACE-BD Study. J Clin Med 2022; 11:jcm11030893. [PMID: 35160345 PMCID: PMC8836480 DOI: 10.3390/jcm11030893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 02/05/2023] Open
Abstract
In patients with bipolar disorder (BD), pain prevalence is close to 30%. It is important to determine whether pain influences BD course and to identify factors associated with pain in BD in order to guide BD management. This naturalistic, prospective study used data on 880 patients with BD from the French FACE-BD cohort who were divided into two groups according to the presence or absence of pain. Multivariate models were used to test whether pain was associated with affective states and personality traits while controlling for confounders. Then, multivariate models were used to test whether pain at baseline predicted global life functioning and depressive symptomatology at one year. At baseline, 22% of patients self-reported pain. The pain was associated with depressive symptomatology, levels of emotional reactivity in a quadratic relationship, and a composite variable of personality traits (affective lability, affective intensity, hostility/anger, and impulsivity). At one year, the pain was predictive of depression and lower global life functioning. Pain worsens mental health and well-being in patients with BD. The role of emotions, depression, and personality traits in pain has to be elucidated to better understand the high prevalence of pain in BD and to promote specific therapeutic strategies for patients experiencing pain.
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Affiliation(s)
- Nathan Risch
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
- Clinique de la Lironde, Clinea Psychiatrie, 34980 Saint-Clément-de-Rivière, France
- Correspondence: ; Tel.: +33-46-733-8581
| | - Jonathan Dubois
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
| | - Katia M’bailara
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- LabPsy, University of Bordeaux, EA 4139, F-33000 Bordeaux, France
- Department of Clinical and Academic Psychiatry, Charles-Perrens Hospital, 33076 Bordeaux, France
| | - Irena Cussac
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Psychiatric Center, Hospital Princesse Grace, 1 Ave. Pasteur, 98000 Monaco, Monaco
| | - Bruno Etain
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Fernand Widal, 75010 Paris, France
- INSERM UMRS 1144-Université de Paris, 75006 Paris, France
| | - Raoul Belzeaux
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
- INT-UMR 7289, CNRS Aix-Marseille Université, 13385 Marseille, France
| | - Caroline Dubertret
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Department of Psychiatry, University of Paris, AP-HP, Louis Mourier Hospital, INSERM UMR 1266 Paris, 92700 Colombes, France
| | - Emmanuel Haffen
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Service de Psychiatrie de l’Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, UBFC, 25000 Besançon, France
| | - Raymund Schwan
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Université de Lorraine, Centre Psychothérapique de Nancy, Pôle Hospitalo-Universitaire de Psychiatrie d’Adultes du Grand Nancy, INSERM U1254, 54000 Nancy, France
| | - Ludovic Samalin
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, UMR 6602 Institut Pascal (IP), 63178 Clermont-Ferrand, France
| | - Paul Roux
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Centre Hospitalier de Versailles, Service de Psychiatrie et D’addictologie Adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France and Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe “PsyDev”, 94807 Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Université Grenoble Alpes, Inserm U1216, Grenoble Institut de Neurosciences, CHU de Grenoble, F-38000 Grenoble, France
| | - Marion Leboyer
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires «H. Mondor», DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Philippe Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
| | - Emilie Olié
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
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16
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Chen ZS. Decoding pain from brain activity. J Neural Eng 2021; 18. [PMID: 34608868 DOI: 10.1088/1741-2552/ac28d4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/21/2021] [Indexed: 11/12/2022]
Abstract
Pain is a dynamic, complex and multidimensional experience. The identification of pain from brain activity as neural readout may effectively provide a neural code for pain, and further provide useful information for pain diagnosis and treatment. Advances in neuroimaging and large-scale electrophysiology have enabled us to examine neural activity with improved spatial and temporal resolution, providing opportunities to decode pain in humans and freely behaving animals. This topical review provides a systematical overview of state-of-the-art methods for decoding pain from brain signals, with special emphasis on electrophysiological and neuroimaging modalities. We show how pain decoding analyses can help pain diagnosis and discovery of neurobiomarkers for chronic pain. Finally, we discuss the challenges in the research field and point to several important future research directions.
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Affiliation(s)
- Zhe Sage Chen
- Department of Psychiatry, Department of Neuroscience and Physiology, Neuroscience Institute, Interdisciplinary Pain Research Program, New York University Grossman School of Medicine, New York, NY 10016, United States of America
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17
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Jo HG, Wudarczyk O, Leclerc M, Regenbogen C, Lampert A, Rothermel M, Habel U. Effect of odor pleasantness on heat-induced pain: An fMRI study. Brain Imaging Behav 2021; 15:1300-1312. [PMID: 32770446 DOI: 10.1007/s11682-020-00328-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Odor modulates the experience of pain, but the neural basis of how the two sensory modalities, olfaction and pain, are linked in the central nervous system is far from clear. In this study, we investigated the mechanisms by which the brain modulates the pain experience under concurrent odorant stimulation. We conducted an fMRI study using a 2 × 3 factorial design, in which one of two temperatures (warm, hot) and one of three types of odors (pleasant, unpleasant, no odor) were presented simultaneously. "Hot" temperatures were individually determined as those perceived as painful (mean temperature = 46.9 °C). The non-painful "warm" temperature was set to 40 °C. Participants rated hot compared to warm stimuli as more intense and unpleasant, especially in the presence of an unpleasant odor. Parametric modeling on the intensity ratings activated the pain network, covering brain regions activated by the hot stimuli. The presence of an odor, irrespective of its valence, activated the amygdalae. In addition, the amygdalae showed stimulus-dependent functional couplings with the right supramarginal gyrus and with the left superior frontal gyrus. The coupling between the right amygdala and the left superior frontal gyrus was related to the intensity and unpleasantness ratings of the pain experience. Our results suggest that these functional connections may reflect the integrating process of the two sensory modalities, enabling olfactory influence on the pain experience.
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Affiliation(s)
- Han-Gue Jo
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany. .,JARA-Institute Brain Structure Function Relationship (INM-10), Research Center Jülich and RWTH Aachen University, Jülich, Germany. .,School of Computer, Information and Communication Engineering, Kunsan National University, Gunsan, South Korea.
| | - Olga Wudarczyk
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,Cluster of Excellence Science of Intelligence, Technische Universität Berlin and Humboldt Universität zu Berlin, 10587, Berlin, Germany
| | - Marcel Leclerc
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Christina Regenbogen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.,JARA-Institute Brain Structure Function Relationship (INM-10), Research Center Jülich and RWTH Aachen University, Jülich, Germany.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Angelika Lampert
- Institute of Physiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Markus Rothermel
- Department of Chemosensation, AG Neuromodulation, Institute for Biology II, RWTH Aachen University, Aachen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.,JARA-Institute Brain Structure Function Relationship (INM-10), Research Center Jülich and RWTH Aachen University, Jülich, Germany
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18
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Fitri SYR, Nasution SK, Nurhidayah I, Maryam NNA. Massage therapy as a non-pharmacological analgesia for procedural pain in neonates: A scoping review. Complement Ther Med 2021; 59:102735. [PMID: 33974990 DOI: 10.1016/j.ctim.2021.102735] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/11/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Neonates who undergo painful medical procedures should be given analgesics to reduce future adverse risks. The evidence for massage therapy (MT) as an analgesic method still varies, both in its terminology and implementation. Only a few studies on this topic have been conducted using a standardised trial approach. This review can thus become the basis for better future research. OBJECTIVE This review aims to identify literature on MT practices as a method to manage or control pain in neonates undergoing painful procedures. METHODS The methodology for this review followed the JBI scoping review methodology guidelines. Searches were performed in several databases: MEDLINE (PubMed), CINAHL (EBSCO), Scopus (Elsevier) and EMBASE. Data collected were then extracted by two independent reviewers, synthesised and presented in the form of tables and narratives. RESULTS Fifteen studies involving a total of 1,058 neonates in nine countries were identified in the search as meeting the criteria set for this review. One study was a comparative study, five were quasi-experiment studies and nine were randomised control trials (RCT). CONCLUSION The implementation of massage as a non-pharmacological analgesic method for neonates undergoing painful procedures varied among the reviewed studies. Differences were identified in terms of the body part massaged, the duration and intensity of the massage, the level of pressure and the combination of massage with other methods. All studies presented positive results for reducing pain intensity in neonates undergoing procedural pain. Therefore, it is crucial that the method used for giving massage should be practical, accurate and safe.
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Affiliation(s)
| | | | - Ikeu Nurhidayah
- Faculty of Nursing, Universitas Padjadjaran Bandung, Indonesia
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19
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Lee JJ, Kim HJ, Čeko M, Park BY, Lee SA, Park H, Roy M, Kim SG, Wager TD, Woo CW. A neuroimaging biomarker for sustained experimental and clinical pain. Nat Med 2021; 27:174-182. [PMID: 33398159 DOI: 10.1038/s41591-020-1142-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022]
Abstract
Sustained pain is a major characteristic of clinical pain disorders, but it is difficult to assess in isolation from co-occurring cognitive and emotional features in patients. In this study, we developed a functional magnetic resonance imaging signature based on whole-brain functional connectivity that tracks experimentally induced tonic pain intensity and tested its sensitivity, specificity and generalizability to clinical pain across six studies (total n = 334). The signature displayed high sensitivity and specificity to tonic pain across three independent studies of orofacial tonic pain and aversive taste. It also predicted clinical pain severity and classified patients versus controls in two independent studies of clinical low back pain. Tonic and clinical pain showed similar network-level representations, particularly in somatomotor, frontoparietal and dorsal attention networks. These patterns were distinct from representations of experimental phasic pain. This study identified a brain biomarker for sustained pain with high potential for clinical translation.
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Affiliation(s)
- Jae-Joong Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Hong Ji Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Marta Čeko
- Institute of Cognitive Science, University of Colorado, Boulder CO, USA.,Department of Psychology and Neuroscience, University of Colorado, Boulder CO, USA
| | - Bo-Yong Park
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.,McConnell Brain Imaging Centre, Montreal Neurological institute and Hospital, McGill University, Montreal, QC, Canada
| | - Soo Ahn Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.,School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Mathieu Roy
- Department of Psychology, McGill University, Montreal, QC, Canada.,Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover NH, USA.
| | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea. .,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea. .,Biomedical Institute for Convergence at SKKU, Sungkyunkwan University, Suwon, South Korea. .,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea.
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20
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Sun G, Wen Z, Ok D, Doan L, Wang J, Chen ZS. Detecting acute pain signals from human EEG. J Neurosci Methods 2021; 347:108964. [PMID: 33010301 PMCID: PMC7744433 DOI: 10.1016/j.jneumeth.2020.108964] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Advances in human neuroimaging has enabled us to study functional connections among various brain regions in pain states. Despite a wealth of studies at high anatomic resolution, the exact neural signals for the timing of pain remain little known. Identifying the onset of pain signals from distributed cortical circuits may reveal the temporal dynamics of pain responses and subsequently provide important feedback for closed-loop neuromodulation for pain. NEW METHOD Here we developed an unsupervised learning method for sequential detection of acute pain signals based on multichannel human EEG recordings. Following EEG source localization, we used a state-space model (SSM) to detect the onset of acute pain signals based on the localized regions of interest (ROIs). RESULTS We validated the SSM-based detection strategy using two human EEG datasets, including one public EEG recordings of 50 subjects. We found that the detection accuracy varied across tested subjects and detection methods. We also demonstrated the feasibility for cross-subject and cross-modality prediction of detecting the acute pain signals. COMPARISON WITH EXISTING METHODS In contrast to the batch supervised learning analysis based on a support vector machine (SVM) classifier, the unsupervised learning method requires fewer number of training trials in the online experiment, and shows comparable or improved performance than the supervised method. CONCLUSIONS Our unsupervised SSM-based method combined with EEG source localization showed robust performance in detecting the onset of acute pain signals.
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Affiliation(s)
- Guanghao Sun
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
| | - Zhenfu Wen
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
| | - Deborah Ok
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University School of Medicine, New York, NY, United States
| | - Lisa Doan
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University School of Medicine, New York, NY, United States
| | - Jing Wang
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University School of Medicine, New York, NY, United States; Department of Neuroscience and Physiology, New York University School of Medicine, New York, NY, United States; The Neuroscience Institute, New York University School of Medicine, New York, NY, United States.
| | - Zhe Sage Chen
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States; Department of Neuroscience and Physiology, New York University School of Medicine, New York, NY, United States; The Neuroscience Institute, New York University School of Medicine, New York, NY, United States.
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21
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Hsiao FJ, Chen WT, Liu HY, Wang YF, Chen SP, Lai KL, Pan LLH, Wang SJ. Individual pain sensitivity is associated with resting-state cortical activities in healthy individuals but not in patients with migraine: a magnetoencephalography study. J Headache Pain 2020; 21:133. [PMID: 33198621 PMCID: PMC7670775 DOI: 10.1186/s10194-020-01200-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022] Open
Abstract
Background Pain sensitivity may determine the risk, severity, prognosis, and efficacy of treatment of clinical pain. Magnetic resonance imaging studies have linked thermal pain sensitivity to changes in brain structure. However, the neural correlates of mechanical pain sensitivity remain to be clarified through investigation of direct neural activities on the resting-state cortical oscillation and synchrony. Methods We recorded the resting-state magnetoencephalographic (MEG) activities of 27 healthy individuals and 30 patients with episodic migraine (EM) and analyzed the source-based oscillatory powers and functional connectivity at 2 to 59 Hz in pain-related cortical regions, which are the bilateral anterior cingulate cortex (ACC), medial orbitofrontal (MOF) cortex, lateral orbitofrontal (LOF) cortex, insula cortex, primary somatosensory cortex (SI), primary motor cortex (MI), and posterior cingulate cortex (PCC). The mechanical punctate pain threshold (MPPT) was obtained at the supraorbital area (the first branch of the trigeminal nerve dermatome, V1) and the forearm (the first thoracic nerve dermatome, T1) and further correlated with MEG measures. Results The MPPT is inversely correlated with the resting-state relative powers of gamma oscillation in healthy individuals (all corrected P < 0.05). Specifically, inverse correlation was noted between the MPPT at V1 and gamma powers in the bilateral insula (r = − 0.592 [left] and − 0.529 [right]), PCC (r = − 0.619 and − 0.541) and MI (r = − 0.497 and − 0.549) and between the MPPT at T1 and powers in the left PCC (r = − 0.561) and bilateral MI (r = − 0.509 and − 0.520). Furthermore, resting-state functional connectivity at the delta to beta bands, especially between frontal (MOF, ACC, LOF, and MI), parietal (PCC), and sensorimotor (bilateral SI and MI) regions, showed a positive correlation with the MPPT at V1 and T1 (all corrected P < 0.05). By contrast, in patients with EM, the MPPT was not associated with resting-state cortical activities. Conclusions Pain sensitivity in healthy individuals is associated with the resting-state gamma oscillation and functional connectivity in pain-related cortical regions. Further studies must be conducted in a large population to confirm whether resting-state cortical activities can be an objective measurement of pain sensitivity in individuals without clinical pain. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-020-01200-8.
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Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
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22
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Park BY, Lee JJ, Kim HJ, Woo CW, Park H. A neuroimaging marker for predicting longitudinal changes in pain intensity of subacute back pain based on large-scale brain network interactions. Sci Rep 2020; 10:17392. [PMID: 33060726 PMCID: PMC7567066 DOI: 10.1038/s41598-020-74217-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022] Open
Abstract
Identification of predictive neuroimaging markers of pain intensity changes is a crucial issue to better understand macroscopic neural mechanisms of pain. Although a single connection between the medial prefrontal cortex and nucleus accumbens has been suggested as a powerful marker, how the complex interactions on a large-scale brain network can serve as the markers is underexplored. Here, we aimed to identify a set of functional connections predictive of longitudinal changes in pain intensity using large-scale brain networks. We re-analyzed previously published resting-state functional magnetic resonance imaging data of 49 subacute back pain (SBP) patients. We built a network-level model that predicts changes in pain intensity over one year by combining independent component analysis and a penalized regression framework. Connections involving top-down pain modulation, multisensory integration, and mesocorticolimbic circuits were identified as predictive markers for pain intensity changes. Pearson’s correlations between actual and predicted pain scores were r = 0.33–0.72, and group classification results between SBP patients with persisting pain and recovering patients, in terms of area under the curve (AUC), were 0.89/0.75/0.75 for visits four/three/two, thus outperforming the previous work (AUC 0.83/0.73/0.67). This study identified functional connections important for longitudinal changes in pain intensity in SBP patients, providing provisional markers to predict future pain using large-scale brain networks.
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Affiliation(s)
- Bo-Yong Park
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jae-Joong Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Hong Ji Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea. .,School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, South Korea.
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23
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Assayag N, Bonneh Y, Parush S, Mell H, Kaplan Neeman R, Bar-Shalita T. Perceived Sensitivity to Pain and Responsiveness to Non-noxious Sensation in Substance Use Disorder. PAIN MEDICINE 2020; 21:1902-1912. [PMID: 31782772 DOI: 10.1093/pm/pnz292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD. METHODS Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)-Revised. RESULTS The SUD group scored higher on the PSQ (P < 0.0001), BAS-R aversiveness (P < 0.0001), BAS-R-unpleasantness (P < 0.0001), and on the aftersensation of auditory aversiveness (P < 0.0001) and unpleasantness (P < 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P < 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ. CONCLUSIONS This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.
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Affiliation(s)
- Naama Assayag
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Yoram Bonneh
- School of Optometry and Vision Science, Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Shula Parush
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Haim Mell
- Yezreel Valley College, Afula, Israel
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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24
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Modified Sensory Stimulation Using Breastmilk for Reducing Pain Intensity in Neonates in Indonesia: A Randomized Controlled Trial. J Pediatr Nurs 2020; 53:e199-e203. [PMID: 32402558 DOI: 10.1016/j.pedn.2020.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Several studies have shown that oral sucrose reduces pain in newborns. However, sucrose has no efficacy in eliminating pain and long-term effects remain unclear. Breast milk may be useful as an alternative, safe sweet solution. Sensorial saturation (SS) is a multisensory analgesic non-pharmacological treatment, which includes touch and sounds as distractors. This study aimed to compare the analgesic effects of SS with sucrose (SSS), SS with breast milk (SSB), and oral sucrose alone (S24%) in neonates undergoing venipuncture. DESIGN AND METHODS This was a randomized controlled trial conducted on 108 neonates who underwent venipuncture at neonatology wards. All babies were randomly assigned to one of three groups: two intervention groups and one control group. Pain response was assessed using the premature infant pain profile-revised (PIPP-R). Data analysis was conducted using the Kruskal-Wallis test and Mann-Whitney U test. RESULTS SSB and SSS were more effective than S24% (p = 0.001). No difference was observed between SSB and SSS (p = 0.669). CONCLUSION Multisensory stimulation is more effective in reducing pain than unimodal (oral sucrose) analgesia. Breast milk can be used as a sensory gustatory stimulus in multisensory stimulation to reduce pain intensity in neonates, and demonstrates a similar analgesic effect to sucrose. PRACTICE IMPLICATIONS The study findings suggest that neonatal nurses could use SSB for management of pain. This intervention could serve as an effective, inexpensive, and safe non-pharmacological analgesic. Additional testing of this intervention is warranted to support its use as an evidence-based pain reduction approach.
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25
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Bar-Shalita T, Granovsky Y, Parush S, Weissman-Fogel I. Sensory Modulation Disorder (SMD) and Pain: A New Perspective. Front Integr Neurosci 2019; 13:27. [PMID: 31379526 PMCID: PMC6659392 DOI: 10.3389/fnint.2019.00027] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/01/2019] [Indexed: 01/17/2023] Open
Abstract
Sensory modulation disorder (SMD) affects sensory processing across single or multiple sensory systems. The sensory over-responsivity (SOR) subtype of SMD is manifested clinically as a condition in which non-painful stimuli are perceived as abnormally irritating, unpleasant, or even painful. Moreover, SOR interferes with participation in daily routines and activities (Dunn, 2007; Bar-Shalita et al., 2008; Chien et al., 2016), co-occurs with daily pain hyper-sensitivity, and reduces quality of life due to bodily pain. Laboratory behavioral studies have confirmed abnormal pain perception, as demonstrated by hyperalgesia and an enhanced lingering painful sensation, in children and adults with SMD. Advanced quantitative sensory testing (QST) has revealed the mechanisms of altered pain processing in SOR whereby despite the existence of normal peripheral sensory processing, there is enhanced facilitation of pain-transmitting pathways along with preserved but delayed inhibitory pain modulation. These findings point to central nervous system (CNS) involvement as the underlying mechanism of pain hypersensitivity in SOR. Based on the mutual central processing of both non-painful and painful sensory stimuli, we suggest shared mechanisms such as cortical hyper-excitation, an excitatory-inhibitory neuronal imbalance, and sensory modulation alterations. This is supported by novel findings indicating that SOR is a risk factor and comorbidity of chronic non-neuropathic pain disorders. This is the first review to summarize current empirical knowledge investigating SMD and pain, a sensory modality not yet part of the official SMD realm. We propose a neurophysiological mechanism-based model for the interrelation between pain and SMD. Embracing the pain domain could significantly contribute to the understanding of this condition’s pathogenesis and how it manifests in daily life, as well as suggesting the basis for future potential mechanism-based therapies.
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Affiliation(s)
- Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Health Care Campus, Haifa, Israel
| | - Shula Parush
- School of Occupational Therapy, Faculty of Medicine of Hadassah, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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26
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Vittersø AD, Halicka M, Buckingham G, Proulx MJ, Bultitude JH. Experimentally induced pain does not influence updating of peripersonal space and body representations following tool-use. PLoS One 2019; 14:e0210045. [PMID: 31095562 PMCID: PMC6522125 DOI: 10.1371/journal.pone.0210045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/07/2019] [Indexed: 12/16/2022] Open
Abstract
Representations of the body and peripersonal space can be distorted for people with some chronic pain conditions. Experimental pain induction can give rise to similar, but transient distortions in healthy individuals. However, spatial and bodily representations are dynamic, and constantly update as we interact with objects in our environment. It is unclear whether induced pain disrupts the mechanisms involved in updating these representations. In the present study, we sought to investigate the effect of induced pain on the updating of peripersonal space and body representations during and following tool-use. We compared performance under three conditions (pain, active placebo, neutral) on a visuotactile crossmodal congruency task and a tactile distance judgement task to measure updating of peripersonal space and body representations, respectively. Consistent with previous findings, the difference in crossmodal interference from visual distractors in the same compared to opposite visual field to the tactile target was less when tools were crossed than uncrossed. This suggests an extension of peripersonal space to incorporate the tips of the tools. Also consistent with previous findings, estimates of the felt tactile distance judgements decreased after active tool-use. In contrast to our predictions, however, we found no evidence that pain interfered with performance on either task when compared to the control conditions. Our findings suggest that the updating of peripersonal space and body representations is not disrupted by induced pain. That is, experiencing acute pain does not give rise to distorted representations of the body and peripersonal space that can be present in people with chronic pain conditions.
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Affiliation(s)
- Axel D Vittersø
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom.,Department of Psychology, University of Bath, Bath, Somerset, United Kingdom.,Department of Sport & Health Sciences, University of Exeter, Exeter, Devon, United Kingdom
| | - Monika Halicka
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom.,Department of Psychology, University of Bath, Bath, Somerset, United Kingdom
| | - Gavin Buckingham
- Department of Sport & Health Sciences, University of Exeter, Exeter, Devon, United Kingdom
| | - Michael J Proulx
- Department of Psychology, University of Bath, Bath, Somerset, United Kingdom.,Centre for Real and Virtual Environments Augmentation Labs, Department of Computer Science, University of Bath, Bath, Somerset, United Kingdom
| | - Janet H Bultitude
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom.,Department of Psychology, University of Bath, Bath, Somerset, United Kingdom
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27
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Shen W, Tu Y, Gollub RL, Ortiz A, Napadow V, Yu S, Wilson G, Park J, Lang C, Jung M, Gerber J, Mawla I, Chan ST, Wasan AD, Edwards RR, Kaptchuk T, Li S, Rosen B, Kong J. Visual network alterations in brain functional connectivity in chronic low back pain: A resting state functional connectivity and machine learning study. NEUROIMAGE-CLINICAL 2019; 22:101775. [PMID: 30927604 PMCID: PMC6444301 DOI: 10.1016/j.nicl.2019.101775] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/22/2019] [Accepted: 03/10/2019] [Indexed: 01/04/2023]
Abstract
Chronic low back pain (cLBP) is associated with widespread functional and structural changes in the brain. This study aims to investigate the resting state functional connectivity (rsFC) changes of visual networks in cLBP patients and the feasibility of distinguishing cLBP patients from healthy controls using machine learning methods. cLBP (n = 90) and control individuals (n = 74) were enrolled and underwent resting-state BOLD fMRI scans. Primary, dorsal, and ventral visual networks derived from independent component analysis were used as regions of interest to compare resting state functional connectivity changes between the cLBP patients and healthy controls. We then applied a support vector machine classifier to distinguish the cLBP patients and control individuals. These results were further verified in a new cohort of subjects. We found that the functional connectivity between the primary visual network and the somatosensory/motor areas were significantly enhanced in cLBP patients. The rsFC between the primary visual network and S1 was negatively associated with duration of cLBP. In addition, we found that the rsFC of the visual network could achieve a classification accuracy of 79.3% in distinguishing cLBP patients from HCs, and these results were further validated in an independent cohort of subjects (accuracy = 66.7%). Our results demonstrate significant changes in the rsFC of the visual networks in cLBP patients. We speculate these alterations may represent an adaptation/self-adjustment mechanism and cross-model interaction between the visual, somatosensory, motor, attention, and salient networks in response to cLBP. Elucidating the role of the visual networks in cLBP may shed light on the pathophysiology and development of the disorder. We investigated rsFC changes of visual networks in cLBP patients. rsFC of the primary visual network with S1 and M1 increased in cLBP patients. rsFC of the visual networks can differentiate cLBP patients from controls (with 79.3% accuracy). Classification results can be validated in an independent cohort (with 66.7% accuracy).
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Affiliation(s)
- Wei Shen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; First Affiliated Hospital of Hainan Medical College, Hainan Medical University, Haikou, Hainan, China
| | - Yiheng Tu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Randy L Gollub
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ana Ortiz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Vitaly Napadow
- Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Siyi Yu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Georgia Wilson
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joel Park
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Courtney Lang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Minyoung Jung
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessica Gerber
- Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ishtiaq Mawla
- Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Suk-Tak Chan
- Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ajay D Wasan
- Department of Anesthesiology, Center for Pain Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ted Kaptchuk
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shasha Li
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bruce Rosen
- Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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28
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Bauer A, Hagenburger J, Plank T, Busch V, Greenlee MW. Mechanical Pain Thresholds and the Rubber Hand Illusion. Front Psychol 2018; 9:712. [PMID: 29867677 PMCID: PMC5962648 DOI: 10.3389/fpsyg.2018.00712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 04/23/2018] [Indexed: 02/03/2023] Open
Abstract
We manipulated the sense of body ownership with the rubber hand illusion (RHI) to determine if perception of a potentially painful threat to the rubber hand can modify the mechanical pain threshold (MPT). Simultaneous tactile stimulation of the subject’s concealed hand and the appropriately positioned visible rubber hand generated the illusion of false body ownership. The MPT was recorded on the left hand of the subjects before and after induction of the RHI, as well as during the phase in which the model hand was pricked with a sharp knife or touched by the blunt knife handle. The results indicate that the RHI could be successfully generated with our set-up. Mechanical stimuli were perceived as more painful in the condition where the rubber hand was simultaneously pricked with a knife. Our findings suggest that the illusion of body ownership gates nociceptive processing of potentially painful stimuli.
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Affiliation(s)
- Anna Bauer
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Julia Hagenburger
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Tina Plank
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Volker Busch
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Mark W Greenlee
- Institute of Psychology, University of Regensburg, Regensburg, Germany
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29
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30
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Brain Oscillations Elicited by the Cold Pressor Test: A Putative Index of Untreated Essential Hypertension. Int J Hypertens 2017; 2017:7247514. [PMID: 28573048 PMCID: PMC5440798 DOI: 10.1155/2017/7247514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 04/10/2017] [Indexed: 11/23/2022] Open
Abstract
Objective Essential hypertension is associated with reduced pain sensitivity of unclear aetiology. This study explores this issue using the Cold Pressor Test (CPT), a reliable pain/stress model, comparing CPT-related EEG activity in first episode hypertensives and controls. Method 22 untreated hypertensives and 18 matched normotensives underwent 24-hour ambulatory blood pressure monitoring (ABPM). EEG recordings were taken before, during, and after CPT exposure. Results Significant group differences in CPT-induced EEG oscillations were covaried with the most robust cardiovascular differentiators by means of a Canonical Analysis. Positive correlations were noted between ABPM variables and Delta (1–4 Hz) oscillations during the tolerance phase; in high-alpha (10–12 Hz) oscillations during the stress unit and posttest phase; and in low-alpha (8–10 Hz) oscillations during CPT phases overall. Negative correlations were found between ABPM variables and Beta2 oscillations (16.5–20 Hz) during the posttest phase and Gamma (28.5–45 Hz) oscillations during the CPT phases overall. These relationships were localised at several sites across the cerebral hemispheres with predominance in the right hemisphere and left frontal lobe. Conclusions These findings provide a starting point for increasing our understanding of the complex relationships between cerebral activation and cardiovascular functioning involved in regulating blood pressure changes.
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31
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Orenius TI, Raij TT, Nuortimo A, Näätänen P, Lipsanen J, Karlsson H. The interaction of emotion and pain in the insula and secondary somatosensory cortex. Neuroscience 2017; 349:185-194. [PMID: 28259800 DOI: 10.1016/j.neuroscience.2017.02.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/21/2017] [Indexed: 11/24/2022]
Abstract
Pain is processed in a large neural network that partially overlaps structures involved in emotion processing. Despite the fact that pain and emotion are known to share neural regions and interact in numerous clinical conditions, relatively little is known about the interaction of pain and emotion at the neural level. This study on healthy adults aimed to investigate the interaction between negative and positive emotional stimuli and experimental pain in an essential pain processing network. Sixteen healthy young adult subjects were exposed to pictures from the International Affective Picture System (IAPS) with negative, neutral or positive valence, along with laser pain stimuli. The stimuli were pseudo-randomly arranged in three 15-min experiment series comprising 49 stimuli each (picture, laser or simultaneous picture and laser stimuli). The whole-brain blood-oxygen-level-dependent (BOLD) signal was acquired using 3T functional magnetic resonance imaging (fMRI). As expected, the pain stimulus elicited activation in the secondary somatosensory cortex (SII), insula and anterior cingulate cortex (ACC) when compared to the baseline. The interaction of negative emotion and laser stimuli related to the activation of the left SII. The interaction of positive emotion and pain stimuli led to bilateral activation of the SII and left insula. These findings reveal interaction in parts of the pain processing network during simultaneous emotion and physical pain. We demonstrated a valence-independent interaction of emotion and pain in SII.
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Affiliation(s)
- Tage I Orenius
- ORTON Orthopaedic Hospital Ltd., ORTON Foundation, Helsinki, Finland.
| | - Tuukka T Raij
- Department of Psychiatry, Helsinki University Hospital, Finland; Department of Neuroscience and Biomedical Engineering and Advanced Magnetic Imaging Centre, Aalto Neuroimaging, Aalto University School of Science, Espoo, Finland.
| | - Antti Nuortimo
- Institute of Behavioural Sciences, University of Helsinki, Finland.
| | | | - Jari Lipsanen
- Institute of Behavioural Sciences, University of Helsinki, Finland.
| | - Hasse Karlsson
- Department of Psychiatry and Turku Brain and Mind Centre, University of Turku and Turku University Hospital, Finland.
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Claassen J, Labrenz F, Ernst T, Icenhour A, Langhorst J, Forsting M, Timmann D, Elsenbruch S. Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome. THE CEREBELLUM 2016; 16:508-517. [DOI: 10.1007/s12311-016-0832-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Senkowski D, Heinz A. Chronic pain and distorted body image: Implications for multisensory feedback interventions. Neurosci Biobehav Rev 2016; 69:252-9. [DOI: 10.1016/j.neubiorev.2016.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 08/01/2016] [Accepted: 08/06/2016] [Indexed: 12/14/2022]
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Rusanescu G, Mao J. Peripheral nerve injury induces adult brain neurogenesis and remodelling. J Cell Mol Med 2016; 21:299-314. [PMID: 27665307 PMCID: PMC5264155 DOI: 10.1111/jcmm.12965] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023] Open
Abstract
Unilateral peripheral nerve chronic constriction injury (CCI) has been widely used as a research model of human neuropathic pain. Recently, CCI has been shown to induce spinal cord adult neurogenesis, which may contribute to the chronic increase in nociceptive sensitivity. Here, we show that CCI also induces rapid and profound asymmetrical anatomical rearrangements in the adult rodent cerebellum and pons. This remodelling occurs throughout the hindbrain, and in addition to regions involved in pain processing, also affects other sensory modalities. We demonstrate that these anatomical changes, partially reversible in the long term, result from adult neurogenesis. Neurogenic markers Mash1, Ngn2, doublecortin and Notch3 are widely expressed in the rodent cerebellum and pons, both under normal and injured conditions. CCI-induced hindbrain structural plasticity is absent in Notch3 knockout mice, a strain with impaired neuronal differentiation, demonstrating its dependence on adult neurogenesis. Grey matter and white matter structural changes in human brain, as a result of pain, injury or learned behaviours have been previously detected using non-invasive neuroimaging techniques. Because neurogenesis-mediated structural plasticity is thought to be restricted to the hippocampus and the subventricular zone, such anatomical rearrangements in other parts of the brain have been thought to result from neuronal plasticity or glial hypertrophy. Our findings suggest the presence of extensive neurogenesis-based structural plasticity in the adult mammalian brain, which may maintain a memory of basal sensory levels, and act as an adaptive mechanism to changes in sensory inputs.
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Affiliation(s)
- Gabriel Rusanescu
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jianren Mao
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Pamment J, Aspell J. Putting pain out of mind with an ‘out of body’ illusion. Eur J Pain 2016; 21:334-342. [DOI: 10.1002/ejp.927] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2016] [Indexed: 12/21/2022]
Affiliation(s)
- J. Pamment
- Department of Psychology; Anglia Ruskin University; Cambridge UK
| | - J.E. Aspell
- Department of Psychology; Anglia Ruskin University; Cambridge UK
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Gopalakrishnan R, Burgess RC, Lempka SF, Gale JT, Floden DP, Machado AG. Pain anticipatory phenomena in patients with central poststroke pain: a magnetoencephalography study. J Neurophysiol 2016; 116:1387-95. [PMID: 27358316 DOI: 10.1152/jn.00215.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/24/2016] [Indexed: 11/22/2022] Open
Abstract
Central poststroke pain (CPSP) is characterized by hemianesthesia associated with unrelenting chronic pain. The final pain experience stems from interactions between sensory, affective, and cognitive components of chronic pain. Hence, managing CPSP will require integrated approaches aimed not only at the sensory but also the affective-cognitive spheres. A better understanding of the brain's processing of pain anticipation is critical for the development of novel therapeutic approaches that target affective-cognitive networks and alleviate pain-related disability. We used magnetoencephalography (MEG) to characterize the neural substrates of pain anticipation in patients suffering from intractable CPSP. Simple visual cues evoked anticipation while patients awaited impending painful (PS), nonpainful (NPS), or no stimulus (NOS) to their nonaffected and affected extremities. MEG responses were studied at gradiometer level using event-related fields analysis and time-frequency oscillatory analysis upon source localization. On the nonaffected side, significantly greater responses were recorded during PS. PS (vs. NPS and NOS) exhibited significant parietal and frontal cortical activations in the beta and gamma bands, respectively, whereas NPS (vs. NOS) displayed greater activation in the orbitofrontal cortex. On the affected extremity, PS (vs. NPS) did not show significantly greater responses. These data suggest that anticipatory phenomena can modulate neural activity when painful stimuli are applied to the nonaffected extremity but not the affected extremity in CPSP patients. This dichotomy may stem from the chronic effects of pain on neural networks leading to habituation or saturation. Future clinically effective therapies will likely be associated with partial normalization of the neurophysiological correlates of pain anticipation.
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Affiliation(s)
- Raghavan Gopalakrishnan
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Richard C Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Scott F Lempka
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio; and
| | - John T Gale
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Department of Neuroscience, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Darlene P Floden
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Andre G Machado
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Department of Neuroscience, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Martini M. Real, rubber or virtual: The vision of "one's own" body as a means for pain modulation. A narrative review. Conscious Cogn 2016; 43:143-51. [PMID: 27295559 DOI: 10.1016/j.concog.2016.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/24/2016] [Accepted: 06/03/2016] [Indexed: 12/30/2022]
Abstract
In the last few years a branch of pain research has been focussing on the modulatory effects of the vision of the body on pain perception. So, for instance, the vision of one's own real body has been proven to induce analgesic effects. On the other hand, bodily illusions such as the rubber hand illusion have provided new tools for the study of perceptual processes during altered body ownership states. Recently, new paradigms of body ownership made use of a technology that is going places both in clinical and in experimental settings, i.e. virtual reality. While the vision of one's own real body has been proven to yield compelling analgesic effects, slightly more controversial are those attributed to the vision of "owned" dummy bodies. This review will discuss the studies that examined the effects on pain perception of the vision of the own body, with or without body ownership illusions.
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Affiliation(s)
- Matteo Martini
- School of Psychology, University of East London, Water Lane, London E15 4LZ, UK.
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Jarcho JM, Feier NA, Labus JS, Naliboff B, Smith SR, Hong JY, Colloca L, Tillisch K, Mandelkern MA, Mayer EA, London ED. Placebo analgesia: Self-report measures and preliminary evidence of cortical dopamine release associated with placebo response. NEUROIMAGE-CLINICAL 2015; 10:107-14. [PMID: 26759785 PMCID: PMC4683423 DOI: 10.1016/j.nicl.2015.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/10/2015] [Accepted: 11/12/2015] [Indexed: 11/25/2022]
Abstract
Placebo analgesia is measured by self-report, yet current, expected, and recalled efficacy may be differentially related to brain function. Here we used a human thermal pain model to compare self-reports of expected, concurrent, and recalled efficacy of a topical placebo analgesic, and tested associations of the three measures of efficacy with changes in dopamine D2/D3 receptor availability in brain using [18F]fallypride with positron emission tomography (PET). Participants (15 healthy women) were assessed on three test days. The first test day included a laboratory visit, during which the temperature needed to evoke consistent pain was determined, placebo analgesia was induced via verbal and experience-based expectation, and the placebo response was measured. On two subsequent test days, PET scans were performed in Control and Placebo conditions, respectively, in counterbalanced order. During Visit 1, concurrent and recalled placebo efficacy were unrelated; during the Placebo PET visit, expected and recalled efficacy were highly correlated (ρ = 0.68, p = 0.005), but concurrent efficacy was unrelated to expected or recalled efficacy. Region of interest analysis revealed dopamine D2/D3 receptor availability was lower in left ventrolateral prefrontal cortex in the Placebo condition (p < 0.001, uncorrected), and greater change in this measure was associated with higher levels of recalled analgesic efficacy (ρ = 0.58, p = 0.02). These preliminary findings underscore the need to consider how self-reported symptom improvement is assessed in clinical trials of analgesics and suggest that dopaminergic activity in the ventrolateral prefrontal cortex may promote recalled efficacy of placebo. Healthy women reported on expected, concurrent, and recalled placebo analgesia. Measures were obtained in the lab and during PET scanning with [18F]fallypride. Dopamine D2/D3 receptor availability in PFC was associated with placebo analgesia. This relationship was specific to recalled placebo analgesia efficacy.
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Affiliation(s)
- Johanna M Jarcho
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Psychology, Stony Brook University, NY, USA
| | - Natasha A Feier
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Alan Edwards Centre for Research on Pain, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Jennifer S Labus
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Physiology, UCLA, Los Angeles, CA, United States; Pain and Interoception Network (PAIN), UCLA, Los Angeles, CA, Unit
| | - Bruce Naliboff
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Physiology, UCLA, Los Angeles, CA, United States; Pain and Interoception Network (PAIN), UCLA, Los Angeles, CA, Unit
| | - Suzanne R Smith
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Physiology, UCLA, Los Angeles, CA, United States; Pain and Interoception Network (PAIN), UCLA, Los Angeles, CA, Unit
| | - Jui-Yang Hong
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Physiology, UCLA, Los Angeles, CA, United States; Pain and Interoception Network (PAIN), UCLA, Los Angeles, CA, Unit
| | - Luana Colloca
- School of Nursing, University of Maryland, Baltimore, MD, USA; School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Kirsten Tillisch
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Physiology, UCLA, Los Angeles, CA, United States; Pain and Interoception Network (PAIN), UCLA, Los Angeles, CA, Unit; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | | | - Emeran A Mayer
- Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Physiology, UCLA, Los Angeles, CA, United States; Pain and Interoception Network (PAIN), UCLA, Los Angeles, CA, Unit
| | - Edythe D London
- Department of Physiology, UCLA, Los Angeles, CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Bar-Shalita T, Deutsch L, Honigman L, Weissman-Fogel I. Ecological aspects of pain in sensory modulation disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 45-46:157-167. [PMID: 26254166 DOI: 10.1016/j.ridd.2015.07.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 07/24/2015] [Accepted: 07/28/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Sensory Modulation Disorder (SMD) interferes with the daily life participation of otherwise healthy individuals and is characterized by over-, under- or seeking responsiveness to naturally occurring sensory stimuli. Previous laboratory findings indicate pain hyper-sensitivity in SMD individuals suggesting CNS alteration in pain processing and modulation. However, laboratory studies lack ecological validity, and warrant clinical completion in order to elicit a sound understanding of the phenomenon studied. Thus, this study explored the association between sensory modulation and pain in a daily life context in a general population sample. METHODS Daily life context of pain and sensations were measured in 250 adults (aged 23-40 years; 49.6% males) using 4 self-report questionnaires: Pain Sensitivity Questionnaire (PSQ) and Pain Catastrophizing Scale (PCS) to evaluate the sensory and cognitive aspects of pain; the Sensory Responsiveness Questionnaire (SRQ) to appraise SMD; and the Short Form - 36 Health Survey, version 2 (SF36) to assess health related Quality of Life (QoL). RESULTS Thirty two individuals (12.8%) were found with over-responsiveness type of SMD, forming the SOR-SMD group. While no group differences (SOR-SMD vs. Non-SMD) were found, low-to-moderate total sample correlations were demonstrated between the SRQ-Aversive sub-scale and i) PSQ total (r=0.31, p<0.01) and sub-scales scores (r=0.27-0.28, p<0.01), as well as ii) PCS total and the sub-scales of Rumination and Helplessness scores (r=0.15, p<0.05). PSQ total and sub-scale scores were more highly correlated with SRQ-Aversive in the SOR-SMD group (r=0.57-0.68, p=0.03-<0.01) compared to Non-SMD group. The Physical Health - Total score (but not the Mental Health - Total) of the SF36 was lower for the SOR-SMD group (p=0.03), mainly due to the difference in the Body pain sub-scale (p=0.04). CONCLUSIONS Results suggest that SOR-SMD is strongly associated with the sensory aspect of pain but weakly associated with the cognitive aspect. This indicates that SMD co-occurs with daily pain sensitivity, thus reducing QoL, but less with the cognitive-catastrophizing manifestation of pain perception.
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Affiliation(s)
- T Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - L Deutsch
- BioStats Statistical Consulting Ltd, Modiin, Israel
| | - L Honigman
- The Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion, Haifa, Israel
| | - I Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
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40
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Gopalakrishnan R, Burgess RC, Plow EB, Floden DP, Machado AG. A magnetoencephalography study of multi-modal processing of pain anticipation in primary sensory cortices. Neuroscience 2015. [PMID: 26210576 DOI: 10.1016/j.neuroscience.2015.07.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pain anticipation plays a critical role in pain chronification and results in disability due to pain avoidance. It is important to understand how different sensory modalities (auditory, visual or tactile) may influence pain anticipation as different strategies could be applied to mitigate anticipatory phenomena and chronification. In this study, using a countdown paradigm, we evaluated with magnetoencephalography the neural networks associated with pain anticipation elicited by different sensory modalities in normal volunteers. When encountered with well-established cues that signaled pain, visual and somatosensory cortices engaged the pain neuromatrix areas early during the countdown process, whereas the auditory cortex displayed delayed processing. In addition, during pain anticipation, the visual cortex displayed independent processing capabilities after learning the contextual meaning of cues from associative and limbic areas. Interestingly, cross-modal activation was also evident and strong when visual and tactile cues signaled upcoming pain. Dorsolateral prefrontal cortex and mid-cingulate cortex showed significant activity during pain anticipation regardless of modality. Our results show pain anticipation is processed with great time efficiency by a highly specialized and hierarchical network. The highest degree of higher-order processing is modulated by context (pain) rather than content (modality) and rests within the associative limbic regions, corroborating their intrinsic role in chronification.
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Affiliation(s)
- R Gopalakrishnan
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
| | - R C Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - E B Plow
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
| | - D P Floden
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - A G Machado
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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Couto B, Adolfi F, Sedeño L, Salles A, Canales-Johnson A, Alvarez-Abut P, Garcia-Cordero I, Pietto M, Bekinschtein T, Sigman M, Manes F, Ibanez A. Disentangling interoception: insights from focal strokes affecting the perception of external and internal milieus. Front Psychol 2015; 6:503. [PMID: 25983697 PMCID: PMC4416458 DOI: 10.3389/fpsyg.2015.00503] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 04/08/2015] [Indexed: 12/17/2022] Open
Abstract
Interoception is the moment-to-moment sensing of the physiological condition of the body. The multimodal sources of interoception can be classified into two different streams of afferents: an internal pathway of signals arising from core structures (i.e., heart, blood vessels, and bronchi) and an external pathway of body-mapped sensations (i.e., chemosensation and pain) arising from peripersonal space. This study examines differential processing along these streams within the insular cortex (IC) and their subcortical tracts connecting frontotemporal networks. Two rare patients presenting focal lesions of the IC (insular lesion, IL) or its subcortical tracts (subcortical lesion, SL) were tested. Internally generated interoceptive streams were assessed through a heartbeat detection (HBD) task, while those externally triggered were tapped via taste, smell, and pain recognition tasks. A differential pattern was observed. The IC patient showed impaired internal signal processing while the SL patient exhibited external perception deficits. Such selective deficits remained even when comparing each patient with a group of healthy controls and a group of brain-damaged patients. These outcomes suggest the existence of distinguishable interoceptive streams. Results are discussed in relation with neuroanatomical substrates, involving a fronto-insulo-temporal network for interoceptive and cognitive contextual integration.
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Affiliation(s)
- Blas Couto
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina ; UDP-INECO Foundation Core on Neuroscience, Diego Portales University Santiago, Chile ; National Scientific and Technical Research Council Buenos Aires, Argentina
| | - Federico Adolfi
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina
| | - Lucas Sedeño
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina ; UDP-INECO Foundation Core on Neuroscience, Diego Portales University Santiago, Chile ; National Scientific and Technical Research Council Buenos Aires, Argentina
| | - Alejo Salles
- Physics Department, University of Buenos Aires Buenos Aires, Argentina
| | - Andrés Canales-Johnson
- UDP-INECO Foundation Core on Neuroscience, Diego Portales University Santiago, Chile ; Medical Research Council-Cognition and Brain Sciences Unit Cambridge, UK
| | - Pablo Alvarez-Abut
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina
| | - Indira Garcia-Cordero
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina
| | - Marcos Pietto
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina
| | | | - Mariano Sigman
- Laboratory of Neuroscience, Universidad Torcuato Di Tella Buenos Aires, Argentina
| | - Facundo Manes
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina ; National Scientific and Technical Research Council Buenos Aires, Argentina ; ARC Centre of Excellence in Cognition and its Disorders Sidney, NSW, Australia
| | - Agustin Ibanez
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University Buenos Aires, Argentina ; UDP-INECO Foundation Core on Neuroscience, Diego Portales University Santiago, Chile ; National Scientific and Technical Research Council Buenos Aires, Argentina ; ARC Centre of Excellence in Cognition and its Disorders Sidney, NSW, Australia ; Universidad Autónoma del Caribe Barranquilla, Colombia
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Osumi M, Imai R, Ueta K, Nobusako S, Morioka S. Negative body image associated with changes in the visual body appearance increases pain perception. PLoS One 2014; 9:e107376. [PMID: 25210738 PMCID: PMC4161431 DOI: 10.1371/journal.pone.0107376] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 08/15/2014] [Indexed: 01/19/2023] Open
Abstract
Changing the visual body appearance by use of as virtual reality system, funny mirror, or binocular glasses has been reported to be helpful in rehabilitation of pain. However, there are interindividual differences in the analgesic effect of changing the visual body image. We hypothesized that a negative body image associated with changing the visual body appearance causes interindividual differences in the analgesic effect although the relationship between the visual body appearance and analgesic effect has not been clarified. We investigated whether a negative body image associated with changes in the visual body appearance increased pain. Twenty-five healthy individuals participated in this study. To evoke a negative body image, we applied the method of rubber hand illusion. We created an “injured rubber hand” to evoke unpleasantness associated with pain, a “hairy rubber hand” to evoke unpleasantness associated with embarrassment, and a “twisted rubber hand” to evoke unpleasantness associated with deviation from the concept of normality. We also created a “normal rubber hand” as a control. The pain threshold was measured while the participant observed the rubber hand using a device that measured pain caused by thermal stimuli. Body ownership experiences were elicited by observation of the injured rubber hand and hairy rubber hand as well as the normal rubber hand. Participants felt more unpleasantness by observing the injured rubber hand and hairy rubber hand than the normal rubber hand and twisted rubber hand (p<0.001). The pain threshold was lower under the injured rubber hand condition than with the other conditions (p<0.001). We conclude that a negative body appearance associated with pain can increase pain sensitivity.
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Affiliation(s)
- Michihiro Osumi
- Department of Neurorehabilitation, Graduate School of Health Science, Kio University, Nara, Japan
- Neurocognitive Rehabilitation Center, Setsunan General Hospital, Osaka, Japan
- * E-mail:
| | - Ryota Imai
- Department of Neurorehabilitation, Graduate School of Health Science, Kio University, Nara, Japan
| | - Kozo Ueta
- Department of Neurorehabilitation, Graduate School of Health Science, Kio University, Nara, Japan
| | - Satoshi Nobusako
- Department of Neurorehabilitation, Graduate School of Health Science, Kio University, Nara, Japan
| | - Shu Morioka
- Department of Neurorehabilitation, Graduate School of Health Science, Kio University, Nara, Japan
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