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Scheliga S, Dohrn MF, Kellermann T, Lampert A, Rolke R, Namer B, Peschke GZ, van den Braak N, Lischka A, Spehr M, Jo HG, Habel U. Painful stimulation increases functional connectivity between supplementary motor area and thalamus in patients with small fibre neuropathy. Eur J Pain 2024. [PMID: 39193929 DOI: 10.1002/ejp.4720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/24/2024] [Accepted: 08/13/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND The lead symptom of small fibre neuropathy (SFN) is neuropathic pain. Recent functional magnetic resonance imaging (fMRI) studies have indicated central changes in SFN patients of different etiologies. However, less is known about brain functional connectivity during acute pain processing in idiopathic SFN. METHODS We conducted fMRI with thermal heat pain application (left volar forearm) in 32 idiopathic SFN patients and 31 healthy controls. We performed functional connectivity analyses with right supplementary motor area (SMA), left insula, and left caudate nucleus (CN) as seed regions, respectively. Since pathogenic gain-of-function variants in voltage gated sodium channels (Nav) have been linked to SFN pathophysiology, explorative connectivity analyses were performed in a homogenous subsample of patients carrying rare heterozygous missense variants. RESULTS For right SMA, we found significantly higher connectivity with the right thalamus in SFN patients compared to controls. This connectivity correlated significantly with intraepidermal nerve fibre density, suggesting a link between peripheral and central pain processing. We found significantly reduced connections between right SMA and right middle frontal gyrus in patients with Nav variants. Likewise, connectivity between left CN and right frontal pole was decreased. CONCLUSIONS Aberrant functional connectivity in SFN is in line with previous research on other chronic pain syndromes. Functional connectivity changes may be linked to SFN, highlighting the need to determine if they result from peripheral changes causing abnormal somatosensory processing. This understanding may be crucial for assessing their impact on painful symptoms and therapy response. SIGNIFICANCE STATEMENT We found increased functional connectivity between SMA and thalamus during painful stimulation in patients with idiopathic SFN. Connectivity correlated significantly with intraepidermal nerve fibre density, suggesting a link between peripheral and central pain processing. Our findings emphasize the importance of investigating functional connectivity changes as a potential feature of SFN.
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Affiliation(s)
- Sebastian Scheliga
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Maike F Dohrn
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Thilo Kellermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Straβe, Jülich, Germany
| | - Angelika Lampert
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Institute of Neurophysiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Roman Rolke
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Department of Palliative Medicine, Medical Faculty RWTH, Aachen University, Aachen, Germany
| | - Barbara Namer
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Institute of Neurophysiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Research Group Neuroscience, Interdisciplinary Centre for Clinical Research, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Greta Z Peschke
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Nortje van den Braak
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Annette Lischka
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Marc Spehr
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Department of Chemosensation, RWTH Aachen University, Institute for Biology II, Aachen, Germany
| | - Han-Gue Jo
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- School of Computer Science & Engineering, Kunsan National University, Gunsan, Republic of Korea
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Scientific Center for Neuropathic Pain Aachen, SCNAachen, Uniklinik RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Straβe, Jülich, Germany
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Zhang P, Wan X, Jiang J, Liu Y, Wang D, Ai K, Liu G, Zhang X, Zhang J. A causal effect study of cortical morphology and related covariate networks in classical trigeminal neuralgia patients. Cereb Cortex 2024; 34:bhae337. [PMID: 39123310 DOI: 10.1093/cercor/bhae337] [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: 06/18/2024] [Revised: 07/17/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
Structural covariance networks and causal effects within can provide critical information on gray matter reorganization and disease-related hierarchical changes. Based on the T1WI data of 43 classical trigeminal neuralgia patients and 45 controls, we constructed morphological similarity networks of cortical thickness, sulcal depth, fractal dimension, and gyrification index. Moreover, causal structural covariance network analyses were conducted in regions with morphological abnormalities or altered nodal properties, respectively. We found that patients showed reduced sulcal depth, gyrification index, and fractal dimension, especially in the salience network and the default mode network. Additionally, the integration of the fractal dimension and sulcal depth networks was significantly reduced, accompanied by decreased nodal efficiency of the bilateral temporal poles, and right pericalcarine cortex within the sulcal depth network. Negative causal effects existed from the left insula to the right caudal anterior cingulate cortex in the gyrification index map, also from bilateral temporal poles to right pericalcarine cortex within the sulcal depth network. Collectively, patients exhibited impaired integrity of the covariance networks in addition to the abnormal gray matter morphology in the salience network and default mode network. Furthermore, the patients may experience progressive impairment in the salience network and from the limbic system to the sensory system in network topology, respectively.
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Affiliation(s)
- Pengfei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan 610041, China
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
- Gansu Medical MRI Equipment Application Industry Technology Center, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Xinyue Wan
- Department of Radiology, Huashan Hospital, Fudan University, No. 12, Urumqi Middle Road, Jingan District, Shanghai 200040, China
| | - Jingqi Jiang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
- Gansu Medical MRI Equipment Application Industry Technology Center, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Yang Liu
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
- Gansu Medical MRI Equipment Application Industry Technology Center, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Danyang Wang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
- Gansu Medical MRI Equipment Application Industry Technology Center, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Kai Ai
- Department of Clinical and Technical Supports, Philips Healthcare, No. 64 West Section, South 2nd Ring Road, Yanta District, Xi'an 710000, China
| | - Guangyao Liu
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
- Gansu Medical MRI Equipment Application Industry Technology Center, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Xinding Zhang
- Department of Neurosurgery and Laboratory of Neurosurgery, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
| | - Jing Zhang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730000, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
- Gansu Medical MRI Equipment Application Industry Technology Center, The Second Hospital & Clinical Medical School, Lanzhou University, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
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Zhang S, Wang Y, Li T, Ma J, He R, Han X, Wu W, Wang C. Relation Between Abnormal Spontaneous Brain Activity and Altered Neuromuscular Activation of Lumbar Paraspinal Muscles in Chronic Low Back Pain. Arch Phys Med Rehabil 2024:S0003-9993(24)01074-8. [PMID: 38969254 DOI: 10.1016/j.apmr.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE To investigate the neural mechanism underlying functional reorganization and motor coordination strategies in patients with chronic low back pain (cLBP). DESIGN A case-control study based on data collected during routine clinical practice. SETTING This study was conducted at a university hospital. PARTICIPANTS Fifteen patients with cLBP and 15 healthy controls. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Whole brain blood oxygen level-dependent signals were measured using functional magnetic resonance imaging and amplitude of low-frequency fluctuation (ALFF) method to identify pain-induced changes in regional spontaneous brain activity. A novel approach based on the surface electromyogram (EMG) system and fine-wire electrodes was used to record EMG signals in the deep multifidus, superficial multifidus, and erector spinae. RESULTS In cLBP, compared with healthy groups, ALFF was higher in the medial prefrontal, primary somatosensory, primary motor, and inferior temporal cortices, whereas it was lower in the cerebellum and anterior cingulate and posterior cingulate cortices. Furthermore, the decrease in the average EMG activity of the 3 lumbar muscles in the cLBP group was positively correlated with the ALFF values of the primary somatosensory cortex, motor cortex, precuneus, and middle temporal cortex but significantly negatively correlated with the ALFF values of the medial prefrontal and inferior temporal cortices. Interestingly, the correlation between the functional activity in the cerebellum and the EMG activity varied in the lumbar muscles. CONCLUSIONS These findings suggest a functional association between changes in spontaneous brain activity and altered voluntary neuromuscular activation patterns of the lumbar paraspinal muscles, providing new insights into the mechanisms underlying pain chronicity as well as important implications for developing novel therapeutic targets of cLBP.
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Affiliation(s)
- Shanshan Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou
| | - Yanjun Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou
| | - Tingting Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou
| | - Junqin Ma
- Department of Rehabilitation Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou
| | - Rongxing He
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiulan Han
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou
| | - Wen Wu
- Department of Rehabilitation Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou.
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4
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Sadvandi G, Kianfar AE, Becker K, Heinzel A, Wolf M, Said‐Yekta Michael S. Systematic review on effects of experimental orthodontic tooth displacement on brain activation assessed by fMRI. Clin Exp Dent Res 2024; 10:e879. [PMID: 38558512 PMCID: PMC10982672 DOI: 10.1002/cre2.879] [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: 12/28/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Orthodontic treatment is often accompanied by discomfort and pain in patients, which are believed to be a result of orthodontic tooth displacement caused by the mechanical forces exerted by the orthodontic appliances on the periodontal tissues. These lead to change blood oxygen level dependent response in related brain regions. OBJECTIVE This systematic review aims to assess the impact of experimental orthodontic tooth displacement on alterations in central nervous system activation assessed by tasked based and resting state fMRI. MATERIALS AND METHODS A literature search was conducted using online databases, following PRISMA guidelines and the PICO framework. Selected studies utilized magnetic resonance imaging to examine the brain activity changes in healthy participants after the insertion of orthodontic appliances. RESULTS The initial database screening resulted in 791 studies. Of these, 234 were duplicates and 547 were deemed irrelevant considering the inclusion and exclusion criteria. Of the ten remaining potential relevant studies, two were excluded during full-text screening. Eight prospective articles were eligible for further analysis. The included studies provided evidence of the intricate interplay between orthodontic treatment, pain perception, and brain function. All of the participants in the included studies employed orthodontic separators in short-term experiments to induce tooth displacement during the early stage of orthodontic treatment. Alterations in brain activation were observed in brain regions, functional connectivity and brain networks, predominantly affecting regions implicated in nociception (thalamus, insula), emotion (insula, frontal areas), and cognition (frontal areas, cerebellum, default mode network). CONCLUSIONS The results suggest that orthodontic treatment influences beyond the pain matrix and affects other brain regions including the limbic system. Furthermore, understanding the orthodontically induced brain activation can aid in development of targeted pain management strategies that do not adversely affect orthodontic tooth movement. Due to the moderate to serious risk of bias and the heterogeneity among the included studies, further clinical trials on this subject are recommended.
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Affiliation(s)
- Gelareh Sadvandi
- Department of OrthodonticsRWTH Aachen University HospitalGermany
| | | | - Kathrin Becker
- Department of Dentofacial Orthopedics and OrthodonticsCharité Universitätsmedizin BerlinBerlinCC03Germany
| | - Alexander Heinzel
- Department of Nuclear MedicineMartin‐Luther‐University Halle‐WittenbergHalleGermany
| | - Michael Wolf
- Department of OrthodonticsRWTH Aachen University HospitalGermany
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Mao Y, Chen C, Falahpour M, MacNiven KH, Heit G, Sharma V, Alataris K, Liu TT. Effects of Sub-threshold Transcutaneous Auricular Vagus Nerve Stimulation on Cingulate Cortex and Insula Resting-state Functional Connectivity. Front Hum Neurosci 2022; 16:862443. [PMID: 35496068 PMCID: PMC9048677 DOI: 10.3389/fnhum.2022.862443] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive alternative to vagus nerve stimulation (VNS) with implantable devices, has shown promise in treating disorders such as depression, migraine, and insomnia. Studies of these disorders with resting-state functional magnetic resonance imaging (MRI) (rsfMRI) have found sustained changes in resting-state functional connectivity (rsFC) in patients treated with low frequency (1-20 Hz) taVNS. A recent study has reported reductions in pain scores in patients with rheumatoid arthritis after a 12-week treatment of high-frequency (20 kHz) sub-threshold taVNS. However, no studies to date have examined the effects of high-frequency sub-threshold taVNS on rsFC. The objective of this study was to determine whether high-frequency sub-threshold taVNS induces changes in rsFC using seed regions from the cingulate cortex and insula, brain regions that play a key role in interoception and processing of pain. With a single-blind placebo-controlled repeated measures experimental design, rsfMRI scans were acquired before and after 15 min of either sub-threshold taVNS treatment or a sham control. Significant taVNS-related changes in functional connections to the cingulate cortex were detected between the anterior cingulate cortex and right superior temporal gyrus and between the midcingulate cortex and right inferior parietal lobule. In addition, significant changes in functional connections to the insula were detected between the posterior insula and right precuneus and between the anterior insula and right cuneus gyrus. These results suggest that high-frequency sub-threshold taVNS can lead to sustained effects on the rsFC of brain regions involved in interoception and processing of pain in a cohort of healthy subjects. This study lays the foundation for future rsfMRI studies of high-frequency sub-threshold taVNS in clinical populations.
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Affiliation(s)
- Yixiang Mao
- Center for Functional MRI, University of California San Diego, La Jolla, CA, United States
| | - Conan Chen
- Center for Functional MRI, University of California San Diego, La Jolla, CA, United States
| | - Maryam Falahpour
- Center for Functional MRI, University of California San Diego, La Jolla, CA, United States
| | - Kelly H. MacNiven
- Department of Psychology, Stanford University, Stanford, CA, United States
- Nēsos Corporation, Redwood City, CA, United States
| | - Gary Heit
- Nēsos Corporation, Redwood City, CA, United States
- Department of Neurosurgery, Hue University of Medicine and Pharmacy, Hue, Vietnam
| | - Vivek Sharma
- Nēsos Corporation, Redwood City, CA, United States
| | | | - Thomas T. Liu
- Center for Functional MRI, University of California San Diego, La Jolla, CA, United States
- Departments of Radiology, Psychiatry, and Bioengineering, University of California San Diego, La Jolla, CA, United States
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You B, Wen H, Jackson T. Identifying resting state differences salient for resilience to chronic pain based on machine learning multivariate pattern analysis. Psychophysiology 2021; 58:e13921. [PMID: 34383330 DOI: 10.1111/psyp.13921] [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: 11/09/2020] [Revised: 06/27/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
Studies have documented behavior differences between more versus less resilient adults with chronic pain (CP), but the presence and nature of underlying neurophysiological differences have received scant attention. In this study, we attempted to identify regions of interest (ROIs) in which resting state (Rs) brain activity discriminated more from less resilient CP subgroups based on multiple kernel learning (MKL). More and less resilient community-dwellers with chronic musculoskeletal pain (70 women, 39 men) engaged in structural and functional magnetic resonance imaging (MRI) scans, wherein MKL assessed Rs activity based on amplitude of low frequency fluctuations (ALFF), fractional amplitudes of low frequency fluctuations (fALFF), and regional homogeneity (ReHo) modalities to identify ROIs most salient for discriminating more versus less resilient subgroups. Compared to classification based on single modalities, multi-modal classification based on combined fALFF and ReHo features achieved a substantially higher classification accuracy rate (79%). Brain regions with the best discriminative power included those implicated in pain processing, reward, executive function, goal-directed action, emotion regulation and resilience to mood disorders though variation trends were not consistent between more and less resilient subgroups. Results revealed patterns of Rs activity that serve as possible biomarkers for resilience to chronic musculoskeletal pain.
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Affiliation(s)
- Beibei You
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China.,School of Nursing, Guizhou Medical University, Guizhou, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
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Cavaleri R, Chipchase LS, Summers SJ, Chalmers J, Schabrun SM. The Relationship Between Corticomotor Reorganization and Acute Pain Severity: A Randomized, Controlled Study Using Rapid Transcranial Magnetic Stimulation Mapping. PAIN MEDICINE 2021; 22:1312-1323. [PMID: 33367763 DOI: 10.1093/pm/pnaa425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Although acute pain has been shown to reduce corticomotor excitability, it remains unknown whether this response resolves over time or is related to symptom severity. Furthermore, acute pain research has relied upon data acquired from the cranial "hotspot," which do not provide valuable information regarding reorganization, such as changes to the distribution of a painful muscle's representation within M1. Using a novel, rapid transcranial magnetic stimulation (TMS) mapping method, this study aimed to 1) explore the temporal profile and variability of corticomotor reorganization in response to acute pain and 2) determine whether individual patterns of corticomotor reorganization are associated with differences in pain, sensitivity, and somatosensory organization. METHODS Corticomotor (TMS maps), pain processing (pain intensity, pressure pain thresholds), and somatosensory (two-point discrimination, two-point estimation) outcomes were taken at baseline, immediately after injection (hypertonic [n = 20] or isotonic saline [n = 20]), and at pain resolution. Follow-up measures were recorded every 15 minutes until 90 minutes after injection. RESULTS Corticomotor reorganization persisted at least 90 minutes after pain resolution. Corticomotor depression was associated with lower pain intensity than was corticomotor facilitation (r = 0.47 [P = 0.04]). These effects were not related to somatosensory reorganization or peripheral sensitization mechanisms. CONCLUSIONS Individual patterns of corticomotor reorganization during acute pain appear to be related to symptom severity, with early corticomotor depression possibly reflecting a protective response. These findings hold important implications for the management and potential prevention of pain chronicity. However, further research is required to determine whether these adaptations relate to long-term outcomes in clinical populations.
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Affiliation(s)
- Rocco Cavaleri
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Lucy S Chipchase
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Simon J Summers
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.,Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Jane Chalmers
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
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Lei M, Zhang J. Brain function state in different phases and its relationship with clinical symptoms of migraine: an fMRI study based on regional homogeneity (ReHo). ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:928. [PMID: 34350243 PMCID: PMC8263876 DOI: 10.21037/atm-21-2097] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 12/28/2022]
Abstract
Background Using fMRI to analysis of brain function state in migraineurs at different phases, and combined with the clinical symptoms to explore the mechanisms and outcomes of migraine. Methods It’s a case-control study. We analyzed the resting-state brain functional magnetic resonance imaging in 19 patients with episodes, 22 patients with interictal phase, and 22 healthy controls. The ReHo method was used for post-processing. All subjects were evaluated using the Montreal cognitive assessment (MoCA) scale, simple mental state examination (MMSE), Hamilton anxiety (HAMA) scale, and Hamilton depression (HAMD) scale. The subjects’ clinical indicators (such as frequency of attack, course of disease, duration of each headache, and severity of headache) were correlated with the ReHo values of brain regions. This study was approved by the ethics committee of Yangtze River Shipping General Hospital. Results Compared with the interictal, patients in the episode group had lower activation in bilateral anterior cingulate cortex (ACC), with Montreal Neurological Institute (MNI) (−9, 42, 15); and had stronger activation in bilateral paracentral lobule (PCL), with MNI (−3, −24, 66). Compared with the control group, patients in interictal phase had lower activation in the bilateral cuneus and bilateral lingual gyrus, with MNI scores of (9, −84, 36) and (0, −72, 6), respectively. No significant difference in brain area was found between the episodes group and the control group. In the episodes group, a significant correlation was observed between attack frequency and ReHo value of the bilateral PCL (r=0.492; P=0.038). Conclusions We need to observe the course of migraine as a whole. In the interictal period, the cuneus and lingual gyrus may affect the development of the disease. The ACC regulates different states of migraine by inducing anti-injury sensation regulation function. The paracentric lobule is not only associated with migraine attacks, but also with the frequency. This may have an effect on the outcome of subsequent migraines, as well as whether the condition becomes chronic, and the remodeling of the brain.
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Affiliation(s)
- Ming Lei
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Zhang X, Li L, Huang G, Zhang L, Liang Z, Shi L, Zhang Z. A Multisensory fMRI Investigation of Nociceptive-Preferential Cortical Regions and Responses. Front Neurosci 2021; 15:635733. [PMID: 33935632 PMCID: PMC8079658 DOI: 10.3389/fnins.2021.635733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 11/13/2022] Open
Abstract
The existence of nociceptive-specific brain regions has been a controversial issue for decades. Multisensory fMRI studies, which examine fMRI activities in response to various types of sensory stimulation, could help identify nociceptive-specific brain regions, but previous studies are limited by sample size and they did not differentiate nociceptive-specific regions and nociceptive-preferential regions, which have significantly larger responses to nociceptive input. In this study, we conducted a multisensory fMRI experiment on 80 healthy participants, with the aim to determine whether there are certain brain regions that specifically or preferentially respond to nociceptive stimulation. By comparing the evoked fMRI responses across four sensory modalities, we found a series of brain regions specifically or preferentially involved in nociceptive sensory input. Particularly, we found different parts of some cortical regions, such as insula and cingulate gyrus, play different functional roles in the processing of nociceptive stimulation. Hence, this multisensory study improves our understanding of the functional integrations and segregations of the nociceptive-related regions.
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Affiliation(s)
- Xiaoxia Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Linling Li
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Gan Huang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Li Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Zhen Liang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Li Shi
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Zhiguo Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China.,Peng Cheng Laboratory, Shenzhen, China
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10
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Yan H, Shan X, Wei S, Liu F, Li W, Lei Y, Guo W, Luo S. Abnormal Spontaneous Brain Activities of Limbic-Cortical Circuits in Patients With Dry Eye Disease. Front Hum Neurosci 2020; 14:574758. [PMID: 33304254 PMCID: PMC7693447 DOI: 10.3389/fnhum.2020.574758] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022] Open
Abstract
Whether brain function is altered in patients with dry eye disease (DED) remains unclear. Twenty patients with DED and 23 healthy controls (HCs) were scanned using resting-state functional magnetic resonance imaging. Regional homogeneity (ReHo) and support vector machine (SVM) were used to analyze the imaging data. Relative to the HCs, the patients with DED showed significantly increased ReHo values in the left inferior occipital gyrus (IOG), left superior temporal gyrus, and right superior medial prefrontal cortex, and significantly decreased ReHo values in the right superior frontal gyrus/middle frontal gyrus and bilateral middle cingulum (MC). SVM results indicated that the combination of ReHo values in the left MC and the left IOG in distinguishing patients with DED from HCs had a sensitivity of 95.00%, a specificity of 91.30%, and an accuracy of 93.02%. The present study found that the patients with DED had abnormal ReHo values in the limbic-cortical circuits. A combination of ReHo values in the left MC and the left IOG could be applied as a potential imaging biomarker to distinguish patients with DED from HCs. The dysfunction of limbic-cortical circuits may play an important role in the pathophysiology of DED.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shubao Wei
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenmei Li
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yiwu Lei
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, China
| | - Shuguang Luo
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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11
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Boyce WP, Lindsay A, Zgonnikov A, Rañó I, Wong-Lin K. Optimality and Limitations of Audio-Visual Integration for Cognitive Systems. Front Robot AI 2020; 7:94. [PMID: 33501261 PMCID: PMC7805627 DOI: 10.3389/frobt.2020.00094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/09/2020] [Indexed: 11/13/2022] Open
Abstract
Multimodal integration is an important process in perceptual decision-making. In humans, this process has often been shown to be statistically optimal, or near optimal: sensory information is combined in a fashion that minimizes the average error in perceptual representation of stimuli. However, sometimes there are costs that come with the optimization, manifesting as illusory percepts. We review audio-visual facilitations and illusions that are products of multisensory integration, and the computational models that account for these phenomena. In particular, the same optimal computational model can lead to illusory percepts, and we suggest that more studies should be needed to detect and mitigate these illusions, as artifacts in artificial cognitive systems. We provide cautionary considerations when designing artificial cognitive systems with the view of avoiding such artifacts. Finally, we suggest avenues of research toward solutions to potential pitfalls in system design. We conclude that detailed understanding of multisensory integration and the mechanisms behind audio-visual illusions can benefit the design of artificial cognitive systems.
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Affiliation(s)
- William Paul Boyce
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry Londonderry, Northern Ireland, United Kingdom
| | - Anthony Lindsay
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry Londonderry, Northern Ireland, United Kingdom
| | - Arkady Zgonnikov
- AiTech, Delft University of Technology, Delft, Netherlands
- Department of Cognitive Robotics, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Delft, Netherlands
| | - Iñaki Rañó
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry Londonderry, Northern Ireland, United Kingdom
| | - KongFatt Wong-Lin
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry Londonderry, Northern Ireland, United Kingdom
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12
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Archibald J, MacMillan EL, Enzler A, Jutzeler CR, Schweinhardt P, Kramer JL. Excitatory and inhibitory responses in the brain to experimental pain: A systematic review of MR spectroscopy studies. Neuroimage 2020; 215:116794. [DOI: 10.1016/j.neuroimage.2020.116794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 01/21/2023] Open
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13
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Hendriks-Balk MC, Megdiche F, Pezzi L, Reynaud O, Da Costa S, Bueti D, Van De Ville D, Wuerzner G. Brainstem Correlates of a Cold Pressor Test Measured by Ultra-High Field fMRI. Front Neurosci 2020; 14:39. [PMID: 32082112 PMCID: PMC7005099 DOI: 10.3389/fnins.2020.00039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Modern imaging techniques such as blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) allow the non-invasive and indirect measurement of brain activity. Whether changes in signal intensity can be detected in small brainstem regions during a cold pressor test (CPT) has not been explored thoroughly. The aim of this study was to measure whole brain and brainstem BOLD signal intensity changes in response to a modified CPT. Methods BOLD fMRI was measured in healthy normotensive participants during a randomized crossover study (modified CPT vs. control test) using ultra-high field 7 Tesla MRI scanner. Data were analyzed using Statistical Parametric Mapping (SPM) in a whole-brain approach, and with a brainstem-specific analysis using the spatially unbiased infra-tentorial template (SUIT) toolbox. Blood pressure (BP) and hormonal responses (norepinephrine and epinephrine levels) were also measured. Paired t-test statistics were used to compare conditions. Results Eleven participants (six women, mean age 28 ± 8.9 years) were analyzed. Mean arterial BP increased from 83 ± 12 mm Hg to 87 ± 12 mm Hg (p = 0.0009) during the CPT. Whole-brain analysis revealed significant activations linked to the CPT in the right supplementary motor cortex, midcingulate (bilateral) and the right anterior insular cortex. The brainstem-specific analysis showed significant activations in the dorsal medulla. Conclusion Changes in BOLD fMRI signal intensity in brainstem regions during a CPT can be detected, and show an increased response during a cold stress in healthy volunteers. Consequently, BOLD fMRI at 7T is a promising tool to explore and acquire new insights in the comprehension of neurogenic hypertension.
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Affiliation(s)
- Mariëlle C Hendriks-Balk
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Fatma Megdiche
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Laura Pezzi
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Reynaud
- Centre d'Imagerie BioMédicale (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sandra Da Costa
- Centre d'Imagerie BioMédicale (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Domenica Bueti
- Centre d'Imagerie BioMédicale (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Dimitri Van De Ville
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Medical Image Processing Laboratory, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Grégoire Wuerzner
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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14
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Landa A, Fallon BA, Wang Z, Duan Y, Liu F, Wager TD, Ochsner K, Peterson BS. When it hurts even more: The neural dynamics of pain and interpersonal emotions. J Psychosom Res 2020; 128:109881. [PMID: 31835079 PMCID: PMC7055518 DOI: 10.1016/j.jpsychores.2019.109881] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/11/2019] [Accepted: 11/17/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Chronic pain is highly prevalent among patients with mood, anxiety, personality, and somatic symptom disorders; and patients with chronic pain often suffer from persistent interpersonal distress. However, the neural mechanisms underlying this phenomenon and its possible role in the etiology of chronic pain are not yet understood. Based on our Developmental Theory of Centralized/Somatoform Pain, and prior research suggesting the existence of a shared neural system subserving interpersonal emotions and pain, we aimed to identify the neural basis for modulation of pain by feelings of interpersonal rejection and the role of the early interpersonal environment in development of this shared neural system. METHODS During fMRI scanning, 22 healthy participants received moderately painful thermal stimuli in 3 interpersonal contexts: Acceptance, Rejection, and Reacceptance (modified Cyberball paradigm). Early interpersonal environment was assessed using the Parental Bonding Instrument. RESULTS Interpersonal context modulated activity in pain neural systems during rejection and during accepting interactions with previously rejecting others. Moreover, the subjective perception of rejection, even when rejection was not occurring, correlated positively with reported pain severity and neural activity in the insula. The magnitude of neural modulation in pain circuits by feelings of rejection was associated with the quality of early interpersonal experience with caregivers. CONCLUSIONS Results suggest that interpersonal emotions play an important role in the development and functioning of the pain system, supporting our Developmental Theory of predisposition to chronic centralized pain. These findings have direct implications for clinical practice, including the importance of treating interpersonal distress to alleviate pain.
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Affiliation(s)
- Alla Landa
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America.
| | - Brian A Fallon
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - Zhishun Wang
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - Yunsuo Duan
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - Feng Liu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
| | - Kevin Ochsner
- Department of Psychology, Columbia University, New York, NY, United States of America
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, Division of Child & Adolescent Psychiatry, Keck School of Medicine at USC, CA, United States of America
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15
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No effect of cold pressor test-induced arousal on attentional benefits and costs in an endogenous spatial orienting paradigm. Neuropsychologia 2019; 135:107250. [PMID: 31682926 DOI: 10.1016/j.neuropsychologia.2019.107250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/28/2019] [Accepted: 10/30/2019] [Indexed: 01/15/2023]
Abstract
Previous studies have shown that arousal can influence hemispatial bias, suggesting that changes in arousal affect the neural networks involved in spatial attention control. The goal of the present study was to measure the effects of increased arousal on endogenous attentional orienting. We used a Spatial Orienting Paradigm to quantify attentional benefits and costs as measures of attentional orienting and re-orienting responses and exposed participants (N = 25; Experiment 1) to a bilateral feet Cold Pressor Test (CPT) to manipulate arousal. Increases in subjective distress ratings and blood pressure confirmed the effect of CPT on arousal. Although no overall effects of CPT on reaction times in the Spatial Orienting Paradigm were detected, an exploratory analysis of sex-specific effects revealed a left-lateralised decrease in benefits and increase in costs after CPT exposure in the male subsample (N = 11). To confirm these preliminary results, we repeated the experiment in a larger sample (N = 29, all male), but found no effect of CPT on orienting, with moderate to strong evidence in favour of a model excluding all (interaction) effects of CPT exposure (all BFIncl < 0.3). Instead, our replicated results indicate that voluntary orienting is unaffected by CPT-induced increases of arousal. In the light of previous studies, and keeping in mind the interpretative challenges of null results, we discuss how and why our findings may be specific to endogenous as opposed to exogenous orienting and how arousal could possibly lead to the previously established effects on visuospatial bias without simultaneously affecting orienting and the underlying attention control networks.
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16
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Reinares-Lara P, Rodríguez-Fuertes A, Garcia-Henche B. The Cognitive Dimension and the Affective Dimension in the Patient's Experience. Front Psychol 2019; 10:2177. [PMID: 31607995 PMCID: PMC6773954 DOI: 10.3389/fpsyg.2019.02177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
This article deals with the experience of the specific client of health services, that is, the patient. Satisfaction questionnaires are usually applied to assess patient experience. However, this tool provides only a cognitive evaluation; it does not afford an affective dimension of the experience. The objective of the present study is to verify the relationship between the cognitive dimension of patient experience, collected through questionnaires, and the affective dimension, derived from the analysis of neurophysiological data. We propose a novel methodology that integrates physiological data collected by facial expression analysis to identify patients' emotions. A first, qualitative procedure was carried out to define the patient journey. This was recorded on video and later used in the experiment. The experiment collected information from the participants using two techniques. First, as they viewed the videos, facial expression analysis (FEA) was applied to assess their responses. Second, after they watched the videos, traditional questionnaires were presented. The results provided by the two techniques were then compared. The results show that there is no relationship between the emotional valence reported by questionnaires and the neurophysiological data. This reflects the two different dimensions of the experience, one cognitive and the other affective. Both facilitate the understanding of patient satisfaction.
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Affiliation(s)
- Pedro Reinares-Lara
- Department of Business Economics, Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Blanca Garcia-Henche
- Department of Economy and Business Management, Universidad de Alcalá, Madrid, Spain
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17
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Chang WJ, Buscemi V, Liston MB, McAuley JH, Hodges PW, Schabrun SM. Sensorimotor Cortical Activity in Acute Low Back Pain: A Cross-Sectional Study. THE JOURNAL OF PAIN 2019; 20:819-829. [PMID: 30660764 DOI: 10.1016/j.jpain.2019.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/04/2018] [Accepted: 01/16/2019] [Indexed: 12/11/2022]
Abstract
Sensorimotor cortical activity is altered in both the immediate acute and chronic stages of musculoskeletal pain. However, these changes are opposite, with decreased cortical activity reported in experimentally induced acute pain (lasting minutes to hours), and increased cortical activity in chronic, clinical pain (lasting >6 months). It is unknown whether sensorimotor cortical activity is altered in acute, clinical musculoskeletal pain (lasting <4 weeks). In 36 individuals with acute, nonspecific, clinical low back pain (LBP) and 36 age- and sex-matched, pain-free controls, we investigated the processing of non-noxious afferent inputs using sensory evoked potentials (SEPs), as well as corticomotor excitability and organization of the primary motor cortex using transcranial magnetic stimulation. Processing of non-noxious sensory inputs was lower (smaller area of the N80-N150-P260 SEP complex) in acute LBP (F1,70 = 45.28, P < .01). The examination of specific SEP components revealed a smaller area of the N150 and P260 SEP components in acute LBP, although interindividual variability was high. Motor cortical map volume was lower in acute LBP (F1,70 = 5.61, P = .02). These findings demonstrate that acute LBP is characterized by lower sensorimotor cortical activity at the group level. However, individual variation was high, suggesting individual adaptation of cortical plasticity in acute pain. PERSPECTIVE: This is the first study to examine sensorimotor cortical activity in the acute stage of clinical LBP. This information is critical for understanding the neurophysiology of acute LBP.
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Affiliation(s)
- Wei-Ju Chang
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Valentina Buscemi
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Matthew B Liston
- Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, Shepherd's House, King's College London, UK
| | - James H McAuley
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Paul W Hodges
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Queensland, Australia
| | - Siobhan M Schabrun
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia..
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18
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Lv K, Song W, Tang R, Pan Z, Zhang Y, Xu Y, Lv B, Fan Y, Xu M. Neurotransmitter alterations in the anterior cingulate cortex in Crohn's disease patients with abdominal pain: A preliminary MR spectroscopy study. NEUROIMAGE-CLINICAL 2018; 20:793-799. [PMID: 30268988 PMCID: PMC6169252 DOI: 10.1016/j.nicl.2018.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/14/2018] [Accepted: 09/13/2018] [Indexed: 02/07/2023]
Abstract
Purpose Crohn's disease (CD) has been known to cause both abdominal pain alongside functional and structural alterations in the central nervous system (CNS) in affected patients. This study seeks to determine the alternations of metabolites in the bilateral anterior cingulate cortex (ACC) of CD patients with abdominal pain by using proton magnetic resonance spectroscopy (1H-MRS) to further explore the neural mechanism. Methods Sixteen CD patients with abdominal pain and 13 CD patients without abdominal pain, were recruited alongside 20 healthy controls (HCs) for this study. Clinical evaluations, including the 0–10 Visual Analogue Scale (VAS) of pain, Hospital Anxiety and Depression Scale (HADS) and Crohn's Disease Activity Index (CDAI), were evaluated prior to MR scanning. This study selected the bilateral ACC as the region of interest (ROI). The metabolites of the bilateral ACC were quantitatively analyzed by LCModel and Gannet. A independent sample t-test and one-way analysis of variance (ANOVA) were performed for statistical analysis. Spearman correlation analyses were performed to examine the relationship between the metabolite levels and clinical evaluations. Results The results indicated that CD patients with abdominal pain exhibited significantly higher levels of Glutamate (Glu)/(creatine + phosphocreatine, total creatine, tCr) over CD patients without abdominal pain, and HCs (p = 0.003, 0.009, respectively) in the bilateral ACC. The level of (Glutamate + Glutamine, Glx)/tCr of pain CD group was higher than non-pain CD group (p = 0.022). Moreover, within the pain CD group, Glu/tCr and Glx/tCr levels correlated strongly with the VAS scores of pain (ρ = 0.86, 0.59 respectively, p < 0.05). Meanwhile, the results indicates that CD patients with abdominal pain have significantly lower levels of γ-aminobutyric acid plus (GABA+)/tCr (p = 0.002) than HCs. To some extent, CDAI demonstrated a trend of negative correlation with GABA+/tCr levels (p = 0.088, ρ = −0.60). Conclusion The neural mechanism of CD patients with abdominal pain in pain processing is tightly associated with neurochemical metabolites. An imbalance in Glu and GABA may play a key role in abdominal pain processing for patients with CD. This mechanism of pain may associate with the intestinal microbiota on the brain-gut axis. The brain metabolite in CD patients with abdominal pain was firstly investigated. The study was conducted in vivo by using 1H-MRS. Glu and GABA levels altered in ACC of CD patients with abdominal pain. CD patients with abdominal pain in pain processing implicated neurotransmitters.
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Affiliation(s)
- Kun Lv
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China; Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Wenwen Song
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Rui Tang
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China; Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhiyong Pan
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yong Zhang
- MR research, GE Healthcare, Shanghai, China
| | - Yi Xu
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Bin Lv
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yihong Fan
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
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19
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Metabolic Changes in Central Poststroke Pain Following Thalamic Intracerebral Hemorrhage: An 18F-FDG PET Study. Clin Nucl Med 2018; 43:e62-e66. [PMID: 29389773 DOI: 10.1097/rlu.0000000000001954] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Central poststroke pain (CPSP) is one of the most refractory neuropathic pains following stroke. Injury in the spinothalamic pathway appears crucial for the development of CPSP, but changes in activity in multiple brain regions may also be related. We investigated brain metabolic changes in patients with CPSP following thalamic intracerebral hemorrhage (ICH). METHODS Forty-three patients with thalamic ICH were examined. Overall brain metabolism was measured with F-FDG PET. Images were analyzed with statistical parametric mapping (SPM12). Patients with CPSP (n = 20) were compared with patients without CPSP (n = 23). In addition, the association between regional brain metabolism and the severity of CPSP was investigated. RESULTS In comparison to patients in the non-CPSP group, the CPSP group exhibited significant hypometabolism in the ipsilesional precentral, postcentral gyri, and the contralesional cuneus (Puncorrected < 0.001), whereas significant hypermetabolism was found in the medial dorsal nucleus of the contralesional thalamus (Puncorrected < 0.001). In addition, brain metabolism in the ipsilesional Crus I and Crus II of the cerebellum was positively correlated to pain intensity ratings (Puncorrected < 0.001). CONCLUSION Our findings suggested that an altered state of resting brain metabolism in various brain regions related to sensory processing and cognitive functioning may be involved in the underlying mechanism of CPSP following thalamic ICH.
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20
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Darbari DS, Brandow AM. Pain-measurement tools in sickle cell disease: where are we now? HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2017; 2017:534-541. [PMID: 29222302 PMCID: PMC6142608 DOI: 10.1182/asheducation-2017.1.534] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pain is a complex multidimensional experience and the most common morbidity in patients with sickle cell disease (SCD). Tools to assess pain can be of use not only to guide pain treatment but also to provide insight into underlying pain neurobiology. Mechanisms of pain in SCD are multifactorial and are not completely elucidated. Although vaso-occlusion of microcirculation by sickled red cells is believed to be the underlying mechanism of acute vaso-occlusive pain, mechanisms for chronic pain and the transition from acute to chronic pain are under investigation. A number of modalities can be used in clinical practice and/or research to capture various dimensions of pain. Selection of a pain-assessment tool should be directed by the purpose of the assessment. Pain-assessment tools, many of which are currently in the early stages of validation, are discussed here. Development and validation of these multimodal tools is crucial for developing improved understanding of SCD pain and its management.
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Affiliation(s)
- Deepika S Darbari
- Division of Hematology, Center for Cancer and Blood Disorders, Children's National Health System, Washington, DC
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC
| | - Amanda M Brandow
- Section of Pediatric Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI; and
- Children's Research Institute, Children's Hospital of Wisconsin, Milwaukee, WI
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Peng K, Steele SC, Becerra L, Borsook D. Brodmann area 10: Collating, integrating and high level processing of nociception and pain. Prog Neurobiol 2017; 161:1-22. [PMID: 29199137 DOI: 10.1016/j.pneurobio.2017.11.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/16/2017] [Accepted: 11/28/2017] [Indexed: 02/08/2023]
Abstract
Multiple frontal cortical brain regions have emerged as being important in pain processing, whether it be integrative, sensory, cognitive, or emotional. One such region, Brodmann Area 10 (BA 10), is the largest frontal brain region that has been shown to be involved in a wide variety of functions including risk and decision making, odor evaluation, reward and conflict, pain, and working memory. BA 10, also known as the anterior prefrontal cortex, frontopolar prefrontal cortex or rostral prefrontal cortex, is comprised of at least two cytoarchitectonic sub-regions, medial and lateral. To date, the explicit role of BA 10 in the processing of pain hasn't been fully elucidated. In this paper, we first review the anatomical pathways and functional connectivity of BA 10. Numerous functional imaging studies of experimental or clinical pain have also reported brain activations and/or deactivations in BA 10 in response to painful events. The evidence suggests that BA 10 may play a critical role in the collation, integration and high-level processing of nociception and pain, but also reveals possible functional distinctions between the subregions of BA 10 in this process.
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Affiliation(s)
- Ke Peng
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
| | - Sarah C Steele
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
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22
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Intrinsic brain abnormalities in irritable bowel syndrome and effect of anxiety and depression. Brain Imaging Behav 2017; 10:1127-1134. [PMID: 26556814 DOI: 10.1007/s11682-015-9478-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This resting-state functional magnetic resonance imaging (rs-fMRI) study investigated intrinsic brain abnormalities in irritable bowel syndrome (IBS) and effect of anxiety and depression. Thirty IBS patients and 31 matched healthy controls underwent rs-fMRI scanning. Regional brain activity was evaluated by measuring the amplitude of low-frequency fluctuation (ALFF) and compared between IBS patients and healthy controls with a two-sample t-test. Areas with abnormal ALFF were further used as seeds in subsequent inter-regional functional connectivity (FC) analysis. Statistical analyses were also performed by including anxiety and depression as covariates to evaluate their effect. Compared to healthy controls, IBS patients showed decreased ALFF in several core default mode network regions (medial prefrontal cortex [MPFC], posterior cingulate cortex [PCC], bilateral inferior parietal cortices [IPC]), and in middle frontal cortex, right orbital part of the superior frontal gyrus (ORBsup), dorsal anterior cingulate cortex (dACC), and ventral anterior cingulated cortex (vACC), while they showed increased ALFF in bilateral posterior insula and cuneus. In addition, IBS patients revealed decreased inter-regional positive FC between MPFC and right ORBsup, between vACC and PCC, as well as decreased negative FC between MPFC and left posterior insula, while they showed increased negative FC between MPFC and cuneus. The inclusion of anxiety and depression as covariates abolished ALFF differences in dACC and vACC, but none of the FC differences. IN CONCLUSION IBS patients had disturbed intrinsic brain function. High levels of anxiety and depression in IBS patients could account for their decreased intrinsic brain activity in regions (the ACC) involved in affective processing.
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23
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Hsu CL, Chen YC, Yang TN, Lin WK. Do website features matter in an online gamification context? Focusing on the mediating roles of user experience and attitude. TELEMATICS AND INFORMATICS 2017. [DOI: 10.1016/j.tele.2017.01.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Eisenblätter A, Lewis R, Dörfler A, Forster C, Zimmermann K. Brain mechanisms of abnormal temperature perception in cold allodynia induced by ciguatoxin. Ann Neurol 2017; 81:104-116. [PMID: 27997033 DOI: 10.1002/ana.24841] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 12/08/2016] [Accepted: 12/08/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Cold allodynia occurs as a major symptom of neuropathic pain states. It remains poorly treated with current analgesics. Ciguatoxins (CTXs), ichthyosarcotoxins that cause ciguatera, produce a large peripheral sensitization to dynamic cold stimuli in Aδ-fibers by activating sodium channels without producing heat or mechanical allodynia. We used CTXs as a surrogate model of cold allodynia to dissect the framework of cold allodynia-activated central pain pathways. METHODS Reversible cold allodynia was induced in healthy male volunteers by shallow intracutaneous injection of low millimolar concentrations of CTX into the dorsal skin of the forefoot. Cold and warm stimuli were delivered to the treated and the control site using a Peltier-driven thermotest device. Functional magnetic resonance imaging (fMRI) scans were acquired with a 3T MRI scanner using a blood oxygen level-dependent (BOLD) protocol. RESULTS The CTX-induced substantial peripheral sensitization to cooling stimuli in Aδ-fibers is particularly retrieved in BOLD changes due to dynamic temperature changes and less during constant cooling. Brain areas that responded during cold allodynia were almost always located bilaterally and appeared in the medial insula, medial cingulate cortex, secondary somatosensory cortex, frontal areas, and cerebellum. Whereas these areas also produced changes in BOLD signal during the dynamic warming stimulus on the control site, they remained silent during the warming stimuli on the injected site. INTERPRETATION We describe the defining feature of the cold allodynia pain percept in the human brain and illustrate why ciguatera sufferers often report a perceptual temperature reversal. ANN NEUROL 2017;81:104-116.
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Affiliation(s)
- Anneka Eisenblätter
- Department of Anesthesiology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.,Institute for Physiology and Pathophysiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Richard Lewis
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Arnd Dörfler
- Department of Neuroradiology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Clemens Forster
- Institute for Physiology and Pathophysiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Katharina Zimmermann
- Department of Anesthesiology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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25
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Fitzgerald JM, MacNamara A, Kennedy AE, Rabinak CA, Rauch SA, Liberzon I, Phan KL. Individual differences in cognitive reappraisal use and emotion regulatory brain function in combat-exposed veterans with and without PTSD. Depress Anxiety 2017; 34:79-88. [PMID: 27559724 PMCID: PMC5222751 DOI: 10.1002/da.22551] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/17/2016] [Accepted: 08/07/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Veterans with posttraumatic stress disorder (PTSD) exhibit marked deficits in emotion regulation. Past research has demonstrated underengagement of the prefrontal cortex during regulation of negative affect in those with PTSD, but has been unable to find evidence of impaired downregulation of the amygdala. One possibility is that there exists variability in amygdala reactivity that cuts across diagnostic status and which can be characterized using a continuous measure of individual differences. In healthy/nontraumatized volunteers, individual variability in amygdala engagement during emotion processing and regulation has been shown to relate to habitual use of regulation strategies. METHODS The current study examined whether self-reported use of cognitive reappraisal and expressive suppression regulation strategies correlated with brain activation during cognitive reappraisal in combat-exposed veterans with (n = 28) and without PTSD (combat-exposed controls, CEC; n = 20). RESULTS Results showed that greater self-reported use of cognitive reappraisal was associated with less activation in the right amygdala during volitional attempts to attenuate negative affect using reappraisal, irrespective of PTSD diagnosis. CONCLUSIONS This finding is in line with prior work and extends evidence of an association between habitual use of regulation strategies and amygdala engagement during emotion regulation to a trauma-exposed sample of individuals both with and without PTSD. Furthermore, by providing evidence of individual differences in regulation-related amygdala response in a traumatized sample, this result may increase understanding of the neural mechanisms that support variability in symptom manifestation observed across individuals with PTSD.
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Affiliation(s)
| | - Annmarie MacNamara
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Amy E. Kennedy
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA,Jesse Brown VA Medical Center, Chicago, IL, USA
| | - Christine A. Rabinak
- Wayne State University, Eugene Applebaum College of Pharmacy & Health Sciences Pharmacy Practice, Detroit, MI, USA
| | - Sheila A.M. Rauch
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA and Atlanta VA Medical Center, Atlanta, GA, USA
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI and Ann Arbor VA Healthcare System, Ann Arbor, MI, USA
| | - K. Luan Phan
- University of Illinois at Chicago, Department of Psychology, Chicago, IL, USA,University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA,Jesse Brown VA Medical Center, Chicago, IL, USA
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26
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Qi R, Liu C, Weng Y, Xu Q, Chen L, Wang F, Zhang LJ, Lu GM. Disturbed Interhemispheric Functional Connectivity Rather than Structural Connectivity in Irritable Bowel Syndrome. Front Mol Neurosci 2016; 9:141. [PMID: 27999530 PMCID: PMC5138208 DOI: 10.3389/fnmol.2016.00141] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/25/2016] [Indexed: 01/18/2023] Open
Abstract
Neuroimaging studies have demonstrated that irritable bowel syndrome (IBS)-a relapsing functional bowel disorder-presents with disrupted brain connections. However, little is known about the alterations of interhemispheric functional connectivity and underlying structural connectivity in IBS. This study combined resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) to investigate changes in interhemispheric coordination in IBS patients. Resting-state functional and structural magnetic resonance images were acquired from 65 IBS patients and 67 healthy controls (HCs; matched for age, sex and educational level). Interhemispheric voxel-mirrored homotopic connectivity (VMHC) was calculated and compared between groups. Homotopic regions showing abnormal VMHC in patients were targeted as regions of interest (ROIs) for analysis of DTI tractography. The fractional anisotropy (FA), fiber number and fiber length were compared between groups. Statistical analysis was also performed by including anxiety and depression as covariates to evaluate their effect. A Pearson correlation analysis between abnormal interhemispheric connectivity and clinical indices of IBS patients was performed. Compared to HCs, IBS patients had higher interhemispheric functional connectivity between bilateral thalami, cuneus, posterior cingulate cortices (PCC), lingual gyri and inferior occipital/cerebellum lobes, as well as lower interhemispheric functional connectivity between bilateral ventral anterior cingulate cortices (vACC) and inferior parietal lobules (IPL). The inclusion of anxiety and depression as covariates abolished VMHC difference in vACC. Microstructural features of white matter tracts connecting functionally abnormal regions did not reveal any differences between the groups. VMHC values in vACC negatively correlated with the quality of life (QOL) scores of patients. In conclusion, this study provides preliminary evidence of the disrupted functional coordination rather than anatomic coordination between interhemispheric regions within the cortex-thalamus circuit in IBS patients, which could partly account for the enhanced visceral information processing and impaired endogenous pain or emotion inhibition associated with IBS.
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Affiliation(s)
- Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Chang Liu
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Liya Chen
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Fangyu Wang
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Long J Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University Nanjing, China
| | - Guang M Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University Nanjing, China
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27
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Kuo PC, Chen YT, Chen YS, Chen LF. Decoding the perception of endogenous pain from resting-state MEG. Neuroimage 2016; 144:1-11. [PMID: 27746387 DOI: 10.1016/j.neuroimage.2016.09.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 07/17/2016] [Accepted: 09/16/2016] [Indexed: 02/08/2023] Open
Abstract
Decoding the neural representations of pain is essential to obtaining an objective assessment as well as an understanding of its underlying mechanisms. The complexities involved in the subjective experience of pain make it difficult to obtain a quantitative assessment from the induced spatiotemporal patterns of brain activity of high dimensionality. Most previous studies have investigated the perception of pain by analyzing the amplitude or spatial patterns in the response of the brain to external stimulation. This study investigated the decoding of endogenous pain perceptions according to resting-state magnetoencephalographic (MEG) recordings. In our experiments, we applied a beamforming method to calculate the brain activity for every brain region and examined temporal and spectral features of brain activity for predicting the intensity of perceived pain in patients with primary dysmenorrhea undergoing menstrual pain. Our results show that the asymmetric index of sample entropy in the precuneus and the sample entropy in the left posterior cingulate gyrus were the most informative characteristics associated with the perception of menstrual pain. The correlation coefficient (ρ=0.64, p<0.001) between the predicted and self-reported pain scores demonstrated the high prediction accuracy. In addition to the estimated brain activity, we were able to predict accurate pain scores directly from MEG channel signals (ρ=0.65, p<0.001). These findings suggest the possibility of using the proposed model based on resting-state MEG to predict the perceived intensity of endogenous pain.
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Affiliation(s)
- Po-Chih Kuo
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Ti Chen
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Yong-Sheng Chen
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan; Institute of Biomedical Engineering, National Chiao Tung University, Hsinchu, Taiwan.
| | - Li-Fen Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Integrated Brain Research Unit, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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28
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Liao CH, Lin HC, Huang CY. Chronic Prostatitis/Chronic Pelvic Pain Syndrome is associated with Irritable Bowel Syndrome: A Population-based Study. Sci Rep 2016; 6:26939. [PMID: 27225866 PMCID: PMC4880941 DOI: 10.1038/srep26939] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/06/2016] [Indexed: 12/12/2022] Open
Abstract
This study aimed to examine this association by comparing the risk of prior irritable bowel syndrome (IBS) between patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and matched controls in Taiwan. Data were retrieved from the Longitudinal Health Insurance Database 2005. This study included 4870 cases with CP/CPPS and 4870 age-matched controls. Conditional logistic regressions were conducted to examine associations of CP/CPPS with previously diagnosed IBS. We found that a total of 753 (7.7%) of the 9740 sampled patients had IBS prior to the index date; IBS was found in 497 (10.2%) cases and in 256 (5.3%) controls. Conditional logistic regression revealed a higher odds ratio (OR) of prior IBS (OR 2.05, 95% CI = 1.75–2.40) for cases than controls. Furthermore, after adjusting for the patients’ monthly income, geographical location, urbanization level, and hypertension and coronary heart disease, the conditional logistic regression analysis indicated that cases were more likely than controls to have prior IBS (OR = 1.96, 95% CI = 1.67–2.29). Furthermore, we found that CP/CPPS was consistently and significantly associated with prior IBS regardless of age group. We concluded that the diagnosis of CP/CPPS was associated with previously diagnosed IBS. Urologists should be aware of the association between CP/CPPS and IBS when treating patients.
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Affiliation(s)
- Chun-Hou Liao
- Division of Urology, Department of Surgery, Cardinal Tien Hospital, Taipei, Taiwan.,College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.,Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Herng-Ching Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chao-Yuan Huang
- School of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Urology, National Taiwan University Hospital, College of Medicine National Taiwan University, Taipei, Taiwan
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29
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Rubio G, López-Muñoz F, Jurado-Barba R, Martínez-Gras I, Rodríguez-Jiménez R, Espinosa R, Pérez-Nieto MÁ, Moratti S, Jiménez-Arriero MÁ, Carlos Leza J. Stress induced by the socially evaluated cold-pressor test cause equivalent deficiencies of sensory gating in male subjects with schizophrenia and healthy controls. Psychiatry Res 2015; 228:283-8. [PMID: 26154819 DOI: 10.1016/j.psychres.2015.05.097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 05/28/2015] [Accepted: 05/31/2015] [Indexed: 12/01/2022]
Abstract
It is known that patients with schizophrenia show a deficiency in the prepulse inhibition reflex (PPI). These patients display abnormalities in autonomic nervous system and hypothalamic-pituitary-adrenal function and may have an altered sensitivity to stress. To date, no studies have been carried out to determine the effect of acute stress on the PPI. We investigated whether there was a differential response in reactivity to acute stress caused by the socially evaluated cold-pressor test (SECPT) in a sample of 58 chronic male patients with schizophrenia and 28 healthy control subjects. PPI, salivary cortisol and heart rate (HR) were measured. The patients were evaluated in two sessions (with and without the SECPT) 72 h apart and basal measurements were carried out and 30 min post-startle probe. We found an increase in salivary cortisol levels and the HR with SECPT condition in both groups and a significantly lower PPI% in patients with schizophrenia. The most relevant findings of this study are that the impairment of the PPI is increased by stress. Stress-induced increase in cortisol in both groups, mainly in healthy control group which allows us to hypothesize that at least such deterioration may be due to the hypercortisolemia caused by the SECPT.
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Affiliation(s)
- Gabriel Rubio
- Department of Psychiatry, 12 de Octubre University Hospital, Madrid, Spain; "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Department of Psychiatry, Complutense University, Madrid, Spain; Networks for Cooperative Research in Health (RETICS-Addictive Disorder Network), Institute of Health Carlos III (ISCIII), MICINN and FEDER, Madrid, Spain
| | - Francisco López-Muñoz
- "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Genomic Medicine and Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain; Department of Biomedical Sciences (Pharmacology Area), Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.
| | - Rosa Jurado-Barba
- Department of Psychiatry, 12 de Octubre University Hospital, Madrid, Spain; "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Department of Psychology, Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
| | - Isabel Martínez-Gras
- Department of Psychiatry, 12 de Octubre University Hospital, Madrid, Spain; "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Department of Psychiatry, Complutense University, Madrid, Spain; Networks for Cooperative Research in Health (RETICS-Addictive Disorder Network), Institute of Health Carlos III (ISCIII), MICINN and FEDER, Madrid, Spain
| | - Roberto Rodríguez-Jiménez
- Department of Psychiatry, 12 de Octubre University Hospital, Madrid, Spain; "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Department of Psychiatry, Complutense University, Madrid, Spain; Networks for Cooperative Research in Health (RETICS-Addictive Disorder Network), Institute of Health Carlos III (ISCIII), MICINN and FEDER, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
| | - Miguel Ángel Pérez-Nieto
- Department of Psychology, Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
| | - Stephan Moratti
- Biomedical Research Center Network for Mental Health (CIBERSAM), Madrid, Spain; Center for Biomedical Technology, Polytechnic University, Madrid, Spain
| | - Miguel Ángel Jiménez-Arriero
- Department of Psychiatry, 12 de Octubre University Hospital, Madrid, Spain; "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Department of Psychiatry, Complutense University, Madrid, Spain; Networks for Cooperative Research in Health (RETICS-Addictive Disorder Network), Institute of Health Carlos III (ISCIII), MICINN and FEDER, Madrid, Spain
| | - Juan Carlos Leza
- "Hospital 12 de Octubre" Research Institute, Madrid, Spain; Biomedical Research Center Network for Mental Health (CIBERSAM), Madrid, Spain; Department of Pharmacology, Complutense University, Madrid, Spain
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30
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Brain Network Response to Acupuncture Stimuli in Experimental Acute Low Back Pain: An fMRI Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:210120. [PMID: 26161117 PMCID: PMC4487721 DOI: 10.1155/2015/210120] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 05/02/2015] [Accepted: 05/05/2015] [Indexed: 12/30/2022]
Abstract
Most neuroimaging studies have demonstrated that acupuncture can significantly modulate brain activation patterns in healthy subjects, while only a few studies have examined clinical pain. In the current study, we combined an experimental acute low back pain (ALBP) model and functional magnetic resonance imaging (fMRI) to explore the neural mechanisms of acupuncture analgesia. All ALBP subjects first underwent two resting state fMRI scans at baseline and during a painful episode and then underwent two additional fMRI scans, once during acupuncture stimulation (ACUP) and once during tactile stimulation (SHAM) pseudorandomly, at the BL40 acupoint. Our results showed that, compared with the baseline, the pain state had higher regional homogeneity (ReHo) values in the pain matrix, limbic system, and default mode network (DMN) and lower ReHo values in frontal gyrus and temporal gyrus; compared with the OFF status, ACUP yielded broad deactivation in subjects, including nearly all of the limbic system, pain status, and DMN, and also evoked numerous activations in the attentional and somatosensory systems; compared with SHAM, we found that ACUP induced more deactivations and fewer activations in the subjects. Multiple brain networks play crucial roles in acupuncture analgesia, suggesting that ACUP exceeds a somatosensory-guided mind-body therapy for ALBP.
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31
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Lepron E, Causse M, Farrer C. Responsibility and the sense of agency enhance empathy for pain. Proc Biol Sci 2015; 282:20142288. [PMID: 25473014 DOI: 10.1098/rspb.2014.2288] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Being held responsible for our actions strongly determines our moral judgements and decisions. This study examined whether responsibility also influences our affective reaction to others' emotions. We conducted two experiments in order to assess the effect of responsibility and of a sense of agency (the conscious feeling of controlling an action) on the empathic response to pain. In both experiments, participants were presented with video clips showing an actor's facial expression of pain of varying intensity. The empathic response was assessed with behavioural (pain intensity estimation from facial expressions and unpleasantness for the observer ratings) and electrophysiological measures (facial electromyography). Experiment 1 showed enhanced empathic response (increased unpleasantness for the observer and facial electromyography responses) as participants' degree of responsibility for the actor's pain increased. This effect was mainly accounted for by the decisional component of responsibility (compared with the execution component). In addition, experiment 2 found that participants' unpleasantness rating also increased when they had a sense of agency over the pain, while controlling for decision and execution processes. The findings suggest that increased empathy induced by responsibility and a sense of agency may play a role in regulating our moral conduct.
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Affiliation(s)
- Evelyne Lepron
- Centre de recherche Cerveau et Cognition, Université de Toulouse UPS and CNRS, Toulouse, France
| | - Michaël Causse
- DMIA, ISAE, Université de Toulouse, 10 Avenue E. Belin, 31055 Toulouse Cedex 4, France
| | - Chlöé Farrer
- Centre de recherche Cerveau et Cognition, Université de Toulouse UPS and CNRS, Toulouse, France
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Zhang SS, Wu W, Liu ZP, Huang GZ, Guo SG, Yang JM. Altered regional homogeneity in experimentally induced low back pain: a resting-state fMRI study. J Neuroeng Rehabil 2014; 11:115. [PMID: 25080831 PMCID: PMC4237877 DOI: 10.1186/1743-0003-11-115] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 07/21/2014] [Indexed: 11/22/2022] Open
Abstract
Background Functional imaging studies have indicated that patients with low back pain can have significant reductions in cerebral cortex grey matter. However, the mechanisms governing the nociceptive pathways in the human brain are unclear. The aim of this study was to use functional magnetic resonance imaging (fMRI) and regional homogeneity (ReHo) to investigate changes in resting-state brain activity in subjects that experienced experimentally induced low back pain. Methods Healthy subjects (n = 15) underwent fMRI (3.0 T) at baseline and during painful stimulation (intramuscular injection of 3% hypertonic saline). Results Compared to the scans conducted at baseline, scans conducted during experimentally induced low back pain showed increased ReHo on the right side in the medial prefrontal cortex, precuneus, insula, parahippocampal gyrus and cerebellum (posterior lobe), but decreased ReHo in the primary somatosensory cortex, anterior cingulate cortex and parahippocampal gyrus on the left side. The right inferior parietal lobule also showed a decreased ReHo (P < 0.05, cluster threshold ≥10). Conclusions These findings suggest that abnormally spontaneous resting-state activity in some brain regions may be associated with pain processing. These changes in neural activity may contribute to the recognition, execution, memory and emotional processing of acute low back pain.
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Affiliation(s)
| | - Wen Wu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, People's Republic of China.
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Central pain processing in chronic chemotherapy-induced peripheral neuropathy: a functional magnetic resonance imaging study. PLoS One 2014; 9:e96474. [PMID: 24821182 PMCID: PMC4018287 DOI: 10.1371/journal.pone.0096474] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 04/08/2014] [Indexed: 12/01/2022] Open
Abstract
Life expectancy in multiple myeloma has significantly increased. However, a high incidence of chemotherapy induced peripheral neuropathy (CIPN) can negatively influence quality of life during this period. This study applied functional magnetic resonance imaging (fMRI) to compare areas associated with central pain processing in patients with multiple myeloma who had chemotherapy induced peripheral neuropathy (MM-CIPN) with those from healthy volunteers (HV). Twenty-four participants (n = 12 MM-CIPN, n = 12 HV) underwent Blood Oxygen Level-Dependent (BOLD) fMRI at 3T whilst noxious heat-pain stimuli were applied to the foot and then thigh. Patients with MM-CIPN demonstrated greater activation during painful stimulation in the precuneus compared to HV (p = 0.014, FWE-corrected). Patients with MM-CIPN exhibited hypo-activation of the right superior frontal gyrus compared to HV (p = 0.031, FWE-corrected). Significant positive correlation existed between the total neuropathy score (reduced version) and activation in the frontal operculum (close to insular cortex) during foot stimulation in patients with MM-CIPN (p = 0.03, FWE-corrected; adjusted R2 = 0.87). Painful stimuli delivered to MM-CIPN patients evoke differential activation of distinct cortical regions, reflecting a unique pattern of central pain processing compared with healthy volunteers. This characteristic activation pattern associated with pain furthers the understanding of the pathophysiology of painful chemotherapy induced peripheral neuropathy. Functional MRI provides a tool for monitoring cerebral changes during anti-cancer and analgesic treatment.
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34
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Parise M, Kubo TTA, Doring TM, Tukamoto G, Vincent M, Gasparetto EL. Cuneus and fusiform cortices thickness is reduced in trigeminal neuralgia. J Headache Pain 2014; 15:17. [PMID: 24661349 PMCID: PMC3997919 DOI: 10.1186/1129-2377-15-17] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 03/12/2014] [Indexed: 01/18/2023] Open
Abstract
Background Chronic pain disorders are presumed to induce changes in brain grey and white matters. Few studies have focused CNS alterations in trigeminal neuralgia (TN). Methods The aim of this study was to explore changes in white matter microstructure in TN subjects using diffusion tensor images (DTI) with tract-based spatial statistics (TBSS); and cortical thickness changes with surface based morphometry. Twenty-four patients with classical TN (37-67 y-o) and 24 healthy controls, matched for age and sex, were included in the study. Results Comparing patients with controls, no diffusivity abnormalities of brain white matter were detected. However, a significant reduction in cortical thickness was observed at the left cuneus and left fusiform cortex in the patients group. The thickness of the fusiform cortex correlated negatively with the carbamazepine dose (p = 0.023). Conclusions Since the cuneus and the fusiform gyrus have been related to the multisensory integration area and cognitive processing, as well as the retrieval of shock perception conveyed by Aδ fibers, our results support the role of these areas in TN pathogenesis. Whether such changes occurs as an epiphenomenon secondary to daily stimulation or represent a structural predisposition to TN in the light of peripheral vascular compression is a matter of future studies.
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Affiliation(s)
- Maud Parise
- Department of Radiology, Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP:21941-913, Brazil.
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Richardson HL, Macey PM, Kumar R, Valladares EM, Woo MA, Harper RM. Neural and physiological responses to a cold pressor challenge in healthy adolescents. J Neurosci Res 2013; 91:1618-27. [PMID: 24105663 DOI: 10.1002/jnr.23283] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/26/2013] [Accepted: 07/07/2013] [Indexed: 11/09/2022]
Abstract
Abnormal autonomic function is common in pediatric diseases. Assessment of central mechanisms underlying autonomic challenges may reveal vulnerabilities antecedent to system failure. Our objective was to characterize central markers and physiological responses to a cold pressor challenge in normal children as a critical step for establishing such screening. We performed functional magnetic resonance imaging (fMRI) and collected physiological measures during cold application to the foot in 24 healthy adolescents (15.5 ± 0.4 years, 13 male). The protocol included a 120-sec baseline, 120-sec right-foot cold water immersion (4°C), and 120-sec recovery. Analyses included heart rate (HR) cross-correlations with fMRI signals. Cold application increased HR 13% 5-7 sec after onset, which remained elevated throughout the challenge. Respiratory rate transiently increased (peak 22%), then declined (nadir 12% below baseline), before normalizing at 75 sec. Cold onset rapidly increased somatosensory cortex and medullary signals, which fell after 25 sec. Right anterior insular cortex signals increased early, followed after 20 sec by the left anterior insula, with HR declining 8 sec later. Amygdalae signals also rose, but signals declined in the posterior cingulate cortex, caudate nucleus, hippocampus, and hypothalamus. Declining signals appeared late in the cerebellar fastigial nuclei (60-120 sec), and in the pons and thalamus. Somatosensory cortex, fastigial nuclei, and hypothalamic responses were principally left-sided, with bilateral responses elsewhere. Late left anterior insula responses likely underlie the HR decline; the late cerebellar pattern may modulate recovery. The laterality, timing, and amplitude of normative responses and rostral response differentiation indicate the complex integration of adolescent autonomic processing and provide indices for pathological comparisons.
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Affiliation(s)
- Heidi L Richardson
- Department of Neurobiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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Bari A, Robbins TW. Inhibition and impulsivity: Behavioral and neural basis of response control. Prog Neurobiol 2013; 108:44-79. [DOI: 10.1016/j.pneurobio.2013.06.005] [Citation(s) in RCA: 1193] [Impact Index Per Article: 108.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 05/24/2013] [Accepted: 06/26/2013] [Indexed: 11/17/2022]
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Differential Localization of Pain-Related and Pain-Unrelated Neural Responses for Acupuncture at BL60 Using BOLD fMRI. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:804696. [PMID: 23853664 PMCID: PMC3703342 DOI: 10.1155/2013/804696] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/31/2013] [Indexed: 11/18/2022]
Abstract
The objective of this study was to differentiate between pain-related and pain-unrelated neural responses of acupuncture at BL60 to investigate the specific effects of acupuncture. A total of 19 healthy volunteers were evaluated. fMRI was performed with sham or verum acupuncture stimulation at the left BL60 before and after local anesthesia. To investigate the relative BOLD signal effect for each session, a one-sample t-test was performed for individual contrast maps, and a paired t-test to investigate the differences between the pre- and post-anesthetic signal effects. Regarding verum acupuncture, areas that were more activated before local anesthesia included the superior, middle, and medial frontal gyri, inferior parietal lobule, superior temporal gyrus, thalamus, middle temporal gyrus, cingulate gyrus, culmen, and cerebellar tonsil. The postcentral gyrus was more deactivated before local anesthesia. After local anesthesia, the middle occipital gyrus, inferior temporal gyrus, postcentral gyrus, precuneus, superior parietal lobule, and declive were deactivated. Pre-anesthetic verum acupuncture at BL60 activated areas of vision and pain transmission. Post-anesthetic verum acupuncture deactivated brain areas of visual function, which is considered to be a pain-unrelated acupuncture response. It indicates that specific effects of acupoint BL60 are to control vision sense as used in the clinical setting.
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Woods AJ, Philbeck JW, Wirtz P. Hyper-arousal decreases human visual thresholds. PLoS One 2013; 8:e61415. [PMID: 23593478 PMCID: PMC3620239 DOI: 10.1371/journal.pone.0061415] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 03/13/2013] [Indexed: 11/18/2022] Open
Abstract
Arousal has long been known to influence behavior and serves as an underlying component of cognition and consciousness. However, the consequences of hyper-arousal for visual perception remain unclear. The present study evaluates the impact of hyper-arousal on two aspects of visual sensitivity: visual stereoacuity and contrast thresholds. Sixty-eight participants participated in two experiments. Thirty-four participants were randomly divided into two groups in each experiment: Arousal Stimulation or Sham Control. The Arousal Stimulation group underwent a 50-second cold pressor stimulation (immersing the foot in 0-2° C water), a technique known to increase arousal. In contrast, the Sham Control group immersed their foot in room temperature water. Stereoacuity thresholds (Experiment 1) and contrast thresholds (Experiment 2) were measured before and after stimulation. The Arousal Stimulation groups demonstrated significantly lower stereoacuity and contrast thresholds following cold pressor stimulation, whereas the Sham Control groups showed no difference in thresholds. These results provide the first evidence that hyper-arousal from sensory stimulation can lower visual thresholds. Hyper-arousal's ability to decrease visual thresholds has important implications for survival, sports, and everyday life.
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Affiliation(s)
- Adam J Woods
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
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Ung H, Brown JE, Johnson KA, Younger J, Hush J, Mackey S. Multivariate classification of structural MRI data detects chronic low back pain. ACTA ACUST UNITED AC 2012; 24:1037-44. [PMID: 23246778 DOI: 10.1093/cercor/bhs378] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic low back pain (cLBP) has a tremendous personal and socioeconomic impact, yet the underlying pathology remains a mystery in the majority of cases. An objective measure of this condition, that augments self-report of pain, could have profound implications for diagnostic characterization and therapeutic development. Contemporary research indicates that cLBP is associated with abnormal brain structure and function. Multivariate analyses have shown potential to detect a number of neurological diseases based on structural neuroimaging. Therefore, we aimed to empirically evaluate such an approach in the detection of cLBP, with a goal to also explore the relevant neuroanatomy. We extracted brain gray matter (GM) density from magnetic resonance imaging scans of 47 patients with cLBP and 47 healthy controls. cLBP was classified with an accuracy of 76% by support vector machine analysis. Primary drivers of the classification included areas of the somatosensory, motor, and prefrontal cortices--all areas implicated in the pain experience. Differences in areas of the temporal lobe, including bordering the amygdala, medial orbital gyrus, cerebellum, and visual cortex, were also useful for the classification. Our findings suggest that cLBP is characterized by a pattern of GM changes that can have discriminative power and reflect relevant pathological brain morphology.
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Affiliation(s)
- Hoameng Ung
- Division of Pain Medicine, Department of Anesthesia
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Asghar AUR, Johnson RL, Woods W, Green GGR, Lewith G, Macpherson H. Oscillatory neuronal dynamics associated with manual acupuncture: a magnetoencephalography study using beamforming analysis. Front Hum Neurosci 2012; 6:303. [PMID: 23248594 PMCID: PMC3522113 DOI: 10.3389/fnhum.2012.00303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 10/19/2012] [Indexed: 11/13/2022] Open
Abstract
Magnetoencephalography (MEG) enables non-invasive recording of neuronal activity, with reconstruction methods providing estimates of underlying brain source locations and oscillatory dynamics from externally recorded neuromagnetic fields. The aim of our study was to use MEG to determine the effect of manual acupuncture on neuronal oscillatory dynamics. A major problem in MEG investigations of manual acupuncture is the absence of onset times for each needle manipulation. Given that beamforming (spatial filtering) analysis is not dependent upon stimulus-driven responses being phase-locked to stimulus onset, we postulated that beamforming could reveal source locations and induced changes in neuronal activity during manual acupuncture. In a beamformer analysis, a two-minute period of manual acupuncture needle manipulation delivered to the ipsilateral right LI-4 (Hegu) acupoint was contrasted with a two-minute baseline period. We considered oscillatory power changes in the theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (30-100 Hz) frequency bands. We found significant decreases in beta band power in the contralateral primary somatosensory cortex and superior frontal gyrus (SFG). In the ipsilateral cerebral hemisphere, we found significant power decreases in beta and gamma frequency bands in only the SFG. No significant power modulations were found in theta and alpha bands. Our results indicate that beamforming is a useful analytical tool to reconstruct underlying neuronal activity associated with manual acupuncture. Our main finding was of beta power decreases in primary somatosensory cortex and SFG, which opens up a line of future investigation regarding whether this contributes toward an underlying mechanism of acupuncture.
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Affiliation(s)
- Aziz U R Asghar
- Hull York Medical School, University of Hull Hull, UK ; York Neuroimaging Centre, University of York, The Biocentre, York Science Park York, UK
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Buhle JT, Kober H, Ochsner KN, Mende-Siedlecki P, Weber J, Hughes BL, Kross E, Atlas LY, McRae K, Wager TD. Common representation of pain and negative emotion in the midbrain periaqueductal gray. Soc Cogn Affect Neurosci 2012; 8:609-16. [PMID: 22446299 DOI: 10.1093/scan/nss038] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Human neuroimaging offers a powerful way to connect animal and human research on emotion, with profound implications for psychological science. However, the gulf between animal and human studies remains a formidable obstacle: human studies typically focus on the cortex and a few subcortical regions such as the amygdala, whereas deeper structures such as the brainstem periaqueductal gray (PAG) play a key role in animal models. Here, we directly assessed the role of PAG in human affect by interleaving in a single fMRI session two conditions known to elicit strong emotional responses--physical pain and negative image viewing. Negative affect and PAG activity increased in both conditions. We next examined eight independent data sets, half featuring pain stimulation and half negative image viewing. In sum, these data sets comprised 198 additional participants. We found increased activity in PAG in all eight studies. Taken together, these findings suggest PAG is a key component of human affective responses.
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Affiliation(s)
- Jason T Buhle
- Social Cognitive Affective Neuroscience Unit, Department of Psychology, Columbia University, 406 Schermerhorn Hall, 1190 Amsterdam Avenue, NY 10027, USA.
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Riganello F, Garbarino S, Sannita WG. Heart Rate Variability, Homeostasis, and Brain Function. J PSYCHOPHYSIOL 2012. [DOI: 10.1027/0269-8803/a000080] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Measures of heart rate variability (HRV) are major indices of the sympathovagal balance in cardiovascular research. These measures are thought to reflect complex patterns of brain activation as well and HRV is now emerging as a descriptor thought to provide information on the nervous system organization of homeostatic responses in accordance with the situational requirements. Current models of integration equate HRV to the affective states as parallel outputs of the central autonomic network, with HRV reflecting its organization of affective, physiological, “cognitive,” and behavioral elements into a homeostatic response. Clinical application is in the study of patients with psychiatric disorders, traumatic brain injury, impaired emotion-specific processing, personality, and communication disorders. HRV responses to highly emotional sensory inputs have been identified in subjects in vegetative state and in healthy or brain injured subjects processing complex sensory stimuli. In this respect, HRV measurements can provide additional information on the brain functional setup in the severely brain damaged and would provide researchers with a suitable approach in the absence of conscious behavior or whenever complex experimental conditions and data collection are impracticable, as it is the case, for example, in intensive care units.
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Affiliation(s)
- Francesco Riganello
- S. Anna Institute and RAN – Research in Advanced Neurorehabilitation, Crotone, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Ophthalmology and Genetics, University of Genova, Italy
| | - Walter G. Sannita
- Department of Neuroscience, Ophthalmology and Genetics, University of Genova, Italy
- Department of Psychiatry, State University of New York, Stony Brook, NY, USA
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Fabjan A, Musizza B, Bajrović FF, Zaletel M, Strucl M. The effect of the cold pressor test on a visually evoked cerebral blood flow velocity response. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:13-20. [PMID: 22104537 DOI: 10.1016/j.ultrasmedbio.2011.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 08/17/2011] [Accepted: 10/12/2011] [Indexed: 05/31/2023]
Abstract
We investigated the hypothesis that during tonic pain stimulus, neurovascular coupling (NVC) decreases, measuring visually evoked cerebral blood flow velocity response (VEFR) during cold pressor test (CPT) in healthy human subjects as a test. VEFR was calculated as a relative increase in blood flow velocity in the posterior cerebral artery from average values during the last 5 s of the stimulus-OFF period to average values during the last 10 s of the stimulus-ON period. Three consecutive experimental phases were compared: basal, CPT and recovery. During CPT, end-diastolic and mean VEFR increased from 20.2 to 23.6% (p < 0.05) and from 17.5 to 20.0% (p < 0.05), respectively. In recovery phase, end-diastolic and mean VEFR decreased to 17.7% and 15.5%, respectively. Both values were statistically significantly different from CPT phase (p < 0.05). Compared with the basal phase, only end-diastolic VEFR was statistically significantly different in the recovery phase (p < 0.05). Our results are consistent with the assumption that there is a change in the activity of NVC during CPT because of the modulatory influence of subcortical structures activated during tonic pain. Contrary to our expectations, the combined effect of such influences increases rather than decreases NVC.
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Affiliation(s)
- Andrej Fabjan
- Institute of Physiology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
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Newberg AB, Hersh EV, Levin LM, Giannakopoulos H, Secreto SA, Wintering NA, Farrar JT. Double-blind, placebo-controlled, randomized pilot study of cerebral blood flow patterns employing SPECT imaging in dental postsurgical pain patients with and without pain relief. Clin Ther 2011; 33:1894-903. [PMID: 22101161 DOI: 10.1016/j.clinthera.2011.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND Single-photon emission computed tomography (SPECT) has been employed in the study of altered regional cerebral blood flow (CBF) in experimental and chronic pain. CBF patterns have not been evaluated in patients with acute postoperative pain. OBJECTIVE The purpose of this pilot study was to employ SPECT to measure CBF distribution associated with postoperative dental pain and to compare these CBF patterns to subsequent images in the same patients who were experiencing pain relief versus continued or worsening pain who had received active or placebo analgesic interventions. The primary outcome measure was the percentage change in blood flow in various regions of interest. METHODS Twenty-two healthy individuals (10 males and 12 females, age range 20-29 years) who underwent the removal of ≥1 partial or full bony impacted mandibular third molars were evaluated for pain intensity as the local anesthesia dissipated, employing a 0 to10 numeric rating scale (0 = no pain; 10 = worst imaginable). When the subjects' pain level reached ≥4/10, they were injected intravenously with 260 MBq of technetium Tc 99m bicisate (ethyl cysteinate dimer). Under double-blind conditions and 10 minutes before being placed in the SPECT scanner, the first 10 subjects were randomized to receive intravenous ketorolac 15 mg or saline while the remaining 12 subjects were randomized to receive by mouth either ibuprofen 400 mg, ibuprofen 200 mg, acetaminophen 1000 mg, or placebo. One hour after drug administration, subjects were reevaluated for pain, injected with 925 MBq of technetium Tc 99m bicisate, given rescue medication if required, and then rescanned. CBF ratios were obtained for regions of interest and by normalizing to average whole brain activity. RESULTS Subjects generally had a moderate degree (mean [SD], 7.3% [4.0%]) of thalamic asymmetry on initial scans with pain; after treatment, subjects reporting worsening pain regardless of the intervention had higher thalamic asymmetry (8.1% vs 2.8%) than those reporting relief of pain. Subjects who reported reduced pain after the intervention had significantly different (P < 0.05) mean CBF changes compared with those reporting worsening pain in the left prefrontal cortex, left sensorimotor area, right anterior cingulate, and right caudate. CONCLUSIONS Acute postoperative dental pain was associated with moderate thalamic asymmetry that improved following successful pain management. Sustained or worsening pain was associated with increased CBF in brain regions associated with pain pathways, whereas pain relief was associated with decreased activity in the same areas.
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Affiliation(s)
- Andrew B Newberg
- Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Lötsch J, Walter C, Felden L, Preibisch C, Nöth U, Martin T, Anti S, Deichmann R, Oertel BG. Extended cortical activations during evaluating successive pain stimuli. Soc Cogn Affect Neurosci 2011; 7:698-707. [PMID: 21768205 DOI: 10.1093/scan/nsr042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Comparing pain is done in daily life and involves short-term memorizing and attention focusing. This event-related functional magnetic resonance imaging study investigated the short-term brain activations associated with the comparison of pain stimuli using a delayed discrimination paradigm. Fourteen healthy young volunteers compared two successive pain stimuli administered at a 10 s interval to the same location at the nasal mucosa. Fourteen age- and sex-matched subjects received similar pain stimuli without performing the comparison task. With the comparison task, the activations associated with the second pain stimulus were significantly greater than with the first stimulus in the anterior insular cortex and the primary somatosensory area. This was observed on the background of a generally increased stimulus-associated brain activation in the presence of the comparison task that included regions of the pain matrix (insular cortex, primary and secondary somatosensory area, midcingulate cortex, supplemental motor area) and regions associated with attention, decision making, working memory and body recognition (frontal and temporal gyri, inferior parietal lobule, precuneus, lingual cortices). This data provides a cerebral correlate for the role of pain as a biological alerting system that gains the subject's attention and then dominates most other perceptions and activities involving pain-specific and non-pain-specific brain regions.
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Affiliation(s)
- Jörn Lötsch
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe-University, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany.
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Staahl C, Krarup AL, Olesen AE, Brock C, Graversen C, Drewes AM. Is Electrical Brain Activity a Reliable Biomarker for Opioid Analgesia in the Gut? Basic Clin Pharmacol Toxicol 2011; 109:321-7. [DOI: 10.1111/j.1742-7843.2011.00727.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Coll MP, Grégoire M, Latimer M, Eugène F, Jackson PL. Perception of pain in others: implication for caregivers. Pain Manag 2011; 1:257-65. [DOI: 10.2217/pmt.11.21] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
SUMMARY The subjective nature of pain renders its perception in others a challenge for clinicians and informal caregivers responsible for its assessment and relief. Adequate perception of others’ pain relies on different behavioral and neurophysiological mechanisms. Several individual, relational and contextual factors can influence the way the brain reacts to others’ pain and the perception and assessment of this pain. This article focuses on recent neurophysiological and psychological evidence that characterizes these factors, and discusses their potential impact on the perception of others’ pain in a caregiving context. Factors influencing the perception of pain in others are divided into factors related to the self (caregiver), factors related to the other (patient), and factors related to the relationship between those individuals and the context in which the pain is perceived. We propose that the perception of others’ pain plays a crucial role in the treatment provided by clinicians and informal caregivers, and that further research could lead to improving decision-making regarding pain management.
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Affiliation(s)
- Michel-Pierre Coll
- École de psychologie, Faculté des Sciences Sociales, Université Laval, Québec, G1V 0A6, Canada; École de psychologie, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques Bureau 1116, Université Laval, Québec G1V 0A6, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Canada
| | - Mathieu Grégoire
- École de psychologie, Faculté des Sciences Sociales, Université Laval, Québec, G1V 0A6, Canada; École de psychologie, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques Bureau 1116, Université Laval, Québec G1V 0A6, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Canada
| | - Margot Latimer
- School of Nursing, Faculty of Health Professions, Dalhousie University, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Canada
| | - Fanny Eugène
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Canada
| | - Philip L Jackson
- Centre de Recherche Université Laval Robert-Giffard, Québec, Canada
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Relaxation Techniques and Guided Imagery. Pain Manag 2011. [DOI: 10.1016/b978-1-4377-0721-2.00132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Gutzeit A, Meier D, Meier ML, von Weymarn C, Ettlin DA, Graf N, Froehlich JM, Binkert CA, Brügger M. Insula-specific responses induced by dental pain. A proton magnetic resonance spectroscopy study. Eur Radiol 2010; 21:807-15. [DOI: 10.1007/s00330-010-1971-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 08/22/2010] [Accepted: 09/02/2010] [Indexed: 11/30/2022]
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Cerebral processing of pain in school-aged children with neonatal nociceptive input: An exploratory fMRI study. Pain 2010; 150:257-267. [DOI: 10.1016/j.pain.2010.04.004] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 02/16/2010] [Accepted: 04/06/2010] [Indexed: 12/22/2022]
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