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Magi CE, Longobucco Y, Amato C, Camedda C, Balestri C, El Aoufy K, Iovino P, Bambi S, Rasero L. Enhancing the comfort of hospitalized elderly patients: pain management strategies for painful nursing procedures. Front Med (Lausanne) 2024; 11:1390695. [PMID: 38966534 PMCID: PMC11223755 DOI: 10.3389/fmed.2024.1390695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/05/2024] [Indexed: 07/06/2024] Open
Affiliation(s)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Carla Amato
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Claudia Camedda
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Department of Head and Neck District Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Chiara Balestri
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Laura Rasero
- Department of Health Sciences, University of Florence, Florence, Italy
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2
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Liu X, Jiao G, Zhou F, Kendrick KM, Yao D, Gong Q, Xiang S, Jia T, Zhang XY, Zhang J, Feng J, Becker B. A neural signature for the subjective experience of threat anticipation under uncertainty. Nat Commun 2024; 15:1544. [PMID: 38378947 PMCID: PMC10879105 DOI: 10.1038/s41467-024-45433-6] [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: 11/29/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Uncertainty about potential future threats and the associated anxious anticipation represents a key feature of anxiety. However, the neural systems that underlie the subjective experience of threat anticipation under uncertainty remain unclear. Combining an uncertainty-variation threat anticipation paradigm that allows precise modulation of the level of momentary anxious arousal during functional magnetic resonance imaging (fMRI) with multivariate predictive modeling, we train a brain model that accurately predicts subjective anxious arousal intensity during anticipation and test it across 9 samples (total n = 572, both gender). Using publicly available datasets, we demonstrate that the whole-brain signature specifically predicts anxious anticipation and is not sensitive in predicting pain, general anticipation or unspecific emotional and autonomic arousal. The signature is also functionally and spatially distinguishable from representations of subjective fear or negative affect. We develop a sensitive, generalizable, and specific neuroimaging marker for the subjective experience of uncertain threat anticipation that can facilitate model development.
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Affiliation(s)
- Xiqin Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Guojuan Jiao
- MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Feng Zhou
- Faculty of Psychology, Southwest University, Chongqing, China
- MOE Key Laboratory of Cognition and Personality, Chongqing, China
| | - Keith M Kendrick
- MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Dezhong Yao
- MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, (Fudan University), Ministry of Education, Shanghai, China
| | - Tianye Jia
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, (Fudan University), Ministry of Education, Shanghai, China
- The Centre for Population Neuroscience and Stratified Medicine (PONS), ISTBI, Fudan University, Shanghai, China
- SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Xiao-Yong Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, (Fudan University), Ministry of Education, Shanghai, China
| | - Jie Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, (Fudan University), Ministry of Education, Shanghai, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, (Fudan University), Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Benjamin Becker
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.
- Department of Psychology, The University of Hong Kong, Hong Kong, China.
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3
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Zillig AL, Pauli P, Wieser M, Reicherts P. Better safe than sorry?-On the influence of learned safety on pain perception. PLoS One 2023; 18:e0289047. [PMID: 37934741 PMCID: PMC10629634 DOI: 10.1371/journal.pone.0289047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/10/2023] [Indexed: 11/09/2023] Open
Abstract
The experience of threat was found to result-mostly-in increased pain, however it is still unclear whether the exact opposite, namely the feeling of safety may lead to a reduction of pain. To test this hypothesis, we conducted two between-subject experiments (N = 94; N = 87), investigating whether learned safety relative to a neutral control condition can reduce pain, while threat should lead to increased pain compared to a neutral condition. Therefore, participants first underwent either threat or safety conditioning, before entering an identical test phase, where the previously conditioned threat or safety cue and a newly introduced visual cue were presented simultaneously with heat pain stimuli. Methodological changes were performed in experiment 2 to prevent safety extinction and to facilitate conditioning in the first place: We included additional verbal instructions, increased the maximum length of the ISI and raised CS-US contingency in the threat group from 50% to 75%. In addition to pain ratings and ratings of the visual cues (threat, safety, arousal, valence, and contingency), in both experiments, we collected heart rate and skin conductance. Analysis of the cue ratings during acquisition indicate successful threat and safety induction, however results of the test phase, when also heat pain was administered, demonstrate rapid safety extinction in both experiments. Results suggest rather small modulation of subjective and physiological pain responses following threat or safety cues relative to the neutral condition. However, exploratory analysis revealed reduced pain ratings in later trials of the experiment in the safety group compared to the threat group in both studies, suggesting different temporal dynamics for threat and safety learning and extinction, respectively. Perspective: The present results demonstrate the challenge to maintain safety in the presence of acute pain and suggest more research on the interaction of affective learning mechanism and pain processing.
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Affiliation(s)
- Anna-Lena Zillig
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Matthias Wieser
- Department of Clinical Psychology, Erasmus University of Rotterdam, Rotterdam, Netherlands
| | - Philipp Reicherts
- Department of Medical Psychology and Sociology, University of Augsburg, Augsburg, Germany
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4
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Schulreich S, Tusche A, Kanske P, Schwabe L. Higher subjective socioeconomic status is linked to increased charitable giving and mentalizing-related neural value coding. Neuroimage 2023; 279:120315. [PMID: 37557972 DOI: 10.1016/j.neuroimage.2023.120315] [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: 04/03/2023] [Revised: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023] Open
Abstract
Socioeconomic status (SES), a concept related to an individual's economic and social position relative to others, can shape social interactions like altruistic behaviors. However, little is known about the exact neurocognitive mechanisms that link SES with altruism. Our study aimed to provide a comprehensive account of the sociocognitive and neural mechanisms through which SES affects charitable giving - an important variant of human altruism. To this end, participants completed a charitable donation task while their brain activity was measured using functional magnetic resonance imaging (fMRI). We also assessed participants' socio-cognitive ability to infer other people's mental states (i.e., mentalizing) - a driver of prosocial behavior - in an independent social task. Behaviorally, we found that both charitable giving and social cognition were status-dependent, as subjective SES positively predicted donations and mentalizing capacity. Moreover, the link between SES and charitable giving was mediated by individuals' mentalizing capacity. At the neural level, a multivariate pattern analysis of fMRI data revealed that higher subjective SES was associated with stronger value coding in the right temporoparietal junction (rTPJ). The strength of this value representation predicted charitable giving and was linked to mentalizing. Furthermore, we observed an increased negative functional coupling between rTPJ and left putamen with higher SES. Together, increased charitable giving in higher-status individuals could be explained by status-dependent recruitment of mentalizing-related value coding and altered functional connectivity in the brain. Our findings provide insights into the socio- and neurocognitive mechanisms explaining why and when higher SES leads to prosociality, which might ultimately inform targeted interventions to promote prosocial behavior in human societies.
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Affiliation(s)
- Stefan Schulreich
- Department of Cognitive Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg 20146, Germany; Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna 1090, Austria.
| | - Anita Tusche
- Queen's Neuroeconomics Laboratory, Departments of Psychology and Economics, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden 01187, Germany
| | - Lars Schwabe
- Department of Cognitive Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg 20146, Germany
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Wang L, Hu X, Ren Y, Lv J, Zhao S, Guo L, Liu T, Han J. Arousal modulates the amygdala-insula reciprocal connectivity during naturalistic emotional movie watching. Neuroimage 2023; 279:120316. [PMID: 37562718 DOI: 10.1016/j.neuroimage.2023.120316] [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: 07/04/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023] Open
Abstract
Emotional arousal is a complex state recruiting distributed cortical and subcortical structures, in which the amygdala and insula play an important role. Although previous neuroimaging studies have showed that the amygdala and insula manifest reciprocal connectivity, the effective connectivities and modulatory patterns on the amygdala-insula interactions underpinning arousal are still largely unknown. One of the reasons may be attributed to static and discrete laboratory brain imaging paradigms used in most existing studies. In this study, by integrating naturalistic-paradigm (i.e., movie watching) functional magnetic resonance imaging (fMRI) with a computational affective model that predicts dynamic arousal for the movie stimuli, we investigated the effective amygdala-insula interactions and the modulatory effect of the input arousal on the effective connections. Specifically, the predicted dynamic arousal of the movie served as regressors in general linear model (GLM) analysis and brain activations were identified accordingly. The regions of interest (i.e., the bilateral amygdala and insula) were localized according to the GLM activation map. The effective connectivity and modulatory effect were then inferred by using dynamic causal modeling (DCM). Our experimental results demonstrated that amygdala was the site of driving arousal input and arousal had a modulatory effect on the reciprocal connections between amygdala and insula. Our study provides novel evidence to the underlying neural mechanisms of arousal in a dynamical naturalistic setting.
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Affiliation(s)
- Liting Wang
- School of Automation, Northwestern Polytechnical University, Xi'an, China
| | - Xintao Hu
- School of Automation, Northwestern Polytechnical University, Xi'an, China.
| | - Yudan Ren
- School of Information Science and Technology, Northwest University, Xi'an, China
| | - Jinglei Lv
- School of Biomedical Engineering and Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Shijie Zhao
- School of Automation, Northwestern Polytechnical University, Xi'an, China
| | - Lei Guo
- School of Automation, Northwestern Polytechnical University, Xi'an, China
| | - Tianming Liu
- School of Computing, University of Georgia, Athens, USA
| | - Junwei Han
- School of Automation, Northwestern Polytechnical University, Xi'an, China
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Jian Z, Longqing R, Dayuan W, Fei J, Bo L, Gang Z, Siying Z, Yan G. Prolonged duration of epidural labour analgesia decreases the success rate of epidural anaesthesia for caesarean section. Ann Med 2022; 54:1112-1117. [PMID: 35443838 PMCID: PMC9891221 DOI: 10.1080/07853890.2022.2067353] [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] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To summarise the process of conversion of epidural labour analgesia to anaesthesia for caesarean delivery and explore the relationship between duration of labour analgesia and conversion. METHODS Parturients who underwent conversion from epidural labour analgesia to anaesthesia for caesarean delivery between May 2019 and April 2020 at the Chengdu Women's and Children's Central Hospital, Sichuan Maternal and Child Health Hospital, and Jinjiang District Maternal and Child Health Hospital were selected. If the position of the epidural catheter was correct and the effect was good, patients were converted to epidural surgical anaesthesia. If epidural labour analgesia was ineffective, spinal anaesthesia (SA) was administered immediately. For category-1 emergency caesarean sections, general anaesthesia (GA) was administered. RESULTS A total of 1084 parturients underwent conversion. Of these, 19 (1.9%) received GA due to the initiation of category-1 emergency caesarean section. 704 (64.9%) were converted to epidural surgical anaesthesia, 2 (0.2%) had failed conversions and were administered GA before delivery, and 357 (32.9%) were converted to SA. Logistic regression analysis showed that prolonged duration of epidural labour analgesia ([Crude odds ratio (OR)=1.065; 95% confidence interval (CI), 1.037-1.094; p < .01]; [Adjusted OR = 1.060; 95% CI, 1.031-1.091; p < .01]) was an independent risk factor for conversion failure. A receiver operating characteristic curve constructed using duration of epidural labour analgesia showed that parturients with a duration of epidural labour analgesia ≥8 h, more frequently required a change of anaesthesia technique during conversion, and the relative risk of conversion failure was 1.54 (95% CI, 1.23-1.93; p < .01). CONCLUSION Prolonged duration of epidural labour analgesia increases the possibility of having an invalid epidural catheter, resulting in an increased risk of conversion failure from epidural labour analgesia to epidural surgical anaesthesia. Further, this risk is higher when the time exceeds 8 h. KEY MESSAGESProlonged duration of epidural labour analgesia > 8 h is associated with conversion failure.If it is impossible to judge whether the conversion is successful immediately, spinal anaesthesia should be administered to minimise complications.
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Affiliation(s)
- Zhang Jian
- Sichuan Provincial Maternity and Child Health Care Hospital (Women's and Children's Hospital Affiliated of Chengdu Medical College), Chengdu
| | - Ran Longqing
- Chengdu Women's and Children's Central Hospital (School of Medicine, University of Electronic Science and Technology of China), Chengdu
| | | | - Jia Fei
- Jinjiang Maternity and Child Health Hospital, Chengdu
| | - Liu Bo
- Jinjiang Maternity and Child Health Hospital, Chengdu
| | - Zhang Gang
- Sichuan Provincial Maternity and Child Health Care Hospital (Women's and Children's Hospital Affiliated of Chengdu Medical College), Chengdu
| | - Zhu Siying
- Sichuan Provincial Maternity and Child Health Care Hospital (Women's and Children's Hospital Affiliated of Chengdu Medical College), Chengdu
| | - Gao Yan
- Sichuan Provincial Maternity and Child Health Care Hospital (Women's and Children's Hospital Affiliated of Chengdu Medical College), Chengdu
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Kreddig N, Hasenbring MI, Keogh E. Comparing the Effects of Thought Suppression and Focused Distraction on Pain-Related Attentional Biases in Men and Women. THE JOURNAL OF PAIN 2022; 23:1958-1972. [PMID: 35914643 DOI: 10.1016/j.jpain.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
Increasing attentional focus away from pain can affect pain experience, suggesting that cognitive strategies that move attentional allocation may be a moderator of pain. In a pre-post-design, the present study examined the effects of 2 cognitive strategies used in pain contexts, thought suppression and focused distraction, on subsequent pain-related attention. Thought suppression was hypothesized to increase pain-related attention, whereas focused distraction was expected to reduce it. Influences of both anxiety and sex were also considered, as secondary questions. 139 (86 women, 53 men) healthy, pain-free participants were randomly assigned to use either thought suppression or focused distraction during a mild cold pressor test (CPT). Pain-related attention was examined using a dot-probe and an attentional blink task, pre-and post-CPT. Questionnaires about relevant cognitive and emotional aspects, demographics, and pain were completed. Results showed no difference in the effect of the 2 pain inhibition strategies on pain-related attention. The hypothesized rebound effect in thought suppression on pain-related attention did not emerge. However, thought suppression showed a short-term benefit in comparison to focused distraction regarding reported pain and perceived threat during the cold pressor test. Few sex differences were found. Thus, the cognitive strategies affected pain outcomes, but did not influence pain-related attention. PERSPECTIVE: Cognitive strategies could help with pain through changing attention allocation. In this study, the effects of the 2 cognitive strategies thought suppression and focused distraction on pain-related attention in men and women were examined. Elucidating mechanisms that lie behind pain strategies that focus on changing attention may help improve treatments.
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Affiliation(s)
- Nina Kreddig
- Ruhr University Bochum, Bochum, Germany; University of Bath, Bath, UK.
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Lin WY, Hsieh JC, Lu CC, Ono Y. Altered metabolic connectivity between the amygdala and default mode network is related to pain perception in patients with cancer. Sci Rep 2022; 12:14105. [PMID: 35982228 PMCID: PMC9388574 DOI: 10.1038/s41598-022-18430-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
We investigated the neural correlates for chronic cancer pain conditions by retrospectively analyzing whole brain regions on 18F-fluoro-2-deoxyglucose-positron emission tomography images acquired from 80 patients with head and neck squamous cell carcinoma and esophageal cancer. The patients were divided into three groups according to perceived pain severity and type of analgesic treatment, namely patients not under analgesic treatment because of no or minor pain, patients with good pain control under analgesic treatment, and patients with poor pain control despite analgesic treatment. Uncontrollable cancer pain enhanced the activity of the hippocampus, amygdala, inferior temporal gyrus, and temporal pole. Metabolic connectivity analysis further showed that amygdala co-activation with the hippocampus was reduced in the group with poor pain control and preserved in the groups with no or minor pain and good pain control. The increased although imbalanced activity of the medial temporal regions may represent poor pain control in patients with cancer. The number of patients who used anxiolytics was higher in the group with poor pain control, whereas the usage rates were comparable between the other two groups. Therefore, further studies should investigate the relationship between psychological conditions and pain in patients with cancer and analyze the resultant brain activity.Trial registration: This study was registered at clinicaltrials.gov on 9/3/20 (NCT04537845).
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Affiliation(s)
- Wen-Ying Lin
- grid.19188.390000 0004 0546 0241Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- grid.260539.b0000 0001 2059 7017Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Ching-Chu Lu
- grid.412094.a0000 0004 0572 7815Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yumie Ono
- grid.411764.10000 0001 2106 7990School of Science and Technology, Meiji University, Kawasaki, Japan
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Schneider SK, Pauli P, Lautenbacher S, Reicherts P. Effects of psychosocial stress and performance feedback on pain processing and its correlation with subjective and neuroendocrine parameters. Scand J Pain 2022; 23:389-401. [PMID: 35938978 DOI: 10.1515/sjpain-2021-0204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 06/28/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Previous research on stress-induced pain modulation suggests that moderate psychological stress usually leads to hyperalgesia while more severe threat results in hypoalgesia. However, existing studies often lack suitable control conditions imperative to identify mere stress effects. Similarly, research mainly focused on pure anticipation of a social threat, not taking into consideration actual experiences of social evaluation. Therefore, we set out to investigate actual social up- and downgrading combined with a standardized stress paradigm to evaluate short-term and prolonged changes in pain perception and their potential association with neuroendocrine and subjective stress parameters. METHODS We allocated 177 healthy women to four experimental conditions, either the standard version of the Trier Social Stress Test (TSST) followed by positive, negative or no performance feedback, or a well-matched but less demanding placebo version of the TSST. Stress responses were assessed with ratings, salivary alpha-amylase, and salivary cortisol. To capture putative effects of stress on pain, heat pain threshold, ratings of phasic heat pain stimuli, and conditioned pain modulation were measured. RESULTS Despite a largely successful stress induction, results do not support a reliable influence of experimentally induced social stress-with or without subsequent performance feedback-on pain in women. Further, we found no clear association of pain modulation and changes in neuroendocrine or subjective stress responses. CONCLUSIONS Our results contrast previous studies, which repeatedly demonstrated stress-induced hypo- or hyperalgesia. This might be due to methodological reasons as former research was often characterized by high heterogeneity regarding the applied stressors, low sample sizes, and lacking or inconclusive control conditions. Thus, our results raise the question whether pain modulation in women by experimental psychosocial stress might have been overestimated in the past. Future research is necessary, which should employ parametric stress induction methods including well-matched control tasks, taking into consideration the participants' gender/sex and the time course of the stress response relative to pain assessment. The study is registered as DRKS00026946 at 'Deutsches Register Klinischer Studien' (DRKS) and can be also found at the World Health Organization's search portal.
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Affiliation(s)
- Sarah Karen Schneider
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany.,Centre of Mental Health, University Hospital of Würzburg, University of Würzburg, Würzburg, Germany
| | - Stefan Lautenbacher
- Department of Physiological Psychology, Institute of Psychology, University of Bamberg, Bamberg, Germany
| | - Philipp Reicherts
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
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Molin B, Zwedberg S, Berger AK, Sand A, Georgsson S. Disempowering women-a mixed methods study exploring informational support about pain persisting after childbirth and its consequences. BMC Pregnancy Childbirth 2022; 22:510. [PMID: 35739466 PMCID: PMC9229078 DOI: 10.1186/s12884-022-04841-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Access to information is essential to achieving individual empowerment; meaning the ability to exercise control, manage one’s own condition and make informed decisions. However, studies have shown that information provided to women regarding physiological changes during the postpartum period and postpartum health was inadequate, incorrect, or inconsistent. Methods The aim of this study was to explore informational support about pain persisting after childbirth and its consequences. A sequential explanatory mixed methods design was used. In the first, quantitative phase, 1,171 women, who gave birth eight months earlier, completed a self-administered questionnaire. In the second, qualitative phase, 20 women who experienced chronic pain were interviewed. Descriptive statistics and qualitative content analysis were used to analyse the data. Results The majority of the women did not receive information about pain persisting after childbirth, or the information was insufficient or incorrect. They did not know when and where to seek help and did not consult health care professionals. In addition, the lack of information had a negative impact on women’s psychological well-being. All women expressed the need to be informed by health care professionals, irrespective of the individual risk of developing chronic pain. Conclusions Health services should ensure availability of information to give the women opportunity to achieve empowerment to make good health decisions, increase control over their health and well-being as well as to enhance their self-efficacy. We propose that a booklet or leaflet with relevant information about the risk of developing chronic pain, symptoms and treatment, along with advice about appropriate health care settings should be provided as part of antenatal or postnatal care.
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Affiliation(s)
- Beata Molin
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 141 86, Stockholm, Huddinge, Sweden. .,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
| | - Sofia Zwedberg
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.,Theme Children's & Women's Health, PA Pregnancy Care and Delivery, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anna Sand
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Georgsson
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 141 86, Stockholm, Huddinge, Sweden.,The Swedish Red Cross University, Stockholm, Sweden
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11
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Bedwell GJ, Louw C, Parker R, van den Broeke E, Vlaeyen JW, Moseley GL, Madden VJ. The influence of a manipulation of threat on experimentally-induced secondary hyperalgesia. PeerJ 2022; 10:e13512. [PMID: 35757170 PMCID: PMC9220919 DOI: 10.7717/peerj.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 05/07/2022] [Indexed: 01/17/2023] Open
Abstract
Pain is thought to be influenced by the threat value of the particular context in which it occurs. However, the mechanisms by which a threat achieves this influence on pain are unclear. Here, we explore how threat influences experimentally-induced secondary hyperalgesia, which is thought to be a manifestation of central sensitization. We developed an experimental study to investigate the effect of a manipulation of threat on experimentally-induced secondary hyperalgesia in 26 healthy human adults (16 identifying as female; 10 as male). We induced secondary hyperalgesia at both forearms using high-frequency electrical stimulation. Prior to the induction, we used a previously successful method to manipulate threat of tissue damage at one forearm (threat site). The effect of the threat manipulation was determined by comparing participant-rated anxiety, perceived threat, and pain during the experimental induction of secondary hyperalgesia, between the threat and control sites. We hypothesized that the threat site would show greater secondary hyperalgesia (primary outcome) and greater surface area (secondary outcome) of induced secondary hyperalgesia than the control site. Despite a thorough piloting procedure to test the threat manipulation, our data showed no main effect of site on pain, anxiety, or threat ratings during high-frequency electrical stimulation. In the light of no difference in threat between sites, the primary and secondary hypotheses cannot be tested. We discuss reasons why we were unable to replicate the efficacy of this established threat manipulation in our sample, including: (1) competition between threats, (2) generalization of learned threat value, (3) safety cues, (4) trust, and requirements for participant safety, (5) sampling bias, (6) sample-specific habituation to threat, and (7) implausibility of (sham) skin examination and report. Better strategies to manipulate threat are required for further research on the mechanisms by which threat influences pain.
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Affiliation(s)
- Gillian J. Bedwell
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, Western Cape, South Africa,Pain Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Caron Louw
- Pain Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Romy Parker
- Pain Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Emanuel van den Broeke
- Institute of Neuroscience, Division Cognitive and Systems, UC Louvain, Brussels, Belgium
| | - Johan W. Vlaeyen
- Research Group Health Psychology, KU Leuven, Leuven, Belgium,Experimental Health Psychology, University of Maastricht, Maastricht, Netherlands
| | | | - Victoria J. Madden
- Pain Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa,Research Group Health Psychology, KU Leuven, Leuven, Belgium,IIMPACT in Health, University of South Australia, Adelaide, Australia,Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
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12
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Macian N, Dualé C, Voute M, Leray V, Courrent M, Bodé P, Giron F, Sonneville S, Bernard L, Joanny F, Menard K, Ducheix G, Pereira B, Pickering G. Short-Term Magnesium Therapy Alleviates Moderate Stress in Patients with Fibromyalgia: A Randomized Double-Blind Clinical Trial. Nutrients 2022; 14:2088. [PMID: 35631229 PMCID: PMC9145501 DOI: 10.3390/nu14102088] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Patients suffering from fibromyalgia often report stress and pain, with both often refractory to usual drug treatment. Magnesium supplementation seems to improve fibromyalgia symptoms, but the level of evidence is still poor. This study is a randomized, controlled, double-blind trial in fibromyalgia patients that compared once a day oral magnesium 100 mg (Chronomag®, magnesium chloride technology formula) to placebo, for 1 month. The primary endpoint was the level of stress on the DASS-42 scale, and secondary endpoints were pain, sleep, quality of life, fatigue, catastrophism, social vulnerability, and magnesium blood concentrations. After 1 month of treatment, the DASS-42 score decreased in the magnesium and placebo groups but not significantly (21.8 ± 9.6 vs. 21.6 ± 10.8, respectively, p = 0.930). Magnesium supplementation significantly reduced the mild/moderate stress subgroup (DASS-42 stress score: 22.1 ± 2.8 to 12.3 ± 7.0 in magnesium vs. 21.9 ± 11.9 to 22.9 ± 11.9 in placebo, p = 0.003). Pain severity diminished significantly (p = 0.029) with magnesium while the other parameters were not significantly different between both groups. These findings show, for the first time, that magnesium improves mild/moderate stress and reduces the pain experience in fibromyalgia patients. This suggests that daily magnesium could be a useful treatment to improve the burden of disease of fibromyalgia patients and calls for a larger clinical trial.
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Affiliation(s)
- Nicolas Macian
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Christian Dualé
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
- INSERM 1107, University Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Marion Voute
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Vincent Leray
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Marion Courrent
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Paula Bodé
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Fatiha Giron
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Sylvie Sonneville
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Lise Bernard
- Clinical Research/Temporary Authorization Department, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France;
| | - Fabienne Joanny
- FJ Recherche et Developpement, Research Organization, 230 Rue du Faubourg Saint-Honoré, F-75008 Paris, France;
| | - Katell Menard
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Gilles Ducheix
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Bruno Pereira
- Clinical Research and Innovation Department, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France;
| | - Gisèle Pickering
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
- INSERM 1107, University Clermont Auvergne, F-63000 Clermont-Ferrand, France
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13
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Zhang F, Li F, Yang H, Jin Y, Lai W, Kemp GJ, Jia Z, Gong Q. Altered Brain Topological Property Associated With Anxiety in Experimental Orthodontic Pain. Front Neurosci 2022; 16:907216. [PMID: 35645708 PMCID: PMC9132585 DOI: 10.3389/fnins.2022.907216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Orthodontic pain is orofacial pain caused by tooth movement. Anxiety is a strong predictor of the severity of such pain, but little is known about the underlying neuropsychological mechanisms of such effects. The purpose of this study was to investigate the effect of orthodontic pain on brain functional networks and to define the mediating role of anxiety in orthodontic pain and brain function. Methods Graph theory-based network analyses were applied to brain functional magnetic resonance imaging data from 48 healthy participants exposed to 24 h orthodontic pain stimuli and 49 healthy controls without any stimulation. Results In the experimental orthodontic pain stimulation, brain functional networks retained a small-world organization. At the regional level, the nodal centrality of ipsilateral brain nodes to the pain stimulus was enhanced; in contrast the nodal centrality of contralateral brain areas was decreased, especially the right mid-cingulate cortex, which is involved in pain intensity coding. Furthermore, anxiety mediated the relationship between nodal efficiency of mid-cingulate cortex and pain severity. Conclusion The results illuminate the neural mechanisms of orthodontic pain by revealing unbalanced hemispherical brain function related to the unilateral pain stimulation, and reveal clinically exploitable evidence that anxiety mediates the relationship between nodal function of right mid-cingulate cortex and orthodontic pain.
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Affiliation(s)
- Feifei Zhang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Fei Li
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Hong Yang
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yu Jin
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Graham J. Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Zhiyun Jia
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Zhiyun Jia,
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, China
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14
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Bingel U, Wiech K, Ritter C, Wanigasekera V, Mhuircheartaigh R, Lee MC, Ploner M, Tracey I. Hippocampus mediates nocebo impairment of opioid analgesia through changes in functional connectivity. Eur J Neurosci 2022; 56:3967-3978. [PMID: 35537867 DOI: 10.1111/ejn.15687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/12/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
Abstract
The neural mechanisms underlying placebo analgesia have attracted considerable attention over the recent years. In contrast, little is known about the neural underpinnings of a nocebo-induced increase in pain. We previously showed that nocebo-induced hyperalgesia is accompanied by increased activity in the hippocampus that scaled with the perceived level of anxiety. As a key node of the neural circuitry of perceived threat and fear, the hippocampus has recently been proposed to coordinate defensive behaviour in a context-dependent manner. Such a role requires close interactions with other regions involved in the detection of and responses to threat. Here, we investigated the functional connectivity of the hippocampus during nocebo-induced hyperalgesia. Our results show an increase in functional connectivity between hippocampus and brain regions implicated in the processing of sensory-discriminative aspects of pain (posterior insula and primary somatosensory/motor cortex) as well as the periaqueductal gray (PAG). This nocebo-induced increase in connectivity scaled with an individual's increase in anxiety. Moreover, hippocampus connectivity with the amygdala was negatively correlated with the pain intensity reported during nocebo hyperalgesia relative to the placebo condition. Our findings suggest that the hippocampus links nocebo-induced anxiety to a heightened responsiveness to nociceptive input through changes in its crosstalk with pain-modulatory brain areas.
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Affiliation(s)
- Ulrike Bingel
- Department of Neurology, Center of Translational Neuro- and Behavioural Sciences, Hufelandstraße 55, University Medicine Essen, University Duisburg-Essen, Essen, Germany
| | - Katja Wiech
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Christoph Ritter
- Department of Neurology, Center of Translational Neuro- and Behavioural Sciences, Hufelandstraße 55, University Medicine Essen, University Duisburg-Essen, Essen, Germany.,Brain Imaging Facility, Interdisciplinary Center for Clinical Research, RWTH Aachen University, Aachen, Germany
| | - Vishvarani Wanigasekera
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Roisin Mhuircheartaigh
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Mater Misericordiae University Hospital, Eccles St., University College Dublin, Dublin, Ireland
| | - Michael C Lee
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Markus Ploner
- Technical University of Munich, School of Medicine, Department of Neurology, Munich, Germany
| | - Irene Tracey
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
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15
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Attention Control and Audiomotor Processes Underlying Anticipation of Musical Themes while Listening to Familiar Sonata-Form Pieces. Brain Sci 2022; 12:brainsci12020261. [PMID: 35204024 PMCID: PMC8870438 DOI: 10.3390/brainsci12020261] [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: 01/22/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022] Open
Abstract
When listening to music, people are excited by the musical cues immediately before rewarding passages. More generally, listeners attend to the antecedent cues of a salient musical event irrespective of its emotional valence. The present study used functional magnetic resonance imaging to investigate the behavioral and cognitive mechanisms underlying the cued anticipation of the main theme’s recurrence in sonata form. Half of the main themes in the musical stimuli were of a joyful character, half a tragic character. Activity in the premotor cortex suggests that around the main theme’s recurrence, the participants tended to covertly hum along with music. The anterior thalamus, pre-supplementary motor area (preSMA), posterior cerebellum, inferior frontal junction (IFJ), and auditory cortex showed increased activity for the antecedent cues of the themes, relative to the middle-last part of the themes. Increased activity in the anterior thalamus may reflect its role in guiding attention towards stimuli that reliably predict important outcomes. The preSMA and posterior cerebellum may support sequence processing, fine-grained auditory imagery, and fine adjustments to humming according to auditory inputs. The IFJ might orchestrate the attention allocation to motor simulation and goal-driven attention. These findings highlight the attention control and audiomotor components of musical anticipation.
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16
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Li L, Di X, Zhang H, Huang G, Zhang L, Liang Z, Zhang Z. Characterization of whole-brain task-modulated functional connectivity in response to nociceptive pain: A multisensory comparison study. Hum Brain Mapp 2021; 43:1061-1075. [PMID: 34761468 PMCID: PMC8764484 DOI: 10.1002/hbm.25707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/12/2021] [Accepted: 10/21/2021] [Indexed: 11/12/2022] Open
Abstract
Previous functional magnetic resonance imaging (fMRI) studies have shown that brain responses to nociceptive pain, non-nociceptive somatosensory, visual, and auditory stimuli are extremely similar. Actually, perception of external sensory stimulation requires complex interactions among distributed cortical and subcortical brain regions. However, the interactions among these regions elicited by nociceptive pain remain unclear, which limits our understanding of mechanisms of pain from a brain network perspective. Task fMRI data were collected with a random sequence of intermixed stimuli of four sensory modalities in 80 healthy subjects. Whole-brain psychophysiological interaction analysis was performed to identify task-modulated functional connectivity (FC) patterns for each modality. Task-modulated FC strength and graph-theoretical-based network properties were compared among the four modalities. Lastly, we performed across-sensory-modality prediction analysis based on the whole-brain task-modulated FC patterns to confirm the specific relationship between brain patterns and sensory modalities. For each sensory modality, task-modulated FC patterns were distributed over widespread brain regions beyond those typically activated or deactivated during the stimulation. As compared with the other three sensory modalities, nociceptive stimulation exhibited significantly different patterns (more widespread and stronger FC within the cingulo-opercular network, between cingulo-opercular and sensorimotor networks, between cingulo-opercular and emotional networks, and between default mode and emotional networks) and global property (smaller modularity). Further, a cross-sensory-modality prediction analysis found that task-modulated FC patterns could predict sensory modality at the subject level successfully. Collectively, these results demonstrated that the whole-brain task-modulated FC is preferentially modulated by pain, thus providing new insights into the neural mechanisms of pain processing.
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Affiliation(s)
- Linling Li
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Huijuan Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gan Huang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Li Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Zhen Liang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Peng Cheng Laboratory, Shenzhen, China
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17
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Baumgartner JN, Quintana D, Leija L, Schuster NM, Bruno KA, Castellanos JP, Case LK. Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2021; 23:156-174. [PMID: 34425251 DOI: 10.1016/j.jpain.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.
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Affiliation(s)
- Jennifer N Baumgartner
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Desiree Quintana
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Linda Leija
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Nathaniel M Schuster
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Kelly A Bruno
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Joel P Castellanos
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Laura K Case
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California.
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18
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Fox S. Psychomotor Predictive Processing. ENTROPY (BASEL, SWITZERLAND) 2021; 23:806. [PMID: 34202804 PMCID: PMC8303599 DOI: 10.3390/e23070806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023]
Abstract
Psychomotor experience can be based on what people predict they will experience, rather than on sensory inputs. It has been argued that disconnects between human experience and sensory inputs can be addressed better through further development of predictive processing theory. In this paper, the scope of predictive processing theory is extended through three developments. First, by going beyond previous studies that have encompassed embodied cognition but have not addressed some fundamental aspects of psychomotor functioning. Second, by proposing a scientific basis for explaining predictive processing that spans objective neuroscience and subjective experience. Third, by providing an explanation of predictive processing that can be incorporated into the planning and operation of systems involving robots and other new technologies. This is necessary because such systems are becoming increasingly common and move us farther away from the hunter-gatherer lifestyles within which our psychomotor functioning evolved. For example, beliefs that workplace robots are threatening can generate anxiety, while wearing hardware, such as augmented reality headsets and exoskeletons, can impede the natural functioning of psychomotor systems. The primary contribution of the paper is the introduction of a new formulation of hierarchical predictive processing that is focused on psychomotor functioning.
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Affiliation(s)
- Stephen Fox
- VTT Technical Research Centre of Finland, FI-02150 Espoo, Finland
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19
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Distinct neural networks subserve placebo analgesia and nocebo hyperalgesia. Neuroimage 2021; 231:117833. [PMID: 33549749 DOI: 10.1016/j.neuroimage.2021.117833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 01/20/2021] [Accepted: 01/30/2021] [Indexed: 12/19/2022] Open
Abstract
Neural networks involved in placebo analgesia and nocebo hyperalgesia processes have been widely investigated with neuroimaging methods. However, few studies have directly compared these two processes and it remains unclear whether common or distinct neural circuits are involved. To address this issue, we implemented a coordinate-based meta-analysis and compared neural representations of placebo analgesia (30 studies; 205 foci; 677 subjects) and nocebo hyperalgesia (22 studies; 301 foci; 401 subjects). Contrast analyses confirmed placebo-specific concordance in the right ventral striatum, and nocebo-specific concordance in the dorsal anterior cingulate cortex (dACC), left posterior insula and left parietal operculum during combined pain anticipation and administration stages. Importantly, no overlapping regions were found for these two processes in conjunction analyses, even when the threshold was low. Meta-analytic connectivity modeling (MACM) and resting-state functional connectivity (RSFC) analyses on key regions further confirmed the distinct brain networks underlying placebo analgesia and nocebo hyperalgesia. Together, these findings indicate that the placebo analgesia and nocebo hyperalgesia processes involve distinct neural circuits, which supports the view that the two phenomena may operate via different neuropsychological processes.
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20
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Sambuco N, Costa VD, Lang PJ, Bradley MM. Assessing the role of the amygdala in fear of pain: Neural activation under threat of shock. J Affect Disord 2020; 276:1142-1148. [PMID: 32791350 PMCID: PMC7490761 DOI: 10.1016/j.jad.2020.07.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The DSM-5 explicitly states that the neural system model of specific phobia is centered on the amygdala. However, this hypothesis is predominantly supported by human studies on animal phobia, whereas visual cuing of other specific phobias, such as dental fear, do not consistently show amygdala activation. Considering that fear of anticipated pain is one of the best predictors of dental phobia, the current study investigated neural and autonomic activity of pain anticipation in individuals varying in the degree of fear of dental pain. METHOD Functional brain activity (fMRI) was measured in women (n = 31) selected to vary in the degree of self-reported fear of dental pain when under the threat of shock, in which one color signaled the possibility of receiving a painful electric shock and another color signaled safety. RESULTS Enhanced functional activity during threat, compared to safety, was found in regions including anterior insula and anterior/mid cingulate cortex. Importantly, threat reactivity in the anterior insula increased as reported fear of pain increased and further predicted skin conductance changes during pain anticipation. LIMITATIONS The sample was comprised of women. CONCLUSIONS Individual differences in fear of pain vary with activation in the anterior insula, rather than with the amygdala, indicating that fear is not uniquely associated with amygdala activation. Whereas coping techniques such as emotion regulation have been found to vary with activation in a frontal-amygdala circuit when confronted with visual cues, precision psychiatry may need to target specific brain circuits to diagnose and treat different types of specific phobia.
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Affiliation(s)
- Nicola Sambuco
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL.
| | - Vincent D Costa
- Department of Behavioral Neuroscience, Oregon Health & Science University
| | - Peter J Lang
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL
| | - Margaret M Bradley
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL
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21
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Fabi SG, Few JW, Moinuddin S. Practical Guidance for Optimizing Patient Comfort During Microfocused Ultrasound with Visualization and Improving Patient Satisfaction. Aesthet Surg J 2020; 40:208-216. [PMID: 30869754 DOI: 10.1093/asj/sjz079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Microfocused ultrasound with visualization (MFU-V; Ultherapy®) is an effective method for correction of skin laxity through lifting and tightening skin on the face, neck, and décolleté as well as on other parts of the body such as the knees, arms, and abdomen. In addition to being a noninvasive modality for tissue tightening, MFU-V has a biological effect on tissue, rejuvenating the skin through stimulation of elastogenesis and neocollagenesis. MFU-V is also commonly combined with other interventions such as fillers, neuromodulators, and absorbable suspension sutures. OBJECTIVES The aim of this study was to share the extensive experience of the authors in optimizing comfort for their MFU-V patients in order to provide guidance to the broader community surrounding optimal patient comfort with this procedure. METHODS The authors discuss their approaches to patient comfort and satisfaction. Elements of each approach include patient selection, pharmacologic and nonpharmacologic comfort measures, and how prioritization of patient comfort affects both their individual patients and practices. RESULTS The authors share their approaches for optimizing patient comfort during the procedure and provide an overview of both pharmacologic and nonpharmacologic measures that can be adopted to support patient comfort and satisfaction. The similarities and differences of each approach are discussed. CONCLUSIONS In addition to diligent patient selection, the authors find that attention to patient comfort is directly related to satisfaction and appears to be a primary factor in patients' decisions to return for additional treatments.
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Affiliation(s)
- Sabrina G Fabi
- dermatologist and cosmetic surgeon in private practice in San Diego, CA
| | - Julius W Few
- University of Chicago Pritzker School of Medicine, Chicago, IL
- Northwestern University, Evanston, IL
| | - Shay Moinuddin
- aesthetic nurse specialist in private practice in Chicago, IL
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22
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Martin SL, Jones AKP, Brown CA, Kobylecki C, Silverdale MA. A neurophysiological investigation of anticipation to pain in Parkinson's disease. Eur J Neurosci 2019; 51:611-627. [DOI: 10.1111/ejn.14559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 07/23/2019] [Accepted: 08/15/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Sarah L. Martin
- The Human Pain Research Group Division of Neuroscience and Experimental Psychology University of Manchester Manchester UK
| | - Anthony K. P. Jones
- The Human Pain Research Group Division of Neuroscience and Experimental Psychology University of Manchester Manchester UK
| | | | - Christopher Kobylecki
- Institution is Department of Neurology Salford Royal NHS Foundation Trust Manchester Academic Health Science Centre The University of Manchester Manchester UK
| | - Monty A. Silverdale
- Institution is Department of Neurology Salford Royal NHS Foundation Trust Manchester Academic Health Science Centre The University of Manchester Manchester UK
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23
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Lindheimer JB, Stegner AJ, Ellingson-Sayen LD, Van Riper SM, Dougherty RJ, Falvo MJ, Cook DB. Influence of pain anticipation on brain activity and pain perception in Gulf War Veterans with chronic musculoskeletal pain. Psychophysiology 2019; 56:e13452. [PMID: 31429944 DOI: 10.1111/psyp.13452] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 12/21/2022]
Abstract
Anticipation of a painful experience can influence brain activity and increase sensitivity to experimental somatosensory stimuli in healthy adults, but this response is poorly understood among individuals with chronic musculoskeletal pain (CMP). Studies of brain and perceptual responses to somatosensory stimuli are used to make inferences about central nervous system dysfunction as a potential mechanism of symptoms. As such, we sought to (a) determine the influence of pain anticipation on pain-relevant brain regions and pain perception, and (b) characterize potential differences in these responses between Gulf War Veterans with CMP and matched healthy control (CO) Veterans. CMP (N = 30) and CO Veterans (N = 31) were randomized to conditions designed to generate expectations that either painful (pain) or nonpainful (no pain) stimuli would be administered. Brain responses to five nonpainful thermal stimuli were measured during fMRI, and each stimulus was rated for pain intensity and unpleasantness. In the pain condition, an incremental linear decrease in activity across stimuli was observed in the posterior cingulate cortex, cingulate cortex, and middle temporal gyrus. Further, in the pain condition, differential responses were observed between CMP and CO Veterans in the middle temporal gyrus. These findings indicate that brain responses to nonpainful thermal stimuli in Veterans with CMP are sensitive to pain anticipation, and we recommend accounting for the influence of pain anticipation in future investigations of central nervous system dysfunction in CMP.
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Affiliation(s)
- Jacob B Lindheimer
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Aaron J Stegner
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Stephanie M Van Riper
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ryan J Dougherty
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Michael J Falvo
- Department of Veterans Affairs, NJ Health Care System, War Related Illness and Injury Study Center, East Orange, New Jersey.,New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey
| | - Dane B Cook
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
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Applications of dynamic functional connectivity to pain and its modulation. Pain Rep 2019; 4:e752. [PMID: 31579848 DOI: 10.1097/pr9.0000000000000752] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/21/2019] [Accepted: 04/07/2019] [Indexed: 12/30/2022] Open
Abstract
Since early work attempting to characterize the brain's role in pain, it has been clear that pain is not generated by a specific brain region, but rather by coordinated activity across a network of brain regions, the "neuromatrix." The advent of noninvasive whole-brain neuroimaging, including functional magnetic resonance imaging, has provided insight on coordinated activity in the pain neuromatrix and how correlations in activity between regions, referred to as "functional connectivity," contribute to pain and its modulation. Initial functional connectivity investigations assumed interregion connectivity remained stable over time, and measured variability across individuals. However, new dynamic functional connectivity (dFC) methods allow researchers to measure how connectivity changes over time within individuals, permitting insights on the dynamic reorganization of the pain neuromatrix in humans. We review how dFC methods have been applied to pain, and insights afforded on how brain connectivity varies across time, either spontaneously or as a function of psychological states, cognitive demands, or the external environment. Specifically, we review psychophysiological interaction, dynamic causal modeling, state-based dynamic community structure, and sliding-window analyses and their use in human functional neuroimaging of acute pain, chronic pain, and pain modulation. We also discuss promising uses of dFC analyses for the investigation of chronic pain conditions and predicting pain treatment efficacy and the relationship between state- and trait-based pain measures. Throughout this review, we provide information regarding the advantages and shortcomings of each approach, and highlight potential future applications of these methodologies for better understanding the brain processes associated with pain.
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25
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Pavlov’s Pain: the Effect of Classical Conditioning on Pain Perception and its Clinical Implications. Curr Pain Headache Rep 2019; 23:19. [DOI: 10.1007/s11916-019-0766-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Lin CS, Wu CY, Wu SY, Lin HH. Brain activations associated with fearful experience show common and distinct patterns between younger and older adults in the hippocampus and the amygdala. Sci Rep 2018; 8:5137. [PMID: 29572480 PMCID: PMC5865205 DOI: 10.1038/s41598-018-22805-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 02/26/2018] [Indexed: 12/30/2022] Open
Abstract
Revisiting threat-related scenes elicits fear and activates a brain network related to cognitive-affective processing. Prior experience may contribute to the present fearful experience. We aimed to investigate (a) patterns of brain activation associated with individual differences in past fearful experiences (pFear) and the present fear elicited by watching videos (eFear) and (b) age-related differences in the activation patterns. Forty healthy adults, including 20 younger adults (YA) and 20 older adults (OA), underwent functional magnetic resonance imaging while watching videos containing high- and low-threat scenes of medical treatment. Both age subgroups showed positive correlations between pFear and bilateral hippocampal activation. Only YA showed threat-related activation in the bilateral anterior insula and activation positively correlated with pFear in the bilateral S1 and the amygdala. The evidence suggests that the hippocampus, amygdala and S1 may play key roles in bridging past fearful experiences and the present fear elicited by revisiting visual scenes and that the interaction between memory and emotional processing may be age dependent.
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
| | - Ching-Yi Wu
- Institute of Oral Biology, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Yun Wu
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiao-Han Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
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Nocebo Effects and Experimental Models in Visceral Pain. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 138:285-306. [PMID: 29681331 DOI: 10.1016/bs.irn.2018.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Despite its clinical relevance and the potential to extend insights into the processing and modulation of pain derived from investigations of placebo phenomena, the nocebo effect has received comparably little attention over the past decades. Research from experimental and clinical studies is only beginning to unravel the behavioral, functional, and psychoneurobiological mechanisms underlying the nocebo effect. Herein, we summarize current evidence regarding nocebo effects in the field of pain, with a particular emphasis on visceral pain. We provide an overview over behavioral and neuroimaging findings on the impact of expectations and learning and propose promising future directions to help fostering the transition of experimental research from bench to bedside.
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Che X, Cash R, Fitzgerald P, Fitzgibbon BM. The Social Regulation of Pain: Autonomic and Neurophysiological Changes Associated With Perceived Threat. THE JOURNAL OF PAIN 2017; 19:496-505. [PMID: 29274393 DOI: 10.1016/j.jpain.2017.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 12/28/2022]
Abstract
The analgesic effect of social support is proposed as a function of social support modulating perceived threat of painful stimuli. In the current study, we directly examined the social buffering effect in the context of the threat of pain. Eighteen healthy participants were subjected to the threat of pain while they held the hand of a close other, a stranger, or not at all. Neural and autonomic responses were recorded using electroencephalogram and heart rate, respectively. Close other hand-holding reduced pain perception. This was accompanied by decreased heart rate and frontal theta oscillation (4-8 Hz) during the threat phase preceding painful stimulation. Interestingly, decreased heart rate and frontal theta in the close other hand-holding condition were uniquely associated with greater pain reduction during subsequent nociceptive stimulation. Neural changes were source-localized to the insular cortex and the rostral-ventral portions of anterior cingulate cortex, regions involved in the processing of threat and pain. Together, our data build upon work to date linking social support to pain by showing autonomic and neurophysiological changes associated with pain reduction. PERSPECTIVE Social support may reduce pain through buffering the autonomic and neurophysiological response to the threatening quality of noxious stimuli. Results implicate that in clinical settings the caregiver could help people with chronic pain reappraise pain and related conditions as less stressful.
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Affiliation(s)
- Xianwei Che
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia.
| | - Robin Cash
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
| | - Paul Fitzgerald
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia; Epworth Clinic, Epworth Healthcare, Camberwell, Victoria, Australia
| | - Bernadette M Fitzgibbon
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
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29
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Chong CD, Dumkrieger G, Schwedt TJ. Structural Co-Variance Patterns in Migraine: A Cross-Sectional Study Exploring the Role of the Hippocampus. Headache 2017; 57:1522-1531. [PMID: 28976002 PMCID: PMC5681397 DOI: 10.1111/head.13193] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/05/2017] [Accepted: 06/05/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To interrogate hippocampal morphology and structural co-variance patterns in migraine patients and to investigate whether structural co-variance patterns relate to migraine disease characteristics. BACKGROUND Migraine is associated with structural alterations in widespread cortical and subcortical regions associated with the sensory, cognitive, and affective components of pain processing. Recent studies have shown that migraine patients have differences in hippocampal structure and function relative to healthy control subjects, but whether hippocampal structure relates to disease characteristics including frequency of attacks, years lived with migraine and symptoms of allodynia remains unknown. Furthermore, this study investigated hippocampal volume co-variance patterns in migraineurs, an indirect measure of brain network connectivity. Here, we explore differences in hippocampal volume and structural co-variance patterns in migraine patients relative to healthy controls and examine whether these hippocampal measures relate to migraine disease burden. METHODS This study included 61 migraine patients and 57 healthy control subjects (healthy controls: median age = 34.0, IQR = 19.0; migraine patients: median age = 35.0, IQR = 17.5; P = .65). Regional brain volumes were automatically calculated using FreeSurfer version 5.3. Symptoms of allodynia were determined using the Allodynia Symptom Checklist 12 (ASC-12). Structural co-variance patterns were interrogated using pairwise correlations and group differences in correlation strength were estimated using Euclidian distance. A stepwise regression was used to investigate the relationship between structural co-variance patterns with migraine burden. RESULTS Migraine patients had less left hippocampal volume (healthy controls: left hippocampal volume = 4276.8 mm3 , SD = 425.3 mm3 , migraine patients: left hippocampal volume = 4089.5 mm3 , SD = 453.9 mm3 , P = .02) and less total (right plus left) hippocampal volume (healthy controls: total hippocampal volume= 8690.8 mm3 , SD = 855.1 mm3 ; migraine patients: total hippocampal volume = 8341.8 mm3 , SD = 917.9 mm3 ; P = .03) compared to healthy controls. Migraineurs had stronger structural covariance between the hippocampi and cortico-limbic regions in the frontal lobe (inferior opercular gyrus), temporal lobe (planum temporale, amygdala), parietal lobe (angular gyrus, precuneus), and the cerebellar white matter. Results of a stepwise regression showed that hippocampal volumes and the interactions between hippocampal volumes with the volumes of other cortico-limbic regions associate with migraine-related allodynia but not with headache frequency or years lived with migraine. CONCLUSION Migraineurs have less hippocampal volume and stronger hippocampal-cortico-limbic connectivity compared to healthy controls. Hippocampal volumes and measures of hippocampal volume connectivity with other cortico-limbic network regions associate with symptoms of allodynia.
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Affiliation(s)
| | - Gina Dumkrieger
- Mayo Clinic, Arizona, Department of Neurology
- Arizona State University, School of Computing Informatics and Decision Systems Engineering
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