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Mota CMD, Madden CJ. Neural circuits of long-term thermoregulatory adaptations to cold temperatures and metabolic demands. Nat Rev Neurosci 2024; 25:143-158. [PMID: 38316956 DOI: 10.1038/s41583-023-00785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 02/07/2024]
Abstract
The mammalian brain controls heat generation and heat loss mechanisms that regulate body temperature and energy metabolism. Thermoeffectors include brown adipose tissue, cutaneous blood flow and skeletal muscle, and metabolic energy sources include white adipose tissue. Neural and metabolic pathways modulating the activity and functional plasticity of these mechanisms contribute not only to the optimization of function during acute challenges, such as ambient temperature changes, infection and stress, but also to longitudinal adaptations to environmental and internal changes. Exposure of humans to repeated and seasonal cold ambient conditions leads to adaptations in thermoeffectors such as habituation of cutaneous vasoconstriction and shivering. In animals that undergo hibernation and torpor, neurally regulated metabolic and thermoregulatory adaptations enable survival during periods of significant reduction in metabolic rate. In addition, changes in diet can activate accessory neural pathways that alter thermoeffector activity. This knowledge may be harnessed for therapeutic purposes, including treatments for obesity and improved means of therapeutic hypothermia.
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Affiliation(s)
- Clarissa M D Mota
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Christopher J Madden
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA.
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2
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Barwood MJ, Eglin C, Hills SP, Johnston N, Massey H, McMorris T, Tipton MJ, Wakabayashi H, Webster L. Habituation of the cold shock response: A systematic review and meta-analysis. J Therm Biol 2024; 119:103775. [PMID: 38211547 DOI: 10.1016/j.jtherbio.2023.103775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
Cold water immersion (CWI) evokes the life-threatening reflex cold shock response (CSR), inducing hyperventilation, increasing cardiac arrhythmias, and increasing drowning risk by impairing safety behaviour. Repeated CWI induces CSR habituation (i.e., diminishing response with same stimulus magnitude) after ∼4 immersions, with variation between studies. We quantified the magnitude and coefficient of variation (CoV) in the CSR in a systematic review and meta-analysis with search terms entered to Medline, SportDiscus, PsychINFO, Pubmed, and Cochrane Central Register. Random effects meta-analyses, including effect sizes (Cohen's d) from 17 eligible groups (k), were conducted for heart rate (HR, n = 145, k = 17), respiratory frequency (fR, n = 73, k = 12), minute ventilation (Ve, n = 106, k = 10) and tidal volume (Vt, n = 46, k=6). All CSR variables habituated (p < 0.001) with large or moderate pooled effect sizes: ΔHR -14 (10) bt. min-1 (d: -1.19); ΔfR -8 (7) br. min-1 (d: -0.78); ΔVe, -21.3 (9.8) L. min-1 (d: -1.64); ΔVt -0.4 (0.3) L -1. Variation was greatest in Ve (control vs comparator immersion: 32.5&24.7%) compared to Vt (11.8&12.1%). Repeated CWI induces CSR habituation potentially reducing drowning risk. We consider the neurophysiological and behavioural consequences.
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Affiliation(s)
- Martin J Barwood
- Faculty of Social and Health Sciences, Leeds Trinity University, Horsforth, UK.
| | - Clare Eglin
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Samuel P Hills
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Nicola Johnston
- Faculty of Social and Health Sciences, Leeds Trinity University, Horsforth, UK
| | - Heather Massey
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Terry McMorris
- Department of Sport and Exercise Science, Institute for Sport, University of Chichester, College Lane, Chichester, West Sussex, UK
| | - Michael J Tipton
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Hitoshi Wakabayashi
- Laboratory of Environmental Ergonomics, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Lisa Webster
- Faculty of Social and Health Sciences, Leeds Trinity University, Horsforth, UK
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3
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Directional Interactions Between Constituents of the Human Large-Scale Thermoregulatory Network. Brain Topogr 2020; 33:489-503. [DOI: 10.1007/s10548-020-00778-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 05/28/2020] [Indexed: 01/04/2023]
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Bud Craig AD. Central neural substrates involved in temperature discrimination, thermal pain, thermal comfort, and thermoregulatory behavior. HANDBOOK OF CLINICAL NEUROLOGY 2018; 156:317-338. [PMID: 30454598 DOI: 10.1016/b978-0-444-63912-7.00019-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A phylogenetically novel pathway that emerged with primate encephalization is described, which conveys high-fidelity cutaneous thermosensory activity in "labeled lines" to a somatotopic map in the dorsal posterior insular cortex. It originates in lamina I of the superficial dorsal horn and ascends by way of the lateral spinothalamic tract and a distinct region in posterolateral thalamus. It evolved from the homeostatic sensory activity that represents the physiologic (interoceptive) condition of the body and drives the central autonomic network, which underlies all affective feelings from the body. Accordingly, human discriminative thermal sensations are accompanied by thermally motivated behaviors and thermal feelings of comfort or discomfort (unless neutral), which evidence suggests are associated with activity in the insular, cingulate, and orbitofrontal cortices, respectively. Yet, the substrates for thermoregulatory behavior have not been established, and several strong candidates (including the hypothalamus and the bed nucleus of the stria terminalis) are discussed. Finally, the neural underpinnings for relationships between thermal affect and social feelings (warm-positive/cold-negative) are addressed, including the association of hyperthermia with clinical depression.
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Affiliation(s)
- Arthur D Bud Craig
- Atkinson Research Laboratory, Barrow Neurological Institute, Phoenix, AZ, United States.
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Muzik O, Diwadkar VA. Regulation of Brown Adipose Tissue Activity by Interoceptive CNS Pathways: The interaction between Brain and Periphery. Front Neurosci 2017; 11:640. [PMID: 29200996 PMCID: PMC5696740 DOI: 10.3389/fnins.2017.00640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/03/2017] [Indexed: 12/31/2022] Open
Abstract
To maintain thermal homeostasis, specific thermogenic tissues are under the control of central thermoregulatory networks that regulate the body's response to thermal challenges. One of these mechanisms involves non-shivering thermogenesis in brown adipose tissue (BAT), which is activated in cold environments in order to defend the body against physical damage as a result of hypothermia. The objective of our study was to assess the interaction between CNS thermoregulatory pathways and sympathetic innervation in BAT during a cold exposure paradigm. Our results show that an innocuous whole-body cooling paradigm induces significant differences in fMRI BOLD signal at the location of the right anterior insula and the red nucleus/substantia nigra region, between lean subjects with high levels of sympathetic innervation in supraclavicular BAT (BAT+ group), and subjects with low levels of sympathetic innervation (BAT− group). Specifically, results indicate significantly larger fMRI BOLD signal changes between periods of cooling and warming of the skin in the BAT+ (as compared to BAT−) group at the location of the right anterior insula. In contrast, the BAT+ group showed significantly smaller fMRI BOLD signal changes in the midbrain between periods of skin cooling and warming. Our findings are consistent with a hierarchical thermoregulatory control system that involves the initiation of inhibitory signals from the right anterior insula toward midbrain areas that normally exert tonic inhibition on the medullary raphe, from where BAT is directly innervated. Our data suggests that exposure to cold elicits differential neuronal activity in interoceptive regulatory centers of subjects with high and low level of sympathetic innervation. As a result, the variability of cold-activated BAT mass observed in humans might be, in part, yoked to different sensitivities of interoceptive cortical brain areas to skin temperature changes.
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Affiliation(s)
- Otto Muzik
- Departments of Pediatrics, Wayne State University School of Medicine, Detroit, MI, United States.,Radiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A Diwadkar
- Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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Riva G, Serino S, Di Lernia D, Pavone EF, Dakanalis A. Embodied Medicine: Mens Sana in Corpore Virtuale Sano. Front Hum Neurosci 2017; 11:120. [PMID: 28360849 PMCID: PMC5352908 DOI: 10.3389/fnhum.2017.00120] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/28/2017] [Indexed: 01/31/2023] Open
Abstract
Progress in medical science and technology drastically improved physicians’ ability to interact with patient’s physical body. Nevertheless, medicine still addresses the human body from a Hippocratic point of view, considering the organism and its processes just as a matter of mechanics and fluids. However, the interaction between the cognitive neuroscience of bodily self-consciousness (BSC), fundamentally rooted in the integration of multisensory bodily inputs, with virtual reality (VR), haptic technologies and robotics is giving a new meaning to the classic Juvenal’s latin dictum “Mens sana in corpore sano” (a healthy mind in a healthy body). This vision provides the basis for a new research field, “Embodied Medicine”: the use of advanced technologies for altering the experience of being in a body with the goal of improving health and well-being. Up to now, most of the research efforts in the field have been focused upon how external bodily information is processed and integrated. Despite the important results, we believe that existing bodily illusions still need to be improved to enhance their capability to effectively correct pathological dysfunctions. First, they do not follow the suggestions provided by the free-energy and predictive coding approaches. More, they lacked to consider a peculiar feature of the human body, the multisensory integration of internal inputs (interoceptive, proprioceptive and vestibular) that constitute our inner body dimension. So, a future challenge is the integration of simulation/stimulation technologies also able to measure and modulate this internal/inner experience of the body. Finally, we also proposed the concept of “Sonoception” as an extension of this approach. The core idea is to exploit recent technological advances in the acoustic field to use sound and vibrations to modify the internal/inner body experience.
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Affiliation(s)
- Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy; Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico ItalianoMilan, Italy
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy; Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico ItalianoMilan, Italy
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Enea Francesco Pavone
- Fondazione Santa Lucia, Istituto Di Ricovero e Cura a Carattere ScientificoRome, Italy; Braintrends Ltd, Applied NeuroscienceRome, Italy
| | - Antonios Dakanalis
- Department of Brain and Behavioral Sciences, University of PaviaPavia, Italy; Department of Medicine and Surgery, University of Milano-BicoccaMilan, Italy
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Muzik O, Diwadkar VA. In vivo correlates of thermoregulatory defense in humans: Temporal course of sub-cortical and cortical responses assessed with fMRI. Hum Brain Mapp 2016; 37:3188-202. [PMID: 27220041 DOI: 10.1002/hbm.23233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 04/18/2016] [Accepted: 04/18/2016] [Indexed: 01/28/2023] Open
Abstract
Extensive studies in rodents have established the role of neural pathways that are activated during thermoregulation. However, few studies have been conducted in humans to assess the complex, hierarchically organized thermoregulatory network in the CNS that maintains thermal homeostasis, especially as it pertains to cold exposure. To study the human thermoregulatory network during whole body cold exposure, we have used functional MRI to characterize changes in the BOLD signal within the constituents of the thermoregulatory network in 20 young adult controls during non-noxious cooling and rewarming of the skin by a water-perfused body suit. Our results indicate significant decreases of BOLD signal during innocuous whole body cooling stimuli in the midbrain, the right anterior insula, the right anterior cingulate, and the right inferior parietal lobe. Whereas brain activation in these areas decreased during cold exposure, brain activation increased significantly in the bilateral orbitofrontal cortex during this period. The BOLD signal time series derived from significant activation sites in the orbitofrontal cortex showed opposed phase to those observed in the other brain regions, suggesting complementary processing mechanisms during mild hypothermia. The significance of our findings lies in the recognition that whole body cooling evokes a response in a hierarchically organized thermoregulatory network that distinguishes between cold and warm stimuli. This network seems to generate a highly resolved interoceptive representation of the body's condition that provides input to the orbitofrontal cortex, where higher-order integration takes place and invests internal states with emotional significance that motivate behavior. Hum Brain Mapp 37:3188-3202, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Otto Muzik
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, 48201.,Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, 48201
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, 48201
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Farrell MJ. Regional brain responses in humans during body heating and cooling. Temperature (Austin) 2016; 3:220-231. [PMID: 27857952 PMCID: PMC4964992 DOI: 10.1080/23328940.2016.1174794] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 10/26/2022] Open
Abstract
Functional brain imaging of responses to thermal challenge in humans provides a viable method to implicate widespread neuroanatomical regions in the processes of thermoregulation. Thus far, functional neuroimaging techniques have been used infrequently in humans to investigate thermoregulation, although preliminary outcomes have been informative and certainly encourage further forays into this field of enquiry. At this juncture, sustained regional brain activations in response to prolonged changes in body temperature are yet to be definitively characterized, but it would appear that thermoregulatory regions are widely distributed throughout the hemispheres of the human brain. Of those autonomic responses to thermal challenge investigated so far, the loci of associated brainstem responses in human are homologous with other species. However, human imaging studies have also implicated a wide range of forebrain regions in thermal sensations and autonomic responses that extend beyond outcomes reported in other species. There is considerable impetus to continue human functional neuroimaging of thermoregulatory responses because of the unique opportunities presented by the method to survey regions across the whole brain in compliant, conscious participants.
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Affiliation(s)
- Michael J Farrell
- Monash Biomedicine Discovery Institute, Department of Medical Imaging and Radiation Sciences, Monash University , Clayton, Australia
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Amano T, Ichinose M, Inoue Y, Nishiyasu T, Koga S, Kenny GP, Kondo N. Influence of forearm muscle metaboreceptor activation on sweating and cutaneous vascular responses during dynamic exercise. Am J Physiol Regul Integr Comp Physiol 2016; 310:R1332-9. [PMID: 27053652 DOI: 10.1152/ajpregu.00545.2015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 03/30/2016] [Indexed: 11/22/2022]
Abstract
We examined whether the sustained activation of metaboreceptor in forearm during cycling exercise can modulate sweating and cutaneous vasodilation. On separate days, 12 young participants performed a 1.5-min isometric handgrip exercise at 40% maximal voluntary contraction followed by 1) 9-min forearm ischemia (Occlusion, to activate metaboreceptor) or 2) no ischemia (Control) in thermoneutral conditions (27°C, 50%) with mean skin temperature clamped at 34°C. Thirty seconds after the handgrip exercise, participants cycled for 13.5 min at 40% V̇o2 max For Occlusion, forearm ischemia was maintained for 9 min followed by no ischemia thereafter. Local sweat rate (SR, ventilated capsule) and cutaneous vascular conductance (CVC, laser-Doppler perfusion units/mean arterial pressure) on the contralateral nonischemic arm as well as esophageal and skin temperatures were measured continuously. The period of ischemia in the early stages of exercise increased SR (+0.03 mg·cm(-2)·min(-1), P < 0.05) but not CVC (P > 0.05) above Control levels. No differences were measured in the esophageal temperature at which onset of sweating (Control 37.19 ± 0.09 vs. Occlusion 37.07 ± 0.09°C) or CVC (Control 37.21 ± 0.08 vs. Occlusion 37.08 ± 0.10°C) as well as slopes for these responses (all P > 0.05). However, a greater elevation in SR occurred thereafter such that SR was significantly elevated at the end of the ischemic period relative to Control (0.37 ± 0.05 vs. 0.23 ± 0.05 mg·cm(-2)·min(-1), respectively, P < 0.05) despite no differences in esophageal temperature. We conclude that the activation of forearm muscle metaboreceptor can modulate sweating, but not CVC, during cycling exercise without affecting the core temperature-SR relationship.
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Affiliation(s)
- Tatsuro Amano
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Masashi Ichinose
- Human Integrative Physiology Laboratory, School of Business Administration, Meiji University, Tokyo, Japan
| | - Yoshimitsu Inoue
- Laboratory for Human Performance Research, Osaka International University, Osaka, Japan
| | - Takeshi Nishiyasu
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
| | - Shunsaku Koga
- Applied Physiology Laboratory, Kobe Design University, Kobe, Japan; and
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan;
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Farrell MJ, Trevaks D, Taylor NAS, McAllen RM. Regional brain responses associated with thermogenic and psychogenic sweating events in humans. J Neurophysiol 2015; 114:2578-87. [PMID: 26289468 DOI: 10.1152/jn.00601.2015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/18/2015] [Indexed: 12/30/2022] Open
Abstract
Sweating events occur in response to mental stress (psychogenic) or with increased body temperature (thermogenic). We previously found that both were linked to activation of common brain stem regions, suggesting that they share the same output pathways: a putative common premotor nucleus was identified in the rostral-lateral medulla (Farrell MJ, Trevaks D, Taylor NA, McAllen RM. Am J Physiol Regul Integr Comp Physiol 304: R810-R817, 2013). We therefore looked in higher brain regions for the neural basis that differentiates the two types of sweating event. Previous work has identified hemispheric activations linked to psychogenic sweating, but no corresponding data have been reported for thermogenic sweating. Galvanic skin responses were used to measure sweating events in two groups of subjects during either psychogenic sweating (n = 11, 35.3 ± 11.8 yr) or thermogenic sweating (n = 11, 34.4 ± 10.2 yr) while regional brain activation was measured by BOLD signals in a 3-Tesla MRI scanner. Common regions activated with sweating events in both groups included the anterior and posterior cingulate cortex, insula, premotor cortex, thalamus, lentiform nuclei, and cerebellum (P(corrected) < 0.05). Psychogenic sweating events were associated with significantly greater activation in the dorsal midcingulate cortex, parietal cortex, premotor cortex, occipital cortex, and cerebellum. No hemispheric region was found to show statistically significantly greater activation with thermogenic than with psychogenic sweating events. However, a discrete cluster of activation in the anterior hypothalamus/preoptic area was seen only with thermogenic sweating events. These findings suggest that the expected association between sweating events and brain regions implicated in "arousal" may apply selectively to psychogenic sweating; the neural basis for thermogenic sweating events may be subcortical.
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Affiliation(s)
- Michael J Farrell
- Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia;
| | - David Trevaks
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Nigel A S Taylor
- Centre for Human and Applied Physiology, School of Medicine, University of Wollongong, Wollongong, Australia; and
| | - Robin M McAllen
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia; Anatomy and Neuroscience, University of Melbourne, Melbourne, Australia
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Thermoregulation and pain perception: Evidence for a homoeostatic (interoceptive) dimension of pain. Eur J Pain 2015; 20:138-48. [DOI: 10.1002/ejp.717] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 01/30/2023]
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12
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Ughi N, Hervey SA, Gualtierotti R, Silvana Z, Herrick AL, Ingegnoli F, Meroni P. Sparing effect of hemiplegia on skin fibrosis and microvascular involvement: reports of two cases of systemic sclerosis and review of the literature. Semin Arthritis Rheum 2014; 44:597-601. [PMID: 25488380 DOI: 10.1016/j.semarthrit.2014.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/13/2014] [Accepted: 10/24/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The sparing effect of hemiplegia in rheumatic diseases has been described, but reports on systemic sclerosis (SSc)-spectrum disorders are unusual. SSc-spectrum disorders are complex diseases of unknown origin characterized by multisystem involvement, skin and organ fibrosis, microvascular alterations, and immunologic abnormalities. We describe two cases of patients with hemiplegia who developed Raynaud׳s phenomenon and skin fibrosis of the non-paretic limb. METHODS Clinical, laboratory, and investigation findings of two cases with hemiplegia who developed scleroderma spectrum disorders of the non-paretic limb are presented. A review of the medical literature was performed in PubMed for all articles in English. RESULTS A total of 46 reports from 1935 to 2012 were identified, especially on osteoarthritis and rheumatoid arthritis. Only two case reports on patients with SSc describe asymmetric SSc skin involvement and unilateral acro-osteolysis on x-ray images of the non-paretic limb. By contrast, we report the first description of capillaroscopic microvascular changes in patients with hemiplegia and asymmetric SSc skin involvement. CONCLUSIONS Our cases point out the potential role of a "cross-talk" between the nervous system and the skin in SSc-spectrum disorders and suggest future directions for research in studies of pathogenesis.
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Affiliation(s)
- Nicola Ughi
- Division of Rheumatology, Department of Clinical Sciences and Community Health, Gaetano Pini Orthopedic Institute, University of Milano, Piazza Cardinal Ferrari 1, Milano 20122, Italy.
| | - Simon A Hervey
- Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - Roberta Gualtierotti
- Division of Rheumatology, Department of Clinical Sciences and Community Health, Gaetano Pini Orthopedic Institute, University of Milano, Piazza Cardinal Ferrari 1, Milano 20122, Italy
| | - Zeni Silvana
- Division of Rheumatology, Department of Clinical Sciences and Community Health, Gaetano Pini Orthopedic Institute, University of Milano, Piazza Cardinal Ferrari 1, Milano 20122, Italy
| | - Ariane L Herrick
- Centre for Musculoskeletal Research, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Francesca Ingegnoli
- Division of Rheumatology, Department of Clinical Sciences and Community Health, Gaetano Pini Orthopedic Institute, University of Milano, Piazza Cardinal Ferrari 1, Milano 20122, Italy
| | - Pierluigi Meroni
- Division of Rheumatology, Department of Clinical Sciences and Community Health, Gaetano Pini Orthopedic Institute, University of Milano, Piazza Cardinal Ferrari 1, Milano 20122, Italy
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De Raedt S, De Vos A, De Keyser J. Autonomic dysfunction in acute ischemic stroke: an underexplored therapeutic area? J Neurol Sci 2014; 348:24-34. [PMID: 25541326 DOI: 10.1016/j.jns.2014.12.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/30/2014] [Accepted: 12/02/2014] [Indexed: 01/04/2023]
Abstract
Impaired autonomic function, characterized by a predominance of sympathetic activity, is common in patients with acute ischemic stroke. This review describes methods to measure autonomic dysfunction in stroke patients. It summarizes a potential relationship between ischemic stroke-associated autonomic dysfunction and factors that have been associated with worse outcome, including cardiac complications, blood pressure variability changes, hyperglycemia, immune depression, sleep disordered breathing, thrombotic effects, and malignant edema. Involvement of the insular cortex has been suspected to play an important role in causing sympathovagal imbalance, but its exact role and that of other brain regions remain unclear. Although sympathetic overactivity in patients with ischemic stroke appears to be a negative prognostic factor, it remains to be seen whether therapeutic strategies that reduce sympathetic activity or increase parasympathetic activity might improve outcome.
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Affiliation(s)
- Sylvie De Raedt
- Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Aurelie De Vos
- Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Jacques De Keyser
- Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Neurology, Universitair Medisch Centrum Groningen, Groningen, The Netherlands.
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Orava J, Nummenmaa L, Noponen T, Viljanen T, Parkkola R, Nuutila P, Virtanen KA. Brown adipose tissue function is accompanied by cerebral activation in lean but not in obese humans. J Cereb Blood Flow Metab 2014; 34:1018-23. [PMID: 24667912 PMCID: PMC4050247 DOI: 10.1038/jcbfm.2014.50] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 02/07/2014] [Accepted: 02/26/2014] [Indexed: 12/30/2022]
Abstract
Brown adipose tissue (BAT) is able to generate heat and dissipate energy in response to cold exposure in mammals. It has recently been acknowledged that adult humans also have functional BAT, whose metabolic activity is reduced in obesity. In healthy humans, the cerebral mechanisms that putatively control BAT function are unclear. By using positron emission tomography (PET), we showed that cold-induced BAT activation is associated with glucose metabolism in the cerebellum, thalamus, and cingulate, temporoparietal, lateral frontal, and occipital cortices in lean participants, whereas no such associations were found under warm control conditions. The cold-induced increase in cerebral glucose metabolism was more robust in lean than obese participants. Cerebral glucose metabolism was not associated with skeletal muscle or white adipose tissue glucose uptake under warm or cold conditions. In conclusion, BAT metabolism was accompanied by the activation of specific cerebral regions, and this shows an uncharacterized role that the brain plays in the regulation of BAT function. In obese participants, the cold-induced response in cerebral activity was attenuated that provides a clue for obesity-induced impairment in BAT metabolism.
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Affiliation(s)
- Janne Orava
- Turku PET Centre, University of Turku, Turku, Finland
| | - Lauri Nummenmaa
- 1] Turku PET Centre, University of Turku, Turku, Finland [2] Department of Biomedical Engineering and Computational Science, School of Science, Aalto University, Espoo, Finland [3] Brain Research Unit, O.V. Lounasmaa Laboratory, School of Science, Espoo, Finland
| | - Tommi Noponen
- Department of Nuclear Medicine, Turku University Hospital, Turku, Finland
| | | | - Riitta Parkkola
- 1] Turku PET Centre, University of Turku, Turku, Finland [2] Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - Pirjo Nuutila
- 1] Turku PET Centre, University of Turku, Turku, Finland [2] Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Kirsi A Virtanen
- 1] Turku PET Centre, University of Turku, Turku, Finland [2] Turku PET Centre, Turku University Hospital, Turku, Finland
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Baier B, zu Eulenburg P, Geber C, Rohde F, Rolke R, Maihöfner C, Birklein F, Dieterich M. Insula and sensory insular cortex and somatosensory control in patients with insular stroke. Eur J Pain 2014; 18:1385-93. [PMID: 24687886 DOI: 10.1002/j.1532-2149.2014.501.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND In functional imaging studies, the insular cortex (IC) has been identified as an essential part of the processing of a whole spectrum of multimodal sensory input. However, there are no lesion studies including a sufficient number of patients, which would reinforce the functional imaging data obtained from healthy subjects. Such lesion studies should examine how damage to the IC affects sensory perception. We chose acute stroke patients with lesions affecting the IC in order to fill this gap. METHODS A comprehensive sensory profiling by applying a quantitative sensory testing protocol was performed and a voxel-lesion behaviour mapping analysis in 24 patients with acute unilateral cortical damage was applied. RESULTS Our data demonstrate that patients with lesions of the posterior IC have deficits in temperature perception, but did not show other sensory deficits such as hot or cold pain perception associated with specific lesion locations. CONCLUSION Our data allow the conclusion that the posterior IC may represent the major region responsible for encoding warm and cold perception in the brain. To what extent focal IC lesions may also impair pain processing or induce post-stroke pain has to be addressed in future studies including more patients.
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Affiliation(s)
- B Baier
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany; Department of Neurology, German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-University, Munich, Germany; Munich Center for Systems Neurology (SyNergy), Germany
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Krämer HH, Ament SJ, Breimhorst M, Klega A, Schmieg K, Endres C, Buchholz HG, Elam M, Schreckenberger M, Birklein F. Central correlation of muscle sympathetic nerve activation during baroreflex unloading - a microneurography-positron emission tomography study. Eur J Neurosci 2013; 39:623-9. [DOI: 10.1111/ejn.12437] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Heidrun H. Krämer
- Department of Neurology; Justus Liebig University; Klinikstrasse 33 35392 Giessen Germany
- Department of Neurology; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Stephan-Johann Ament
- Department of Nuclear Medicine; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Markus Breimhorst
- Department of Neurology; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Andre Klega
- Department of Nuclear Medicine; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Katharina Schmieg
- Department of Nuclear Medicine; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Corina Endres
- Department of Neurology; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Hans-Georg Buchholz
- Department of Nuclear Medicine; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Mikael Elam
- Department of Clinical Neurophysiology; The Sahlgrenska Academy of Gothenburg University; 41345 Gothenburg Sweden
| | - Mathias Schreckenberger
- Department of Nuclear Medicine; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
| | - Frank Birklein
- Department of Neurology; University Medical Center; Johannes Gutenberg-University; 56101 Mainz Germany
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The autonomic brain: an activation likelihood estimation meta-analysis for central processing of autonomic function. J Neurosci 2013; 33:10503-11. [PMID: 23785162 DOI: 10.1523/jneurosci.1103-13.2013] [Citation(s) in RCA: 561] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The autonomic nervous system (ANS) is of paramount importance for daily life. Its regulatory action on respiratory, cardiovascular, digestive, endocrine, and many other systems is controlled by a number of structures in the CNS. While the majority of these nuclei and cortices have been identified in animal models, neuroimaging studies have recently begun to shed light on central autonomic processing in humans. In this study, we used activation likelihood estimation to conduct a meta-analysis of human neuroimaging experiments evaluating central autonomic processing to localize (1) cortical and subcortical areas involved in autonomic processing, (2) potential subsystems for the sympathetic and parasympathetic divisions of the ANS, and (3) potential subsystems for specific ANS responses to different stimuli/tasks. Across all tasks, we identified a set of consistently activated brain regions, comprising left amygdala, right anterior and left posterior insula and midcingulate cortices that form the core of the central autonomic network. While sympathetic-associated regions predominate in executive- and salience-processing networks, parasympathetic regions predominate in the default mode network. Hence, central processing of autonomic function does not simply involve a monolithic network of brain regions, instead showing elements of task and division specificity.
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Farrell MJ, Trevaks D, Taylor NAS, McAllen RM. Brain stem representation of thermal and psychogenic sweating in humans. Am J Physiol Regul Integr Comp Physiol 2013; 304:R810-7. [DOI: 10.1152/ajpregu.00041.2013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Functional MRI was used to identify regions in the human brain stem activated during thermal and psychogenic sweating. Two groups of healthy participants aged 34.4 ± 10.2 and 35.3 ± 11.8 years (both groups comprising 1 woman and 10 men) were either heated by a water-perfused tube suit or subjected to a Stroop test, while they lay supine with their head in a 3-T MRI scanner. Sweating events were recorded as electrodermal responses (increases in AC conductance) from the palmar surfaces of fingers. Each experimental session consisted of two 7.9-min runs, during which a mean of 7.3 ± 2.1 and 10.2 ± 2.5 irregular sweating events occurred during psychogenic (Stroop test) and thermal sweating, respectively. The electrodermal waveform was used as the regressor in each subject and run to identify brain stem clusters with significantly correlated blood oxygen level-dependent signals in the group mean data. Clusters of significant activation were found with both psychogenic and thermal sweating, but a voxelwise comparison revealed no brain stem cluster whose signal differed significantly between the two conditions. Bilaterally symmetric regions that were activated by both psychogenic and thermal sweating were identified in the rostral lateral midbrain and in the rostral lateral medulla. The latter site, between the facial nuclei and pyramidal tracts, corresponds to a neuron group found to drive sweating in animals. These studies have identified the brain stem regions that are activated with sweating in humans and indicate that common descending pathways may mediate both thermal and psychogenic sweating.
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Affiliation(s)
- Michael J. Farrell
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - David Trevaks
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Nigel A. S. Taylor
- Centre for Human and Applied Physiology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Robin M. McAllen
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Anatomy and Neuroscience, University of Melbourne, Parkville, Victoria, Australia; and
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Miao Q, Zhao XL, Zhang QY, Zhang ZY, Guan YH, Ye HY, Zhang S, Zeng MF, Zuo CT, Li YM. Stability in brain glucose metabolism following brown adipose tissue inactivation in chinese adults. AJNR Am J Neuroradiol 2012; 33:1464-9. [PMID: 22576895 DOI: 10.3174/ajnr.a3006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The thermogenesis of BAT is believed to be controlled through some pathways initiated in the brain, though the changes in brain activity among different states of BAT-positive subjects are still unclear. We hypothesized that some significant differences of regional cerebral metabolism between various groups were related to the BAT activities regardless of temperature changes. MATERIALS AND METHODS Relative regional cerebral glucose metabolism was compared between 15 healthy subjects with activated BAT and 30 healthy controls without activated BAT by using a brain FDG-PET scan. A follow-up PET scan was performed to assess metabolic changes of the brain when BAT activity was eliminated by heat exposure. RESULTS Compared with controls, BAT-positive subjects exhibited lower activity in the inferior parietal lobule, limbic system, and frontal lobe and higher activity in the precuneus before heat exposure. Compared with the BAT elimination status, subjects with activated BAT showed a decreased metabolism in the parietal lobe, frontal lobe, culmen, cingulate gyrus, and sublobar region. Compared with controls, BAT-positive subjects after BAT inactivation had significant hypometabolic areas in the temporal lobe and limbic lobe and hypermetabolic areas in the parietal lobe. CONCLUSIONS Our findings illustrate that changes of regional cerebral metabolism are related to BAT activities regardless of temperature changes. This before-after controlled study supports the finding that the brain responses appear to be active in modulating the metabolic function of BAT activity.
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Affiliation(s)
- Q Miao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Bodily illusions in health and disease: Physiological and clinical perspectives and the concept of a cortical ‘body matrix’. Neurosci Biobehav Rev 2012; 36:34-46. [DOI: 10.1016/j.neubiorev.2011.03.013] [Citation(s) in RCA: 307] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 03/22/2011] [Accepted: 03/25/2011] [Indexed: 12/31/2022]
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