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Zhou XC, Chen LH, Wu S, Wang KZ, Wei ZC, Li T, Huang YS, Hua ZH, Xia Q, Lv ZZ, Lv LJ. Brain effect mechanism of lever positioning manipulation on LDH analgesia based on multimodal MRI: a study protocol. BMC Complement Med Ther 2024; 24:246. [PMID: 38915038 PMCID: PMC11194935 DOI: 10.1186/s12906-024-04549-4] [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: 01/21/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION The clinical symptoms of Lumbar Disc Herniation (LDH) can be effectively ameliorated through Lever Positioning Manipulation (LPM), which is closely linked to the brain's pain-regulating mechanisms. Magnetic Resonance Imaging (MRI) offers an objective and visual means to study how the brain orchestrates the characteristics of analgesic effects. From the perspective of multimodal MRI, we applied functional MRI (fMRI) and Magnetic Resonance Spectrum (MRS) techniques to comprehensively evaluate the characteristics of the effects of LPM on the brain region of LDH from the aspects of brain structure, brain function and brain metabolism. This multimodal MRI technique provides a biological basis for the clinical application of LPM in LDH. METHODS AND ANALYSIS A total of 60 LDH patients and 30 healthy controls, matched by gender, age, and years of education, will be enrolled in this study. The LDH patients will be divided into two groups (Group 1, n = 30; Group 2, n = 30) using a random number table method. Group 1 will receive LPM treatment once every two days, for a total of 12 times over 4 weeks. Group 2 will receive sham LPM treatment during the same period as Group 1. All 30 healthy controls will be divided into Group 3. Multimodal MRI will be performed on Group 1 and Group 2 at three time points (TPs): before LPM (TP1), after one LPM session (TP2), and after a full course of LPM treatment. The healthy controls (Group 3) will not undergo LPM and will be subject to only a single multimodal MRI scan. Participants in both Group 1 and Group 2 will be required to complete clinical questionnaires. These assessments will focus on pain intensity and functional disorders, using the Visual Analog Scale (VAS) and the Japanese Orthopaedic Association (JOA) scoring systems, respectively. DISCUSSION The purpose of this study is to investigate the multimodal brain response characteristics of LDH patients after treatment with LPM, with the goal of providing a biological basis for clinical applications. TRIAL REGISTRATION NUMBER https://clinicaltrials.gov/ct2/show/NCT05613179 , identifier: NCT05613179.
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Affiliation(s)
- Xing-Chen Zhou
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Long-Hao Chen
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shuang Wu
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Kai-Zheng Wang
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zi-Cheng Wei
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Tao Li
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuan-Shen Huang
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zi-Han Hua
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qiong Xia
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhi-Zhen Lv
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
| | - Li-Jiang Lv
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
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Meng J, Zhang T, Hao T, Xie X, Zhang M, Zhang L, Wan X, Zhu C, Li Q, Wang K. Functional and Structural Abnormalities in the Pain Network of Generalized Anxiety Disorder Patients with Pain Symptoms. Neuroscience 2024; 543:28-36. [PMID: 38382693 DOI: 10.1016/j.neuroscience.2024.02.006] [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: 10/23/2023] [Revised: 01/16/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
Pain symptoms significantly impact the well-being and work capacity of individuals with generalized anxiety disorder (GAD), and hinder treatment and recovery. Despite existing literature focusing on the neural substrate of pain and anxiety separately, further exploration is needed to understand the possible neuroimaging mechanisms of the pain symptoms in GAD patients. We recruited 73 GAD patients and 75 matched healthy controls (HC) for clinical assessments, as well as resting-state functional and structural magnetic resonance imaging scans. We defined a pain-related network through a published meta-analysis, including the insula, thalamus, periaqueductal gray, prefrontal cortex, anterior cingulate cortex, amygdala, and hippocampus. Subsequently, we conducted the regional homogeneity (ReHo) and the gray matter volume (GMV) within the pain-related network. Correlation analysis was then employed to explore associations between abnormal regions and self-reported outcomes, assessed using the Patient Health Questionnaire-15 (PHQ-15) and pain scores. We observed significantly increased ReHo in the bilateral insula but decreased GMV in the bilateral thalamus of GAD compared to HC. Further correlation analysis revealed a positive correlation between ReHo of the left anterior insula and pain scores in GAD patients, while a respective negative correlation between GMV of the bilateral thalamus and PHQ-15 scores. In summary, GAD patients exhibit structural and functional abnormalities in pain-related networks. The enhanced ReHo in the left anterior insula is correlated with pain symptoms, which might be a crucial brain region of pain symptoms in GAD.
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Affiliation(s)
- Jie Meng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Ting Zhang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Tong Hao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Xiaohui Xie
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Mengdan Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Lei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Xingsong Wan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Chunyan Zhu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China; Institute of Artificial Intelligence, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Qianqian Li
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China.
| | - Kai Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China; Institute of Artificial Intelligence, University of Science and Technology of China, Hefei, Anhui Province, China.
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Zhu H, Tao Y, Wang S, Zhu X, Lin K, Zheng N, Chen LM, Xu F, Wu R. fMRI, LFP, and anatomical evidence for hierarchical nociceptive routing pathway between somatosensory and insular cortices. Neuroimage 2024; 289:120549. [PMID: 38382864 DOI: 10.1016/j.neuroimage.2024.120549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
The directional organization of multiple nociceptive regions, particularly within obscure operculoinsular areas, underlying multidimensional pain processing remains elusive. This study aims to establish the fundamental organization between somatosensory and insular cortices in routing nociceptive information. By employing an integrated multimodal approach of high-field fMRI, intracranial electrophysiology, and transsynaptic viral tracing in rats, we observed a hierarchically organized connection of S1/S2 → posterior insula → anterior insula in routing nociceptive information. The directional nociceptive pathway determined by early fMRI responses was consistent with that examined by early evoked LFP, intrinsic effective connectivity, and anatomical projection, suggesting fMRI could provide a valuable facility to discern directional neural circuits in animals and humans non-invasively. Moreover, our knowledge of the nociceptive hierarchical organization of somatosensory and insular cortices and the interface role of the posterior insula may have implications for the development of targeted pain therapies.
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Affiliation(s)
- Hongyan Zhu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200032, China
| | - Yan Tao
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200032, China
| | - Siqi Wang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430071, China
| | - Xutao Zhu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Kunzhang Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Ning Zheng
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430071, China
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science and Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA.
| | - Fuqiang Xu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430071, China.
| | - Ruiqi Wu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200032, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 200031, China.
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Wen Z, Pace-Schott EF, Lazar SW, Rosén J, Åhs F, Phelps EA, LeDoux JE, Milad MR. Distributed neural representations of conditioned threat in the human brain. Nat Commun 2024; 15:2231. [PMID: 38472184 PMCID: PMC10933283 DOI: 10.1038/s41467-024-46508-0] [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: 04/28/2023] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Detecting and responding to threat engages several neural nodes including the amygdala, hippocampus, insular cortex, and medial prefrontal cortices. Recent propositions call for the integration of more distributed neural nodes that process sensory and cognitive facets related to threat. Integrative, sensitive, and reproducible distributed neural decoders for the detection and response to threat and safety have yet to be established. We combine functional MRI data across varying threat conditioning and negative affect paradigms from 1465 participants with multivariate pattern analysis to investigate distributed neural representations of threat and safety. The trained decoders sensitively and specifically distinguish between threat and safety cues across multiple datasets. We further show that many neural nodes dynamically shift representations between threat and safety. Our results establish reproducible decoders that integrate neural circuits, merging the well-characterized 'threat circuit' with sensory and cognitive nodes, discriminating threat from safety regardless of experimental designs or data acquisition parameters.
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Affiliation(s)
- Zhenfu Wen
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Edward F Pace-Schott
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Jörgen Rosén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Åhs
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | | | - Joseph E LeDoux
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Center for Neural Science and Department of Psychology, New York University, New York, NY, USA
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- The Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Mohammed R Milad
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
- The Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA.
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
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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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Kucyi A, Anderson N, Bounyarith T, Braun D, Shareef-Trudeau L, Treves I, Braga RM, Hsieh PJ, Hung SM. Individual variability in neural representations of mind-wandering. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.20.576471. [PMID: 38328109 PMCID: PMC10849545 DOI: 10.1101/2024.01.20.576471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Mind-wandering is a frequent, daily mental activity, experienced in unique ways in each person. Yet neuroimaging evidence relating mind-wandering to brain activity, for example in the default mode network (DMN), has relied on population-rather than individual-based inferences due to limited within-individual sampling. Here, three densely-sampled individuals each reported hundreds of mind-wandering episodes while undergoing multi-session functional magnetic resonance imaging. We found reliable associations between mind-wandering and DMN activation when estimating brain networks within individuals using precision functional mapping. However, the timing of spontaneous DMN activity relative to subjective reports, and the networks beyond DMN that were activated and deactivated during mind-wandering, were distinct across individuals. Connectome-based predictive modeling further revealed idiosyncratic, whole-brain functional connectivity patterns that consistently predicted mind-wandering within individuals but did not fully generalize across individuals. Predictive models of mind-wandering and attention that were derived from larger-scale neuroimaging datasets largely failed when applied to densely-sampled individuals, further highlighting the need for personalized models. Our work offers novel evidence for both conserved and variable neural representations of self-reported mind-wandering in different individuals. The previously-unrecognized inter-individual variations reported here underscore the broader scientific value and potential clinical utility of idiographic approaches to brain-experience associations.
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Murray GM, Sessle BJ. Pain-sensorimotor interactions: New perspectives and a new model. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2024; 15:100150. [PMID: 38327725 PMCID: PMC10847382 DOI: 10.1016/j.ynpai.2024.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/25/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
How pain and sensorimotor behavior interact has been the subject of research and debate for many decades. This article reviews theories bearing on pain-sensorimotor interactions and considers their strengths and limitations in the light of findings from experimental and clinical studies of pain-sensorimotor interactions in the spinal and craniofacial sensorimotor systems. A strength of recent theories is that they have incorporated concepts and features missing from earlier theories to account for the role of the sensory-discriminative, motivational-affective, and cognitive-evaluative dimensions of pain in pain-sensorimotor interactions. Findings acquired since the formulation of these recent theories indicate that additional features need to be considered to provide a more comprehensive conceptualization of pain-sensorimotor interactions. These features include biopsychosocial influences that range from biological factors such as genetics and epigenetics to psychological factors and social factors encompassing environmental and cultural influences. Also needing consideration is a mechanistic framework that includes other biological factors reflecting nociceptive processes and glioplastic and neuroplastic changes in sensorimotor and related brain and spinal cord circuits in acute or chronic pain conditions. The literature reviewed and the limitations of previous theories bearing on pain-sensorimotor interactions have led us to provide new perspectives on these interactions, and this has prompted our development of a new concept, the Theory of Pain-Sensorimotor Interactions (TOPSMI) that we suggest gives a more comprehensive framework to consider the interactions and their complexity. This theory states that pain is associated with plastic changes in the central nervous system (CNS) that lead to an activation pattern of motor units that contributes to the individual's adaptive sensorimotor behavior. This activation pattern takes account of the biological, psychological, and social influences on the musculoskeletal tissues involved in sensorimotor behavior and on the plastic changes and the experience of pain in that individual. The pattern is normally optimized in terms of biomechanical advantage and metabolic cost related to the features of the individual's musculoskeletal tissues and aims to minimize pain and any associated sensorimotor changes, and thereby maintain homeostasis. However, adverse biopsychosocial factors and their interactions may result in plastic CNS changes leading to less optimal, even maladaptive, sensorimotor changes producing motor unit activation patterns associated with the development of further pain. This more comprehensive theory points towards customized treatment strategies, in line with the management approaches to pain proposed in the biopsychosocial model of pain.
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Affiliation(s)
- Greg M. Murray
- Discipline of Restorative and Reconstructive Dentistry, Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Darcy Road, Westmead, NSW 2145, Australia
| | - Barry J. Sessle
- Faculty of Dentistry and Temerty Faculty of Medicine Department of Physiology, and Centre for the Study of Pain, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada
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Erdal S, Harman Özdoğan M, Yildirim D, Kuni A, Selçuk S, Güneri A, Arslan EN. Effects of Orange Oil Aromatherapy on Pain and Anxiety During Invasive Interventions in Patients With Hematopoietic Stem Cell Transplants. JOURNAL OF INFUSION NURSING 2024; 47:54-60. [PMID: 38211616 DOI: 10.1097/nan.0000000000000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Invasive interventions, such as peripheral intravenous cannula, port needle placement, and blood collection, are often required for both inpatient and outpatient follow-up patients with hematological malignancies and hematopoietic stem cell transplants. This prospective, randomized controlled experimental study assessed the effect of orange oil inhalation used in aromatherapy on pain and anxiety levels in invasive interventions with hematological malignancies and hematopoietic stem cell transplants. It was conducted prospectively with 80 patients with hematological malignancies who were treated in the adult bone marrow transplant unit and adult hematology service of a private hospital between May 2021 and April 2022. The orange oil inhalation used in aromatherapy was applied to patients in the intervention group. The Visual Analog Scale (VAS) and State-Trait Anxiety Inventory (STAI) were used for data collection. Regarding the personal characteristics of the patients, 42.5% were ≥61 years old, 60% were men, and 85% were married. VAS pain scores of the intervention group were statistically lower than those of the control group (P < .001). However, there was no statistically significant difference in the STAI scores of groups (P >.05). The study results show that orange oil inhalation has been determined to reduce pain during invasive interventions.
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Affiliation(s)
- Seckin Erdal
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
| | - Merve Harman Özdoğan
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
| | - Dilek Yildirim
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
| | - Ayşem Kuni
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
| | - Sevinc Selçuk
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
| | - Azize Güneri
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
| | - Elif Naz Arslan
- Acibadem Altunizade Hospital, Adult Bone Marrow Transplantation Unit, İstanbul, Turkey (Erdal, Kuni, Selçuk, Güneri, and Arslan); Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University, Sinop, Turkey (Harman Özdoğan); and Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey (Yildirim)
- Seckin Erdal, RN, is currently working as a nurse in charge in the adult bone marrow transplant unit at Acibadem Altunizade Hospital. She started her professional career as an emergency, internal medicine, and oncology nurse and has been a nurse in charge of bone marrow transplantation since 1989. In 2015, she founded and chaired the European Blood and Bone Marrow Transplantation Turkey Nurse Group
- Merve Harman Özdoğan, MSN, RN, completed her undergraduate education in 2011 and her graduate education in 2016. She worked as a nurse in the stem cell transplant service for 8 years. She has been working as a lecturer at Sinop University since 2019. Her areas of interest are internal medicine, oncology, hematology, and dialysis
- Dilek Yıldırım, PhD, RN, graduated from Istanbul University Florence Nightingale School of Nursing in 2009. She completed her master's degree at Istanbul University Institute of Health Sciences, Internal Medicine Nursing Master Program, in 2013. She completed a doctorate program at the same university in 2018. Her research areas of interest concern nursing education, palliative care, cancer, pain, cancer symptoms, intensive care nursing research, and internal medicine nursing. Dr. Yildirim is working as an assistant professor at the nursing department in Istanbul Aydin University, Faculty of Health Sciences
- Ayşem Kuni, RN, graduated from Sakarya University, Department of Nursing, in 2014. She has been working as a case manager nurse in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital since 2014
- Sevinc Selçuk, RN, has been working as a training nurse in the adult hematology service of Acıbadem Altunizade Hospital since 2014. She graduated from Ege University, Department of Nursing, in 2014
- Azize Güner, RN, graduated from Konya Health Vocational High School Nursing Department in 2011. She is currently working as a nurse team leader in the adult bone marrow transplant unit of Acıbadem Altunizade Hospital. She began her professional career as a surgery, internal medicine nurse. She has been working as an adult bone marrow transplant nurse since 2014
- Elif Naz Arslan, MPsych, is a clinical psychologist and has a master of science degree in the clinical and community psychology field in University of East London (UEL). She has worked with adults in private clinics since 2017 and is currently working as a clinical psychologist in the adult bone marrow transplantation unit, hematolytic service, and her private clinic
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9
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Abilashimova D, Aubakirova M, Abdildin Y, Viderman D. Safinamide for pain management in patients with Parkinson's disease. Rev Neurol (Paris) 2023:S0035-3787(23)01143-8. [PMID: 38103994 DOI: 10.1016/j.neurol.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/16/2023] [Accepted: 10/12/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Pain is often neglected in Parkinson's disease (PD), although it impacts most PD patients. While the mechanism of pain in PD is still being studied, various pharmacological, interventional, and alternative treatment options have been offered for pain relief. Safinamide, a recently approved drug for PD, has shown promising results in improving pain in patients with PD. Several clinical studies report changes in pain scores in PD patients treated with safinamide, but these have not been systematically summarized. Therefore, our main goal was to perform a systematic review and statistical analysis of relevant studies. METHODS A systematic search of studies was conducted using four databases: Pubmed, Cochrane Library, Google Scholar, and Scopus. The nine included randomized controlled trials did not provide sufficient data for a meta-analysis; therefore, we conducted a qualitative systematic review. RESULTS Our results suggest that safinamide at a daily dose of 100mg is more effective for treating PD pain than that of 50mg. Moreover, the reduction in fluctuation-related pain and pain from edema was more consistent when treated with safinamide compared to other PD pain types. We also attempted to suggest a mechanism of action for safinamide on pain processing in the brain, which should be explored in more detail in future studies. CONCLUSION Clinical evidence suggests that safinamide may be particularly beneficial for PD patients experiencing fluctuation-related pain and pain from edema, as these subtypes of pain showed greater improvement compared to other types of pain. Based on the findings of the included studies, safinamide appears to relieve the overall pain burden. However, the lack of sufficient data for conducting a meta-analysis highlights the need for future studies to report mean pain scores and their standard deviations.
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Affiliation(s)
- D Abilashimova
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kerei, Zhanibek khandar street 5/1, Astana 020000, Kazakhstan
| | - M Aubakirova
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kerei, Zhanibek khandar street 5/1, Astana 020000, Kazakhstan
| | - Y Abdildin
- School of Engineering and Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr Avenue, Astana 010000, Kazakhstan
| | - D Viderman
- Department of Surgery, School of Medicine, Nazarbayev University, Kerei and Zhanibek khandar street 5/1, Astana 020000, Kazakhstan; Department of Anesthesiology, Intensive Care, and Pain Medicine, National Research Oncology Center, Kerei and Zhanibek khandar street 5/1, Astana 020000, Kazakhstan.
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10
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Clairis N, Lopez-Persem A. Debates on the dorsomedial prefrontal/dorsal anterior cingulate cortex: insights for future research. Brain 2023; 146:4826-4844. [PMID: 37530487 PMCID: PMC10690029 DOI: 10.1093/brain/awad263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023] Open
Abstract
The dorsomedial prefrontal cortex/dorsal anterior cingulate cortex (dmPFC/dACC) is a brain area subject to many theories and debates over its function(s). Even its precise anatomical borders are subject to much controversy. In the past decades, the dmPFC/dACC has been associated with more than 15 different cognitive processes, which sometimes appear quite unrelated (e.g. body perception, cognitive conflict). As a result, understanding what the dmPFC/dACC does has become a real challenge for many neuroscientists. Several theories of this brain area's function(s) have been developed, leading to successive and competitive publications bearing different models, which sometimes contradict each other. During the last two decades, the lively scientific exchanges around the dmPFC/dACC have promoted fruitful research in cognitive neuroscience. In this review, we provide an overview of the anatomy of the dmPFC/dACC, summarize the state of the art of functions that have been associated with this brain area and present the main theories aiming at explaining the dmPFC/dACC function(s). We explore the commonalities and the arguments between the different theories. Finally, we explain what can be learned from these debates for future investigations of the dmPFC/dACC and other brain regions' functions.
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Affiliation(s)
- Nicolas Clairis
- Laboratory of Behavioral Genetics (LGC)- Brain Mind Institute (BMI)- Sciences de la Vie (SV), École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Alizée Lopez-Persem
- FrontLab, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne University, AP HP, Hôpital de la Pitié Salpêtrière, 75013 Paris, France
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11
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Flor H, Noguchi K, Treede RD, Turk DC. The role of evolving concepts and new technologies and approaches in advancing pain research, management, and education since the establishment of the International Association for the Study of Pain. Pain 2023; 164:S16-S21. [PMID: 37831955 DOI: 10.1097/j.pain.0000000000003063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/09/2023] [Indexed: 10/15/2023]
Abstract
ABSTRACT The decades since the inauguration of the International Association for the Study of Pain have witnessed major advances in scientific concepts (such as the biopsychosocial model and chronic primary pain as a disease in its own right) and in new technologies and approaches (from molecular biology to brain imaging) that have inspired innovations in pain research. These have guided progress in pain management and education about pain for healthcare professionals, the general public, and administrative agencies.
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Affiliation(s)
- Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Koichi Noguchi
- Laboratory of Pain Mechanism Research, Hyogo Medical University, Hyogo, Japan
| | - Rolf-Detlef Treede
- Department of Neurophysiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dennis C Turk
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
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12
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Neumann N, Domin M, Schmidt CO, Lotze M. Chronic pain is associated with less grey matter volume in the anterior cingulum, anterior and posterior insula and hippocampus across three different chronic pain conditions. Eur J Pain 2023; 27:1239-1248. [PMID: 37366271 DOI: 10.1002/ejp.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Chronic pain of different aetiologies and localization has been associated with less grey matter volume (GMV) in several cortical and subcortical brain areas. Recent meta-analyses reported low reproducibility of GMV alterations between studies and pain syndromes. METHODS To investigate GMV in common chronic pain conditions defined by body location (chronic back pain, n = 174; migraine, n = 92; craniomandibular disorder, n = 39) compared to controls (n = 296), we conducted voxel-based morphometry and determined GMV from high-resolution cranial MRIs obtained in an epidemiologic survey. Mediation analyses were performed between the presence of chronic pain and GMV testing the mediators stress and mild depression. The predictability of chronic pain was investigated with binomial logistic regression. RESULTS Whole-brain analyses yielded reduced GMV within the left anterior insula and the anterior cingulate cortex, for a ROI approach additionally the left posterior insula and left hippocampus showing less GMV across all patients with chronic pain. The relationship of pain with GMV in the left hippocampus was mediated by self-reported stressors in the last 12 months. Binomial logistic regression revealed a predictive effect for GMV in the left hippocampus and left anterior insula/temporal pole for the presence of chronic pain. CONCLUSIONS Chronic pain across three different pain conditions was characterized by less GMV in brain regions consistently described for different chronic pain conditions before. Less GMV in the left hippocampus mediated by experienced stress during the last year might be related to altered pain learning mechanisms in chronic pain patients. SIGNIFICANCE Grey matter reorganization could serve as a diagnostic biomarker for chronic pain. In a large cohort, we here replicated findings of less grey matter volume across three pain conditions in the left anterior and posterior insula, anterior cingulate and left hippocampus. Less hippocampal grey matter was mediated by experienced stress.
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Affiliation(s)
- Nicola Neumann
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Carsten-Oliver Schmidt
- Institute for Community Medicine- Department SHIP/KEF, University Medicine Greifswald, Greifswald, Germany
| | - Martin Lotze
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
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13
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Motzkin JC, Kanungo I, D’Esposito M, Shirvalkar P. Network targets for therapeutic brain stimulation: towards personalized therapy for pain. FRONTIERS IN PAIN RESEARCH 2023; 4:1156108. [PMID: 37363755 PMCID: PMC10286871 DOI: 10.3389/fpain.2023.1156108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Precision neuromodulation of central brain circuits is a promising emerging therapeutic modality for a variety of neuropsychiatric disorders. Reliably identifying in whom, where, and in what context to provide brain stimulation for optimal pain relief are fundamental challenges limiting the widespread implementation of central neuromodulation treatments for chronic pain. Current approaches to brain stimulation target empirically derived regions of interest to the disorder or targets with strong connections to these regions. However, complex, multidimensional experiences like chronic pain are more closely linked to patterns of coordinated activity across distributed large-scale functional networks. Recent advances in precision network neuroscience indicate that these networks are highly variable in their neuroanatomical organization across individuals. Here we review accumulating evidence that variable central representations of pain will likely pose a major barrier to implementation of population-derived analgesic brain stimulation targets. We propose network-level estimates as a more valid, robust, and reliable way to stratify personalized candidate regions. Finally, we review key background, methods, and implications for developing network topology-informed brain stimulation targets for chronic pain.
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Affiliation(s)
- Julian C. Motzkin
- Departments of Neurology and Anesthesia and Perioperative Care (Pain Management), University of California, San Francisco, San Francisco, CA, United States
| | - Ishan Kanungo
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Mark D’Esposito
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Prasad Shirvalkar
- Departments of Neurology and Anesthesia and Perioperative Care (Pain Management), University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
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14
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Shirvalkar P, Prosky J, Chin G, Ahmadipour P, Sani OG, Desai M, Schmitgen A, Dawes H, Shanechi MM, Starr PA, Chang EF. First-in-human prediction of chronic pain state using intracranial neural biomarkers. Nat Neurosci 2023; 26:1090-1099. [PMID: 37217725 PMCID: PMC10330878 DOI: 10.1038/s41593-023-01338-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/18/2023] [Indexed: 05/24/2023]
Abstract
Chronic pain syndromes are often refractory to treatment and cause substantial suffering and disability. Pain severity is often measured through subjective report, while objective biomarkers that may guide diagnosis and treatment are lacking. Also, which brain activity underlies chronic pain on clinically relevant timescales, or how this relates to acute pain, remains unclear. Here four individuals with refractory neuropathic pain were implanted with chronic intracranial electrodes in the anterior cingulate cortex and orbitofrontal cortex (OFC). Participants reported pain metrics coincident with ambulatory, direct neural recordings obtained multiple times daily over months. We successfully predicted intraindividual chronic pain severity scores from neural activity with high sensitivity using machine learning methods. Chronic pain decoding relied on sustained power changes from the OFC, which tended to differ from transient patterns of activity associated with acute, evoked pain states during a task. Thus, intracranial OFC signals can be used to predict spontaneous, chronic pain state in patients.
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Affiliation(s)
- Prasad Shirvalkar
- UCSF Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California San Francisco, San Francisco, CA, USA.
- UCSF Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
| | - Jordan Prosky
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Gregory Chin
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Parima Ahmadipour
- Departments of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Omid G Sani
- Departments of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Maansi Desai
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Ashlyn Schmitgen
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Heather Dawes
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Maryam M Shanechi
- Departments of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Philip A Starr
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- UCSF Department of Physiology, University of California San Francisco, San Francisco, CA, USA
| | - Edward F Chang
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- UCSF Department of Physiology, University of California San Francisco, San Francisco, CA, USA
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Generalization and Idiosyncrasy: Two Sides of the Same Brain. J Neurosci 2022; 42:8755-8757. [PMID: 36418180 PMCID: PMC9698678 DOI: 10.1523/jneurosci.1427-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 12/29/2022] Open
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