1
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Cao B, Xu Q, Shi Y, Zhao R, Li H, Zheng J, Liu F, Wan Y, Wei B. Pathology of pain and its implications for therapeutic interventions. Signal Transduct Target Ther 2024; 9:155. [PMID: 38851750 PMCID: PMC11162504 DOI: 10.1038/s41392-024-01845-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 04/08/2024] [Accepted: 04/25/2024] [Indexed: 06/10/2024] Open
Abstract
Pain is estimated to affect more than 20% of the global population, imposing incalculable health and economic burdens. Effective pain management is crucial for individuals suffering from pain. However, the current methods for pain assessment and treatment fall short of clinical needs. Benefiting from advances in neuroscience and biotechnology, the neuronal circuits and molecular mechanisms critically involved in pain modulation have been elucidated. These research achievements have incited progress in identifying new diagnostic and therapeutic targets. In this review, we first introduce fundamental knowledge about pain, setting the stage for the subsequent contents. The review next delves into the molecular mechanisms underlying pain disorders, including gene mutation, epigenetic modification, posttranslational modification, inflammasome, signaling pathways and microbiota. To better present a comprehensive view of pain research, two prominent issues, sexual dimorphism and pain comorbidities, are discussed in detail based on current findings. The status quo of pain evaluation and manipulation is summarized. A series of improved and innovative pain management strategies, such as gene therapy, monoclonal antibody, brain-computer interface and microbial intervention, are making strides towards clinical application. We highlight existing limitations and future directions for enhancing the quality of preclinical and clinical research. Efforts to decipher the complexities of pain pathology will be instrumental in translating scientific discoveries into clinical practice, thereby improving pain management from bench to bedside.
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Affiliation(s)
- Bo Cao
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Qixuan Xu
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Yajiao Shi
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China
| | - Ruiyang Zhao
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Hanghang Li
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Jie Zheng
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China
| | - Fengyu Liu
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China.
| | - You Wan
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China.
| | - Bo Wei
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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2
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Yang H, Yanagisawa T. Is Phantom Limb Awareness Necessary for the Treatment of Phantom Limb Pain? Neurol Med Chir (Tokyo) 2024; 64:101-107. [PMID: 38267056 PMCID: PMC10992984 DOI: 10.2176/jns-nmc.2023-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/31/2023] [Indexed: 01/26/2024] Open
Abstract
Phantom limb pain is attributed to abnormal sensorimotor cortical representations. Various feedback treatments have been applied to induce the reorganization of the sensorimotor cortical representations to reduce pain. We developed a training protocol using a brain-computer interface (BCI) to induce plastic changes in the sensorimotor cortical representation of phantom hand movements and demonstrated that BCI training effectively reduces phantom limb pain. By comparing the induced cortical representation and pain, the mechanisms worsening the pain have been attributed to the residual phantom hand representation. Based on our data obtained using neurofeedback training without explicit phantom hand movements and hand-like visual feedback, we suggest a direct relationship between cortical representation and pain. In this review, we summarize the results of our BCI training protocol and discuss the relationship between cortical representation and phantom limb pain. We propose a treatment for phantom limb pain based on real-time neuroimaging to induce appropriate cortical reorganization by monitoring cortical activities.
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Affiliation(s)
- Huixiang Yang
- Institute for Advanced Co-creation Studies, Osaka University
| | - Takufumi Yanagisawa
- Institute for Advanced Co-creation Studies, Osaka University
- Department of Neurosurgery, Graduate School of Medicine, Osaka University
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3
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Demarest P, Rustamov N, Swift J, Xie T, Adamek M, Cho H, Wilson E, Han Z, Belsten A, Luczak N, Brunner P, Haroutounian S, Leuthardt EC. A novel theta-controlled vibrotactile brain-computer interface to treat chronic pain: a pilot study. Sci Rep 2024; 14:3433. [PMID: 38341457 PMCID: PMC10858946 DOI: 10.1038/s41598-024-53261-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Limitations in chronic pain therapies necessitate novel interventions that are effective, accessible, and safe. Brain-computer interfaces (BCIs) provide a promising modality for targeting neuropathology underlying chronic pain by converting recorded neural activity into perceivable outputs. Recent evidence suggests that increased frontal theta power (4-7 Hz) reflects pain relief from chronic and acute pain. Further studies have suggested that vibrotactile stimulation decreases pain intensity in experimental and clinical models. This longitudinal, non-randomized, open-label pilot study's objective was to reinforce frontal theta activity in six patients with chronic upper extremity pain using a novel vibrotactile neurofeedback BCI system. Patients increased their BCI performance, reflecting thought-driven control of neurofeedback, and showed a significant decrease in pain severity (1.29 ± 0.25 MAD, p = 0.03, q = 0.05) and pain interference (1.79 ± 1.10 MAD p = 0.03, q = 0.05) scores without any adverse events. Pain relief significantly correlated with frontal theta modulation. These findings highlight the potential of BCI-mediated cortico-sensory coupling of frontal theta with vibrotactile stimulation for alleviating chronic pain.
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Affiliation(s)
- Phillip Demarest
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St Louis, MO, 63130, USA
| | - Nabi Rustamov
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - James Swift
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Tao Xie
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Markus Adamek
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Hohyun Cho
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Elizabeth Wilson
- Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Washington University Pain Center, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Zhuangyu Han
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St Louis, MO, 63130, USA
| | - Alexander Belsten
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Nicholas Luczak
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Peter Brunner
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St Louis, MO, 63130, USA
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Simon Haroutounian
- Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
- Washington University Pain Center, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA
| | - Eric C Leuthardt
- Division of Neurotechnology, Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA.
- Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St Louis, MO, 63130, USA.
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St Louis, MO, 63110, USA.
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4
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Fauchon C, Bastuji H, Peyron R, Garcia-Larrea L. Fractal Similarity of Pain Brain Networks. ADVANCES IN NEUROBIOLOGY 2024; 36:639-657. [PMID: 38468056 DOI: 10.1007/978-3-031-47606-8_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The conscious perception of pain is the result of dynamic interactions of neural activities from local brain regions to distributed brain networks. Mapping out the networks of functional connections between brain regions that form and disperse when an experimental participant received nociceptive stimulations allow to characterize the pattern of network connections related to the pain experience.Although the pattern of intra- and inter-areal connections across the brain are incredibly complex, they appear also largely scale free, with "fractal" connectivity properties reproducing at short and long-time scales. Our results combining intracranial recordings and functional imaging in humans during pain indicate striking similarities in the activity and topological representation of networks at different orders of temporality, with reproduction of patterns of activation from the millisecond to the multisecond range. The connectivity analyzed using graph theory on fMRI data was organized in four sets of brain regions matching those identified through iEEG (i.e., sensorimotor, default mode, central executive, and amygdalo-hippocampal).Here, we discuss similarities in brain network organization at different scales or "orders," in participants as they feel pain. Description of this fractal-like organization may provide clues about how our brain regions work together to create the perception of pain and how pain becomes chronic when its organization is altered.
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Affiliation(s)
- Camille Fauchon
- Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France.
- Université Jean Monnet, Inserm, CRNL, NeuroPain, Saint-Etienne, France.
| | - Hélène Bastuji
- Université Claude Bernard Lyon 1, UJM, Inserm, CRNL, NeuroPain, Bron, France
| | - Roland Peyron
- Université Jean Monnet, Inserm, CRNL, NeuroPain, Saint-Etienne, France
- CHU, centre de la douleur, Saint-Etienne, France
| | - Luis Garcia-Larrea
- Université Claude Bernard Lyon 1, UJM, Inserm, CRNL, NeuroPain, Bron, France
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5
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Ueta Y, Miyata M. Functional and structural synaptic remodeling mechanisms underlying somatotopic organization and reorganization in the thalamus. Neurosci Biobehav Rev 2023; 152:105332. [PMID: 37524138 DOI: 10.1016/j.neubiorev.2023.105332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/09/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
The somatosensory system organizes the topographic representation of body maps, termed somatotopy, at all levels of an ascending hierarchy. Postnatal maturation of somatotopy establishes optimal somatosensation, whereas deafferentation in adults reorganizes somatotopy, which underlies pathological somatosensation, such as phantom pain and complex regional pain syndrome. Here, we focus on the mouse whisker somatosensory thalamus to study how sensory experience shapes the fine topography of afferent connectivity during the critical period and what mechanisms remodel it and drive a large-scale somatotopic reorganization after peripheral nerve injury. We will review our findings that, following peripheral nerve injury in adults, lemniscal afferent synapses onto thalamic neurons are remodeled back to immature configuration, as if the critical period reopens. The remodeling process is initiated with local activation of microglia in the brainstem somatosensory nucleus downstream to injured nerves and heterosynaptically controlled by input from GABAergic and cortical neurons to thalamic neurons. These fruits of thalamic studies complement well-studied cortical mechanisms of somatotopic organization and reorganization and unveil potential intervention points in treating pathological somatosensation.
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Affiliation(s)
- Yoshifumi Ueta
- Division of Neurophysiology, Department of Physiology, School of Medicine, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Mariko Miyata
- Division of Neurophysiology, Department of Physiology, School of Medicine, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
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6
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Yanagisawa T, Fukuma R, Seymour B, Tanaka M, Yamashita O, Hosomi K, Kishima H, Kamitani Y, Saitoh Y. Neurofeedback Training without Explicit Phantom Hand Movements and Hand-Like Visual Feedback to Modulate Pain: A Randomized Crossover Feasibility Trial. THE JOURNAL OF PAIN 2022; 23:2080-2091. [PMID: 35932992 DOI: 10.1016/j.jpain.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/25/2022] [Accepted: 07/20/2022] [Indexed: 01/04/2023]
Abstract
Phantom limb pain is attributed to abnormal sensorimotor cortical representations, although the causal relationship between phantom limb pain and sensorimotor cortical representations suffers from the potentially confounding effects of phantom hand movements. We developed neurofeedback training to change sensorimotor cortical representations without explicit phantom hand movements or hand-like visual feedback. We tested the feasibility of neurofeedback training in fourteen patients with phantom limb pain. Neurofeedback training was performed in a single-blind, randomized, crossover trial using two decoders constructed using motor cortical currents measured during phantom hand movements; the motor cortical currents contralateral or ipsilateral to the phantom hand (contralateral and ipsilateral training) were estimated from magnetoencephalograms. Patients were instructed to control the size of a disk, which was proportional to the decoding results, but to not move their phantom hands or other body parts. The pain assessed by the visual analogue scale was significantly greater after contralateral training than after ipsilateral training. Classification accuracy of phantom hand movements significantly increased only after contralateral training. These results suggested that the proposed neurofeedback training changed phantom hand representation and modulated pain without explicit phantom hand movements or hand-like visual feedback, thus showing the relation between the phantom hand representations and pain. PERSPECTIVE: Our work demonstrates the feasibility of using neurofeedback training to change phantom hand representation and modulate pain perception without explicit phantom hand movements and hand-like visual feedback. The results enhance the mechanistic understanding of certain treatments, such as mirror therapy, that change the sensorimotor cortical representation.
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Affiliation(s)
- Takufumi Yanagisawa
- Osaka University, Institute for Advanced Co-Creation Studies, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka University Graduate School of Medicine, Department of Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; ATR Computational Neuroscience Laboratories, Department of Neuroinformatics, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan.
| | - Ryohei Fukuma
- Osaka University, Institute for Advanced Co-Creation Studies, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka University Graduate School of Medicine, Department of Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; ATR Computational Neuroscience Laboratories, Department of Neuroinformatics, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan
| | - Ben Seymour
- University of Oxford, Institute of Biomedical Engineering, Department of Engineering Science, Old Road Campus Research Building, Oxford OX3 7DQ, UK; National Institute for Information and Communications Technology, Center for Information and Neural Networks, 1-3 Suita, Osaka 565-0871, Japan
| | - Masataka Tanaka
- Osaka University Graduate School of Medicine, Department of Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Okito Yamashita
- RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Building, 15th floor, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; ATR Neural Information Analysis Laboratories, Department of Computational Brain Imaging, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan
| | - Koichi Hosomi
- Osaka University Graduate School of Medicine, Department of Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka University Graduate School of Medicine, Department of Neuromodulation and Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Haruhiko Kishima
- Osaka University Graduate School of Medicine, Department of Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yukiyasu Kamitani
- ATR Computational Neuroscience Laboratories, Department of Neuroinformatics, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan; Kyoto University, Graduate School of Informatics, Yoshidahonmachi, Sakyoku, Kyoto, Kyoto 606-8501, Japan
| | - Youichi Saitoh
- Osaka University Graduate School of Medicine, Department of Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka University Graduate School of Medicine, Department of Neuromodulation and Neurosurgery, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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7
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Fauchon C, Kim JA, El-Sayed R, Osborne NR, Rogachov A, Cheng JC, Hemington KS, Bosma RL, Dunkley BT, Oh J, Bhatia A, Inman RD, Davis KD. A Hidden Markov Model reveals magnetoencephalography spectral frequency-specific abnormalities of brain state power and phase-coupling in neuropathic pain. Commun Biol 2022; 5:1000. [PMID: 36131088 PMCID: PMC9492713 DOI: 10.1038/s42003-022-03967-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
Neuronal populations in the brain are engaged in a temporally coordinated manner at rest. Here we show that spontaneous transitions between large-scale resting-state networks are altered in chronic neuropathic pain. We applied an approach based on the Hidden Markov Model to magnetoencephalography data to describe how the brain moves from one activity state to another. This identified 12 fast transient (~80 ms) brain states including the sensorimotor, ascending nociceptive pathway, salience, visual, and default mode networks. Compared to healthy controls, we found that people with neuropathic pain exhibited abnormal alpha power in the right ascending nociceptive pathway state, but higher power and coherence in the sensorimotor network state in the beta band, and shorter time intervals between visits of the sensorimotor network, indicating more active time in this state. Conversely, the neuropathic pain group showed lower coherence and spent less time in the frontal attentional state. Therefore, this study reveals a temporal imbalance and dysregulation of spectral frequency-specific brain microstates in patients with neuropathic pain. These findings can potentially impact the development of a mechanism-based therapeutic approach by identifying brain targets to stimulate using neuromodulation to modify abnormal activity and to restore effective neuronal synchrony between brain states.
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Affiliation(s)
- Camille Fauchon
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada
| | - Junseok A Kim
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Rima El-Sayed
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Natalie R Osborne
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Anton Rogachov
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Joshua C Cheng
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Kasey S Hemington
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Rachael L Bosma
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada
| | - Benjamin T Dunkley
- Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, ON, M5G 0A4, Canada.,Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, M5T 1W7, Canada
| | - Jiwon Oh
- Div of Neurology, Dept of Medicine, St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada
| | - Anuj Bhatia
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Anesthesia and Pain Medicine, Toronto Western Hospital, and University of Toronto, Toronto, ON, M5T 2S8, Canada
| | - Robert D Inman
- Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada.,Division of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Karen Deborah Davis
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, M5T 2S8, Canada. .,Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada. .,Department of Surgery, University of Toronto, Toronto, ON, M5T 1P5, Canada.
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8
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Colzato LS, Beste C, Hommel B. Focusing on cognitive potential as the bright side of mental atypicality. Commun Biol 2022; 5:188. [PMID: 35233060 PMCID: PMC8888587 DOI: 10.1038/s42003-022-03126-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/04/2022] [Indexed: 12/18/2022] Open
Abstract
Standard accounts of mental health are based on a "deficit view" solely focusing on cognitive impairments associated with psychiatric conditions. Based on the principle of neural competition, we suggest an alternative. Rather than focusing on deficits, we should focus on the cognitive potential that selective dysfunctions might bring with them. Our approach is based on two steps: the identification of the potential (i.e., of neural systems that might have benefited from reduced competition) and the development of corresponding training methods, using the testing-the-limits approach. Counterintuitively, we suggest to train not only the impaired function but on the function that might have benefitted or that may benefit from the lesser neural competition of the dysfunctional system.
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Affiliation(s)
- Lorenza S Colzato
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany. .,Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China. .,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany.
| | - Bernhard Hommel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
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9
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Browne JD, Fraiser R, Cai Y, Leung D, Leung A, Vaninetti M. Unveiling the phantom: What neuroimaging has taught us about phantom limb pain. Brain Behav 2022; 12:e2509. [PMID: 35218308 PMCID: PMC8933774 DOI: 10.1002/brb3.2509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/05/2021] [Accepted: 01/11/2022] [Indexed: 11/08/2022] Open
Abstract
Phantom limb pain (PLP) is a complicated condition with diverse clinical challenges. It consists of pain perception of a previously amputated limb. The exact pain mechanism is disputed and includes mechanisms involving cerebral, peripheral, and spinal origins. Such controversy limits researchers' and clinicians' ability to develop consistent therapeutics or management. Neuroimaging is an essential tool that can address this problem. This review explores diffusion tensor imaging, functional magnetic resonance imaging, electroencephalography, and magnetoencephalography in the context of PLP. These imaging modalities have distinct mechanisms, implications, applications, and limitations. Diffusion tensor imaging can outline structural changes and has surgical applications. Functional magnetic resonance imaging captures functional changes with spatial resolution and has therapeutic applications. Electroencephalography and magnetoencephalography can identify functional changes with a strong temporal resolution. Each imaging technique provides a unique perspective and they can be used in concert to reveal the true nature of PLP. Furthermore, researchers can utilize the respective strengths of each neuroimaging technique to support the development of innovative therapies. PLP exemplifies how neuroimaging and clinical management are intricately connected. This review can assist clinicians and researchers seeking a foundation for applications and understanding the limitations of neuroimaging techniques in the context of PLP.
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Affiliation(s)
- Jonathan D Browne
- School of Medicine, California University of Science and Medicine, Colton, California, USA
| | - Ryan Fraiser
- Center for Pain Medicine, University of California San Diego, La Jolla, California, USA
| | - Yi Cai
- Center for Pain Medicine, University of California San Diego, La Jolla, California, USA
| | - Dillon Leung
- College of Letters and Science, University of California Berkeley, Berkeley, California, USA
| | - Albert Leung
- Center for Pain Medicine, University of California San Diego, La Jolla, California, USA
| | - Michael Vaninetti
- Center for Pain Medicine, University of California San Diego, La Jolla, California, USA
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10
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van den Boom M, Miller KJ, Gregg NM, Ojeda Valencia G, Lee KH, Richner TJ, Ramsey NF, Worrell GA, Hermes D. Typical somatomotor physiology of the hand is preserved in a patient with an amputated arm: An ECoG case study. Neuroimage Clin 2021; 31:102728. [PMID: 34182408 PMCID: PMC8253998 DOI: 10.1016/j.nicl.2021.102728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/17/2021] [Accepted: 05/10/2021] [Indexed: 12/03/2022]
Abstract
Electrophysiological signals in the human motor system may change in different ways after deafferentation, with some studies emphasizing reorganization while others propose retained physiology. Understanding whether motor electrophysiology is retained over longer periods of time can be invaluable for patients with paralysis (e.g. ALS or brainstem stroke) when signals from sensorimotor areas may be used for communication or control over neural prosthetic devices. In addition, a maintained electrophysiology can potentially benefit the treatment of phantom limb pains through prolonged use of these signals in a brain-machine interface (BCI). Here, we were presented with the unique opportunity to investigate the physiology of the sensorimotor cortex in a patient with an amputated arm using electrocorticographic (ECoG) measurements. While implanted with an ECoG grid for clinical evaluation of electrical stimulation for phantom limb pain, the patient performed attempted finger movements with the contralateral (lost) hand and executed finger movements with the ipsilateral (healthy) hand. The electrophysiology of the sensorimotor cortex contralateral to the amputated hand remained very similar to that of hand movement in healthy people, with a spatially focused increase of high-frequency band (65-175 Hz; HFB) power over the hand region and a distributed decrease in low-frequency band (15-28 Hz; LFB) power. The representation of the three different fingers (thumb, index and little) remained intact and HFB patterns could be decoded using support vector learning at single-trial classification accuracies of >90%, based on the first 1-3 s of the HFB response. These results indicate that hand representations are largely retained in the motor cortex. The intact physiological response of the amputated hand, the high distinguishability of the fingers and fast temporal peak are encouraging for neural prosthetic devices that target the sensorimotor cortex.
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Affiliation(s)
- Max van den Boom
- Department of Physiology and Biomedical Engineering, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Kai J Miller
- Department of Neurosurgery, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Nicholas M Gregg
- Department of Neurology, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Gabriela Ojeda Valencia
- Department of Physiology and Biomedical Engineering, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Kendall H Lee
- Department of Neurosurgery, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Thomas J Richner
- Department of Neurosurgery, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Nick F Ramsey
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Greg A Worrell
- Department of Neurology, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Dora Hermes
- Department of Physiology and Biomedical Engineering, Mayo Clinic Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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11
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Bettoni MC, Castellini C. Interaction in Assistive Robotics: A Radical Constructivist Design Framework. Front Neurorobot 2021; 15:675657. [PMID: 34177510 PMCID: PMC8221426 DOI: 10.3389/fnbot.2021.675657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/04/2021] [Indexed: 01/05/2023] Open
Abstract
Despite decades of research, muscle-based control of assistive devices (myocontrol) is still unreliable; for instance upper-limb prostheses, each year more and more dexterous and human-like, still provide hardly enough functionality to justify their cost and the effort required to use them. In order to try and close this gap, we propose to shift the goal of myocontrol from guessing intended movements to creating new circular reactions in the constructivist sense defined by Piaget. To this aim, the myocontrol system must be able to acquire new knowledge and forget past one, and knowledge acquisition/forgetting must happen on demand, requested either by the user or by the system itself. We propose a unifying framework based upon Radical Constructivism for the design of such a myocontrol system, including its user interface and user-device interaction strategy.
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Affiliation(s)
- Marco C Bettoni
- Steinbeis Consulting Centre, Knowledge Management and Collaboration (KMC), Basel, Switzerland
| | - Claudio Castellini
- The Adaptive Bio-Interfaces Group, German Aerospace Centre (DLR), Institute of Robotics and Mechatronics, Oberpfaffenhofen, Germany
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12
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Sex differences in brain modular organization in chronic pain. Pain 2021; 162:1188-1200. [PMID: 33044396 DOI: 10.1097/j.pain.0000000000002104] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT Men and women can exhibit different pain sensitivities, and many chronic pain conditions are more prevalent in one sex. Although there is evidence of sex differences in the brain, it is not known whether there are sex differences in the organization of large-scale functional brain networks in chronic pain. Here, we used graph theory with modular analysis and machine-learning of resting-state-functional magnetic resonance imaging data from 220 participants: 155 healthy controls and 65 individuals with chronic low back pain due to ankylosing spondylitis, a form of arthritis. We found an extensive overlap in the graph partitions with the major brain intrinsic systems (ie, default mode, central, visual, and sensorimotor modules), but also sex-specific network topological characteristics in healthy people and those with chronic pain. People with chronic pain exhibited higher cross-network connectivity, and sex-specific nodal graph properties changes (ie, hub disruption), some of which were associated with the severity of the chronic pain condition. Females exhibited atypically higher functional segregation in the mid cingulate cortex and subgenual anterior cingulate cortex and lower connectivity in the network with the default mode and frontoparietal modules, whereas males exhibited stronger connectivity with the sensorimotor module. Classification models on nodal graph metrics could classify an individual's sex and whether they have chronic pain with high accuracies (77%-92%). These findings highlight the organizational abnormalities of resting-state-brain networks in people with chronic pain and provide a framework to consider sex-specific pain therapeutics.
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Surgical prevention of terminal neuroma and phantom limb pain: a literature review. Arch Plast Surg 2021; 48:310-322. [PMID: 34024077 PMCID: PMC8143949 DOI: 10.5999/aps.2020.02180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/08/2021] [Indexed: 12/02/2022] Open
Abstract
The incidence of extremity amputation is estimated at about 200,000 cases annually. Over 25% of patients suffer from terminal neuroma or phantom limb pain (TNPLP), resulting in pain, inability to wear a prosthetic device, and lost work. Once TNPLP develops, there is no definitive cure. Therefore, there has been an emerging focus on TNPLP prevention. We examined the current literature on TNPLP prevention in patients undergoing extremity amputation. A literature review was performed using Ovid Medline, Cochrane Collaboration Library, and Google Scholar to identify all original studies that addressed surgical prophylaxis against TNPLP. The search was conducted using both Medical Subject Headings and free-text using the terms “phantom limb pain,” “amputation neuroma,” and “surgical prevention of amputation neuroma.” Fifteen studies met the inclusion criteria, including six prospective trials, two comprehensive literature reviews, four retrospective chart reviews, and three case series/technique reviews. Five techniques were identified, and each was incorporated into a target-based classification system. A small but growing body of literature exists regarding the surgical prevention of TNPLP. Targeted muscle reinnervation (TMR), a form of physiologic target reassignment, has the greatest momentum in the academic surgical community, with multiple recent prospective studies demonstrating superior prevention of TNPLP. Neurorrhaphy and transposition with implantation are supported by less robust evidence, but merit future study as alternatives to TMR.
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14
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Li C, Liu SY, Pi W, Zhang PX. Cortical plasticity and nerve regeneration after peripheral nerve injury. Neural Regen Res 2021; 16:1518-1523. [PMID: 33433465 PMCID: PMC8323687 DOI: 10.4103/1673-5374.303008] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With the development of neuroscience, substantial advances have been achieved in peripheral nerve regeneration over the past decades. However, peripheral nerve injury remains a critical public health problem because of the subsequent impairment or absence of sensorimotor function. Uncomfortable complications of peripheral nerve injury, such as chronic pain, can also cause problems for families and society. A number of studies have demonstrated that the proper functioning of the nervous system depends not only on a complete connection from the central nervous system to the surrounding targets at an anatomical level, but also on the continuous bilateral communication between the two. After peripheral nerve injury, the interruption of afferent and efferent signals can cause complex pathophysiological changes, including neurochemical alterations, modifications in the adaptability of excitatory and inhibitory neurons, and the reorganization of somatosensory and motor regions. This review discusses the close relationship between the cerebral cortex and peripheral nerves. We also focus on common therapies for peripheral nerve injury and summarize their potential mechanisms in relation to cortical plasticity. It has been suggested that cortical plasticity may be important for improving functional recovery after peripheral nerve damage. Further understanding of the potential common mechanisms between cortical reorganization and nerve injury will help to elucidate the pathophysiological processes of nerve injury, and may allow for the reduction of adverse consequences during peripheral nerve injury recovery. We also review the role that regulating reorganization mechanisms plays in functional recovery, and conclude with a suggestion to target cortical plasticity along with therapeutic interventions to promote peripheral nerve injury recovery.
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Affiliation(s)
- Ci Li
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing, China
| | - Song-Yang Liu
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing, China
| | - Wei Pi
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing, China
| | - Pei-Xun Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University; National Center for Trauma Medicine, Beijing, China
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Makin TR, Flor H. Brain (re)organisation following amputation: Implications for phantom limb pain. Neuroimage 2020; 218:116943. [PMID: 32428706 PMCID: PMC7422832 DOI: 10.1016/j.neuroimage.2020.116943] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
Following arm amputation the region that represented the missing hand in primary somatosensory cortex (S1) becomes deprived of its primary input, resulting in changed boundaries of the S1 body map. This remapping process has been termed 'reorganisation' and has been attributed to multiple mechanisms, including increased expression of previously masked inputs. In a maladaptive plasticity model, such reorganisation has been associated with phantom limb pain (PLP). Brain activity associated with phantom hand movements is also correlated with PLP, suggesting that preserved limb functional representation may serve as a complementary process. Here we review some of the most recent evidence for the potential drivers and consequences of brain (re)organisation following amputation, based on human neuroimaging. We emphasise other perceptual and behavioural factors consequential to arm amputation, such as non-painful phantom sensations, perceived limb ownership, intact hand compensatory behaviour or prosthesis use, which have also been related to both cortical changes and PLP. We also discuss new findings based on interventions designed to alter the brain representation of the phantom limb, including augmented/virtual reality applications and brain computer interfaces. These studies point to a close interaction of sensory changes and alterations in brain regions involved in body representation, pain processing and motor control. Finally, we review recent evidence based on methodological advances such as high field neuroimaging and multivariate techniques that provide new opportunities to interrogate somatosensory representations in the missing hand cortical territory. Collectively, this research highlights the need to consider potential contributions of additional brain mechanisms, beyond S1 remapping, and the dynamic interplay of contextual factors with brain changes for understanding and alleviating PLP.
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Affiliation(s)
- Tamar R Makin
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London, UK.
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychology, School of Social Sciences, University of Mannheim, Germany; Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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16
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Granata G, Valle G, Di Iorio R, Iodice F, Petrini FM, Strauss I, D'anna E, Iberite F, Lauretti L, Fernandez E, Romanello R, Stieglitz T, Raspopovic S, Calabresi P, Micera S, Rossini PM. Cortical plasticity after hand prostheses use: Is the hypothesis of deafferented cortex "invasion" always true? Clin Neurophysiol 2020; 131:2341-2348. [PMID: 32828036 DOI: 10.1016/j.clinph.2020.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To study motor cortex plasticity after a period of training with a new prototype of bidirectional hand prosthesis in three left trans-radial amputees, correlating these changes with the modification of Phantom Limb Pain (PLP) in the same period. METHODS Each subject underwent a brain motor mapping with Transcranial Magnetic Stimulation (TMS) and PLP evaluation with questionnaires during a six-month training with a prototype of bidirectional hand prosthesis. RESULTS The baseline motor maps showed in all three amputees a smaller area of muscles representation of the amputated side compared to the intact limb. After training, there was a partial reversal of the baseline asymmetry. The two subjects affected by PLP experienced a statistically significant reduction of pain. CONCLUSIONS Two apparently opposite findings, the invasion of the "deafferented" cortex by neighbouring areas and the "persistence" of neural structures after amputation, could vary according to different target used for measurement. Our results do not support a correlation between PLP and motor cortical changes. SIGNIFICANCE The selection of the target and of the task is essential for studies investigating motor brain plasticity. This study boosts against a direct and unique role of motor cortical changes on PLP genesis.
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Affiliation(s)
- G Granata
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - G Valle
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - R Di Iorio
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - F Iodice
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Department of Neuroscience, San Raffaele Pisana IRCCS, Rome, Italy
| | - F M Petrini
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - I Strauss
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - E D'anna
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - F Iberite
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - L Lauretti
- Institute of Neurosurgery, Catholic University of The Sacred Heart, Roma, Italy
| | - E Fernandez
- Institute of Neurosurgery, Catholic University of The Sacred Heart, Roma, Italy
| | - R Romanello
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg and BrainLinks-BrainTools Center, University of Freiburg, Freiburg, Germany
| | - S Raspopovic
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - P Calabresi
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - S Micera
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - P M Rossini
- Department of Neuroscience, San Raffaele Pisana IRCCS, Rome, Italy
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17
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Yanagisawa T, Fukuma R, Seymour B, Tanaka M, Hosomi K, Yamashita O, Kishima H, Kamitani Y, Saitoh Y. BCI training to move a virtual hand reduces phantom limb pain: A randomized crossover trial. Neurology 2020; 95:e417-e426. [PMID: 32675074 PMCID: PMC7455320 DOI: 10.1212/wnl.0000000000009858] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/12/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether training with a brain-computer interface (BCI) to control an image of a phantom hand, which moves based on cortical currents estimated from magnetoencephalographic signals, reduces phantom limb pain. METHODS Twelve patients with chronic phantom limb pain of the upper limb due to amputation or brachial plexus root avulsion participated in a randomized single-blinded crossover trial. Patients were trained to move the virtual hand image controlled by the BCI with a real decoder, which was constructed to classify intact hand movements from motor cortical currents, by moving their phantom hands for 3 days ("real training"). Pain was evaluated using a visual analogue scale (VAS) before and after training, and at follow-up for an additional 16 days. As a control, patients engaged in the training with the same hand image controlled by randomly changing values ("random training"). The 2 trainings were randomly assigned to the patients. This trial is registered at UMIN-CTR (UMIN000013608). RESULTS VAS at day 4 was significantly reduced from the baseline after real training (mean [SD], 45.3 [24.2]-30.9 [20.6], 1/100 mm; p = 0.009 < 0.025), but not after random training (p = 0.047 > 0.025). Compared to VAS at day 1, VAS at days 4 and 8 was significantly reduced by 32% and 36%, respectively, after real training and was significantly lower than VAS after random training (p < 0.01). CONCLUSION Three-day training to move the hand images controlled by BCI significantly reduced pain for 1 week. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that BCI reduces phantom limb pain.
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Affiliation(s)
- Takufumi Yanagisawa
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan.
| | - Ryohei Fukuma
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Ben Seymour
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Masataka Tanaka
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Koichi Hosomi
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Okito Yamashita
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Haruhiko Kishima
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Yukiyasu Kamitani
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
| | - Youichi Saitoh
- From the Institute for Advanced Co-Creation Studies (T.Y.), Osaka University; Departments of Neurosurgery (T.Y., R.F., M.T., K.H., H.K., Y.S.) and Neuromodulation and Neurosurgery (K.H., Y.S.), Osaka University Graduate School of Medicine; Department of Neuroinformatics (T.Y., R.F., Y.K.), ATR Computational Neuroscience Laboratories, Kyoto, Japan; Computational and Biological Learning Laboratory, Department of Engineering (B.S.), University of Cambridge, UK; Center for Information and Neural Networks (B.S.), National Institute for Information and Communications Technology, Osaka; RIKEN Center for Advanced Intelligence Project (O.Y.), Tokyo; Department of Computational Brain Imaging (O.Y.), ATR Neural Information Analysis Laboratories, Kyoto; and Graduate School of Informatics (Y.K.), Kyoto University, Japan
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Ito H, Fujiki S, Mori Y, Kansaku K. Self-reorganization of neuronal activation patterns in the cortex under brain-machine interface and neural operant conditioning. Neurosci Res 2020; 156:279-292. [DOI: 10.1016/j.neures.2020.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/23/2020] [Accepted: 02/29/2020] [Indexed: 10/24/2022]
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Ward H, West SJ. Microglia: sculptors of neuropathic pain? ROYAL SOCIETY OPEN SCIENCE 2020; 7:200260. [PMID: 32742693 PMCID: PMC7353970 DOI: 10.1098/rsos.200260] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/01/2020] [Indexed: 05/02/2023]
Abstract
Neuropathic pain presents a huge societal and individual burden. The limited efficacy of current analgesics, diagnostic markers and clinical trial outcome measures arises from an incomplete understanding of the underlying mechanisms. A large and growing body of evidence has established the important role of microglia in the onset and possible maintenance of neuropathic pain, and these cells may represent an important target for future therapy. Microglial research has further revealed their important role in structural remodelling of the nervous system. In this review, we aim to explore the evidence for microglia in sculpting nervous system structure and function, as well as their important role in neuropathic pain, and finally integrate these studies to synthesize a new model for microglia in somatosensory circuit remodelling, composed of six key and inter-related mechanisms. Summarizing the mechanisms through which microglia modulate nervous system structure and function helps to frame a better understanding of neuropathic pain, and provide a clear roadmap for future research.
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Affiliation(s)
- Harry Ward
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Steven J. West
- Sainsbury Wellcome Centre, University College London, 25 Howland St, London WC1E 6BT, UK
- Author for correspondence: Steven J. West e-mail:
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Dhawan AG. Memory Reactivation and Its Effect on Exercise Performance and Heart Rate. Front Sports Act Living 2020; 2:20. [PMID: 33345014 PMCID: PMC7739786 DOI: 10.3389/fspor.2020.00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 02/25/2020] [Indexed: 12/02/2022] Open
Abstract
Neuronal ensemble and brain plasticity both play an important role in memory consolidation and subsequently memory reactivation. To date, many studies have been designed to study the effect of exercise, heart-rate variability, and other factors on brain plasticity and memory. Here, we present a case study in which we have demonstrated the effect of neuronal ensemble and memory formed during High-intensity aerobic training (VO2 max) and Target Heart-Rate (THR) training and the effect of reactivation of same memory on THR and performance. Of note is the fact that the reactivation and recreation of memory stimulus learned and formed during High-intensity training, such as place, time, odor, and other conditions, can elevate the THR to the same previous peak zone even at low intensity. This demonstrates that reactivation of previously acquired memory or using the stimulation from the neuronal ensemble of consolidated memory during the specific event of training may exert similar physiological effects on exercise or the body to those that are learned during the memory acquisition phase. Hence, as exercise has an effect on memory, the memories may have an effect on exercise performances.
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Role of Potassium Ions Quantum Tunneling in the Pathophysiology of Phantom Limb Pain. Brain Sci 2020; 10:brainsci10040241. [PMID: 32325702 PMCID: PMC7226264 DOI: 10.3390/brainsci10040241] [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: 03/03/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022] Open
Abstract
(1) Background: multiple theories were proposed to explain the phenomenon of phantom limb pain (PLP). Nevertheless, the phenomenon is still shrouded in mystery. The aim of this study is to explore the phenomenon from a new perspective, where quantum tunneling of ions, a promising field in medical practice, might play a major role. (2) Methods: investigators designed a quantum mathematical model based on the Schrödinger equation to examine the probability of potassium ions quantum tunneling through closed membrane potassium channels to the inside of phantom axons, leading to the generation of action potential. (3) Results: the model suggests that the probability of action potential induction at a certain region of the membrane of phantom neurons, when a neuron of the stump area is stimulated over 1 mm2 surface area of the membrane available for tunneling is 1.04 × 10−2. Furthermore, upon considering two probabilities of potassium channelopathies, one that decreased the energy of the barrier by 25% and another one by 50%, the tunneling probability became 1.22 × 10−8 and 3.86 × 10−4, respectively. (4) Conclusion: quantum models of potassium ions can provide a reliable theoretical hypothesis to unveil part of the ambiguity behind PLP.
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Huo BB, Zheng MX, Hua XY, Shen J, Wu JJ, Xu JG. Brain Metabolism in Rats with Neuropathic Pain Induced by Brachial Plexus Avulsion Injury and Treated via Electroacupuncture. J Pain Res 2020; 13:585-595. [PMID: 32273747 PMCID: PMC7106655 DOI: 10.2147/jpr.s232030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/19/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Brain organisation is involved in the mechanism of neuropathic pain. Acupuncture is a common clinical practise in traditional Chinese medicine for the treatment of chronic pain. This study explored electroacupuncture's effects on brain metabolism following brachial plexus avulsion injury (BPAI)-induced pain. METHODS A total of 32 female rats were randomised into a normal group, model group, sham electroacupuncture group, and electroacupuncture group. A pain model was included via right BPAI. The electroacupuncture intervention at cervical "Jiaji" points (C5-7) was performed for 11 weeks. The mechanical withdrawal threshold of the non-injured (left) forepaw was measured at the baseline and on days 3, 7, 14, 21, 28, 56, 84, and 112 subsequent to BPAI. Positron emission tomography (PET) was applied to explore metabolic changes on days 28, 84, and 112. RESULTS After electroacupuncture, the mechanical withdrawal threshold of the left forepaws was significantly elevated and the effect persisted until 4 weeks after the intervention ceased (p<0.05 or p<0.001). In the sensorimotor-related brain regions, standardised uptake values in the bilateral somatosensory and motor cortices were observed in the electroacupuncture group. Metabolism particularly increased in the right somatosensory cortex. Metabolism changes also occurred in the pain-related brain regions and emotion- and cognition-related brain regions. CONCLUSION The present study demonstrated the beneficial effects of electroacupuncture for relieving BPAI-induced neuropathic pain in rats. Electroacupuncture intervention might inhibit maladaptive plasticity in brain areas governing multidimensional functions, especially in sensorimotor- and cognition-related cortices.
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Affiliation(s)
- Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Jun Shen
- Department of Orthopedic, Guanghua Hospital of Integrative Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Jia-Jia Wu
- Department of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Jian-Guang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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23
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Bu J, Young KD, Hong W, Ma R, Song H, Wang Y, Zhang W, Hampson M, Hendler T, Zhang X. Effect of deactivation of activity patterns related to smoking cue reactivity on nicotine addiction. Brain 2020; 142:1827-1841. [PMID: 31135053 DOI: 10.1093/brain/awz114] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/24/2019] [Accepted: 02/24/2019] [Indexed: 02/04/2023] Open
Abstract
With approximately 75% of smokers resuming cigarette smoking after using the Gold Standard Programme for smoking cessation, investigation into novel therapeutic approaches is warranted. Typically, smoking cue reactivity is crucial for smoking behaviour. Here we developed a novel closed-loop, smoking cue reactivity patterns EEG-based neurofeedback protocol and evaluated its therapeutic efficacy on nicotine addiction. During an evoked smoking cue reactivity task participants' brain activity patterns corresponding to smoking cues were obtained with multivariate pattern analysis of all EEG channels data, then during neurofeedback the EEG activity patterns of smoking cue reactivity were continuously deactivated with adaptive closed-loop training. In a double-blind, placebo-controlled, randomized clinical trial, 60 nicotine-dependent participants were assigned to receive two neurofeedback training sessions (∼1 h/session) either from their own brain (n = 30, real-feedback group) or from the brain activity pattern of a matched participant (n = 30, yoked-feedback group). Cigarette craving and craving-related P300 were assessed at pre-neurofeedback and post-neurofeedback. The number of cigarettes smoked per day was assessed at baseline, 1 week, 1 month, and 4 months following the final neurofeedback visit. In the real-feedback group, participants successfully deactivated EEG activity patterns of smoking cue reactivity. The real-feedback group showed significant decrease in cigarette craving and craving-related P300 amplitudes compared with the yoked-feedback group. The rates of cigarettes smoked per day at 1 week, 1 month and 4 months follow-up decreased 30.6%, 38.2%, and 27.4% relative to baseline in the real-feedback group, compared to decreases of 14.0%, 13.7%, and 5.9% in the yoked-feedback group. The neurofeedback effects on craving change and smoking amount at the 4-month follow-up were further predicted by neural markers at pre-neurofeedback. This novel neurofeedback training approach produced significant short-term and long-term effects on cigarette craving and smoking behaviour, suggesting the neurofeedback protocol described herein is a promising brain-based tool for treating addiction.
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Affiliation(s)
- Junjie Bu
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Kymberly D Young
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Wei Hong
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Ru Ma
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Hongwen Song
- School of Humanities and Social Science, University of Science and Technology of China, Hefei, China
| | - Ying Wang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Wei Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Michelle Hampson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Talma Hendler
- Functional Brain Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Xiaochu Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China.,School of Humanities and Social Science, University of Science and Technology of China, Hefei, China.,Hefei Medical Research Center on Alcohol Addiction, Anhui Mental Health Center, Hefei, China.,Academy of Psychology and Behaviour, Tianjin Normal University, Tianjin, China
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24
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Kirin SC, Yanagisawa T, Oshino S, Edakawa K, Tanaka M, Kishima H, Nishimura Y. Somatosensation Evoked by Cortical Surface Stimulation of the Human Primary Somatosensory Cortex. Front Neurosci 2019; 13:1019. [PMID: 31607854 PMCID: PMC6769168 DOI: 10.3389/fnins.2019.01019] [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: 01/24/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022] Open
Abstract
Electrical stimulation of the primary somatosensory cortex using intracranial electrodes is crucial for the evocation of artificial somatosensations, typically tactile sensations associated with specific regions of the body, in brain-machine interface (BMI) applications. The qualitative characteristics of these artificially evoked somatosensations has been well documented. As of yet, however, the quantitative aspects of these evoked somatosensations, that is to say the quantitative relationship between intensity of electrical stimulation and perceived intensity of the resultant somatosensation remains obscure. This study aimed to explore this quantitative relationship by surface electrical stimulation of the primary somatosensory cortex in two human participants undergoing electrocorticographic monitoring prior to surgical treatment of intractable epilepsy. Electrocorticogram electrodes on the primary somatosensory cortical surface were stimulated with varying current intensities, and a visual analogue scale was employed to provide a quantitative measure of intensity of the evoked sensations. Evoked sensations included those of the thumb, tongue, and hand. A clear linear relationship between current intensity and perceived intensity of sensation was observed. These findings provide novel insight into the quantitative nature of primary somatosensory cortex electrical stimulation-evoked sensation for development of somatosensory neuroprosthetics for clinical use.
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Affiliation(s)
- St. Clair Kirin
- Department of Developmental Physiology, National Institute for Physiological Sciences, Okazaki, Japan
- Department of Physiological Sciences, School of Life Sciences, The Graduate University for Advanced Studies (SOKENDAI), Hayama, Japan
| | - Takufumi Yanagisawa
- Department of Neurosurgery, Graduate School of Medicine Osaka University, Suita, Japan
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan
- Institute for Advanced Co-Creation Studies, Osaka University, Suita, Japan
- *Correspondence: Takufumi Yanagisawa, ;
| | - Satoru Oshino
- Department of Neurosurgery, Graduate School of Medicine Osaka University, Suita, Japan
| | - Kohtaroh Edakawa
- Department of Neurosurgery, Graduate School of Medicine Osaka University, Suita, Japan
| | - Masataka Tanaka
- Department of Neurosurgery, Graduate School of Medicine Osaka University, Suita, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Graduate School of Medicine Osaka University, Suita, Japan
| | - Yukio Nishimura
- Department of Developmental Physiology, National Institute for Physiological Sciences, Okazaki, Japan
- Department of Physiological Sciences, School of Life Sciences, The Graduate University for Advanced Studies (SOKENDAI), Hayama, Japan
- Neural Prosthesis Project, Department of Dementia and Higher Brain Function, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Yukio Nishimura,
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25
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Takeda Y, Suzuki K, Kawato M, Yamashita O. MEG Source Imaging and Group Analysis Using VBMEG. Front Neurosci 2019; 13:241. [PMID: 30967756 PMCID: PMC6438955 DOI: 10.3389/fnins.2019.00241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/01/2019] [Indexed: 11/13/2022] Open
Abstract
Variational Bayesian Multimodal EncephaloGraphy (VBMEG) is a MATLAB toolbox that estimates distributed source currents from magnetoencephalography (MEG)/electroencephalography (EEG) data by integrating functional MRI (fMRI) (https://vbmeg.atr.jp/). VBMEG also estimates whole-brain connectome dynamics using anatomical connectivity derived from a diffusion MRI (dMRI). In this paper, we introduce the VBMEG toolbox and demonstrate its usefulness. By collaborating with VBMEG's tutorial page (https://vbmeg.atr.jp/docs/v2/static/vbmeg2_tutorial_neuromag.html), we show its full pipeline using an open dataset recorded by Wakeman and Henson (2015). We import the MEG data and preprocess them to estimate the source currents. From the estimated source currents, we perform a group analysis and examine the differences of current amplitudes between conditions by controlling the false discovery rate (FDR), which yields results consistent with previous studies. We highlight VBMEG's characteristics by comparing these results with those obtained by other source imaging methods: weighted minimum norm estimate (wMNE), dynamic statistical parametric mapping (dSPM), and linearly constrained minimum variance (LCMV) beamformer. We also estimate source currents from the EEG data and the whole-brain connectome dynamics from the MEG data and dMRI. The observed results indicate the reliability, characteristics, and usefulness of VBMEG.
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Affiliation(s)
- Yusuke Takeda
- ATR Neural Information Analysis Laboratories, Kyoto, Japan
| | - Keita Suzuki
- ATR Neural Information Analysis Laboratories, Kyoto, Japan
| | - Mitsuo Kawato
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
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26
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Huo BB, Shen J, Hua XY, Zheng MX, Lu YC, Wu JJ, Shan CL, Xu JG. Alteration of metabolic connectivity in a rat model of deafferentation pain: a 18F-FDG PET/CT study. J Neurosurg 2019; 132:1295-1303. [PMID: 30835695 DOI: 10.3171/2018.11.jns181815] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/21/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Refractory deafferentation pain has been evidenced to be related to central nervous system neuroplasticity. In this study, the authors sought to explore the underlying glucose metabolic changes in the brain after brachial plexus avulsion, particularly metabolic connectivity. METHODS Rats with unilateral deafferentation following brachial plexus avulsion, a pain model of deafferentation pain, were scanned by small-animal 2-deoxy-[18F]fluoro-d-glucose (18F-FDG) PET/CT to explore the changes of metabolic connectivity among different brain regions. Thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT) of the intact forepaw were also measured for evaluating pain sensitization. Brain metabolic connectivity and TWL were compared from baseline to 1 week after brachial plexus avulsion. RESULTS Alterations of metabolic connectivity occurred not only within the unilateral hemisphere contralateral to the injured forelimb, but also in the other hemisphere and even in the connections between bilateral hemispheres. Metabolic connectivity significantly decreased between sensorimotor-related areas within the left hemisphere (contralateral to the injured forelimb) (p < 0.05), as well as between areas across bilateral hemispheres (p < 0.05). Connectivity between areas within the right hemisphere (ipsilateral to the injured forelimb) significantly increased (p = 0.034). TWL and MWT of the left (intact) forepaw after surgery were significantly lower than those at baseline (p < 0.001). CONCLUSIONS This study revealed that unilateral brachial plexus avulsion facilitates pain sensitization in the opposite limb. A specific pattern of brain metabolic changes occurred in this procedure. Metabolic connectivity reorganized not only in the sensorimotor area corresponding to the affected forelimb, but also in extensive areas involving the bilateral hemispheres. These findings may broaden our understanding of central nervous system changes, as well as provide new information and a potential intervention target for nosogenesis of deafferentation pain.
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Affiliation(s)
- Bei-Bei Huo
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and
| | - Jun Shen
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and
| | - Xu-Yun Hua
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and.,3Trauma and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mou-Xiong Zheng
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and.,3Trauma and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ye-Chen Lu
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and
| | - Jia-Jia Wu
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and.,Departments of2Rehabilitation Medicine and
| | - Chun-Lei Shan
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and.,Departments of2Rehabilitation Medicine and
| | - Jian-Guang Xu
- 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and.,Departments of2Rehabilitation Medicine and
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27
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Shen J, Huo BB, Hua XY, Zheng MX, Lu YC, Wu JJ, Shan CL, Xu JG. Cerebral 18F-FDG metabolism alteration in a neuropathic pain model following brachial plexus avulsion: A PET/CT study in rats. Brain Res 2019; 1712:132-138. [PMID: 30738025 DOI: 10.1016/j.brainres.2019.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 12/14/2022]
Abstract
The present study aimed to investigate cerebral metabolic changes in a neuropathic pain model following deafferentation. A total of 24 Sprague-Dawley rats were included for modeling of right brachial plexus avulsion (BPA) through the posterior approach. As nerve injury would cause central sensitization and facilitate pain sensitivity in other parts of the body, thermal withdrawal latency (TWL) of the intact forepaw was assessed to investigate the level of pain perception following BPA-induced neuropathic pain. [Fluorine-18]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET) was applied to the brain before and after brachial plexus avulsion to explore metabolic changes in neuropathic pain following deafferentation. The TWL of the left (intact) forepaw was significantly lower after BPA than that of baseline (p < 0.001). Using TWL as a covariate, standardized uptake values (SUVs) of 18F-FDG significantly increased in the ipsilateral dorsolateral thalamus and contralateral anterodorsal hippocampus after BPA. Conversely, SUVs in multiple brain regions decreased, including the contralateral somatosensory cortex, ipsilateral cingulate cortex, and ipsilateral temporal association cortex. The Pearson correlation analysis showed that the SUVs of the contralateral anterodorsal hippocampus and ipsilateral dorsolateral thalamus were negatively related to the TWL of the intact forepaw, whereas the SUVs in the contralateral somatosensory cortex and ipsilateral cingulate cortex were positively related to it (p < 0.05). These findings indicate that upregulation of metabolism in the anterodorsal hippocampus and dorsolateral thalamus and downregulation metabolism in the contralateral somatosensory cortex and ipsilateral cingulate cortex could be a unique pattern of metabolic changes for neuropathic pain following brachial plexus avulsion.
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Affiliation(s)
- Jun Shen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Trauma and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mou-Xiong Zheng
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Trauma and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ye-Chen Lu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun-Lei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian-Guang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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28
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Kikkert S, Mezue M, O'Shea J, Henderson Slater D, Johansen-Berg H, Tracey I, Makin TR. Neural basis of induced phantom limb pain relief. Ann Neurol 2019; 85:59-73. [PMID: 30383312 PMCID: PMC6492189 DOI: 10.1002/ana.25371] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Phantom limb pain (PLP) is notoriously difficult to treat, partly due to an incomplete understanding of PLP-related disease mechanisms. Noninvasive brain stimulation (NIBS) is used to modulate plasticity in various neuropathological diseases, including chronic pain. Although NIBS can alleviate neuropathic pain (including PLP), both disease and treatment mechanisms remain tenuous. Insight into the mechanisms underlying both PLP and NIBS-induced PLP relief is needed for future implementation of such treatment and generalization to related conditions. METHODS We used a within-participants, double-blind, and sham-controlled design to alleviate PLP via task-concurrent NIBS over the primary sensorimotor missing hand cortex (S1/M1). To specifically influence missing hand signal processing, amputees performed phantom hand movements during anodal transcranial direct current stimulation. Brain activity was monitored using neuroimaging during and after NIBS. PLP ratings were obtained throughout the week after stimulation. RESULTS A single session of intervention NIBS significantly relieved PLP, with effects lasting at least 1 week. PLP relief associated with reduced activity in the S1/M1 missing hand cortex after stimulation. Critically, PLP relief and reduced S1/M1 activity correlated with preceding activity changes during stimulation in the mid- and posterior insula and secondary somatosensory cortex (S2). INTERPRETATION The observed correlation between PLP relief and decreased S1/M1 activity confirms our previous findings linking PLP with increased S1/M1 activity. Our results further highlight the driving role of the mid- and posterior insula, as well as S2, in modulating PLP. Lastly, our novel PLP intervention using task-concurrent NIBS opens new avenues for developing treatment for PLP and related pain conditions. ANN NEUROL 2019;85:59-73.
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Affiliation(s)
- Sanne Kikkert
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands.,Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Melvin Mezue
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Jacinta O'Shea
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
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29
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Lee D, Jang C, Park HJ. Neurofeedback learning for mental practice rather than repetitive practice improves neural pattern consistency and functional network efficiency in the subsequent mental motor execution. Neuroimage 2018; 188:680-693. [PMID: 30599191 DOI: 10.1016/j.neuroimage.2018.12.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 12/20/2018] [Accepted: 12/27/2018] [Indexed: 10/27/2022] Open
Abstract
During brain modulation, repeated mental practice may not always result in efficient learning. Particularly, the effectiveness of mental motor practice depends on how well one induces neural activity in a desired state consistently across mental trials, which calls for feedbacks to adjust one's performance. We hypothesized that even a brief experience of neurofeedback learning enhances trial-by-trial neural pattern consistency during subsequent mental motor execution and that this experience would change recruitment of functional connectivity in the motor imagery and default mode networks. To test this hypothesis, we conducted an experiment with two sessions of mental motor practice before and after a neurofeedback training session, in which participants conducted four types of first-person mental motor execution tasks (walking forward, turning left, turning right, and touching a tree). During the neurofeedback training session, in which participants conducted a virtual navigation game, 10 experimental participants received real-time fMRI neuro-feedbacks, while 10 control participants simply repeated the same mental task according to given cues without feedbacks. The experimental group showed significantly higher effects of neuro-feedback training on trial-by-trial consistencies and classification accuracies of activated neural patterns than the control group. Task-performing global node strength and network efficiency were increased in the motor imagery network but decreased in the default mode network only in the experimental group. These results demonstrate that even a brief experience of feedback learning is more effective than simple practice repetitions without evaluation, which was reflected in increased neural pattern consistency and task-dependent functional connectivity during a mental motor execution task.
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Affiliation(s)
- Dongha Lee
- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal; Center for Systems and Translational Brain Sciences, Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea
| | - Changwon Jang
- BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae-Jeong Park
- Center for Systems and Translational Brain Sciences, Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea; BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Cognitive Science, Yonsei University, Seoul, Republic of Korea.
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Karri J, Li S, Zhang L, Chen YT, Stampas A, Li S. Neuropathic pain modulation after spinal cord injury by breathing-controlled electrical stimulation (BreEStim) is associated with restoration of autonomic dysfunction. J Pain Res 2018; 11:2331-2341. [PMID: 30349358 PMCID: PMC6190809 DOI: 10.2147/jpr.s174475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recent findings have implicated supraspinal origins from the pain neuromatrix- central autonomic network (PNM-CAN) in the generation of neuropathic pain (NP) after spinal cord injury (SCI). The aim of this study was to further investigate the theorized PNM-CAN mechanisms in persons with SCI by using a centrally directed pain intervention, provided by breathing-controlled electrical stimulation (BreEStim), to measure resultant autonomic changes measured by time and frequency domain heart rate variability (HRV) analysis. METHODS Null and active BreEStim interventions were administered to SCI+NP subjects (n=10) in a random order. HRV data and VAS pain scores were collected at resting pre-test and 30 minutes post-test time points. Resting HRV data were also collected from SCI-NP subjects (n=11). RESULTS SCI+NP subjects demonstrated a lower baseline HRV and parasympathetic tone, via SD of the normal-to-normal intervals (SDNN) and low frequency (LF) parameters, compared with SCI-NP subjects. However, following active BreEStim, SCI+NP subjects exhibited an increase in HRV and parasympathetic tone, most notably via pairs of successive R-R beat lengths varying by greater than 50 ms (NN50) and proportion of NN50 for total number of beats (pNN50) parameters along with lower VAS scores. Additionally, the post-test SCI+NP group was found to have a statistically comparable autonomic profile to the SCI-NP group across all HRV variables, including SDNN and LF parameters. CONCLUSION The analgesic effects of active BreEStim in SCI+NP subjects were associated with restoration of autonomic dysfunction in this population.
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Affiliation(s)
- Jay Karri
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,
| | - Shengai Li
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,
| | - Larry Zhang
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,
| | - Yen-Ting Chen
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,
| | - Argyrios Stampas
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,
- TIRR Memorial Hermann Research Center, TIRR Memorial Hermann Hospital, Houston, TX, USA
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Mano H, Kotecha G, Leibnitz K, Matsubara T, Sprenger C, Nakae A, Shenker N, Shibata M, Voon V, Yoshida W, Lee M, Yanagida T, Kawato M, Rosa MJ, Seymour B. Classification and characterisation of brain network changes in chronic back pain: A multicenter study. Wellcome Open Res 2018; 3:19. [PMID: 29774244 PMCID: PMC5930551 DOI: 10.12688/wellcomeopenres.14069.2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2018] [Indexed: 01/03/2023] Open
Abstract
Background. Chronic pain is a common, often disabling condition thought to involve a combination of peripheral and central neurobiological factors. However, the extent and nature of changes in the brain is poorly understood. Methods. We investigated brain network architecture using resting-state fMRI data in chronic back pain patients in the UK and Japan (41 patients, 56 controls), as well as open data from USA. We applied machine learning and deep learning (conditional variational autoencoder architecture) methods to explore classification of patients/controls based on network connectivity. We then studied the network topology of the data, and developed a multislice modularity method to look for consensus evidence of modular reorganisation in chronic back pain. Results. Machine learning and deep learning allowed reliable classification of patients in a third, independent open data set with an accuracy of 63%, with 68% in cross validation of all data. We identified robust evidence of network hub disruption in chronic pain, most consistently with respect to clustering coefficient and betweenness centrality. We found a consensus pattern of modular reorganisation involving extensive, bilateral regions of sensorimotor cortex, and characterised primarily by negative reorganisation - a tendency for sensorimotor cortex nodes to be less inclined to form pairwise modular links with other brain nodes. Furthermore, these regions were found to display increased connectivity with the pregenual anterior cingulate cortex, a region known to be involved in endogenous pain control. In contrast, intraparietal sulcus displayed a propensity towards positive modular reorganisation, suggesting that it might have a role in forming modules associated with the chronic pain state. Conclusion. The results provide evidence of consistent and characteristic brain network changes in chronic pain, characterised primarily by extensive reorganisation of the network architecture of the sensorimotor cortex.
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Affiliation(s)
- Hiroaki Mano
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, Japan
| | - Gopal Kotecha
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kenji Leibnitz
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, Japan
| | | | - Christian Sprenger
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Aya Nakae
- Osaka University School of Medicine, Osaka, Japan.,Immunology Frontiers Research Center, Osaka University, Osaka, Japan
| | - Nicholas Shenker
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Valerie Voon
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Wako Yoshida
- Advanced Telecommunications Research Center International, Kyoto, Japan
| | - Michael Lee
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Toshio Yanagida
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, Japan
| | - Mitsuo Kawato
- Advanced Telecommunications Research Center International, Kyoto, Japan
| | - Maria Joao Rosa
- Max-Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK.,Department of Computer Science, University College London, London, UK
| | - Ben Seymour
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, Japan.,Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, UK.,Immunology Frontiers Research Center, Osaka University, Osaka, Japan.,Advanced Telecommunications Research Center International, Kyoto, Japan
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Page DM, George JA, Kluger DT, Duncan C, Wendelken S, Davis T, Hutchinson DT, Clark GA. Motor Control and Sensory Feedback Enhance Prosthesis Embodiment and Reduce Phantom Pain After Long-Term Hand Amputation. Front Hum Neurosci 2018; 12:352. [PMID: 30319374 PMCID: PMC6166773 DOI: 10.3389/fnhum.2018.00352] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 08/17/2018] [Indexed: 12/29/2022] Open
Abstract
We quantified prosthesis embodiment and phantom pain reduction associated with motor control and sensory feedback from a prosthetic hand in one human with a long-term transradial amputation. Microelectrode arrays were implanted in the residual median and ulnar arm nerves and intramuscular electromyography recording leads were implanted in residual limb muscles to enable sensory feedback and motor control. Objective measures (proprioceptive drift) and subjective measures (survey answers) were used to assess prosthesis embodiment. For both measures, there was a significant level of embodiment of the physical prosthetic limb after open-loop motor control of the prosthesis (i.e., without sensory feedback), open-loop sensation from the prosthesis (i.e., without motor control), and closed-loop control of the prosthesis (i.e., motor control with sensory feedback). There was also a statistically significant reduction in reported phantom pain after experimental sessions that included open-loop nerve microstimulation, open-loop prosthesis motor control, or closed-loop prosthesis motor control. The closed-loop condition provided no additional significant improvements in phantom pain reduction or prosthesis embodiment relative to the open-loop sensory condition or the open-loop motor condition. This study represents the first long-term (14-month), systematic report of phantom pain reduction and prosthesis embodiment in a human amputee across a variety of prosthesis use cases.
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Affiliation(s)
- David M. Page
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States
| | - Jacob A. George
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States
| | - David T. Kluger
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States
| | - Christopher Duncan
- Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, United States
| | - Suzanne Wendelken
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States
| | - Tyler Davis
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, United States
| | | | - Gregory A. Clark
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States
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Andoh J, Milde C, Tsao J, Flor H. Cortical plasticity as a basis of phantom limb pain: Fact or fiction? Neuroscience 2018; 387:85-91. [DOI: 10.1016/j.neuroscience.2017.11.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 10/04/2017] [Accepted: 11/09/2017] [Indexed: 12/12/2022]
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35
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Yanagisawa T, Fukuma R, Seymour B, Hosomi K, Kishima H, Shimizu T, Yokoi H, Hirata M, Yoshimine T, Kamitani Y, Saitoh Y. MEG-BMI to Control Phantom Limb Pain. Neurol Med Chir (Tokyo) 2018; 58:327-333. [PMID: 29998936 PMCID: PMC6092605 DOI: 10.2176/nmc.st.2018-0099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A brachial plexus root avulsion (BPRA) causes intractable pain in the insensible affected hands. Such pain is partly due to phantom limb pain, which is neuropathic pain occurring after the amputation of a limb and partial or complete deafferentation. Previous studies suggested that the pain was attributable to maladaptive plasticity of the sensorimotor cortex. However, there is little evidence to demonstrate the causal links between the pain and the cortical representation, and how much cortical factors affect the pain. Here, we applied lesioning of the dorsal root entry zone (DREZotomy) and training with a brain–machine interface (BMI) based on real-time magnetoencephalography signals to reconstruct affected hand movements with a robotic hand. The DREZotomy successfully reduced the shooting pain after BPRA, but a part of the pain remained. The BMI training successfully induced some plastic changes in the sensorimotor representation of the phantom hand movements and helped control the remaining pain. When the patient tried to control the robotic hand by moving their phantom hand through association with the representation of the intact hand, this especially decreased the pain while decreasing the classification accuracy of the phantom hand movements. These results strongly suggested that pain after the BPRA was partly attributable to cortical representation of phantom hand movements and that the BMI training controlled the pain by inducing appropriate cortical reorganization. For the treatment of chronic pain, we need to know how to modulate the cortical representation by novel methods.
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Affiliation(s)
- Takufumi Yanagisawa
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Osaka University Institute for Advanced Co-Creation Studies.,Department of Neuroinformatics, ATR Computational Neuroscience Laboratories.,Division of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University
| | - Ryohei Fukuma
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Department of Neuroinformatics, ATR Computational Neuroscience Laboratories
| | - Ben Seymour
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge.,Center for Information and Neural Networks, National Institute for Information and Communications Technology
| | - Koichi Hosomi
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine
| | - Takeshi Shimizu
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine
| | - Hiroshi Yokoi
- Department of Mechanical Engineering and Intelligent Systems, The University of Electro-Communications
| | - Masayuki Hirata
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Division of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University
| | - Toshiki Yoshimine
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Division of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University
| | - Yukiyasu Kamitani
- Department of Neuroinformatics, ATR Computational Neuroscience Laboratories.,Graduate School of Informatics, Kyoto University
| | - Youichi Saitoh
- Department of Neurosurgery, Osaka University Graduate School of Medicine.,Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine
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36
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Fukuma R, Yanagisawa T, Yokoi H, Hirata M, Yoshimine T, Saitoh Y, Kamitani Y, Kishima H. Training in Use of Brain-Machine Interface-Controlled Robotic Hand Improves Accuracy Decoding Two Types of Hand Movements. Front Neurosci 2018; 12:478. [PMID: 30050405 PMCID: PMC6050372 DOI: 10.3389/fnins.2018.00478] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/25/2018] [Indexed: 11/21/2022] Open
Abstract
Objective: Brain-machine interfaces (BMIs) are useful for inducing plastic changes in cortical representation. A BMI first decodes hand movements using cortical signals and then converts the decoded information into movements of a robotic hand. By using the BMI robotic hand, the cortical representation decoded by the BMI is modulated to improve decoding accuracy. We developed a BMI based on real-time magnetoencephalography (MEG) signals to control a robotic hand using decoded hand movements. Subjects were trained to use the BMI robotic hand freely for 10 min to evaluate plastic changes in the cortical representation due to the training. Method: We trained nine young healthy subjects with normal motor function. In open-loop conditions, they were instructed to grasp or open their right hands during MEG recording. Time-averaged MEG signals were then used to train a real decoder to control the robotic arm in real time. Then, subjects were instructed to control the BMI-controlled robotic hand by moving their right hands for 10 min while watching the robot's movement. During this closed-loop session, subjects tried to improve their ability to control the robot. Finally, subjects performed the same offline task to compare cortical activities related to the hand movements. As a control, we used a random decoder trained by the MEG signals with shuffled movement labels. We performed the same experiments with the random decoder as a crossover trial. To evaluate the cortical representation, cortical currents were estimated using a source localization technique. Hand movements were also decoded by a support vector machine using the MEG signals during the offline task. The classification accuracy of the movements was compared among offline tasks. Results: During the BMI training with the real decoder, the subjects succeeded in improving their accuracy in controlling the BMI robotic hand with correct rates of 0.28 ± 0.13 to 0.50 ± 0.11 (p = 0.017, n = 8, paired Student's t-test). Moreover, the classification accuracy of hand movements during the offline task was significantly increased after BMI training with the real decoder from 62.7 ± 6.5 to 70.0 ± 11.1% (p = 0.022, n = 8, t(7) = 2.93, paired Student's t-test), whereas accuracy did not significantly change after BMI training with the random decoder from 63.0 ± 8.8 to 66.4 ± 9.0% (p = 0.225, n = 8, t(7) = 1.33). Conclusion: BMI training is a useful tool to train the cortical activity necessary for BMI control and to induce some plastic changes in the activity.
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Affiliation(s)
- Ryohei Fukuma
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan.,Department of Neuroinformatics, ATR Computational Neuroscience Laboratories, Seika-cho, Japan
| | - Takufumi Yanagisawa
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan.,Department of Neuroinformatics, ATR Computational Neuroscience Laboratories, Seika-cho, Japan.,Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan.,Institute for Advanced Co-Creation Studies, Osaka University, Suita, Japan.,Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Hiroshi Yokoi
- Department of Mechanical Engineering and Intelligent Systems, University of Electro-Communications, Chofu, Japan
| | - Masayuki Hirata
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan.,Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan.,Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Toshiki Yoshimine
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan.,Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Youichi Saitoh
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan.,Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yukiyasu Kamitani
- Department of Neuroinformatics, ATR Computational Neuroscience Laboratories, Seika-cho, Japan.,Graduate School of Informatics, Kyoto University, Kyoto, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Suita, Japan
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37
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Collins KL, Russell HG, Schumacher PJ, Robinson-Freeman KE, O'Conor EC, Gibney KD, Yambem O, Dykes RW, Waters RS, Tsao JW. A review of current theories and treatments for phantom limb pain. J Clin Invest 2018; 128:2168-2176. [PMID: 29856366 DOI: 10.1172/jci94003] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Following amputation, most amputees still report feeling the missing limb and often describe these feelings as excruciatingly painful. Phantom limb sensations (PLS) are useful while controlling a prosthesis; however, phantom limb pain (PLP) is a debilitating condition that drastically hinders quality of life. Although such experiences have been reported since the early 16th century, the etiology remains unknown. Debate continues regarding the roles of the central and peripheral nervous systems. Currently, the most posited mechanistic theories rely on neuronal network reorganization; however, greater consideration should be given to the role of the dorsal root ganglion within the peripheral nervous system. This Review provides an overview of the proposed mechanistic theories as well as an overview of various treatments for PLP.
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Affiliation(s)
| | - Hannah G Russell
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Patrick J Schumacher
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - Ellen C O'Conor
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Kyla D Gibney
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Olivia Yambem
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Robert W Dykes
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | | | - Jack W Tsao
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Neurology, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
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38
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Kikkert S, Johansen-Berg H, Tracey I, Makin TR. Reaffirming the link between chronic phantom limb pain and maintained missing hand representation. Cortex 2018; 106:174-184. [PMID: 30005369 PMCID: PMC6143485 DOI: 10.1016/j.cortex.2018.05.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/16/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022]
Abstract
Phantom limb pain (PLP) is commonly considered to be a result of maladaptive brain plasticity. This model proposes that PLP is mainly caused by reorganisation in the primary somatosensory cortex, presumably characterised by functional degradation of the missing hand representation and remapping of other body part representations. In the current study, we replicate our previous results by showing that chronic PLP correlates with maintained representation of the missing hand in the primary sensorimotor missing hand cortex. We asked unilateral upper-limb amputees to move their phantom hand, lips or other body parts and measured the associated neural responses using functional magnetic resonance imaging (fMRI). We confirm that amputees suffering from worse chronic PLP have stronger activity in the primary sensorimotor missing hand cortex while performing phantom hand movements. We find no evidence of lip representation remapping into the missing hand territory, as assessed by measuring activity in the primary sensorimotor missing hand cortex during lip movements. We further show that the correlation between chronic PLP and maintained representation of the missing hand cannot be explained by the experience of chronic non-painful phantom sensations or compensatory usage of the residual arm or an artificial arm (prosthesis). Together, our results reaffirm a likely relationship between persistent peripheral inputs pertaining to the missing hand representation and chronic PLP. Our findings emphasise a need to further study the role of peripheral inputs from the residual nerves to better understand the mechanisms underlying chronic PLP.
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Affiliation(s)
- Sanne Kikkert
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
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Yoshino A, Okamoto Y, Okada G, Takamura M, Ichikawa N, Shibasaki C, Yokoyama S, Doi M, Jinnin R, Yamashita H, Horikoshi M, Yamawaki S. Changes in resting-state brain networks after cognitive-behavioral therapy for chronic pain. Psychol Med 2018; 48:1148-1156. [PMID: 28893330 DOI: 10.1017/s0033291717002598] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) is thought to be useful for chronic pain, with the pathology of the latter being closely associated with cognitive-emotional components. However, there are few resting-state functional magnetic resonance imaging (R-fMRI) studies. We used the independent component analysis method to examine neural changes after CBT and to assess whether brain regions predict treatment response. METHODS We performed R-fMRI on a group of 29 chronic pain (somatoform pain disorder) patients and 30 age-matched healthy controls (T1). Patients were enrolled in a weekly 12-session group CBT (T2). We assessed selected regions of interest that exhibited differences in intrinsic connectivity network (ICN) connectivity strength between the patients and controls at T1, and compared T1 and T2. We also examined the correlations between treatment effects and rs-fMRI data. RESULTS Abnormal ICN connectivity of the orbitofrontal cortex (OFC) and inferior parietal lobule within the dorsal attention network (DAN) and of the paracentral lobule within the sensorimotor network in patients with chronic pain normalized after CBT. Higher ICN connectivity strength in the OFC indicated greater improvements in pain intensity. Furthermore, ICN connectivity strength in the dorsal posterior cingulate cortex (PCC) within the DAN at T1 was negatively correlated with CBT-related clinical improvements. CONCLUSIONS We conclude that the OFC is crucial for CBT-related improvement of pain intensity, and that the dorsal PCC activation at pretreatment also plays an important role in improvement of clinical symptoms via CBT.
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Affiliation(s)
- A Yoshino
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - Y Okamoto
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - G Okada
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - M Takamura
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - N Ichikawa
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - C Shibasaki
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - S Yokoyama
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - M Doi
- Department of Dental Anesthesiology,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - R Jinnin
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - H Yamashita
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
| | - M Horikoshi
- National Center for Cognitive Behavior Therapy and Research,National Center of Neurology and Psychiatry (NCNP),4-1-1, Ogawahigashicho,Kodaira,Tokyo 187-0031,Japan
| | - S Yamawaki
- Department of Psychiatry and Neurosciences,Division of Frontier Graduate School of Biomedical Sciences,Hiroshima University,1-2-3 Kasumi,Minami-ku,Hiroshima 734-8551,Japan
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40
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Mano H, Kotecha G, Leibnitz K, Matsubara T, Nakae A, Shenker N, Shibata M, Voon V, Yoshida W, Lee M, Yanagida T, Kawato M, Rosa MJ, Seymour B. Classification and characterisation of brain network changes in chronic back pain: A multicenter study. Wellcome Open Res 2018; 3:19. [DOI: 10.12688/wellcomeopenres.14069.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2018] [Indexed: 11/20/2022] Open
Abstract
Background. Chronic pain is a common, often disabling condition thought to involve a combination of peripheral and central neurobiological factors. However, the extent and nature of changes in the brain is poorly understood. Methods. We investigated brain network architecture using resting-state fMRI data in chronic back pain patients in the UK and Japan (41 patients, 56 controls), as well as open data from USA. We applied machine learning and deep learning (conditional variational autoencoder architecture) methods to explore classification of patients/controls based on network connectivity. We then studied the network topology of the data, and developed a multislice modularity method to look for consensus evidence of modular reorganisation in chronic back pain. Results. Machine learning and deep learning allowed reliable classification of patients in a third, independent open data set with an accuracy of 63%, with 68% in cross validation of all data. We identified robust evidence of network hub disruption in chronic pain, most consistently with respect to clustering coefficient and betweenness centrality. We found a consensus pattern of modular reorganisation involving extensive, bilateral regions of sensorimotor cortex, and characterised primarily by negative reorganisation - a tendency for sensorimotor cortex nodes to be less inclined to form pairwise modular links with other brain nodes. In contrast, intraparietal sulcus displayed a propensity towards positive modular reorganisation, suggesting that it might have a role in forming modules associated with the chronic pain state. Conclusion. The results provide evidence of consistent and characteristic brain network changes in chronic pain, characterised primarily by extensive reorganisation of the network architecture of the sensorimotor cortex.
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41
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Scheyltjens I, Vreysen S, Van den Haute C, Sabanov V, Balschun D, Baekelandt V, Arckens L. Transient and localized optogenetic activation of somatostatin-interneurons in mouse visual cortex abolishes long-term cortical plasticity due to vision loss. Brain Struct Funct 2018; 223:2073-2095. [PMID: 29372324 PMCID: PMC5968055 DOI: 10.1007/s00429-018-1611-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 01/14/2018] [Indexed: 04/13/2023]
Abstract
Unilateral vision loss through monocular enucleation (ME) results in partial reallocation of visual cortical territory to another sense in adult mice. The functional recovery of the visual cortex occurs through a combination of spared-eye potentiation and cross-modal reactivation driven by whisker-related, somatosensory inputs. Brain region-specific intracortical inhibition was recently recognized as a crucial regulator of the cross-modal component, yet the contribution of specific inhibitory neuron subpopulations remains poorly understood. Somatostatin (SST)-interneurons are ideally located within the cortical circuit to modulate sensory integration. Here we demonstrate that optogenetic stimulation of visual cortex SST-interneurons prior to eye removal decreases ME-induced cross-modal recovery at the stimulation site. Our results suggest that SST-interneurons act as local hubs, which are able to control the influx and extent of cortical cross-modal inputs into the deprived cortex. These insights critically expand our understanding of SST-interneuron-specific regulation of cortical plasticity induced by sensory loss.
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Affiliation(s)
- Isabelle Scheyltjens
- Laboratory of Neuroplasticity and Neuroproteomics, KU Leuven, Naamsestraat 59, Box 2467, 3000, Leuven, Belgium.
| | - Samme Vreysen
- Laboratory of Neuroplasticity and Neuroproteomics, KU Leuven, Naamsestraat 59, Box 2467, 3000, Leuven, Belgium
| | - Chris Van den Haute
- Laboratory for Neurobiology and Gene Therapy, KU Leuven, 3000, Leuven, Belgium.,Leuven Viral Vector Core, KU Leuven, 3000, Leuven, Belgium
| | - Victor Sabanov
- Laboratory of Biological Psychology, KU Leuven, 3000, Leuven, Belgium
| | - Detlef Balschun
- Laboratory of Biological Psychology, KU Leuven, 3000, Leuven, Belgium
| | - Veerle Baekelandt
- Laboratory for Neurobiology and Gene Therapy, KU Leuven, 3000, Leuven, Belgium
| | - Lutgarde Arckens
- Laboratory of Neuroplasticity and Neuroproteomics, KU Leuven, Naamsestraat 59, Box 2467, 3000, Leuven, Belgium
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42
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Mogilner AY. Neuromodulation and Neuronal Plasticity. Neuromodulation 2018. [DOI: 10.1016/b978-0-12-805353-9.00009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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43
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Kikkert S, Mezue M, Henderson Slater D, Johansen-Berg H, Tracey I, Makin TR. Motor correlates of phantom limb pain. Cortex 2017; 95:29-36. [PMID: 28822914 PMCID: PMC5637164 DOI: 10.1016/j.cortex.2017.07.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/12/2017] [Accepted: 07/18/2017] [Indexed: 11/03/2022]
Abstract
Following amputation, individuals ubiquitously report experiencing lingering sensations of their missing limb. While phantom sensations can be innocuous, they are often manifested as painful. Phantom limb pain (PLP) is notorious for being difficult to monitor and treat. A major challenge in PLP management is the difficulty in assessing PLP symptoms, given the physical absence of the affected body part. Here, we offer a means of quantifying chronic PLP by harnessing the known ability of amputees to voluntarily move their phantom limbs. Upper-limb amputees suffering from chronic PLP performed a simple finger-tapping task with their phantom hand. We confirm that amputees suffering from worse chronic PLP had worse motor control over their phantom hand. We further demonstrate that task performance was consistent over weeks and did not relate to transient PLP or non-painful phantom sensations. Finally, we explore the neural basis of these behavioural correlates of PLP. Using neuroimaging, we reveal that slower phantom hand movements were coupled with stronger activity in the primary sensorimotor phantom hand cortex, previously shown to associate with chronic PLP. By demonstrating a specific link between phantom hand motor control and chronic PLP, our findings open up new avenues for PLP management and improvement of existing PLP treatments.
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Affiliation(s)
- Sanne Kikkert
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Melvin Mezue
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Heidi Johansen-Berg
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
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Decoding finger movement in humans using synergy of EEG cortical current signals. Sci Rep 2017; 7:11382. [PMID: 28900188 PMCID: PMC5595824 DOI: 10.1038/s41598-017-09770-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/31/2017] [Indexed: 12/31/2022] Open
Abstract
The synchronized activity of neuronal populations across multiple distant brain areas may reflect coordinated interactions of large-scale brain networks. Currently, there is no established method to investigate the temporal transitions between these large-scale networks that would allow, for example, to decode finger movements. Here we applied a matrix factorization method employing principal component and temporal independent component analyses to identify brain activity synchronizations. In accordance with previous studies investigating “muscle synergies”, we refer to this activity as “brain activity synergy”. Using electroencephalography (EEG), we first estimated cortical current sources (CSs) and then identified brain activity synergies within the estimated CS signals. A decoding analysis for finger movement in eight directions showed that such CS synergies provided more information for dissociating between movements than EEG sensor signals, EEG synergy, or CS signals, suggesting that temporal activation patterns of the synchronizing CSs may contain information related to motor control. A quantitative analysis of features selected by the decoders further revealed temporal transitions among the primary motor area, dorsal and ventral premotor areas, pre-supplementary motor area, and supplementary motor area, which may reflect transitions in motor planning and execution. These results provide a proof of concept for brain activity synergy estimation using CSs.
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Yoshimura S. Japanese Congress of Neurological Surgeons Presidential Address—Treatment of Carotid Artery Stenosis Based on Plaque Imaging. Neurosurgery 2017; 64:129-133. [DOI: 10.1093/neuros/nyx231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/27/2017] [Indexed: 11/12/2022] Open
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Yamada T, Hashimoto RI, Yahata N, Ichikawa N, Yoshihara Y, Okamoto Y, Kato N, Takahashi H, Kawato M. Resting-State Functional Connectivity-Based Biomarkers and Functional MRI-Based Neurofeedback for Psychiatric Disorders: A Challenge for Developing Theranostic Biomarkers. Int J Neuropsychopharmacol 2017; 20:769-781. [PMID: 28977523 PMCID: PMC5632305 DOI: 10.1093/ijnp/pyx059] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/12/2017] [Indexed: 12/28/2022] Open
Abstract
Psychiatric research has been hampered by an explanatory gap between psychiatric symptoms and their neural underpinnings, which has resulted in poor treatment outcomes. This situation has prompted us to shift from symptom-based diagnosis to data-driven diagnosis, aiming to redefine psychiatric disorders as disorders of neural circuitry. Promising candidates for data-driven diagnosis include resting-state functional connectivity MRI (rs-fcMRI)-based biomarkers. Although biomarkers have been developed with the aim of diagnosing patients and predicting the efficacy of therapy, the focus has shifted to the identification of biomarkers that represent therapeutic targets, which would allow for more personalized treatment approaches. This type of biomarker (i.e., "theranostic biomarker") is expected to elucidate the disease mechanism of psychiatric conditions and to offer an individualized neural circuit-based therapeutic target based on the neural cause of a condition. To this end, researchers have developed rs-fcMRI-based biomarkers and investigated a causal relationship between potential biomarkers and disease-specific behavior using functional MRI (fMRI)-based neurofeedback on functional connectivity. In this review, we introduce a recent approach for creating a theranostic biomarker, which consists mainly of 2 parts: (1) developing an rs-fcMRI-based biomarker that can predict diagnosis and/or symptoms with high accuracy, and (2) the introduction of a proof-of-concept study investigating the relationship between normalizing the biomarker and symptom changes using fMRI-based neurofeedback. In parallel with the introduction of recent studies, we review rs-fcMRI-based biomarker and fMRI-based neurofeedback, focusing on the technological improvements and limitations associated with clinical use.
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Affiliation(s)
- Takashi Yamada
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Ryu-ichiro Hashimoto
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Noriaki Yahata
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Naho Ichikawa
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Yujiro Yoshihara
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Yasumasa Okamoto
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Nobumasa Kato
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Hidehiko Takahashi
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi)
| | - Mitsuo Kawato
- Department of Decoded Neurofeedback, ATR Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan (Drs Yamada, Hashimoto, Yahata, and Kawato); Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan (Drs Yamada, Hashimoto, and Kato); Department of Language Sciences, Graduate School of Humanities (Dr Hashimoto), and Research Center for Language, Brain and Genetics (Dr Hashimoto), Tokyo Metropolitan University, Tokyo, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Dr Yahata); Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr Yahata); Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan (Ms Ichikawa and Dr Okamoto); Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan (Drs Yoshihara and Takahashi).,Correspondence: Mitsuo Kawato, PhD, 2-2-2 Hikaridai, Seika-cho, Sorakugun, Kyoto, Japan ()
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Altered microstructure rather than morphology in the corpus callosum after lower limb amputation. Sci Rep 2017; 7:44780. [PMID: 28303959 PMCID: PMC5355997 DOI: 10.1038/srep44780] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/13/2017] [Indexed: 02/07/2023] Open
Abstract
The corpus callosum (CC) has been implicated in the reorganization of the brain following amputation. However, it is unclear which regions of the CC are involved in this process. In this study, we explored the morphometric and microstructural changes in CC subregions in patients with unilateral lower limb amputation. Thirty-eight patients and 38 age- and gender-matched normal controls were included. The CC was divided into five regions, and the area, thickness and diffusion parameters of each region were investigated. While morphometric analysis showed no significant differences between the two groups, amputees showed significant higher values in axial diffusivity, radial diffusivity and mean diffusivity in region II of the CC, which connects the bilateral premotor and supplementary motor areas. In contrast, the mean fractional anisotropy value of the fibers generated by these cortical areas, as measured by tractography, was significantly smaller in amputees. These results demonstrate that the interhemispheric pathways contributing to motor coordination and imagery are reorganized in lower limb amputees.
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48
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PANDORA'S BOX. BJPsych Int 2017; 14:24-25. [PMID: 29093931 PMCID: PMC5618828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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