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Czarnecki J, Nowakowska-Domagała K, Mokros Ł. Combined cold-water immersion and breathwork may be associated with improved mental health and reduction in the duration of upper respiratory tract infection - a case-control study. Int J Circumpolar Health 2024; 83:2330741. [PMID: 38509857 PMCID: PMC10962303 DOI: 10.1080/22423982.2024.2330741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
A polar plunge is a term referring to an ice-cold water immersion (CWI), usually in the winter period. It is also a part of a specific training program (STP) which currently gains popularity worldwide and was proven to display paradigm-shifting characteristics. The aim of this study was to compare the indices of mental functioning (including depression, anxiety, mindfulness) and duration of upper respiratory tract infection (URTI) measured among the study participants. A set of questionnaires was distributed via the Internet. Participants declaring regular STP practice were selected (N = 77). Two groups were matched based on a case-control principle: the first one (the control group) comprised participants who did not declare nor CWI practice, nor STP practice. The second one comprised participants declaring regular CWI practice only. The CWI only group displayed better mental health indices and shorter URTIs compared to the control group. Moreover, the STP group also displayed better general mental health, less somatic complaints, and shorter URTIs compared to the CWI only group. This study suggests the existence of CWI's potential in boosting mental health and immune system functioning, however when complemented by a specific breathwork, this potential can be increased. However, further research is required.
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Affiliation(s)
- Jan Czarnecki
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Łukasz Mokros
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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Mehnert J, Tinnermann A, Basedau H, May A. Functional representation of trigeminal nociceptive input in the human periaqueductal gray. Sci Adv 2024; 10:eadj8213. [PMID: 38507498 PMCID: PMC10954197 DOI: 10.1126/sciadv.adj8213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/13/2024] [Indexed: 03/22/2024]
Abstract
The periaqueductal gray (PAG) is located in the mesencephalon in the upper brainstem and, as part of the descending pain modulation, is considered a crucial structure for pain control. Its modulatory effect on painful sensation is often seen as a systemic function affecting the whole body similarly. However, recent animal data suggest some kind of somatotopy in the PAG. This would make the PAG capable of dermatome-specific analgesic function. We electrically stimulated the three peripheral dermatomes of the trigemino-cervical complex and the greater occipital nerve in 61 humans during optimized brainstem functional magnetic resonance imaging. We provide evidence for a fine-grained and highly specific somatotopic representation of nociceptive input in the PAG in humans and a functional connectivity between the individual representations of the peripheral nerves in the PAG and the brainstem nuclei of these nerves. Our data suggest that the downstream antinociceptive properties of the PAG may be rather specific down to the level of individual dermatomes.
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Affiliation(s)
| | | | - Hauke Basedau
- Department of Systems Neuroscience, University Medical Center Eppendorf, 20146 Hamburg, Germany
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Rho G, Callara AL, Bernardi G, Scilingo EP, Greco A. EEG cortical activity and connectivity correlates of early sympathetic response during cold pressor test. Sci Rep 2023; 13:1338. [PMID: 36693870 DOI: 10.1038/s41598-023-27480-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
Previous studies have identified several brain regions involved in the sympathetic response and its integration with pain, cognition, emotions and memory processes. However, little is known about how such regions dynamically interact during a sympathetic activation task. In this study, we analyzed EEG activity and effective connectivity during a cold pressor test (CPT). A source localization analysis identified a network of common active sources including the right precuneus (r-PCu), right and left precentral gyri (r-PCG, l-PCG), left premotor cortex (l-PMC) and left anterior cingulate cortex (l-ACC). We comprehensively analyzed the network dynamics by estimating power variation and causal interactions among the network regions through the direct directed transfer function (dDTF). A connectivity pattern dominated by interactions in [Formula: see text] (8-12) Hz band was observed in the resting state, with r-PCu acting as the main hub of information flow. After the CPT onset, we observed an abrupt suppression of such [Formula: see text]-band interactions, followed by a partial recovery towards the end of the task. On the other hand, an increase of [Formula: see text]-band (1-4) Hz interactions characterized the first part of CPT task. These results provide novel information on the brain dynamics induced by sympathetic stimuli. Our findings suggest that the observed suppression of [Formula: see text] and rise of [Formula: see text] dynamical interactions could reflect non-pain-specific arousal and attention-related response linked to stimulus' salience.
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Wang L, Fu LL, Deng ZR, Zhang J, Zu MD, Wu JC, Wang Y. Overexpression of BDNF in the ventrolateral periaqueductal gray regulates the behavior of epilepsy-migraine comorbid rats. Brain Behav 2022; 12:e2594. [PMID: 35557046 PMCID: PMC9226826 DOI: 10.1002/brb3.2594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the effects of brain-derived neurotrophic factor (BDNF) overexpression in the ventrolateral periaqueductal gray (vlPAG) on behavioral changes in epilepsy-migraine comorbid rats. METHOD We used an adeno-associated virus (AAV)-mediated vector to supplement BDNF in the vlPAG area prior to the establishment of a pilocarpine-nitroglycerin (Pilo-NTG) combination-induced comorbid model of epilepsy and migraine. Seizure- and migraine-related behaviors were analyzed. Cell loss and apoptosis in vlPAG were detected through hematoxylin-eosin (HE) and TUNEL staining. Immunofluorescence staining analyses were employed to detect expressions of BDNF and its receptor, tyrosine kinase B (TrkB), in vlPAG. Immunohistochemical staining was conducted to detect expressions of c-Fos and calcitonin gene-related peptide (CGRP) in the trigeminal nucleus caudalis (TNC) and trigeminal ganglion (TG). RESULTS Comparing to control group, AAV-BDNF injected comorbid group showed lower pain sensitivity, scratching head, and spontaneous seizures accompanied by the downregulation of c-Fos labeling neurons and CGRP immunoreactivity in the TNC and TG. However, these changes were still significantly higher in the comorbid group than those in both epilepsy and migraine groups under the same intervention. CONCLUSION These data demonstrated that supplying BDNF to vlPAG may protect structural and functional abnormalities in vlPAG and provide an antiepileptic and analgesic therapy.
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Affiliation(s)
- Long Wang
- Department of Neurology, The Second People's Hospital of Hefei, Hefei, China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lu-Lan Fu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zi-Ru Deng
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Juan Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mei-Dan Zu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jun-Cang Wu
- Department of Neurology, The Second People's Hospital of Hefei, Hefei, China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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5
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Baraniuk JN. Review of the Midbrain Ascending Arousal Network Nuclei and Implications for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Gulf War Illness (GWI) and Postexertional Malaise (PEM). Brain Sci 2022; 12:132. [PMID: 35203896 PMCID: PMC8870178 DOI: 10.3390/brainsci12020132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 12/10/2022] Open
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS and Gulf War Illness (GWI) share features of post-exertional malaise (PEM), exertional exhaustion, or postexertional symptom exacerbation. In a two-day model of PEM, submaximal exercise induced significant changes in activation of the dorsal midbrain during a high cognitive load working memory task (Washington 2020) (Baraniuk this issue). Controls had no net change. However, ME/CFS had increased activity after exercise, while GWI had significantly reduced activity indicating differential responses to exercise and pathological mechanisms. These data plus findings of the midbrain and brainstem atrophy in GWI inspired a review of the anatomy and physiology of the dorsal midbrain and isthmus nuclei in order to infer dysfunctional mechanisms that may contribute to disease pathogenesis and postexertional malaise. The nuclei of the ascending arousal network were addressed. Midbrain and isthmus nuclei participate in threat assessment, awareness, attention, mood, cognition, pain, tenderness, sleep, thermoregulation, light and sound sensitivity, orthostatic symptoms, and autonomic dysfunction and are likely to contribute to the symptoms of postexertional malaise in ME/CFS and GWI.
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Abstract
Despite the huge development of pain management in the past decades, pain remains elusive and many patients still remain in the middle of the ford struggling between low drug efficacy and their overuse. A reason for pain elusiveness is its nature of subjective phenomenon, escaping the meshes of the objectivist, mechanist-reductionist net prevailing in medicine. Actually, pain is not only a symptom but an essential aspect of life, consciousness and contact with the world and its noetic and autonoetic components play a key role in the development of the concepts of pleasure-unpleasure and good-evil. The intensity and tolerability of pain and suffering also depends on what the pain means to the patient. The outstanding effects of placebo and nocebo, behavioral and non-pharmacological techniques warrant the need for a shift from the traditional positivist idea of patient as passive carrier of disease to the patient as active player of recovery and move toward a patient's centered approach exploiting individual resources for recovery. Among the mentioned techniques, hypnosis has proved to increase pain threshold up to the level of surgical analgesia, improve acute and chronic pain as well as coping and resilience, helping to decrease both drug overuse and the costs of pharmacological therapy. The wealth of available data suggest the need for a holistic approach, aiming to take care of the individual as an inseparable mind-body unit in its interplay with the environment, where patient's inner world, his/her experience and cognition are taken into due account as powerful resources for recovery through a phenomenological-existential approach.
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Affiliation(s)
- Enrico Facco
- Studium Patavinum, Department of Neurosciences, University of Padua, Padua, Italy - .,Institute F. Granone, Italian Center of Clinical and Experimental Hypnosis (CIICS), Turin, Italy -
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Weis CN, Bennett KP, Huggins AA, Parisi EA, Gorka SM, Larson C. A 7-Tesla MRI Study of the Periaqueductal Grey: Resting State and Task Activation Under Threat. Soc Cogn Affect Neurosci 2021; 17:187-197. [PMID: 34244809 PMCID: PMC8847906 DOI: 10.1093/scan/nsab085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
The periaqueductal grey (PAG) is a region of the midbrain implicated in a variety of behaviors including defensive responses to threat. Despite the wealth of knowledge pertaining to the differential functional roles of the PAG columns in nonhuman and human research, the basic functional connectivity of the PAG at rest has not been well characterized. Therefore, the current study utilized 7-Tesla MRI to characterize PAG functional connectivity at rest and task activation under uncertain threat. A sample of 53 neurologically healthy undergraduate participants (Mage=22.2, SDage=3.62) underwent structural and resting state functional MRI scans. Supporting previous work, voxel-wise analyses showed the PAG is functionally connected to emotion regulation and fear networks. Comparison of functional connectivity of PAG columns did not reveal any significant differences. Thirty-five participants from the same sample also completed an uncertain threat task with blocks of 3 conditions-No shock, Predictable shock, and Unpredictable shock. There were no robust activity differences within the PAG columns or the whole PAG across conditions, though there was differential activity at the voxel level in the PAG and in other regions theoretically relevant to uncertain threat. Results of this study elucidate PAG connectivity at rest and activation in response to uncertain threat.
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Affiliation(s)
- Carissa N Weis
- University of Wisconsin, Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | | | - Ashley A Huggins
- University of Wisconsin, Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Elizabeth A Parisi
- University of Wisconsin, Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Stephanie M Gorka
- The Ohio State University, Institute for Behavioral Medicine Research, Columbus, OH, USA
| | - Christine Larson
- University of Wisconsin, Milwaukee, Department of Psychology, Milwaukee, WI, USA
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Paparella G, Di Stefano G, Fasolino A, Di Pietro G, Colella D, Truini A, Cruccu G, Berardelli A, Bologna M. Painful stimulation increases spontaneous blink rate in healthy subjects. Sci Rep 2020; 10:20014. [PMID: 33203984 PMCID: PMC7672065 DOI: 10.1038/s41598-020-76804-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022] Open
Abstract
Spontaneous blink rate is considered a biomarker of central dopaminergic activity. Recent evidence suggests that the central dopaminergic system plays a role in nociception. In the present study, we aimed to investigate whether pain modulates spontaneous blink rate in healthy subjects. We enrolled 15 participants. Spontaneous blink rate was quantified with an optoelectronic system before and after: (1) a painful laser stimulation, and (2) an acoustic startling stimulation. In control experiments, we investigated whether laser stimulation effects depended on stimulation intensity and whether laser stimulation induced any changes in the blink reflex recovery cycle. Finally, we investigated any relationship between spontaneous blink rate modification and pain modulation effect during the cold pressor test. Laser, but not acoustic, stimulation increased spontaneous blink rate. This effect was independent of stimulation intensity and negatively correlated with pain perception. No changes in trigeminal-facial reflex circuit excitability were elicited by laser stimulation. The cold pressor test also induced an increased spontaneous blink rate. Our study provides evidence on the role of dopamine in nociception and suggests that dopaminergic activity may be involved in pain modulation. These findings lay the groundwork for further investigations in patients with pathological conditions characterized by dopaminergic deficit and pain.
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Affiliation(s)
| | - Giulia Di Stefano
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Alessandra Fasolino
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giuseppe Di Pietro
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Donato Colella
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Andrea Truini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giorgio Cruccu
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, IS, Italy. .,Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
| | - Matteo Bologna
- IRCCS Neuromed, Pozzilli, IS, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
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Weber A, Busbridge S, Governo R. Evaluation of the Efficacy of Musical Vibroacupuncture in Pain Relief: A Randomized Controlled Pilot Study. Neuromodulation 2020; 24:1475-1482. [PMID: 33029913 DOI: 10.1111/ner.13281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/05/2020] [Accepted: 08/24/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate if skin vibration employing consonant frequencies emitted by skin transducers attached to a combination of acupuncture points and according to musical harmony (musical chord) produces more significant pain relief compared to just a single frequency. MATERIALS AND METHODS Skin vibrostimulation produced by five electromagnet transducers was applied at five acupoints traditionally used to pain relief and anxiety in 13 pain-free healthy volunteers using the cold pressor test (CPT). The study consisted of three randomized sessions conducted on alternate days, with participants receiving either simultaneous frequencies of 32, 48, and 64 Hz that equate those used in a musical chord, hereby defined as musical vibroacupuncture (MVA), a single frequency of 32 Hz, set as vibroacupuncture (VA) and sham procedure (SP). CPT scores for pain thresholds and pain tolerance were assessed using repeated-measures ANOVAs. Pain intensity was evaluated using a numerical rating scale (NRS), while sensory and affective aspects of pain were rated using the short-form McGill Pain Questionnaire (SF-MPQ) and State-Trait Anxiety Inventory (STAI) Y-Form. RESULTS Pain thresholds did not vary significantly between trials. Pain tolerance scores were markedly higher in MVA compared to baseline (p = 0.0043) or SP (p = 0.006) but not for VA. Pain intensity for MVA also differed significantly from the baseline (p = 0.007) or SP (p = 0.027), but not for VA. No significant differences were found in SF-MPQ and STAI questionnaires. CONCLUSIONS These results suggest that MVA effectively increased pain tolerance and reduced pain intensity when compared with all groups, although not significant to the VA group.
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Affiliation(s)
- Augusto Weber
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton, East Sussex, UK
| | - Simon Busbridge
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton, East Sussex, UK
| | - Ricardo Governo
- Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, East Sussex, UK
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Muhsen A, Moss P, Gibson W, Walker B, Jacques A, Schug S, Wright A. The Association Between Conditioned Pain Modulation and Manipulation-induced Analgesia in People With Lateral Epicondylalgia. Clin J Pain 2019; 35:435-42. [PMID: 30801339 DOI: 10.1097/AJP.0000000000000696] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Conditioned pain modulation (CPM) and manipulation-induced analgesia (MIA) may activate similar neurophysiological mechanisms to mediate their analgesic effects. This study assessed the association between CPM and MIA responses in people with lateral epicondylalgia. MATERIALS AND METHODS Seventy participants with lateral epicondylalgia were assessed for CPM followed by MIA. A single assessor measured pressure pain thresholds (PPT) before, during, and after cold water immersion (10°C) of the asymptomatic hand and contralateral lateral glide (CLG) mobilization of the neck. For analyses, linear mixed models evaluated differences in CPM and MIA responses. Pearson partial correlations and regression analyses evaluated the association between CPM and MIA PPT. RESULTS There was a significant increase (CPM and MIA, P<0.001) in PPT from baseline during the interventions (CPM mean: 195.84 kPa for elbow and 201.87 kPa for wrist, MIA mean: 123.01 kPa for elbow and 126.06 kPa for wrist) and after the interventions (CPM mean: 126.06 kPa for elbow, 114.24 kPa for wrist, MIA mean: 123.50 kPa for elbow and 122.16 kPa for wrist). There were also significant moderate and positive partial linear correlations (r: 0.40 to 0.54, P<0.001) between CPM and MIA measures, controlling for baseline measures. Regression analyses showed that CPM PPT was a significant predictor of MIA PPT (P<0.001) and the models explained between 73% and 85% of the variance in MIA PPT. DISCUSSION This study showed that CPM and MIA responses were significantly correlated and that the CPM response was a significant predictor of MIA response.
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Washington SD, Rayhan RU, Garner R, Provenzano D, Zajur K, Addiego FM, VanMeter JW, Baraniuk JN. Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Brain Commun 2020; 2:fcaa070. [PMID: 32954325 PMCID: PMC7425336 DOI: 10.1093/braincomms/fcaa070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 12/20/2022] Open
Abstract
Gulf War Illness affects 25-30% of American veterans deployed to the 1990-91 Persian Gulf War and is characterized by cognitive post-exertional malaise following physical effort. Gulf War Illness remains controversial since cognitive post-exertional malaise is also present in the more common Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. An objective dissociation between neural substrates for cognitive post-exertional malaise in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome would represent a biological basis for diagnostically distinguishing these two illnesses. Here, we used functional magnetic resonance imaging to measure neural activity in healthy controls and patients with Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome during an N-back working memory task both before and after exercise. Whole brain activation during working memory (2-Back > 0-Back) was equal between groups prior to exercise. Exercise had no effect on neural activity in healthy controls yet caused deactivation within dorsal midbrain and cerebellar vermis in Gulf War Illness relative to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients. Further, exercise caused increased activation among Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients within the dorsal midbrain, left operculo-insular cortex (Rolandic operculum) and right middle insula. These regions-of-interest underlie threat assessment, pain, interoception, negative emotion and vigilant attention. As they only emerge post-exercise, these regional differences likely represent neural substrates of cognitive post-exertional malaise useful for developing distinct diagnostic criteria for Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
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Affiliation(s)
- Stuart D Washington
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Rakib U Rayhan
- Department of Physiology and Biophysics, Howard University College of Medicine, Adams Building Rm 2420, 520 W Street NW, Washington, DC 20059, USA
| | - Richard Garner
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Destie Provenzano
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Kristina Zajur
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Florencia Martinez Addiego
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - John W VanMeter
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA.,Department of Physiology and Biophysics, Howard University College of Medicine, Adams Building Rm 2420, 520 W Street NW, Washington, DC 20059, USA.,Center for Functional and Molecular Imaging, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - James N Baraniuk
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
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Abstract
Pain from burn injuries is among the most excruciating encountered in clinical practice. Pharmacological methods often fail to achieve acceptable level of analgesia in these patients, especially during burn wound dressing and debridement. Virtual reality (VR) distraction is a promising analgesic technique that progressed significantly in the last decade with development of commercially available, low-cost, high-resolution, wide field-of-view, standalone VR devices that can be used in many clinical scenarios. VR has demonstrated clinical benefit as an adjunctive analgesic during burn wound dressing and other painful medical procedures. The technique has proven useful also in preparing patients for magnetic resonance imaging scans, particularly in claustrophobic patients. Modulation of pain-related brain activity at cortical and subcortical levels by VR, and its correlation with subjective improvement in various laboratory and clinical pain experiences has been demonstrated using multiple functional brain imaging studies including functional magnetic resonance imaging and brain perfusion single photon emission computed tomography.
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Affiliation(s)
- Mohammed S Bermo
- Texas Tech University Health Science Center at El Paso, El Paso, TX
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13
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Makovac E, Dipasquale O, Jackson JB, Medina S, O'Daly O, O'Muircheartaigh J, de Lara Rubio A, Williams SCR, McMahon SB, Howard MA. Sustained perturbation in functional connectivity induced by cold pain. Eur J Pain 2020; 24:1850-1861. [PMID: 32648623 DOI: 10.1002/ejp.1633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 06/27/2020] [Accepted: 07/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Functional connectivity (FC) perturbations have been reported in multiple chronic pain phenotypes, but the nature of reported changes varies between cohorts and may relate to the consequences of living with chronic-pain related comorbidities, such as anxiety and depression. Healthy volunteer studies provide opportunities to study the effects of tonic noxious stimulation independently of these sequelae. Connectivity changes in task negative and positive networks, for example, the default mode and salience networks (DMN/SN), respectively, have been described, but how these and other connectivity networks, for example, those governing descending pain control are affected by the presence of tonic, noxious stimulation in healthy, pain-free individuals, remains unknown. METHOD In 20 healthy volunteers, we assessed FC prior to, during, and following tonic cold painful stimulation in the ventromedial prefrontal cortex (vmPFC), rostral anterior insula (rAI), subgenual anterior cingulate cortex (ACC) and periaqueductal grey (PAG). We also recorded subjectively reported pain using a computerised visual analogue scale. RESULTS We saw DMN FC changes during painful stimulation and that inter-network connectivity between the rAI with the vmPFC increased during pain, whereas PAG-precuneus FC decreased. Pain-induced FC alterations persisted following noxious stimulation. FC changes related to the magnitude of individuals' subjectively reported pain. CONCLUSIONS We demonstrate FC changes during and following tonic cold-pain in healthy participants. Similarities between our findings and reports of patients with chronic pain suggest that some FC changes observed in these patients may relate to the presence of an ongoing afferent nociceptive drive. SIGNIFICANCE How pain-related resting state networks are affected by tonic cold-pain remains unknown. We investigated functional connectivity alterations during and following tonic cold pain in healthy volunteers. Cold pain perturbed the functional connectivity of the ventro-medial prefrontal cortex, anterior insula, and the periacquaductal grey area. These connectivity changes were associated with the magnitude of individuals' reported pain. We suggest that some connectivity changes described in chronic pain patients may be due to an ongoing afferent peripheral drive.
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Affiliation(s)
- Elena Makovac
- Department of Neuroimaging, King's College London, London, UK.,Wolfson Centre for Age Related Diseases, King's College London, London, UK
| | | | - Jade B Jackson
- Department of Neuroimaging, King's College London, London, UK.,Wolfson Centre for Age Related Diseases, King's College London, London, UK
| | - Sonia Medina
- Department of Neuroimaging, King's College London, London, UK.,Wolfson Centre for Age Related Diseases, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, King's College London, London, UK
| | - Jonathan O'Muircheartaigh
- Department of Neuroimaging, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, King's College London, London, UK.,Centre for the Developing Brain, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | | | | | - Stephen B McMahon
- Wolfson Centre for Age Related Diseases, King's College London, London, UK
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Bitar N, Dugré JR, Marchand S, Potvin S. Medial Orbitofrontal De-Activation During Tonic Cold Pain Stimulation: A fMRI Study Examining the Opponent-Process Theory. J Pain Res 2020; 13:1335-1347. [PMID: 32606900 PMCID: PMC7292263 DOI: 10.2147/jpr.s248056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/22/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND While the concomitant administration of painful and rewarding stimuli tends to reduce the perception of one another, recent evidence shows that pleasant pain relief is experience after the interruption of noxious stimuli. On neurobiological grounds, these opponent processes should translate into decreased activity in brain reward regions during nociceptive stimulation and increased activity in these regions after its interruption. While growing evidence supports the latter assumption, evidence is lacking in humans in support of the former. METHODS Twenty-six healthy individuals underwent a functional magnetic resonance imaging (fMRI) session during which they were administered a cold pain stimulation, using a novel paradigm which consisted in a cold gel applied on the right foot of participants. RESULTS After the interruption of noxious stimulation, participants experienced significant levels of pleasant pain relief. During cold pain stimulation, brain activations were observed in key regions of the pain matrix (eg, thalamus, primary somatosensory cortex and insula). Conversely, the medial orbitofrontal cortex was found to be de-activated. Medial orbitofrontal de-activations were negatively correlated with subclinical pain symptoms. DISCUSSION Our results show that a key brain reward region (eg, medial orbitofrontal cortex) is de-activated during cold pain stimulation, a result which is consistent with one of the central assumptions of the opponent-process theory. On methodological grounds, our results show that the cold gel applied to the foot can be used to trigger activations in the pain matrix, and that the interruption of the cold pressor test elicits significant levels of pleasant pain relief. fMRI studies on pain-reward interactions in chronic pain patients are warranted.
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Affiliation(s)
- Nathalie Bitar
- Research Center of the Institute of Mental Health of Montreal, Montreal, Canada
- Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Jules R Dugré
- Research Center of the Institute of Mental Health of Montreal, Montreal, Canada
- Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Serge Marchand
- Genome Quebec, Montreal, Canada
- Department of Surgery, Faculty of Medicine, University of Sherbrooke, Sherbrooke, Canada
| | - Stéphane Potvin
- Research Center of the Institute of Mental Health of Montreal, Montreal, Canada
- Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Canada
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15
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Duan G, Wu Z, Duan Z, Yang G, Fang L, Chen F, Bao X, Li H. Effects of Spicy Stimulation and Spicy-Food Consumption on Human Pain Sensitivity: A Healthy Volunteer Study. J Pain 2019; 21:848-857. [PMID: 31783132 DOI: 10.1016/j.jpain.2019.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 01/28/2023]
Abstract
Spicy-food intake has been shown to affect various human physiological systems and diseases. This study tested the analgesia effect caused by stimulation of a spicy sensation (spicy stimulation) and explored the effect of spicy-food consumption on human basal pain sensitivity. A total of 60 healthy undergraduates were included in the primary study. Placebo and sweet stimulation were used as reference interventions. Pressure and cold-pain thresholds were measured before and after taste stimulation. The frequency of spicy-food intake was also evaluated. An additional 100 subjects were recruited to validate the results. Compared to placebo stimulation, both pressure and cold-pain thresholds increased during spicy stimulation (P < .05). The increased thresholds remained, even when the taste stimulation residue was nearly eliminated (P < .05). The pressure (10.0 [2.1] vs 12.7 [3.0] kg/cm2, P < .001) and cold-pain (4.4 [1.6] vs 6.2 [2.7] seconds, P = .003) thresholds in subjects who consume spicy food ≥3 days/week were significantly lower than in those who consume it <3 days/week. In the validation population, the frequency of spicy-food intake was negatively associated with subjects' pressure (β = -.218, P = .013) and cold-pain (β = -.205, P = .035) thresholds. Spicy stimulation has an analgesia effect on adults that persists even after the taste stimulation stops. Conversely, a long-term spicy diet can reduce the human basal pain threshold. TRIAL REGISTRATION: The study protocol was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Army Medical University, People's Liberation Army (identification No., 2017-023-01), and it was registered on the Chinese Clinical Trial Registry at www.chictr.org.cn (No. ChiCTR1800015053). PERSPECTIVE: This study directly examined the effects of stimulation of a spicy sensation on adult pain sensitivity and was the first to explore the relationship between long-term spicy-food intake and human pain sensitivity. The results provide evidence for future clinical pain intervention and individualized pain treatment.
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Affiliation(s)
- Guangyou Duan
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Zhuoxi Wu
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Zhenxin Duan
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Guiying Yang
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Liang Fang
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Fang Chen
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Xiaohang Bao
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China
| | - Hong Li
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, PLA, Chongqing, China.
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King M, Carnahan H. Revisiting the brain activity associated with innocuous and noxious cold exposure. Neurosci Biobehav Rev 2019; 104:197-208. [DOI: 10.1016/j.neubiorev.2019.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/29/2019] [Accepted: 06/14/2019] [Indexed: 12/25/2022]
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17
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Ferris CF, Nodine S, Pottala T, Cai X, Knox TM, Fofana FH, Kim S, Kulkarni P, Crystal JD, Hohmann AG. Alterations in brain neurocircuitry following treatment with the chemotherapeutic agent paclitaxel in rats. Neurobiol Pain 2019; 6:100034. [PMID: 31223138 DOI: 10.1016/j.ynpai.2019.100034] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/09/2019] [Accepted: 05/26/2019] [Indexed: 12/21/2022]
Abstract
Imaging the reorganization of pain neural circuitry within 8 days of chemotherapy. Using rat model of neuropathy with multimodal MRI. Showing loss of anticorrelation between prefrontal cortex and PAG. Identifying the interaction between periaqueductal gray and brainstem raphe.
Human and animal studies suggest that both traumatic nerve injury and toxic challenge with chemotherapeutic agents involves the reorganization of neural circuits in the brain. However, there have been no prospective studies, human or animal, using magnetic resonance imaging (MRI) to identify changes in brain neural circuitry that accompany the development of chemotherapy-induced neuropathic pain (i.e. within days following cessation of chemotherapy treatment and without the confound cancer). To this end, different MRI protocols were used to ascertain whether a reorganization of brain neural circuits is observed in otherwise normal rats exposed to the taxane chemotherapeutic agent paclitaxel. We conducted an imaging study to evaluate the impact of a well-established paclitaxel dosing regimen, validated to induce allodynia in control rats within eight days of treatment, on brain neural circuitry. Rats received either paclitaxel (2 mg/kg/day i.p; cumulative dose of 8 mg/kg) or its vehicle four times on alternate days (i.e. day 0, 2, 4, 6). Following the cessation of treatments (i.e. on day 8), all rats were tested for responsiveness to cold followed by diffusion weighted magnetic resonance imaging and assessment of resting state functional connectivity. Imaging data were analyzed using a 3D MRI rat with 173 segmented and annotated brain areas. Paclitaxel-treated rats were more sensitive to a cold stimulus compared to controls. Diffusion weighted imaging identified brain areas involved in the emotional and motivational response to chronic pain that were impacted by paclitaxel treatment. Affected brain regions included the prefrontal cortex, amygdala, hippocampus, hypothalamus and the striatum/nucleus accumbens. This putative reorganization of gray matter microarchitecture formed a continuum of brain areas stretching from the basal medial/lateral forebrain to the midbrain. Resting state functional connectivity showed reorganization between the periaqueductal gray, a key node in nociceptive neural circuitry, and connections to the brainstem. Our results, employing different imaging modalities to assess the central nervous system effects of chemotherapy, fit the theory that chronic pain is regulated by emotion and motivation and influences activity in the periaqueductal gray and brainstem to modulate pain perception.
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18
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Groumpas E, Koutsoupidou M, Karanasiou IS, Papageorgiou C, Uzunoglu N. Real-Time Passive Brain Monitoring System Using Near-Field Microwave Radiometry. IEEE Trans Biomed Eng 2019; 67:158-165. [PMID: 30969913 DOI: 10.1109/tbme.2019.2909994] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Near-field microwave radiometry has emerged as a tool for real-time passive monitoring of local brain activation, possibly attributed to local changes in blood flow that correspond to temperature and/or conductivity changes. The aim of this study is to design and evaluate a prototype system based on microwave radiometry intended to detect local changes of temperature and conductivity in depth in brain tissues. A novel radiometric system that comprises a four port total power Dicke-switch sensitive receiver that operates at 1.5 GHz has been developed. METHODS AND RESULTS The efficacy of the system was assessed through simulation and experiment on brain tissue mimicking phantoms under different setup conditions, where temperature and conductivity changes were accurately detected. In order to validate the radiometer's capability to sense low power signals occurring spontaneously from regions in the human brain, the somatosensory cortices of one volunteer were measured under pain-inducing psychophysiological conditions. The promising results from the initial in vivo measurements prove the system's potential for more extensive investigative trials. CONCLUSION AND SIGNIFICANCE The significance of this study lies on the development of a compact and sensitive radiometer for totally passive monitoring of local brain activation as a potential complementary tool for contributing to the research effort for investigating brain functionality.
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Niu X, Bai L, Sun Y, Wang S, Cao J, Sun C, Wang Z, Xu H, Gan S, Fan G, Huang W, Gu C, Yin B, Bai G, Xu X, Zhang M. Disruption of periaqueductal grey-default mode network functional connectivity predicts persistent post-traumatic headache in mild traumatic brain injury. J Neurol Neurosurg Psychiatry 2019; 90:326-332. [PMID: 30554137 DOI: 10.1136/jnnp-2018-318886] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/01/2018] [Accepted: 11/13/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Post-traumatic headache (PTH) is one of the most frequent and persistent physical symptoms following mild traumatic brain injury (mTBI) and develop in more than 50% of this population. This study aimed to investigate the periaqueductal grey (PAG)-seeded functional connectivity (FC) in patients with mTBI with acute post-traumatic headache (APTH) and further examine whether the FC can be used as a neural biomarker to identify patients developing chronic pain 3 months postinjury. METHODS 70 patients with mTBI underwent neuropsychological measurements and MRI scans within 7 days postinjury and 56 (80%) of patients were followed up at 3 months. 46 healthy controls completed the same protocol on recruitment to the study. PAG-seeded resting-state FC analysis was measured in 54 patients with mTBI with APTH, in comparison with 46 healthy volunteers. RESULTS The mTBI+APTH group presented significantly reduced PAG-seeded FC within the default mode network (DMN), compared with healthy volunteers group. The connectivity strength can also predict patients' complaints on the impact of headache on their lives. Crucially, the initial FC strength between the PAG-right precuneus as well as the PAG-right inferior parietal lobule became the important predictor to identify patients with mTBI developing persistent PTH 3 months postinjury. CONCLUSIONS Patients with mTBI+APTH exhibited significant PAG-related FC differences mainly within the DMN. These regions extended beyond traditional pain processing areas and may reflect the diminished top-down attention regulation of pain perception through antinociceptive descending modulation network. The disrupted PAG-DMN FC may be used as an early imaging biomarker to identify patients at risk of developing persistent PTH.
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Affiliation(s)
- Xuan Niu
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Yingxiang Sun
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Jieli Cao
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Chuanzhu Sun
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Zhuonan Wang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hui Xu
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Shuoqiu Gan
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Geng Fan
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Wenmin Huang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Chenghui Gu
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xi'an, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xi'an, China
| | - Guanghui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xi'an, China
| | - Xiaoling Xu
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ming Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Zelena D, Menant O, Andersson F, Chaillou E. Periaqueductal gray and emotions: the complexity of the problem and the light at the end of the tunnel, the magnetic resonance imaging. Endocr Regul 2018; 52:222-38. [DOI: 10.2478/enr-2018-0027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Abstract
The periaqueductal gray (PAG) is less referred in relationship with emotions than other parts of the brain (e.g. cortex, thalamus, amygdala), most probably because of the difficulty to reach and manipulate this small and deeply lying structure. After defining how to evaluate emotions, we have reviewed the literature and summarized data of the PAG contribution to the feeling of emotions focusing on the behavioral and neurochemical considerations. In humans, emotions can be characterized by three main domains: the physiological changes, the communicative expressions, and the subjective experiences. In animals, the physiological changes can mainly be studied. Indeed, early studies have considered the PAG as an important center of the emotions-related autonomic and motoric processes. However, in vivo imaging have changed our view by highlighting the PAG as a significant player in emotions-related cognitive processes. The PAG lies on the crossroad of networks important in the regulation of emotions and therefore it should not be neglected. In vivo imaging represents a good tool for studying this structure in living organism and may reveal new information about its role beyond its importance in the neurovegetative regulation.
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Choi S, Park SG, Lee HH. The analgesic effect of music on cold pressor pain responses: The influence of anxiety and attitude toward pain. PLoS One 2018; 13:e0201897. [PMID: 30080889 PMCID: PMC6078312 DOI: 10.1371/journal.pone.0201897] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 07/24/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The analgesic effect of music has been recognized for pain relief, but individual differences and adjuvant methods are poorly understood. This study employed a cold-pressor task (CPT) to observe the effects of music (without considering personal preferences) on pain experience and how this is affected by individuals' general (and pain-specific) anxiety symptomology. METHODS Fifty participants were each presented with three conditions (randomized into different orders): music-listening, news-listening, and no sound (control). Pain responses, including pain tolerance time (PT), pain intensity (PI), and pain unpleasantness (PU), were assessed using CPT and compared with a 3x3 crossover design. Participants also completed the anxiety sensitivity index (ASI-16) and pain anxiety symptom scale (PASS-20). RESULTS CPT pain responses during the music intervention were significantly different from responses during the news intervention and control conditions, respectively. Among participants with normal anxiety levels, pain responses during the music condition differed significantly from the news and control groups; this was not the case for the anxiety risk group. Pain responses during the music condition for those with normal levels of pain-specific anxiety differed significantly from the control, but this was not the case for the risk group. CONCLUSIONS Music appears to influence diminished pain responses relative to the absence of an intervention. However, this was not the case when individuals listened to news stories. These effects were more robust for individuals experiencing normal levels of general and pain-specific anxiety. Thus, music (even outside one's own preferences) was an effective adjuvant method for managing pain, especially among those without significant anxiety symptomology.
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Affiliation(s)
- Suvin Choi
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Korea
- Da Vinci College of General Education, Chung-Ang University, Seoul, Korea
| | - Sang-Gue Park
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
- * E-mail:
| | - Hyung-Hwan Lee
- Department of Traditional Music, Chung-Ang University, Anseong, Korea
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Abstract
Pain is a complex neural function involving cognition, sensory, emotion, and memory. Imaging studies have shown that multiple brain regions are actively engaged in the processing of pain. However, roles of each brain regions and their contribution to pain are still largely unknown. Recent studies with electrophysiology especially high-density electroencephalogram (EEG) or multichannel recordings techniques have provided more insights into the dynamics of pain signature. The accumulations of the evidence could facilitate our understanding of pain and provide potential methods for objective pain evaluation and treatment of chronic pain.
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Andre-Obadia N, Magnin M, Simon E, Garcia-Larrea L. Somatotopic effects of rTMS in neuropathic pain? A comparison between stimulation over hand and face motor areas. Eur J Pain 2017; 22:707-715. [DOI: 10.1002/ejp.1156] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2017] [Indexed: 11/09/2022]
Affiliation(s)
- N. Andre-Obadia
- Neurophysiology & Epilepsy Unit; Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
- University Hospital Pain Center (CETD); Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
| | - M. Magnin
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
| | - E. Simon
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
- Neurosurgery Unit; Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
| | - L. Garcia-Larrea
- University Hospital Pain Center (CETD); Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
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Lelic D, Hansen TM, Mark EB, Olesen AE, Drewes AM. The effects of analgesics on central processing of tonic pain: A cross-over placebo controlled study. Neuropharmacology 2017. [DOI: 10.1016/j.neuropharm.2017.06.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hansen TM, Mark EB, Olesen SS, Gram M, Frøkjær JB, Drewes AM. Characterization of cortical source generators based on electroencephalography during tonic pain. J Pain Res 2017; 10:1401-1409. [PMID: 28652806 PMCID: PMC5476635 DOI: 10.2147/jpr.s132909] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of the present study was to characterize the cortical source generators evoked by experimental tonic pain. Methods Electroencephalography (EEG) was recorded on two separate days during rest and with immersion of the hand in ice water for 2 minutes (cold pressor test). Exact low-resolution brain electromagnetic tomography source localization was performed in 31 healthy volunteers to characterize the cortical source generators. Results Reliability was high in all eight frequency bands during rest and cold pressor conditions (intraclass coefficients =0.47–0.83 in the cingulate and insula). Tonic pain increased cortical activities in the delta (1–4 Hz), theta (4–8 Hz), beta1 (12–18 Hz), beta2 (18–24 Hz), beta3 (24–32 Hz), and gamma (32–60 Hz) bands (all P<0.011) in widespread areas mainly in the limbic system, whereas decreased cortical activities were found in cingulate and pre- and postcentral gyri in the alpha2 (10–12 Hz) band (P=0.007). The pain intensity was correlated with cingulate activity in the beta2, beta3, and gamma bands (all P<0.04). Conclusion Source localization of EEG is a reliable method to estimate cortical source generators. Activities in different brain regions, mainly in the limbic system, showed fluctuations in various frequency bands. Cingulate changes were correlated with pain intensity. Significance This method might add information to the objective assessment of the cortical pain response in future experimental pain studies.
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Affiliation(s)
- Tine Maria Hansen
- Mech-Sense, Department of Radiology, Aalborg University Hospital.,Department of Clinical Medicine, Aalborg University
| | - Esben Bolvig Mark
- Mech-Sense, Department of Radiology, Aalborg University Hospital.,Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Schou Olesen
- Department of Clinical Medicine, Aalborg University.,Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Mikkel Gram
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Mech-Sense, Department of Radiology, Aalborg University Hospital.,Department of Clinical Medicine, Aalborg University
| | - Asbjørn Mohr Drewes
- Department of Clinical Medicine, Aalborg University.,Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
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Lapotka M, Ruz M, Salamanca Ballesteros A, Ocón Hernández O. Cold pressor gel test: A safe alternative to the cold pressor test in fMRI. Magn Reson Med 2016; 78:1464-1468. [PMID: 27779778 DOI: 10.1002/mrm.26529] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/30/2016] [Accepted: 10/01/2016] [Indexed: 11/08/2022]
Abstract
PURPOSE This study describes a new methodology-the cold pressor gel test (CPGT)-for delivering an accessible experimental pain stimulus, which is reproducible and safe for functional MRI (fMRI). METHODS The cold pressor test was modified to put safety precautions into the CPGT. The material used is cool gelled water with a thickening product, which provides a stable temperature at 0.2 °C. Thirteen women with chronic pelvic pain were scanned using a 3 Tesla (T) MR scanner equipped with a 12-channel head coil. Changes in BOLD activation during cold-induced pain were estimated. RESULTS The results have demonstrated that gel substances maintain a stable temperature during the experiment, resulting in an insignificant variation. Before the experiment, the mean temperature was 0.2 ± 0.11 °C, and at the end it was 0.7 ± 0.15 °C. The time taken by participants to reach the maximum level of pain during the CPGT was 56.92 ± 11.09 s. The pain intensity during the experiments was 6.92 ± 1.66 on the visual analog scale (VAS). The fMRI analysis showed significant BOLD activation in the main brain regions involved in chronic pain processing. CONCLUSION The CPGT is an experimental tool to deliver pain that is easily reproducible, particularly in brain functional imaging studies. Moreover, it is cost-effective, safe, and compatible with fMRI. Magn Reson Med 78:1464-1468, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Maryna Lapotka
- Doctorate program in Clinical Medicine and Public Health, University of Granada, Spain
| | - María Ruz
- Department of Experimental Psychology, University of Granada, Spain.,Brain, Mind and Behavior Research Center, University of Granada, Spain
| | - Alberto Salamanca Ballesteros
- Department of Obstetrics and Gynecology, University of Granada, Spain.,Obstetrics and Gynecology, Virgen de las Nieves Hospital, Granada, Spain
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Nakajima F, Aratani S, Fujita H, Nakatani K, Makita K, Nakajima T. A case of fibromyalgia involving pain throughout the body treated with site-specific targeted pain control. Springerplus 2016; 5:1027. [PMID: 27441146 PMCID: PMC4938810 DOI: 10.1186/s40064-016-2572-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/14/2016] [Indexed: 12/02/2022]
Abstract
Introduction Fibromyalgia is characterized by chronic pain and tenderness throughout the body. Patients with fibromyalgia are treated with pharmacotherapy and many other therapies. However, because the cause of fibromyalgia is unclear, there is currently no clinically effective treatment method. Case presentation We report the case of a patient who developed fibromyalgia after left femoral neck fracture. After several caudal epidural blocks for lumbar pain, the pain throughout the body and abnormal discomfort in the laryngopharyngeal region reduced. Site-specific targeted pain control was effective in treating his pain and discomfort. Conclusion The present case suggests that treatment targeting symptoms in one part of the body might produce a systemic therapeutic effect in patients with fibromyalgia.
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Affiliation(s)
- Fukami Nakajima
- Daiichi Rehabilitation Hospital, 2-14 Kutanda Kochi-shi, Kochi, 781-0112 Japan ; Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402 Japan ; Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoko Aratani
- Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402 Japan ; Physician, Student, and Researcher Support Center, Tokyo Medical University, Tokyo, Japan
| | - Hidetoshi Fujita
- Future Medical Science Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | | | - Koshi Makita
- Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshishiro Nakajima
- Daiichi Rehabilitation Hospital, 2-14 Kutanda Kochi-shi, Kochi, 781-0112 Japan ; Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402 Japan ; Future Medical Science Institute of Medical Science, Tokyo Medical University, Tokyo, Japan ; Bayside Misato Medical Center, Kochi, Japan
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Duggento A, Bianciardi M, Passamonti L, Wald LL, Guerrisi M, Barbieri R, Toschi N. Globally conditioned Granger causality in brain-brain and brain-heart interactions: a combined heart rate variability/ultra-high-field (7 T) functional magnetic resonance imaging study. Philos Trans A Math Phys Eng Sci 2016; 374:20150185. [PMID: 27044985 PMCID: PMC4822445 DOI: 10.1098/rsta.2015.0185] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2016] [Indexed: 05/24/2023]
Abstract
The causal, directed interactions between brain regions at rest (brain-brain networks) and between resting-state brain activity and autonomic nervous system (ANS) outflow (brain-heart links) have not been completely elucidated. We collected 7 T resting-state functional magnetic resonance imaging (fMRI) data with simultaneous respiration and heartbeat recordings in nine healthy volunteers to investigate (i) the causal interactions between cortical and subcortical brain regions at rest and (ii) the causal interactions between resting-state brain activity and the ANS as quantified through a probabilistic, point-process-based heartbeat model which generates dynamical estimates for sympathetic and parasympathetic activity as well as sympathovagal balance. Given the high amount of information shared between brain-derived signals, we compared the results of traditional bivariate Granger causality (GC) with a globally conditioned approach which evaluated the additional influence of each brain region on the causal target while factoring out effects concomitantly mediated by other brain regions. The bivariate approach resulted in a large number of possibly spurious causal brain-brain links, while, using the globally conditioned approach, we demonstrated the existence of significant selective causal links between cortical/subcortical brain regions and sympathetic and parasympathetic modulation as well as sympathovagal balance. In particular, we demonstrated a causal role of the amygdala, hypothalamus, brainstem and, among others, medial, middle and superior frontal gyri, superior temporal pole, paracentral lobule and cerebellar regions in modulating the so-called central autonomic network (CAN). In summary, we show that, provided proper conditioning is employed to eliminate spurious causalities, ultra-high-field functional imaging coupled with physiological signal acquisition and GC analysis is able to quantify directed brain-brain and brain-heart interactions reflecting central modulation of ANS outflow.
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Affiliation(s)
- Andrea Duggento
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Marta Bianciardi
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Luca Passamonti
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Richerche, Catanzaro, Italy Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Lawrence L Wald
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Maria Guerrisi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Riccardo Barbieri
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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Montenegro EJN, Guimarães de Alencar G, Rocha de Siqueira G, Guerino MR, Maia JN, Araújo de Oliveira D. Effect of low frequency transcutaneous electrical nerve stimulation of TE5 (waiguan) and PC6 (neiguan) acupoints on cold-induced pain. J Phys Ther Sci 2016; 28:76-81. [PMID: 26957732 PMCID: PMC4755978 DOI: 10.1589/jpts.28.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/09/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study assesse the effect of low frequency transcutaneous electrical nerve stimulation (TENS) of theTE5 (waiguan) and PC6 (neiguan) acupoints on cold-induced pain. [Subjects and Methods] Forty-eight subjects were divided by convenience into three groups: TENS with electrodes of 1 cm(2) area, TENS with electrodes of area 15 cm(2) and a placebo group. The study consisted of three phases: cold-induced pain without electroanalgesia, cold-induced pain with electroanalgesia or placebo, and cold-induced pain post-electroanalgesia or placebo. [Results] Acupuncture like TENS increased the pain threshold latency during treatment (45.7 ± 11.7s) compared to pre-treatment (30.9 ± 8.9s) in the TENS group with 1 cm(2) electrodes. In the TENS group with 15 cm(2) electrodes, the pain threshold latency increased at post-treatment (36.2 ± 12.9s) compared to pre-treatment (25.5 ± 7.4s). The placebo group showed no significant changes. The group with 1 cm(2) electrodes showed a significantly higher pain threshold latency (45.7 ± 11.7s) than the other two groups. At post-treatment, the pain threshold latencies of both the 1 cm(2) (39.4 ± 11.5s) and 15 cm(2) (36.2 ± 12.9s) TENS group were higher than that of the placebo group (22.4 ± 7.4s). [Conclusion] Acupuncture like TENS applied to PC6 and TE5 acupoints increased the pain threshold latency. The pain intensity was reduced by TENS with an electrode area of 1 cm(2).
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Affiliation(s)
| | | | | | | | - Juliana Netto Maia
- Department of Physical Therapy, UFPE-Federal University of Pernambuco, Brazil
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Abstract
Central nervous system processing of autonomic function involves a network of regions throughout the brain which can be visualized and measured with neuroimaging techniques, notably functional magnetic resonance imaging (fMRI). The development of fMRI procedures has both confirmed and extended earlier findings from animal models, and human stroke and lesion studies. Assessments with fMRI can elucidate interactions between different central sites in regulating normal autonomic patterning, and demonstrate how disturbed systems can interact to produce aberrant regulation during autonomic challenges. Understanding autonomic dysfunction in various illnesses reveals mechanisms that potentially lead to interventions in the impairments. The objectives here are to: (1) describe the fMRI neuroimaging methodology for assessment of autonomic neural control, (2) outline the widespread, lateralized distribution of function in autonomic sites in the normal brain which includes structures from the neocortex through the medulla and cerebellum, (3) illustrate the importance of the time course of neural changes when coordinating responses, and how those patterns are impacted in conditions of sleep-disordered breathing, and (4) highlight opportunities for future research studies with emerging methodologies. Methodological considerations specific to autonomic testing include timing of challenges relative to the underlying fMRI signal, spatial resolution sufficient to identify autonomic brainstem nuclei, blood pressure, and blood oxygenation influences on the fMRI signal, and the sustained timing, often measured in minutes of challenge periods and recovery. Key findings include the lateralized nature of autonomic organization, which is reminiscent of asymmetric motor, sensory, and language pathways. Testing brain function during autonomic challenges demonstrate closely-integrated timing of responses in connected brain areas during autonomic challenges, and the involvement with brain regions mediating postural and motoric actions, including respiration, and cardiac output. The study of pathological processes associated with autonomic disruption shows susceptibilities of different brain structures to altered timing of neural function, notably in sleep disordered breathing, such as obstructive sleep apnea and congenital central hypoventilation syndrome. The cerebellum, in particular, serves coordination roles for vestibular stimuli and blood pressure changes, and shows both injury and substantially altered timing of responses to pressor challenges in sleep-disordered breathing conditions. The insights into central autonomic processing provided by neuroimaging have assisted understanding of such regulation, and may lead to new treatment options for conditions with disrupted autonomic function.
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Affiliation(s)
- Paul M Macey
- UCLA School of Nursing, University of California at Los AngelesLos Angeles, CA, USA; Brain Research Institute, University of California at Los AngelesLos Angeles, CA, USA
| | - Jennifer A Ogren
- Department of Neurobiology, University of California at Los Angeles Los Angeles, CA, USA
| | - Rajesh Kumar
- Brain Research Institute, University of California at Los AngelesLos Angeles, CA, USA; Department of Anesthesiology, University of California at Los AngelesLos Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at University of California at Los AngelesLos Angeles, CA, USA; Department of Bioengineering, University of California at Los AngelesLos Angeles, CA, USA
| | - Ronald M Harper
- Brain Research Institute, University of California at Los AngelesLos Angeles, CA, USA; Department of Neurobiology, University of California at Los AngelesLos Angeles, CA, USA
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Youssef A, Macefield V, Henderson L. Pain inhibits pain; human brainstem mechanisms. Neuroimage 2016; 124:54-62. [DOI: 10.1016/j.neuroimage.2015.08.060] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 08/26/2015] [Accepted: 08/27/2015] [Indexed: 11/23/2022] Open
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Khan H, Stroman P. Inter-individual differences in pain processing investigated by functional magnetic resonance imaging of the brainstem and spinal cord. Neuroscience 2015; 307:231-41. [DOI: 10.1016/j.neuroscience.2015.08.059] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 01/01/2023]
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Pickering G, Kastler A, Macian N, Pereira B, Valabrègue R, Lehericy S, Boyer L, Dubray C, Jean B. The brain signature of paracetamol in healthy volunteers: a double-blind randomized trial. Drug Des Devel Ther 2015; 9:3853-62. [PMID: 26229445 PMCID: PMC4517518 DOI: 10.2147/dddt.s81004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Paracetamol's (APAP) mechanism of action suggests the implication of supraspinal structures but no neuroimaging study has been performed in humans. METHODS AND RESULTS This randomized, double-blind, crossover, placebo-controlled trial in 17 healthy volunteers (NCT01562704) aimed to evaluate how APAP modulates pain-evoked functional magnetic resonance imaging signals. We used behavioral measures and functional magnetic resonance imaging to investigate the response to experimental thermal stimuli with APAP or placebo administration. Region-of-interest analysis revealed that activity in response to noxious stimulation diminished with APAP compared to placebo in prefrontal cortices, insula, thalami, anterior cingulate cortex, and periaqueductal gray matter. CONCLUSION These findings suggest an inhibitory effect of APAP on spinothalamic tracts leading to a decreased activation of higher structures, and a top-down influence on descending inhibition. Further binding and connectivity studies are needed to evaluate how APAP modulates pain, especially in the context of repeated administration to patients with pain.
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Affiliation(s)
- Gisèle Pickering
- CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, Faculté de medicine, France ; Centre d'Investigation Clinique - Inserm 1405, Faculté de medicine, France ; Clermont Université, Laboratoire de Pharmacologie, Faculté de medicine, France
| | - Adrian Kastler
- CHU Gabriel Montpied, Clermont-Ferrand, Service d'Imagerie Ostéo-articulaire thoracique et neurologique, Clermont-Ferrand, France
| | - Nicolas Macian
- CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, Faculté de medicine, France ; Centre d'Investigation Clinique - Inserm 1405, Faculté de medicine, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation Recherche Clinique et à l'Innovation, Clermont-Ferrand, France
| | - Romain Valabrègue
- Institut du Cerveau et de la Moelle epiniere - ICM, Centre de NeuroImagerie de Recherche CENIR, Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC University Paris, Paris, France, Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Stéphane Lehericy
- Institut du Cerveau et de la Moelle epiniere - ICM, Centre de NeuroImagerie de Recherche CENIR, Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC University Paris, Paris, France, Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Louis Boyer
- CHU Gabriel Montpied, Clermont-Ferrand, Service d'Imagerie Ostéo-articulaire thoracique et neurologique, Clermont-Ferrand, France ; UMR CNRS UdA 6284, Clemont-Ferrand, France
| | - Claude Dubray
- CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, Faculté de medicine, France ; Centre d'Investigation Clinique - Inserm 1405, Faculté de medicine, France ; Clermont Université, Laboratoire de Pharmacologie, Faculté de medicine, France
| | - Betty Jean
- CHU Gabriel Montpied, Clermont-Ferrand, Service d'Imagerie Ostéo-articulaire thoracique et neurologique, Clermont-Ferrand, France
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Wang J, Yi M, Zhang C, Bian Z, Wan Y, Chen R, Li X. Cortical activities of heat-sensitization responses in suspended moxibustion: an EEG source analysis with sLORETA. Cogn Neurodyn 2015; 9:581-8. [PMID: 26557928 DOI: 10.1007/s11571-015-9349-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 06/03/2015] [Accepted: 07/09/2015] [Indexed: 11/28/2022] Open
Abstract
Moxibustion is under active research as a complementary and alternative treatment for various diseases such as pain. "Heat-sensitization" responses have been reported during suspended moxibustion, whose occurrence is associated with significantly better therapeutic effects. The present study aimed to investigate the cortical activities of this interesting phenomenon by a standardized low-resolution brain electromagnetic tomography. We performed electroencephalography recording in a group of patients with chronic low back pain before, during, and after moxibustion treatment at Yaoyangguan (DU3) areas. 11 out of 21 subjects experienced strong heat-sensitization during moxibustion, which were accompanied with significant decreases of current densities in the beta frequency bands in prefrontal, primary and second somatosensory, and cingulate cortices, as well as increased current densities in the alpha2 band in the left insula. No changes were detected in patients without sensitization responses, or in the post-moxibustion phase of either group. These data indicated widespread activity changes across different frequency bands during heat-sensitization. Cortical oscillatory activities could be used to evaluate the "heat-sensitization" responses during suspended moxibustion.
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Affiliation(s)
- Juan Wang
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, 066004 People's Republic of China
| | - Ming Yi
- Neuroscience Research Institute, Peking University, 38 Xueyuan Road, Beijing, 100191 People's Republic of China
| | - Chan Zhang
- Neuroscience Research Institute, Peking University, 38 Xueyuan Road, Beijing, 100191 People's Republic of China
| | - Zhijie Bian
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, 066004 People's Republic of China
| | - You Wan
- Neuroscience Research Institute, Peking University, 38 Xueyuan Road, Beijing, 100191 People's Republic of China ; Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, 38 Xueyuan Road, Beijing, 100191 People's Republic of China
| | - Rixin Chen
- Affiliated Hospital of Jiangxi University of TCM, Nanchang, 330006 People's Republic of China
| | - Xiaoli Li
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, 066004 People's Republic of China
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Carcamo CR. Bimodal Modulation of Ipsilateral Spinal-Coeruleo-Spinal Pathway in CRPS: A Novel Model for Explaining Different Clinical Features of the Syndrome. Pain Med 2015; 16:1589-96. [PMID: 26058872 DOI: 10.1111/pme.12733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective is to present a hypothesis to explain the sensory, autonomic, and motor disturbances associated with complex regional pain syndrome (CRPS) syndrome. METHODS The author reviewed the available and relevant literature, which was supplemented with research on experimental animal models, with a focus on how they may translate into humans, particularly in areas about pathophysiologic mechanisms of CRPS. RESULTS We propose that different CRPS subtypes may result from facilitative or inhibitory influences exerted by the spinal-coeruleo-spinal pathway in three sites at the spinal cord: the dorsal horn (DH), intermediolateral cell column (IML) and ventral horn (VH). A facilitatory influence over DH may have a pronociceptive effect that explains exacerbated pain, sensory disturbances, and spreading sensitization and neuroinflammation. Conversely, a facilitatory influence over preganglionic neurons located in IML cell column may increase sympathetic outflow with peripheral vasoconstriction, which leads to cold skin, ipsilateral limb ischaemia, and sympathetically maintained pain (SMP). For patients presenting with these symptoms, a descending inhibitory influence would be predicted to result in decreased sympathetic outflow and warm skin, as well as impairment of peripheral vasoconstrictor reflexes. Finally, a descending inhibitory influence over VH could explain muscle weakness and decreased active range of motion, while also facilitating motor reflexes, tremor and dystonia. CONCLUSIONS The proposed model provides a mechanistically based diagnostic scheme for classifying and explaining the sensory, autonomic and motor disturbances associated with CRPS syndrome.
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Affiliation(s)
- Cesar R Carcamo
- Chronic Pain Unit, Mutual de Seguridad Hospital, Santiago, Chile
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