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McDaniel AL, Dimitrov TN, Bruehl SP, Monroe TB, Failla MD, Cowan RL, Ryan C, Anderson AR. Psychophysics of Pain: A Methodological Introduction. Pain Manag Nurs 2023; 24:442-451. [PMID: 36948969 PMCID: PMC10440278 DOI: 10.1016/j.pmn.2023.02.006] [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: 06/28/2022] [Revised: 12/29/2022] [Accepted: 02/15/2023] [Indexed: 03/24/2023]
Abstract
For over 100 years, psychophysics ..÷ the scientific study between physical stimuli and sensation ... has been successfully employed in numerous scientific and healthcare disciplines, as an objective measure of sensory phenomena. This manuscript provides an overview of fundamental psychophysical concepts, emphasizing pain and research application..÷defining common terms, methods, and procedures.Psychophysics can provide systematic and objective measures of sensory perception that can be used by nursing scientists to explore complex, subjective phenomena..÷such as pain perception. While there needs to be improved standardization of terms and techniques, psychophysical approaches are diverse and may be tailored to address or augment current research paradigms. The interdisciplinary nature of psychophysics..÷like nursing..÷provides a unique lens for understanding how our perceptions are influenced by measurable sensations. While the quest to understand human perception is far from complete, nursing science has an opportunity to contribute to pain research by using the techniques and methods available through psychophysical procedures.
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Affiliation(s)
- Aaron L McDaniel
- From The Ohio State University College of Nursing, Columbus, Ohio.
| | | | - Stephen P Bruehl
- Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Todd B Monroe
- From The Ohio State University College of Nursing, Columbus, Ohio
| | | | - Ronald L Cowan
- Department of Psychiatry, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Claire Ryan
- Vanderbilt University Medical Center, Nashville, Tennessee
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Wijnia JW, Oudman E, Batjes DM, Brouwer BA, Oey M, Postma A. Korsakoff syndrome and altered pain perception: a search of underlying neural mechanisms. Scand J Pain 2023; 23:424-432. [PMID: 36117250 DOI: 10.1515/sjpain-2022-0053] [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: 04/04/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Patients with Korsakoff syndrome (KS) may have a diminished pain perception. Information on KS and pain is scarce and limited to case descriptions. The present study is the first to investigate the underlying neural mechanisms of altered pain perception in patients with KS more systematically. METHODS We conducted a literature search on neural correlates of pain perception in other neurocognitive disorders in which extensive research was done. RESULTS The brain areas that are affected in KS showed considerable overlap with the neural correlates of pain perception in other neurocognitive disorders. We discussed which different aspects of disturbed pain perception could play a role within KS, based on distinct neural damage and brain areas involved in pain perception. CONCLUSIONS Combining current knowledge, we hypothesize that diminished pain perception in KS may be related to lesioned neural connections between cerebral cortical networks and relays of mainly the thalamus, the periaqueductal gray, and possibly lower brain stem regions projecting to the cerebellum. Based on these neural correlates of altered pain perception, we assume that increased pain thresholds, inhibition of pain signals, and disturbed input to cerebral and cerebellar cortical areas involved in pain processing, all are candidate mechanisms in cases of diminished pain perception in KS. We recommend that clinicians need to be alert for somatic morbidity in patients with KS. Due to altered neural processing of nociceptive input the clinical symptoms of somatic morbidity may present differently (i.e. limited pain responses) and therefore are at risk of being missed.
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Affiliation(s)
- Jan W Wijnia
- Slingedael Center of Expertise for Korsakoff Syndrome, Rotterdam, The Netherlands
| | - Erik Oudman
- Slingedael Center of Expertise for Korsakoff Syndrome, Rotterdam, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Deirdre M Batjes
- Slingedael Center of Expertise for Korsakoff Syndrome, Rotterdam, The Netherlands
| | - Brigitte A Brouwer
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Misha Oey
- Slingedael Center of Expertise for Korsakoff Syndrome, Rotterdam, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Albert Postma
- Slingedael Center of Expertise for Korsakoff Syndrome, Rotterdam, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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Martin SL, Jones AKP, Brown CA, Kobylecki C, Whitaker GA, El-Deredy W, Silverdale MA. Altered Pain Processing Associated with Administration of Dopamine Agonist and Antagonist in Healthy Volunteers. Brain Sci 2022; 12:brainsci12030351. [PMID: 35326306 PMCID: PMC8946836 DOI: 10.3390/brainsci12030351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/10/2022] Open
Abstract
Striatal dopamine dysfunction is associated with the altered top-down modulation of pain processing. The dopamine D2-like receptor family is a potential substrate for such effects due to its primary expression in the striatum, but evidence for this is currently lacking. Here, we investigated the effect of pharmacologically manipulating striatal dopamine D2 receptor activity on the anticipation and perception of acute pain stimuli in humans. Participants received visual cues that induced either certain or uncertain anticipation of two pain intensity levels delivered via a CO2 laser. Rating of the pain intensity and unpleasantness was recorded. Brain activity was recorded with EEG and analysed via source localisation to investigate neural activity during the anticipation and receipt of pain. Participants completed the experiment under three conditions, control (Sodium Chloride), D2 receptor agonist (Cabergoline), and D2 receptor antagonist (Amisulpride), in a repeated-measures, triple-crossover, double-blind study. The antagonist reduced an individuals’ ability to distinguish between low and high pain following uncertain anticipation. The EEG source localisation showed that the agonist and antagonist reduced neural activations in specific brain regions associated with the sensory integration of salient stimuli during the anticipation and receipt of pain. During anticipation, the agonist reduced activity in the right mid-temporal region and the right angular gyrus, whilst the antagonist reduced activity within the right postcentral, right mid-temporal, and right inferior parietal regions. In comparison to control, the antagonist reduced activity within the insula during the receipt of pain, a key structure involved in the integration of the sensory and affective aspects of pain. Pain sensitivity and unpleasantness were not changed by D2R modulation. Our results support the notion that D2 receptor neurotransmission has a role in the top-down modulation of pain.
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Affiliation(s)
- Sarah L. Martin
- Department of Psychology, Manchester Metropolitan University, Manchester M15 6GX, UK
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester M13 9PL, UK; (A.K.P.J.); (C.A.B.)
- Correspondence:
| | - Anthony K. P. Jones
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester M13 9PL, UK; (A.K.P.J.); (C.A.B.)
| | - Christopher A. Brown
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester M13 9PL, UK; (A.K.P.J.); (C.A.B.)
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Christopher Kobylecki
- Salford Royal NHS Foundation Trust, Department of Neurology, Manchester Academic Health Science Centre, Salford M6 8HD, UK; (C.K.); (M.A.S.)
| | - Grace A. Whitaker
- Advanced Center for Electrical and Electronics Engineering, Federico Santa María Technical University, Valparaíso 1680, Chile;
| | - Wael El-Deredy
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaiso 1680, Chile;
| | - Monty A. Silverdale
- Salford Royal NHS Foundation Trust, Department of Neurology, Manchester Academic Health Science Centre, Salford M6 8HD, UK; (C.K.); (M.A.S.)
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Inter-individual differences in pain anticipation and pain perception in migraine: Neural correlates of migraine frequency and cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio. PLoS One 2021; 16:e0261570. [PMID: 34929017 PMCID: PMC8687546 DOI: 10.1371/journal.pone.0261570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/05/2021] [Indexed: 01/03/2023] Open
Abstract
Previous studies targeting inter-individual differences in pain processing in migraine mainly focused on the perception of pain. Our main aim was to disentangle pain anticipation and perception using a classical fear conditioning task, and investigate how migraine frequency and pre-scan cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio as an index of neurobiological stress response would relate to neural activation in these two phases. Functional Magnetic Resonance Imaging (fMRI) data of 23 participants (18 females; mean age: 27.61± 5.36) with episodic migraine without aura were analysed. We found that migraine frequency was significantly associated with pain anticipation in brain regions comprising the midcingulate and caudate, whereas pre-scan cortisol-to DHEA-S ratio was related to pain perception in the pre-supplementary motor area (pre-SMA). Both results suggest exaggerated preparatory responses to pain or more general to stressors, which may contribute to the allostatic load caused by stressors and migraine attacks on the brain.
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Lu JS, Chen QY, Chen X, Li XH, Zhou Z, Liu Q, Lin Y, Zhou M, Xu PY, Zhuo M. Cellular and synaptic mechanisms for Parkinson's disease-related chronic pain. Mol Pain 2021; 17:1744806921999025. [PMID: 33784837 PMCID: PMC8020085 DOI: 10.1177/1744806921999025] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Parkinson’s disease is the second most common neurodegenerative disorder after
Alzheimer’s disease. Chronic pain is experienced by the vast majority of
patients living with Parkinson’s disease. The degeneration of dopaminergic
neuron acts as the essential mechanism of Parkinson’s disease in the midbrain
dopaminergic pathway. The impairment of dopaminergic neurons leads to
dysfunctions of the nociceptive system. Key cortical areas, such as the anterior
cingulate cortex (ACC) and insular cortex (IC) that receive the dopaminergic
projections are involved in pain transmission. Dopamine changes synaptic
transmission via several pathway, for example the D2-adenly cyclase (AC)-cyclic
AMP (cAMP)-protein kinase A (PKA) pathway and D1-G protein-coupled receptor
kinase 2 (GRK2)-fragile X mental retardation protein (FMRP) pathway. The
management of Parkinson’s disease-related pain implicates maintenance of stable
level of dopaminergic drugs and analgesics, however a more selective drug
targeting at key molecules in Parkinson’s disease-related pain remains to be
investigated.
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Affiliation(s)
- Jing-Shan Lu
- Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Qi-Yu Chen
- Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Xiang Chen
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xu-Hui Li
- Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Zhaoxiang Zhou
- Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Qin Liu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuwan Lin
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Miaomiao Zhou
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ping-Yi Xu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Zhuo
- Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
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Cintra RR, Lins LCRF, Medeiros KAAL, Souza MF, Gois AM, Bispo JMM, Melo MS, Leal PC, Meurer YSR, Ribeiro AM, Silva RH, Marchioro M, Santos JR. Nociception alterations precede motor symptoms in a progressive model of parkinsonism induced by reserpine in middle-aged rats. Brain Res Bull 2021; 171:1-9. [PMID: 33675933 DOI: 10.1016/j.brainresbull.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 10/22/2022]
Abstract
Nociception alterations are frequent non-motor symptoms of the prodromal phase of Parkinson's disease (PD). The period for the onset of symptoms and the pathophysiological mechanisms underlying these alterations remain unclear. We investigated the course of nociception alterations in a progressive model of parkinsonism induced by reserpine (RES) in rats. Male Wistar rats (6-7 months) received 5 or 10 subcutaneous injections of RES (0.1 mg/kg) or vehicle daily for 20 days. Motor evaluation and nociceptive assessment were performed throughout the treatment. At the end of the treatment rats were euthanized, the brains removed and processed for immunohistochemical analysis (TH and c-Fos). The RES-treated rats exhibited an increased nociceptive response to mechanical and chemical stimulation in the electronic von Frey and formalin tests, respectively. Moreover, these alterations preceded the motor impairment observed in the catalepsy test. In addition, the RES treatment reduced the TH-immunoreactivity in the ventral tegmental area (VTA) and increased the c-Fos expression in the ventral-lateral periaqueductal gray (vlPAG), rostral ventral medulla (RVM) and dorsal raphe nucleus (DRN) after noxious stimuli induced by formalin. Taken together, our results reinforce that nociceptive changes are one of the early signs of PD and monoamine depletion in basal ganglia can be involved in the abnormal processing of nociceptive information in PD.
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Affiliation(s)
- Rachel R Cintra
- Laboratory of Neurophysiology, Department of Physiology, Federal University of Sergipe, São Cristovão, SE, Brazil
| | - Lívia C R F Lins
- Department of Health Education, Federal University of Sergipe, Lagarto, SE, Brazil
| | - Katty A A L Medeiros
- Laboratory of Neurophysiology, Department of Physiology, Federal University of Sergipe, São Cristovão, SE, Brazil
| | - Marina F Souza
- Laboratory of Behavioral and Evolutionary Neurobiology, Department of Biosciences, Federal University of Sergipe, Itabaiana, SE, Brazil
| | - Auderlan M Gois
- Laboratory of Behavioral and Evolutionary Neurobiology, Department of Biosciences, Federal University of Sergipe, Itabaiana, SE, Brazil
| | - José M M Bispo
- Laboratory of Behavioral and Evolutionary Neurobiology, Department of Biosciences, Federal University of Sergipe, Itabaiana, SE, Brazil
| | - Mônica S Melo
- Department of Health Education, Federal University of Sergipe, Lagarto, SE, Brazil
| | - Pollyana C Leal
- Post-graduate Program of Dentistry, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Ywlliane S R Meurer
- Laboratory of Behavioral and Molecular Neuroscience, Department of Pharmacology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Alessandra M Ribeiro
- Laboratory of Neuroscience and Bioprospecting of Natural Products, Department of Biosciences, Federal University of São Paulo, Santos, SP, Brazil
| | - Regina H Silva
- Laboratory of Behavioral and Molecular Neuroscience, Department of Pharmacology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Murilo Marchioro
- Laboratory of Neurophysiology, Department of Physiology, Federal University of Sergipe, São Cristovão, SE, Brazil
| | - José R Santos
- Laboratory of Behavioral and Evolutionary Neurobiology, Department of Biosciences, Federal University of Sergipe, Itabaiana, SE, Brazil.
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7
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Author response to comment on "The association between pain and impulse control behaviours in Parkinson's disease". Parkinsonism Relat Disord 2021; 83:128-129. [PMID: 33478869 DOI: 10.1016/j.parkreldis.2021.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 11/24/2022]
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Holmes SA, Kim A, Borsook D. The brain and behavioral correlates of motor-related analgesia (MRA). Neurobiol Dis 2020; 148:105158. [PMID: 33157210 DOI: 10.1016/j.nbd.2020.105158] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/03/2023] Open
Abstract
The human motor system has the capacity to act as an internal form of analgesia. Since the discovery of the potential influence of motor systems on analgesia in rodent models, clinical applications of targeting the motor system for analgesia have been implemented. However, a neurobiological basis for motor activation's effects on analgesia is not well defined. Motor-related analgesia (MRA) is a phenomenon wherein a decrease in pain symptoms can be achieved through either indirect or direct activation of the motor axis. To date, research has focused on (a) evaluating the pain-motor interaction as one focused on the acute protection from painful stimuli; (b) motor cortex stimulation for chronic pain; or (c) exercise as a method of improving chronic pain in animal and human models. This review evaluates (1) current knowledge surrounding how pain interferes with canonical neurological performance throughout the motor axis; and (2) the physiological basis for motor-related analgesia as a means to reduce pain symptom loads for patients. A proposal for future research directions is provided.
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Affiliation(s)
- S A Holmes
- Center for Pain and the Brain, Boston Childrens Hospital and Harvard Medical School, 1-Department of Anesthesiology Critical Care and Pain Medicine, Boston Children's Hospital- Harvard Medical School, Boston, United States.
| | - A Kim
- Center for Pain and the Brain, Boston Childrens Hospital and Harvard Medical School, 1-Department of Anesthesiology Critical Care and Pain Medicine, Boston Children's Hospital- Harvard Medical School, Boston, United States.
| | - D Borsook
- Center for Pain and the Brain, Boston Childrens Hospital and Harvard Medical School, 1-Department of Anesthesiology Critical Care and Pain Medicine, Boston Children's Hospital- Harvard Medical School, Boston, United States.
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