Analysis of pain-related somatosensory evoked magnetic fields using the MUSIC (multiple signal classification) algorithm for magnetoencephalography

Nociceptive Intra-epidermal Electric Stimulation Evokes Steady-State Responses in the Secondary Somatosensory Cortex

Recent studies have established the presence of nociceptive steady-state evoked potentials (SSEPs), generated in response to thermal or intra-epidermal electric stimuli. This study explores cortical sources and generation mechanisms of nociceptive SSEPs in response to intra-epidermal electric stimuli. Our method was to stimulate healthy volunteers (n = 22, all men) with 100 intra-epidermal pulse sequences. Each sequence had a duration of 8.5 s, and consisted of pulses with a pulse rate between 20 and 200 Hz, which was frequency modulated with a multisine waveform of 3, 7 and 13 Hz (n = 10, 1 excluded) or 3 and 7 Hz (n = 12, 1 excluded). As a result, evoked potentials in response to stimulation onset and contralateral SSEPs at 3 and 7 Hz were observed. The SSEPs at 3 and 7 Hz had an average time delay of 137 ms and 143 ms respectively. The evoked potential in response to stimulation onset had a contralateral minimum (N1) at 115 ms and a central maximum (P2) at 300 ms. Sources for the multisine SSEP at 3 and 7 Hz were found through beamforming near the primary and secondary somatosensory cortex. Sources for the N1 were found near the primary and secondary somatosensory cortex. Sources for the N2-P2 were found near the supplementary motor area. Harmonic and intermodulation frequencies in the SSEP power spectrum remained below a detectable level and no evidence for nonlinearity of nociceptive processing, i.e. processing of peripheral firing rate into cortical evoked potentials, was found.

Dipole source localisation using independent component analysis: single trial localisation of laser evoked pain

The accuracy of the inverse solution that finds the spatial location of the generating sources from averaged scalp-recorded event related potentials (ERPs) relies on assumptions about the ERP signals and the sources. We provide evidence that using independent component analysis (ICA) as a signal decomposition filter prior to applying the inverse solution reveals sources that cannot be detected by conventional source localisation methods. Five clusters of sources emerged: a single source cluster in caudal cingulate and bilateral sources in secondary somatosensory cortex (SII), inferior parietal cortex, premotor cortex and insular cortex. The locations of the source dipoles were consistent with findings using fMRI and PET but have not all been previously detected in a single electrophysiological study. In addition, the time-course of the activation of these dipoles was estimated. The results suggest that using ICA to localise single trial data is a powerful tool for exploring the spatiotemporal dynamics of rapid and complex brain processes.

Analysis of magnetic source localization of P300 using the multiple signal classification algorithm

The authors studied the localization of P300 magnetic sources using the multiple signal classification (MUSIC) algorithm. Six healthy subjects (aged 24-34 years old) were investigated with 148-channel whole-head type magnetencephalography using an auditory oddball paradigm in passive mode. The authors also compared six stimulus combinations in order to find the optimal stimulus parameters for P300 magnetic field (P300m) in passive mode. Bilateral MUSIC peaks were located on the mesial temporal, superior temporal and parietal lobes. Interestingly, all MUSIC peaks in these regions emerged earlier in the right hemisphere than in the left hemisphere, suggesting that the right hemisphere has predominance over the left in the processing activity associated with P300m. There were no significant differences among the six stimulus combinations in evoking those P300m sources. The results of the present study suggest that the MUSIC algorithm could be a useful tool for analysis of the time-course of P300m.

Spatiotemporal brain dynamics in response to muscle stimulation

The objective of the present study was to assess the spatiotemporal scenario of brain activity associated with sensory stimulation of the abductor pollicis brevis muscle. Spatiotemporal dipole models, using realistic individual boundary element head models, were built from somatosensory evoked potentials (SEPs; 64 Ch. EEG) to nonpainful and painful intramuscular electrostimulation (IMES) as well as to cutaneous electrostimulation delivered to the distal phalanx of the thumb. Nonpainful and painful muscle stimuli resulted in activation of the same brain regions. In temporal order, these were: the contralateral primary sensorimotor cortex, contralateral dorso-lateral premotor area (PM), bilateral operculo-insular cortices, caudal cingulate motor area (CMA), and posterior cingulate cortex/precuneus. Brain processing induced by muscle sensory input showed a characteristic pattern in contrast to cutaneous sensory input, namely: (1) no early SEP components to IMES; (2) an initial IMES component likely generated by proprioceptive input is not present for digit stimulation; (3) one source was located in the PM only for IMES. This source was unmasked by the lower stimulus intensity; (4) a source for IMES was located in the contralateral caudal CMA rather than being located in the cingulate gyrus. Cerebral sensory processing of input from the muscle involved several sensory and motor areas and likely occurs in two parallel streams subserving higher order somatosensory processing as well as sensory-motor integration. The two streams might on one hand involve sensory discrimination via SI and SII and on the other hand integration of sensory feedback for further motor processing via MI, lateral PM area, and caudal CMA.

Human brain mechanisms of pain perception and regulation in health and disease

CONTEXT

The perception of pain due to an acute injury or in clinical pain states undergoes substantial processing at supraspinal levels. Supraspinal, brain mechanisms are increasingly recognized as playing a major role in the representation and modulation of pain experience. These neural mechanisms may then contribute to interindividual variations and disabilities associated with chronic pain conditions.

OBJECTIVE

To systematically review the literature regarding how activity in diverse brain regions creates and modulates the experience of acute and chronic pain states, emphasizing the contribution of various imaging techniques to emerging concepts.

DATA SOURCES

MEDLINE and PRE-MEDLINE searches were performed to identify all English-language articles that examine human brain activity during pain, using hemodynamic (PET, fMRI), neuroelectrical (EEG, MEG) and neurochemical methods (MRS, receptor binding and neurotransmitter modulation), from January 1, 1988 to March 1, 2003. Additional studies were identified through bibliographies.

STUDY SELECTION

Studies were selected based on consensus across all four authors. The criteria included well-designed experimental procedures, as well as landmark studies that have significantly advanced the field.

DATA SYNTHESIS

Sixty-eight hemodynamic studies of experimental pain in normal subjects, 30 in clinical pain conditions, and 30 using neuroelectrical methods met selection criteria and were used in a meta-analysis. Another 24 articles were identified where brain neurochemistry of pain was examined. Technical issues that may explain differences between studies across laboratories are expounded. The evidence for and the respective incidences of brain areas constituting the brain network for acute pain are presented. The main components of this network are: primary and secondary somatosensory, insular, anterior cingulate, and prefrontal cortices (S1, S2, IC, ACC, PFC) and thalamus (Th). Evidence for somatotopic organization, based on 10 studies, and psychological modulation, based on 20 studies, is discussed, as well as the temporal sequence of the afferent volley to the cortex, based on neuroelectrical studies. A meta-analysis highlights important methodological differences in identifying the brain network underlying acute pain perception. It also shows that the brain network for acute pain perception in normal subjects is at least partially distinct from that seen in chronic clinical pain conditions and that chronic pain engages brain regions critical for cognitive/emotional assessments, implying that this component of pain may be a distinctive feature between chronic and acute pain. The neurochemical studies highlight the role of opiate and catecholamine transmitters and receptors in pain states, and in the modulation of pain with environmental and genetic influences.

CONCLUSIONS

The nociceptive system is now recognized as a sensory system in its own right, from primary afferents to multiple brain areas. Pain experience is strongly modulated by interactions of ascending and descending pathways. Understanding these modulatory mechanisms in health and in disease is critical for developing fully effective therapies for the treatment of clinical pain conditions.

CNS Activation by Noxious Heat to the Hand or Foot: Site-Dependent Delay in Sensory But Not Emotion Circuitry

Recently, functional magnetic resonance imaging has been used as a novel method of evaluating the CNS response to noxious stimuli. In a previous study, a prolonged noxious thermal stimulus applied to the dorsum of the hand produced more than one hemodynamic response that was temporally segregated. The two major responses displayed activation in primary sensory regions (classic pain circuitry) and regions involved in emotion (reward/aversion circuitry), respectively. In the current study, we applied the same thermal stimulus separately to the dorsum of the left foot and the dorsum of the left hand in the same subjects and compared the hemodynamic responses to evaluate the effects of conduction distance on CNS activation within these two segregated systems. After stimulus delivery to the foot, the hemodynamic response in primary sensory networks occurs after a delay of 3.6 ± 1.3 s as compared with the response after hand stimulation. The relative delay of the hemodynamic response in reward/aversion regions is not significantly different between hand and foot stimulation (0.6 ± 2.1 s). These results within the primary sensory system are consistent with the greater conduction distance of the peripheral nerves from the hand versus the foot. The observation that the response within the reward/aversion pathways occurs with the same rapid temporal characteristics after either hand or foot stimulation supports the notion that the circuitry involved in the evaluation of aversive stimuli is rapid in onset and probably represents a major protective mechanism for survival.

Effects of sleep on pain-related somatosensory evoked magnetic fields in humans

We investigated the effects of sleep on pain-related somatosensory evoked magnetic fields (SEFs) following painful electrical stimulation to identify the mechanisms generating them in both fast A-beta fibers relating to touch and slow A-delta fibers relating to pain. While the subjects were awake, non-painful and painful electrical stimulations were applied, and while asleep, painful stimulation was applied to the left index finger. During awake, five components (1M-5M) were identified following both non-painful and painful stimulation, but the 4M and 5M at around 70-100 ms and 140-180 ms, respectively, were significantly enhanced following painful stimulation. During sleep, 1M and 2M generated in the primary somatosensory cortex (SI) did not show a significant change, 3M in SI showed a slight but significant amplitude reduction, and 4M and 5M generated in both SI and the secondary somatosensory cortex (SII) were significantly decreased in amplitude or disappeared. The 4M and 5M are complicated components generated in SI and SII ascending through both A-beta fibers and A-delta fibers. They are specifically enhanced by painful stimulation due to an increase of signals ascending through A-delta fibers, and are markedly decreased during sleep, because they much involve cognitive function.

Effects of sleep on pain-related somatosensory evoked potentials in humans

We investigated effects of sleep on pain-related somatosensory evoked potentials (SEP) following painful electrical stimulation of the left index finger. The biggest advantage of this method is that signals ascending through both A-beta fibers relating to touch and A-delta fibers relating to pain can be recorded simultaneously. While the subject was awake, non-painful stimulation evoked early- and middle latency components, N20, P30 and N60, at the C4 electrode, and painful stimulation evoked not only early- and middle latency components at the C4 but also later pain-specific components, N130 and P240, at the Cz electrode. During sleep, N20 and P30 did not show a significant change in amplitude, N60 showed a slight but significant amplitude reduction, and N130 and P240 significantly decreased in amplitude or disappeared, as compared with those while awake. Therefore, we speculate on the mechanisms generating each component as follows; (1) N20 and P30 are the primary components generated in SI ascending through A-beta fibers. (2) N60 is the secondary component generated in SI involving cognitive function to some degree. (3) N130-P240 are the pain-specific components ascending through A-delta fibers, and closely related to cognitive function, because they were much affected by consciousness, different from the components ascending through A-beta fibers.