Separate, parallel sensory and hedonic pathways in the mammalian somatosensory system

Bilateral hypogeusia and food aversion due to lacunar infarct in the right dorsomedial pontine tegmentum

A 70-year-old right-handed housewife suffered an acute loss of taste, an unpleasant change in the taste of foods and liquids, and a strong aversion to all kinds of food due to a small lacune in the right dorsomedial pontine tegmentum. Eating became so unpleasant that she lost 7 kg in three weeks. Olfaction and the sensibility of the tongue were spared. The right medial longitudinal fascicle, the central tegmental tract, or both, were injured by the tegmental lesion. A discrete right-sided lesion in the upper pontine tegmentum may cause a reversible syndrome consisting of bilateral hypogeusia which is more severe ipsilaterally.

Thermosensory thalamus: parallel processing across model organisms

The thalamus acts as an interface between the periphery and the cortex, with nearly every sensory modality processing information in the thalamocortical circuit. Despite well-established thalamic nuclei for visual, auditory, and tactile modalities, the key thalamic nuclei responsible for innocuous thermosensation remains under debate. Thermosensory information is first transduced by thermoreceptors located in the skin and then processed in the spinal cord. Temperature information is then transmitted to the brain through multiple spinal projection pathways including the spinothalamic tract and the spinoparabrachial tract. While there are fundamental studies of thermal transduction via thermosensitive channels in primary sensory afferents, thermal representation in the spinal projection neurons, and encoding of temperature in the primary cortical targets, comparatively little is known about the intermediate stage of processing in the thalamus. Multiple thalamic nuclei have been implicated in thermal encoding, each with a corresponding cortical target, but without a consensus on the role of each pathway. Here, we review a combination of anatomy, physiology, and behavioral studies across multiple animal models to characterize the thalamic representation of temperature in two proposed thermosensory information streams.

The tongue map and the spatial modulation of taste perception

There is undoubtedly a spatial component to our experience of gustatory stimulus qualities such as sweet, bitter, salty, sour, and umami, however its importance is currently unknown. Taste thresholds have been shown to differ at different locations within the oral cavity where gustatory receptors are found. However, the relationship between the stimulation of particular taste receptors and the subjective spatially-localized experience of taste qualities is uncertain. Although the existence of the so-called ‘tongue map’ has long been discredited, the psychophysical evidence clearly demonstrates significant (albeit small) differences in taste sensitivity across the tongue, soft palate, and pharynx (all sites where taste buds have been documented). Biases in the perceived localization of gustatory stimuli have also been reported, often resulting from tactile capture (i.e., a form of crossmodal, or multisensory, interaction). At the same time, varying responses to supratheshold tastants along the tongue's anterior-posterior axis have putatively been linked to the ingestion-ejection response. This narrative review highlights what is currently known concerning the spatial aspects of gustatory perception, considers how such findings might be explained, given the suggested balanced distribution of taste receptors for each basic taste quality where taste papillae are present, and suggests why knowing about such differences may be important.

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The existence of the tongue map has long been discredited.

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Taste receptors in the oral cavity respond to all tastes regardless of their location.

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Human psychophysical data highlights a significant spatial modulation of taste perception in the oral cavity.

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Highly-controlled studies of taste psychophysics rarely capture the full multisensory experience associated with eating and drinking.

The Changes of Brain Function After Spinal Manipulation Therapy in Patients with Chronic Low Back Pain: A Rest BOLD fMRI Study

OBJECTIVE

To investigate the changes of regional homogeneity (Reho) values before and after spinal manipulative therapy (SMT) in patients with chronic low back pain (CLBP) through rest blood-oxygen-level-dependent functional magnetic resonance imaging (BOLD fMRI).

METHODS

Patients with CLBP (Group 1, n = 20) and healthy control subjects (Group 2, n = 20) were recruited. The fMRI was performed three times in Group 1 before SMT (time point 1, TP1), after the first SMT (time point 2, TP2), after the sixth SMT (time point 3, TP3), and for one time in Group 2, which received no intervention. The clinical scales were finished in Group 1 every time before fMRI was performed. The Reho values were compared among Group 1 at different time points, and between Group 1 and Group 2. The correlation between Reho values with the statistical differences and the clinical scale scores were calculated.

RESULTS

The bilateral precuneus and right mid-frontal gyrus in Group 1 had different Reho values compared with Group 2 at TP1. The Reho values were increased in the left precuneus and decreased in the left superior frontal gyrus in Group 1 at TP2 compared with TP1. The Reho values were increased in the left postcentral gyrus and decreased in the left posterior cingulate cortex and the superior frontal gyrus in Group 1 at TP3 compared with TP1. The ReHo values of the left precuneus in Group 1 at TP1 were negatively correlated with the pain degree at TP1 and TP2 (r = -0.549, -0.453; p = 0.012, 0.045). The Reho values of the middle temporal gyrus in Group 1 at TP3 were negatively correlated with the changes of clinical scale scores between TP3 and TP1 (r = 0.454, 0.559; p = 0.044, 0.01).

CONCLUSION

Patients with CLBP showed abnormal brain function activity, which was altered after SMT. The Reho values of the left precuneus could predict the immediate analgesic effect of SMT.

Association between pain sensitivity and gray matter properties in the sensorimotor network in women with irritable bowel syndrome

BACKGROUND

Enhanced perception of visceral stimuli is an important feature of Irritable Bowel Syndrome (IBS), but it is not known whether visceral sensitivity is associated with regional structural brain properties in IBS.

METHODS

Structural brain magnetic resonance imaging data from 216 women with IBS and 138 healthy women were parcellated with FreeSurfer to define regional gray matter morphometry (volume, cortical thickness, surface area and mean curvature) in the sensorimotor network. General linear models were used to detect group differences between IBS and health. In a second set of 48 female IBS patients, pain threshold, pain intensity ratings during rectal balloon distension, and reported levels of abdominal pain and bloating were correlated with brain regions that showed differences between IBS and health in the first data set.

KEY RESULTS

Several statistically significant differences between IBS patients and healthy controls were found, mainly higher gray matter volume and cortical thickness in primary somatosensory cortex, secondary somatosensory cortex, and subcortical regions, and lesser gray matter volume, surface area and cortical thickness in posterior insula and superior frontal gyrus. Pain intensity ratings during rectal distension were associated with left primary somatosensory cortical thickness, and pain threshold was associated with right nucleus accumbens volume.

CONCLUSIONS AND INFERENCES

Regional gray matter differences in sensorimotor network are associated with visceral sensitivity and may represent neuroplastic changes in female IBS patients.

Modulation of the Negative Affective Dimension of Pain: Focus on Selected Neuropeptidergic System Contributions

It is well known that emotions can interfere with the perception of physical pain, as well as with the development and maintenance of painful conditions. On the other hand, somatic pain can have significant consequences on an individual’s affective behavior. Indeed, pain is defined as a complex and multidimensional experience, which includes both sensory and emotional components, thus exhibiting the features of a highly subjective experience. Over the years, neural pathways involved in the modulation of the different components of pain have been identified, indicating the existence of medial and lateral pain systems, which, respectively, project from medial or lateral thalamic nuclei to reach distinct cortex regions relating to specific functions. However, owing to the limited information concerning how mood state and painful input affect each other, pain treatment is frequently unsatisfactory. Different neuromodulators, including endogenous neuropeptides, appear to be involved in pain-related emotion and in its affective influence on pain perception, thus playing key roles in vulnerability and clinical outcome. Hence, this review article focuses on evidence concerning the modulation of the sensory and affective dimensions of pain, with particular attention given to some selected neuropeptidergic system contributions.

Imbalance Between Excitatory and Inhibitory Synaptic Transmission in the Primary Somatosensory Cortex Caused by Persistent Nociception in Rats

There is substantial evidence supporting the notion that the primary somatosensory (S1) cortex is an important structure involved in the perceptional component of pain. However, investigations have mainly focused on other pain-related formations, and few reports have been provided to investigate the synaptic plasticity in the S1 cortex in response to persistent pain. In the present study, we report that bee venom (BV) injection triggered an imbalance between excitatory and inhibitory synaptic transmission in the S1 cortex in rats. Using a multi-electrode array recording, we found that BV-induced persistent inflammatory pain led to temporal and spatial enhancement of synaptic plasticity. Moreover, slice patch clamp recordings on identified pyramidal neurons demonstrated that BV injection increased presynaptic and postsynaptic transmission in excitatory synapses and decreased postsynaptic transmission in inhibitory synapses in the layer II/III neurons within the S1 cortex. In immunohistochemistry and Western blot sections, the distribution and expression of total AMPA receptor subunits and gamma-amino butyric acid-A (GABA_A) were unaffected, although the membrane fractions of GluR2 and GABA_A were decreased, and their cytosolic fractions were increased in contrast. The change of GluR1 was opposite to that of GluR2, and GluR3 did not change significantly. Our studies, therefore, provide direct evidence for both presynaptic and postsynaptic changes in synapses within the S1 cortex in persistent nociception, which are probably related to the membrane trafficking of GluR1, GluR2, and GABA_A. Perspective: Increased synaptic plasticity was detected in S1 after peripheral nociception, with enhanced excitatory and decreased inhibitory synaptic transmissions. Increased GluR1, and decreased GABA_Aα1 and GluR2 membrane trafficking were detected. Therefore, the disrupted excitatory/inhibitory balance in transmissions is involved in nociception processing, and S1 can be a potential antinociceptive site.

A Single-Blinded Trial Using Resting-State Functional Magnetic Resonance Imaging of Brain Activity in Patients with Type 2 Diabetes and Painful Neuropathy

About two-thirds of patients with painful diabetic neuropathy (PDN) suffer from anxiety and/or depression disorders. However, the pathogenesis of PDN is unclear, in particular with respect to the mechanism associated with the central nervous system. We used the neuroimaging techniques of fraction amplitude of low-frequency fluctuation (fALFF) and regional homogeneity of resting-state functional magnetic resonance imaging (fMRI) to explore the brain activity in patients with PDN. The symptoms, signs and mental conditions of 19 patients with PDN and of 18 patients with non-pain neuropathy were assessed separately and compared. Blood oxygenation level-dependent resting-state fMRI scans of the brain were performed in all 37 patients with neuropathy and in 15 gender- and age-matched healthy controls. Our data showed that patients with PDN had increased insulin resistance (p  = 0.03), increased depression (p  = 0.02) and increased anxiety (p  < 0.001) compared with the controls and that all of these conditions were associated with abnormal spontaneous activities in several regions of the brain, including the somatosensory, cognitive and emotional regions. The duration of diabetes, level of glycated hemoglobin, homeostasis model assessment of insulin resistance and estimated glomerular filtration rate were significantly correlated to abnormal spontaneous activity in patients' brains. These results lead to the conclusion that patients with PDN have abnormal brain activity, indicating that the central nervous system may contribute to painful diabetic neuropathy. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT03700502.

As Soon as You Taste It: Evidence for Sequential and Parallel Processing of Gustatory Information

The quick and reliable detection and identification of a tastant in the mouth regulate nutrient uptake and toxin expulsion. Consistent with the pivotal role of the gustatory system, taste category information (e.g., sweet, salty) is represented during the earliest phase of the taste-evoked cortical response (Crouzet et al., 2015), and different tastes are perceived and responded to within only a few hundred milliseconds, in rodents (Perez et al., 2013) and humans (Bujas, 1935). Currently, it is unknown whether taste detection and discrimination are sequential or parallel processes, i.e., whether you know what it is as soon as you taste it. To investigate the sequence of processing steps involved in taste perceptual decisions, participants tasted sour, salty, bitter, and sweet solutions and performed a taste-detection and a taste-discrimination task. We measured response times (RTs) and 64-channel scalp electrophysiological recordings and tested the link between the timing of behavioral decisions and the timing of neural taste representations determined with multivariate pattern analyses. Irrespective of taste and task, neural decoding onset and behavioral RTs were strongly related, demonstrating that differences between taste judgments are reflected early during chemosensory encoding. Neural and behavioral detection times were faster for the iso-hedonic salty and sour tastes than their discrimination time. No such latency difference was observed for sweet and bitter, which differ hedonically. Together, these results indicate that the human gustatory system detects a taste faster than it discriminates between tastes, yet hedonic computations may run in parallel (Perez et al., 2013) and facilitate taste identification.

As Soon as You Taste It: Evidence for Sequential and Parallel Processing of Gustatory Information

The quick and reliable detection and identification of a tastant in the mouth regulate nutrient uptake and toxin expulsion. Consistent with the pivotal role of the gustatory system, taste category information (e.g., sweet, salty) is represented during the earliest phase of the taste-evoked cortical response (Crouzet et al., 2015), and different tastes are perceived and responded to within only a few hundred milliseconds, in rodents (Perez et al., 2013) and humans (Bujas, 1935). Currently, it is unknown whether taste detection and discrimination are sequential or parallel processes, i.e., whether you know what it is as soon as you taste it. To investigate the sequence of processing steps involved in taste perceptual decisions, participants tasted sour, salty, bitter, and sweet solutions and performed a taste-detection and a taste-discrimination task. We measured response times (RTs) and 64-channel scalp electrophysiological recordings and tested the link between the timing of behavioral decisions and the timing of neural taste representations determined with multivariate pattern analyses. Irrespective of taste and task, neural decoding onset and behavioral RTs were strongly related, demonstrating that differences between taste judgments are reflected early during chemosensory encoding. Neural and behavioral detection times were faster for the iso-hedonic salty and sour tastes than their discrimination time. No such latency difference was observed for sweet and bitter, which differ hedonically. Together, these results indicate that the human gustatory system detects a taste faster than it discriminates between tastes, yet hedonic computations may run in parallel (Perez et al., 2013) and facilitate taste identification.

Self-reported Pleasantness Ratings and Examiner-Coded Defensiveness in Response to Touch in Children with ASD: Effects of Stimulus Material and Bodily Location

Tactile defensiveness, characterized by behavioral hyperresponsiveness and negative emotional responses to touch, is a common manifestation of aberrant sensory processing in autism spectrum disorders (ASD) and other developmental disabilities (DD). Variations in tactile defensiveness with the properties of the stimulus and the bodily site of stimulation have been addressed in adults with self-report of perceived tactile pleasantness, but not in children. We presented three materials (pleasant, unpleasant, social) at three bodily sites and measured both examiner-coded defensiveness and self-reported pleasantness from a group of children with ASD and two comparison groups (one with DD, one with typical development (TD)). The main findings were: (1) children with ASD and DD showed significantly more defensiveness reactions and lower pleasantness ratings than the TD group, with higher variability, (2) there was a double dissociation for the effects of material and bodily site of stimulation: while bodily site predicted behavioral defensiveness, material predicted pleasantness rating. Additionally, it was noted that (3) the most pleasant material and the social touch conditions best distinguished ASD and DD from TD on defensiveness, and (4) within the ASD group, social impairment and defensiveness in bodily sites associated with social touch were positively correlated, suggesting a clinically relevant distinction between social and discriminative touch in ASD.

Brain Stimulation Therapy for Central Post-Stroke Pain from a Perspective of Interhemispheric Neural Network Remodeling

Central post-stroke pain (CPSP) is a debilitating, severe disorder affecting patient quality of life. Since CPSP is refractory to medication, various treatment modalities have been tried with marginal results. Following the first report of epidural motor cortex (M1) stimulation (MCS) for CPSP, many researchers have investigated the mechanisms of electrical stimulation of the M1. CPSP is currently considered to be a maladapted network reorganization problem following stroke, and recent studies have revealed that the activities of the impaired hemisphere after stroke may be inhibited by the contralesional hemisphere. Even though this interhemispheric inhibition (IHI) theory was originally proposed to explain the motor recovery process in stroke patients, we considered that IHI may also contribute to the CPSP mechanism. Based on the IHI theory and the fact that electrical stimulation of the M1 suppresses CPSP, we hypothesized that the inhibitory signals from the contralesional hemisphere may suppress the activities of the M1 in the ipsilesional hemisphere, and therefore pain suppression mechanisms may be malfunctioning in CPSP patients. In this context, transcranial direct current stimulation (tDCS) was considered to be a reasonable procedure to address the interhemispheric imbalance, as the bilateral M1 can be simultaneously stimulated using an anode (excitatory) and cathode (inhibitory). In this article, we review the potential mechanisms and propose a new model of CPSP. We also report two cases where CPSP was addressed with tDCS, discuss the potential roles of tDCS in the treatment of CPSP, and make recommendations for future studies.

Visual input to the mouse lateral posterior and posterior thalamic nuclei: photoreceptive origins and retinotopic order

KEY POINTS

The lateral posterior and posterior thalamic nuclei have been implicated in aspects of visually guided behaviour and reflex responses to light, including those dependent on melanopsin photoreception. Here we investigated the extent and basic properties of visually evoked activity across the mouse lateral posterior and posterior thalamus. We show that a subset of retinal projections to these regions derive from melanopsin-expressing retinal ganglion cells and find many cells that exhibit melanopsin-dependent changes in firing. We also show that subsets of cells across these regions integrate signals from both eyes in various ways and that, within the lateral posterior thalamus, visual responses are retinotopically ordered.

ABSTRACT

In addition to the primary thalamocortical visual relay in the lateral geniculate nuclei, a number of other thalamic regions contribute to aspects of visual processing. Thus, the lateral posterior thalamic nuclei (LP/pulvinar) appear important for various functions including determining visual saliency, visually guided behaviours and, alongside dorsal portions of the posterior thalamic nuclei (Po), multisensory processing of information related to aversive stimuli. However, despite the growing importance of mice as a model for understanding visual system organisation, at present we know very little about the basic visual response properties of cells in the mouse LP or Po. Prompted by earlier suggestions that melanopsin photoreception might be important for certain functions of these nuclei, we first employ specific viral tracing to show that a subset of retinal projections to the LP derive from melanopsin-expressing retinal ganglion cells. We next use multielectrode electrophysiology to demonstrate that LP and dorsal Po cells exhibit a variety of responses to simple visual stimuli including two distinct classes that express melanopsin-dependent changes in firing (together comprising ∼25% of neurons we recorded). We also show that subgroups of LP/Po cells integrate signals from both eyes in various ways and that, within the LP, visual responses are retinotopically ordered. Together our data reveal a diverse population of visually responsive neurons across the LP and dorsal Po whose properties align with some of the established functions of these nuclei and suggest new possible routes through which melanopsin photoreception could contribute to reflex light responses and/or higher order visual processing.

Control of Somatosensory Cortical Processing by Thalamic Posterior Medial Nucleus: A New Role of Thalamus in Cortical Function

Current knowledge of thalamocortical interaction comes mainly from studying lemniscal thalamic systems. Less is known about paralemniscal thalamic nuclei function. In the vibrissae system, the posterior medial nucleus (POm) is the corresponding paralemniscal nucleus. POm neurons project to L1 and L5A of the primary somatosensory cortex (S1) in the rat brain. It is known that L1 modifies sensory-evoked responses through control of intracortical excitability suggesting that L1 exerts an influence on whisker responses. Therefore, thalamocortical pathways targeting L1 could modulate cortical firing. Here, using a combination of electrophysiology and pharmacology in vivo, we have sought to determine how POm influences cortical processing. In our experiments, single unit recordings performed in urethane-anesthetized rats showed that POm imposes precise control on the magnitude and duration of supra- and infragranular barrel cortex whisker responses. Our findings demonstrated that L1 inputs from POm imposed a time and intensity dependent regulation on cortical sensory processing. Moreover, we found that blocking L1 GABAergic inhibition or blocking P/Q-type Ca2+ channels in L1 prevents POm adjustment of whisker responses in the barrel cortex. Additionally, we found that POm was also controlling the sensory processing in S2 and this regulation was modulated by corticofugal activity from L5 in S1. Taken together, our data demonstrate the determinant role exerted by the POm in the adjustment of somatosensory cortical processing and in the regulation of cortical processing between S1 and S2. We propose that this adjustment could be a thalamocortical gain regulation mechanism also present in the processing of information between cortical areas.

Faithful Representation of Tactile Intensity under Different Contexts Emerges from the Distinct Adaptive Properties of the First Somatosensory Relay Stations

Adaptation allows neurons to respond to a wide range of stimulus intensities. However, it also leads to ambiguity as the representation of the external world depends on the context. We recorded neurons from Wistar rats' brainstem nuclei belonging to two major somatosensory pathways (lemniscal and paralemniscal) and explored the way in which they encode noisy stimuli under different contexts. We found that although their unadapted intensity-response curves are very similar, the adapted curves of the two pathways are distinctively different as they are optimized for encoding different intensity ranges. Lemniscal neurons most faithfully encoded stimuli when the background intensity was high, whereas paralemniscal cells best encoded stimuli under low intensity context. Intracellular recordings indicate that these differences emerge already at the synaptic level. We suggest that the two pathways synergistically improve the ability of this system to encode a wide range of intensities during natural stimulation, potentially reducing the inherent ambiguity of adaptive coding.

Learning touch preferences with a tactile robot using dopamine modulated STDP in a model of insular cortex

Neurorobots enable researchers to study how behaviors are produced by neural mechanisms in an uncertain, noisy, real-world environment. To investigate how the somatosensory system processes noisy, real-world touch inputs, we introduce a neurorobot called CARL-SJR, which has a full-body tactile sensory area. The design of CARL-SJR is such that it encourages people to communicate with it through gentle touch. CARL-SJR provides feedback to users by displaying bright colors on its surface. In the present study, we show that CARL-SJR is capable of learning associations between conditioned stimuli (CS; a color pattern on its surface) and unconditioned stimuli (US; a preferred touch pattern) by applying a spiking neural network (SNN) with neurobiologically inspired plasticity. Specifically, we modeled the primary somatosensory cortex, prefrontal cortex, striatum, and the insular cortex, which is important for hedonic touch, to process noisy data generated directly from CARL-SJR's tactile sensory area. To facilitate learning, we applied dopamine-modulated Spike Timing Dependent Plasticity (STDP) to our simulated prefrontal cortex, striatum, and insular cortex. To cope with noisy, varying inputs, the SNN was tuned to produce traveling waves of activity that carried spatiotemporal information. Despite the noisy tactile sensors, spike trains, and variations in subject hand swipes, the learning was quite robust. Further, insular cortex activities in the incremental pathway of dopaminergic reward system allowed us to control CARL-SJR's preference for touch direction without heavily pre-processed inputs. The emerged behaviors we found in this model match animal's behaviors wherein they prefer touch in particular areas and directions. Thus, the results in this paper could serve as an explanation on the underlying neural mechanisms for developing tactile preferences and hedonic touch.

Smile without euphoria induced by deep brain stimulation: a case report

Poststroke central pain (PSCP) can be a debilitating medication-refractory disorder. We report a single case where right unilateral ventral capsule/ventral striatum (VC/VS) deep brain stimulation was used to treat PSCP and inadvertently induced a smile without euphoria. The patient was a 69 year-old woman who had a stroke with resultant dysesthesia and allodynia in her left hemibody and also a painful left hemibody dystonia. In her case, VC/VS stimulation induced a smile phenomenon, but without a euphoric sensation. This phenomenon was different from the typical smile responses we have observed in obsessive-compulsive disorder cases. This difference was considered to be possibly attributable to impairment in the emotional smile pathway.

Specific activation of the paralemniscal pathway during nociception

Two main neuronal pathways connect facial whiskers to the somatosensory cortex in rodents: (i) the lemniscal pathway, which originates in the brainstem principal trigeminal nucleus and is relayed in the ventroposterior thalamic nucleus and (ii) the paralemniscal pathway, originating in the spinal trigeminal nucleus and relayed in the posterior thalamic nucleus. While lemniscal neurons are readily activated by whisker contacts, the contribution of paralemniscal neurons to perception is less clear. Here, we functionally investigated these pathways by manipulating input from the whisker pad in freely moving mice. We report that while lemniscal neurons readily respond to neonatal infraorbital nerve sectioning or whisker contacts in vivo, paralemniscal neurons do not detectably respond to these environmental changes. However, the paralemniscal pathway is specifically activated upon noxious stimulation of the whisker pad. These findings reveal a nociceptive function for paralemniscal neurons in vivo that may critically inform context-specific behaviour during environmental exploration.

Advances in cortical modulation of pain

Pain is an intricate phenomenon composed of not only sensory-discriminative aspects but also of emotional, cognitive, motivational, and affective components. There has been ample evidence for the existence of an extensive cortical network associated with pain processing over the last few decades. This network includes the anterior cingulate cortex, forebrain, insular cortex, ventrolateral orbital cortex, somatosensory cortex, occipital cortex, retrosplenial cortex, motor cortex, and prefrontal cortex. Diverse neurotransmitters participate in the cortical circuits associated with pain processing, including glutamate, gamma-aminobutyric acid, dopamine, and opioids. This work examines recent rodent studies about cortical modulation of pain, mainly at a molecular level.

Effects of sensory behavioral tasks on pain threshold and cortical excitability

Background/Objective

Transcutaneous electrical stimulation has been proven to modulate nervous system activity, leading to changes in pain perception, via the peripheral sensory system, in a bottom up approach. We tested whether different sensory behavioral tasks induce significant effects in pain processing and whether these changes correlate with cortical plasticity.

Methodology/Principal Findings

This randomized parallel designed experiment included forty healthy right-handed males. Three different somatosensory tasks, including learning tasks with and without visual feedback and simple somatosensory input, were tested on pressure pain threshold and motor cortex excitability using transcranial magnetic stimulation (TMS). Sensory tasks induced hand-specific pain modulation effects. They increased pain thresholds of the left hand (which was the target to the sensory tasks) and decreased them in the right hand. TMS showed that somatosensory input decreased cortical excitability, as indexed by reduced MEP amplitudes and increased SICI. Although somatosensory tasks similarly altered pain thresholds and cortical excitability, there was no significant correlation between these variables and only the visual feedback task showed significant somatosensory learning.

Conclusions/Significance

Lack of correlation between cortical excitability and pain thresholds and lack of differential effects across tasks, but significant changes in pain thresholds suggest that analgesic effects of somatosensory tasks are not primarily associated with motor cortical neural mechanisms, thus, suggesting that subcortical neural circuits and/or spinal cord are involved with the observed effects. Identifying the neural mechanisms of somatosensory stimulation on pain may open novel possibilities for combining different targeted therapies for pain control.

Activation of glycine site and GluN2B subunit of NMDA receptors is necessary for ERK/CREB signaling cascade in rostral anterior cingulate cortex in rats: implications for affective pain

OBJECTIVE

The rostral anterior cingulate cortex (rACC) is implicated in processing the emotional component of pain. N-methyl-D-aspartate receptors (NMDARs) are highly expressed in the rACC and mediate pain-related affect by activating a signaling pathway that involves cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) and/or extracellular regulated kinase (ERK)/cAMP-response element-binding protein (CREB). The present study investigated the contributions of the NMDAR glycine site and GluN2B subunit to the activation of ERK and CREB both in vitro and in vivo in rat rACC.

METHODS

Immunohistochemistry and Western blot analysis were used to separately assess the expression of phospho-ERK (pERK) and phospho-CREB (pCREB) in vitro and in vivo. Double immunostaining was also used to determine the colocalization of pERK and pCREB.

RESULTS

Both bath application of NMDA in brain slices in vitro and intraplantar injection of formalin into the rat hindpaw in vivo induced significant up-regulation of pERK and pCREB in the rACC, which was inhibited by the NMDAR antagonist DL-2-amino-5-phospho-novaleric acid. Selective blockade of the NMDAR GluN2B subunit and the glycine-binding site, or degradation of endogenous D-serine, a co-agonist for the glycine site, significantly decreased the up-regulation of pERK and pCREB expression in the rACC. Further, the activated ERK predominantly colocalized with CREB.

CONCLUSION

Either the glycine site or the GluN2B subunit of NMDARs participates in the phosphorylation of ERK and CREB induced by bath application of NMDA in brain slices or hindpaw injection of 5% formalin in rats, and these might be fundamental molecular mechanisms underlying pain affect.

Brain-immune interactions and the neural basis of disease-avoidant ingestive behaviour

Neuro-immune interactions are widely manifested in animal physiology. Since immunity competes for energy with other physiological functions, it is subject to a circadian trade-off between other energy-demanding processes, such as neural activity, locomotion and thermoregulation. When immunity is challenged, this trade-off is tilted to an adaptive energy protecting and reallocation strategy that is identified as 'sickness behaviour'. We review diverse disease-avoidant behaviours in the context of ingestion, indicating that several adaptive advantages have been acquired by animals (including humans) during phylogenetic evolution and by ontogenetic experiences: (i) preventing waste of energy by reducing appetite and consequently foraging/hunting (illness anorexia), (ii) avoiding unnecessary danger by promoting safe environments (preventing disease encounter by olfactory cues and illness potentiation neophobia), (iii) help fighting against pathogenic threats (hyperthermia/somnolence), and (iv) by associative learning evading specific foods or environments signalling danger (conditioned taste avoidance/aversion) and/or at the same time preparing the body to counteract by anticipatory immune responses (conditioning immunomodulation). The neurobiology behind disease-avoidant ingestive behaviours is reviewed with special emphasis on the body energy balance (intake versus expenditure) and an evolutionary psychology perspective.

Behavioral assessments of the aversive quality of pain in animals

Animals and humans share similar mechanisms of pain detection and similar brain areas involved in pain processing. Also, they show similar pain behaviors, such as reflexed sensation to nociceptive stimuli. Pain is often described in sensory discrimination (algosity) and affective motivation (unpleasantness) dimensions. Both basic and clinical findings indicate that individuals with chronic pain usually suffer more from pain-associated affective disturbances than from the actual pain sensations per se. Although the neural systems responsible for the sensory component of pain have been studied extensively, the neural mechanisms underlying negative affective component are not well understood. This is partly due to the relative paucity of animal paradigms for reliable examination of each component of pain. In humans, the experience of pain and suffering can be reported by language, while in animals, pain can only be inferred through physical and behavioral reactions. Animal behaviors, cognitive psychology and functional brain imaging have made it possible to assess pain affection and pain memory in animals. Animals subjected to either neuropathic injury or inflammatory insult display significant conditioned place aversion to a pain-paired environment in behaviors. The present review aims to summarize the common methods of affective unpleasantness assessment in rats.

Cerebral cortex modulation of pain

Pain is a complex experience encompassing sensory-discriminative, affective-motivational and cognitiv e-emotional components mediated by different mechanisms. Contrary to the traditional view that the cerebral cortex is not involved in pain perception, an extensive cortical network associated with pain processing has been revealed using multiple methods over the past decades. This network consistently includes, at least, the anterior cingulate cortex, the agranular insular cortex, the primary (SI) and secondary somatosensory (SII) cortices, the ventrolateral orbital cortex and the motor cortex. These cortical structures constitute the medial and lateral pain systems, the nucleus submedius-ventrolateral orbital cortex-periaqueductal gray system and motor cortex system, respectively. Multiple neurotransmitters, including opioid, glutamate, GABA and dopamine, are involved in the modulation of pain by these cortical structures. In addition, glial cells may also be involved in cortical modulation of pain and serve as one target for pain management research. This review discusses recent studies of pain modulation by these cerebral cortical structures in animals and human.

Multisensory convergence in auditory cortex, II. Thalamocortical connections of the caudal superior temporal plane

Recent studies of macaque monkey auditory cortex have revealed convergent auditory and somatosensory activity in the caudomedial area (CM) of the belt region. In the present study and its companion (Smiley et al., J. Comp. Neurol. [this issue]), neuroanatomical tracers were injected into CM and adjacent areas of the superior temporal plane to identify sources of auditory and somatosensory input to this region. Other than CM, target areas included: A1, caudolateral belt (CL), retroinsular (Ri), and temporal parietotemporal (Tpt). Cells labeled by injections of these areas were distributed mainly among the ventral (MGv), posterodorsal (MGpd), anterodorsal (MGad), and magnocellular (MGm) divisions of the medial geniculate complex (MGC) and several nuclei with established multisensory features: posterior (Po), suprageniculate (Sg), limitans (Lim), and medial pulvinar (PM). The principal inputs of CM were MGad, MGv, and MGm, with secondary inputs from multisensory nuclei. The main inputs of CL were Po and MGpd, with secondary inputs from MGad, MGm, and multisensory nuclei. A1 was dominated by inputs from MGv and MGad, with light multisensory inputs. The input profile of Tpt closely resembled that of CL, but with reduced MGC inputs. Injections of Ri also involved CM but strongly favored MGm and multisensory nuclei, with secondary inputs from MGC and the inferior division (VPI) of the ventroposterior complex (VP). The results indicate that the thalamic inputs of areas in the caudal superior temporal plane arise mainly from the same nuclei, but in different proportions. Somatosensory inputs may reach CM and CL through MGm or the multisensory nuclei but not VP.

Expectations and associations that heal: Immunomodulatory placebo effects and its neurobiology

The use of placebo may have accompanied healing and medical practices since their origins (Plato; Charmides, 155-156). Recent experimental data indicate that we would be well advised to further consider placebo effects in future therapeutic strategies, with a better knowledge of their potency, psychological basis and underlying neurobiological mechanisms. Current research in the areas of pain, depression and Parkinson's disease has uncovered some of the potential neurobiological mechanisms of placebo effects. These data indicate that conscious expectation and unconscious behavioral conditioning processes appear to be the major neurobiological mechanisms capable of releasing endogenous neurotransmitters and/or neurohormones that mimic the expected or conditioned pharmacological effects. To date, research on placebo responses affecting immune-related diseases is scarce, but there are consistent indications that skin and mucosal inflammatory diseases, in particular, are strongly modulated by placebo treatments. However, the brain's capability to modulate peripheral immune reactivity has been impressively demonstrated by paradigms of behavioral conditioning in animal experiments and human studies. Thus, placebo effects can benefit end organ functioning and the overall health of the individual through positive expectations and behavioral conditioning processes.

Expression of the glycinergic system during the course of embryonic development in the mouse spinal cord and its co-localization with GABA immunoreactivity

To understand better the role of glycine and gamma-aminobutyric acid (GABA) in the mouse spinal cord during development, we previously described the ontogeny of GABA. Now, we present the ontogeny of glycine-immunoreactive (Gly-ir) somata and fibers, at brachial and lumbar levels, from embryonic day 11.5 (E11.5) to postnatal day 0 (P0). Spinal Gly-ir somata appeared at E12.5 in the ventral horn, with a higher density at the brachial level. They were intermingled with numerous Gly-ir fibers reaching the border of the marginal zone. By E13.5, at the brachial level, the number of Gly-ir perikarya sharply increased throughout the whole ventral horn, whereas the density of fibers declined in the marginal zone. In the dorsal horn, the first Gly-ir somata were then detected. From E13.5 to E16.5, at the brachial level, the density of Gly-ir cells remained stable in the ventral horn, and after E16.5 it decreased to reach a plateau. In the dorsal horn, the density of Gly-ir cells increased, and after E16.5 it remained stable. At the lumbar level, maximum expression was reached at E16.5 in both the ventral and dorsal horn. Finally, the co-localization of glycine and GABA was analyzed, in the ventral motor area, at E13.5, E15.5, and E17.5. The results showed that, regardless of developmental stage studied, one-third of the stained somata co-expressed GABA and glycine. Our data show that the glycinergic system matures 1 day later than the GABAergic system and follows a parallel spatiotemporal evolution, leading to a larger population of glycine cells in the ventral horn.

Tactile perception of the roughness of the end of a tool: what role does tool handle roughness play?

We investigated whether the perceived roughness of the end of a tool is influenced by the texture of the handle used to hold it. Participants rated the roughness of the ends (caps) of a series of tools by rubbing them along their forearm, and indicated the perceived roughness of the tool's cap by means of an anchored visual scale. The caps of the tools had one of eight different levels of roughness varying from very smooth (sample 1) to very rough (sample 8). The participants held the tool handle in one hand while rubbing the cap of the tool against their contralateral forearm. The tool handle was either smooth (similar in smoothness to sample 1) or else very rough (matched in roughness to sample 8). Overall, participants were remarkably good at ignoring the roughness of the tool's handle when discriminating the roughness of the tool's cap. Nevertheless, the roughness of the tool handle was shown to modulate roughness judgments concerning the tool cap under certain conditions: in particular, tool caps at the rougher end of the scale (6 and 7) were rated as being significantly less rough when the participants held tools with a rough handle than when they held tools with a smooth handle. Our results therefore demonstrate a small but significant effect of the roughness of the handle of a tool on the perceived roughness of its cap.

Contributions of the anterior cingulate cortex and amygdala to pain- and fear-conditioned place avoidance in rats

The pain experience includes a sensory-discriminative and an affective-emotional component. The sensory component of pain has been extensively studied, while data about the negative affective component of pain are quite limited. The anterior cingulate cortex (ACC), and amygdala are thought to be key neural substrates underlying emotional responses. Using formalin-induced conditioned place avoidance (F-CPA) and electric foot-shock conditioned place avoidance (S-CPA) models, the present study observed the effects of bilateral excitotoxic (quinolinic acid 200 nmol/microl) lesions of the ACC and amygdala on pain and fear induced negative emotion, as well as on sensory component of pain. In the place-conditioning paradigm, both intraplantar (i.pl.) injection of formalin and electric foot-shock produced conditioned place avoidance. Excitotoxin-induced lesion of either the ACC or amygdala significantly reduced the magnitude of F-CPA. However, the decrease in the magnitude of S-CPA occurred only in the amygdala, but not ACC lesioned animals. Neither ACC nor amygdala lesion significantly changed formalin-induced acute nociceptive behaviors. These results suggest that the amygdala is involved in both pain- and fear-related negative emotion, and the ACC might play a critical role in the expression of pain-related negative emotion.

Effects of long-term exposure of lemon essential oil odor on behavioral, hormonal and neuronal parameters in male and female rats

Behavioral, hormonal and neuronal responses to prolonged exposure to the volatile components of essential oil (EO) extracted from citrus lemon were investigated in male and female rats. Animals were exposed to the lemon essence for 2 weeks while in their cage. Anxiety was then determined with the elevated plus-maze apparatus while nociception was evaluated with a phasic thermal pain stimulus (plantar test) and with a chemical pain stimulus (formalin test). At the end of the experimental sessions, brain areas were dissected to measure beta-endorphin (beta-EP) concentrations in the hypothalamus and periaqueductal gray matter (PAG). Blood samples were collected to determine corticosterone plasma levels. In both sexes, prolonged EO exposure decreased the time spent in the open arms of the plus-maze apparatus. EO-exposed males and females showed higher thermal nociceptive thresholds than controls when tested with the plantar test apparatus. EO exposure induced female-specific decreases in formalin-induced pain behaviors during the formalin test. beta-EP concentrations in the hypothalamus and PAG were affected by EO. Corticosterone was lower in EO-exposed animals of both sexes than in their controls. These results suggest that long-term exposure to lemon EO can induce significant, at times sex-specific, changes in neuronal circuits involved in anxiety and pain.

Dual separate pathways for sensory and hedonic aspects of taste

It is proposed that in the gustatory system there exist separate sensory and hedonic (reward-aversion) representations in each of the primary structures in which processing of gustatory stimuli occurs. Anatomical and physiological data are used to determine putative separate sensory and hedonic representations in the nucleus of the solitary tract, parabrachial complex, gustatory thalamus, and cortical gustatory areas. In the nucleus of the solitary tract, the sensory representation is located in the rostralmost part of the nucleus, and the hedonic representation most probably in the intermediate parts. In the parabrachial complex, the sensory representation is located in the central medial and ventral lateral subnuclei, and in the waist area, and the hedonic representation in the inner division of the external lateral subnucleus and in the external medial subnucleus. In the rodent gustatory thalamic relay, the sensory representation occurs in the dorsal lateral parts of the nucleus, and the hedonic representation in the ventromedial parts. In rodent gustatory insular cortex, the sensory representation is found in anterior parts of the gustatory area, and the hedonic representation caudal to the sensory representation. The function of the separate sensory and hedonic representations is discussed in relation to the conditioned taste aversion paradigm.

The medial pain system: neural representations of the motivational aspect of pain

In this article, we propose that the pathways mediating the motivational aspect of pain originate in laminae VII and VIII of the spinal cord, and in the deep layers of the spinal trigeminal complex, and projections from these areas reach three central structures where pain motivation is represented, the ventrolateral quadrant of the periaqueductal gray, posterior hypothalamic nucleus, and intralaminar thalamic nuclei. A final representation of the motivational aspect of pain is located within the anterior cingulate cortex, and this representation receives inputs from the intralaminar nuclei. Outputs from these representations reach premotor structures located in the medulla, striatum, and cingulate premotor cortex. We discuss pathways and structures that provide inputs to these representations, including those involved in producing involuntary (innate) and instrumental responses which occur in response to the recognition of stimuli associated with footshock and other nociceptive stimuli.