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Miltner WHR, Franz M, Naumann E. Neuroscientific results of experimental studies on the control of acute pain with hypnosis and suggested analgesia. Front Psychol 2024; 15:1371636. [PMID: 38638524 PMCID: PMC11025616 DOI: 10.3389/fpsyg.2024.1371636] [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: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
This narrative review summarizes a representative collection of electrophysiological and imaging studies on the neural processes and brain sources underlying hypnotic trance and the effects of hypnotic suggestions on the processing of experimentally induced painful events. It complements several reviews on the effect of hypnosis on brain processes and structures of chronic pain processing. Based on a summary of previous findings on the neuronal processing of experimentally applied pain stimuli and their effects on neuronal brain structures in healthy subjects, three neurophysiological methods are then presented that examine which of these neuronal processes and structures get demonstrably altered by hypnosis and can thus be interpreted as neuronal signatures of the effect of analgesic suggestions: (A) On a more global neuronal level, these are electrical processes of the brain that can be recorded from the cranial surface of the brain with magnetoencephalography (MEG) and electroencephalography (EEG). (B) On a second level, so-called evoked (EPs) or event-related potentials (ERPs) are discussed, which represent a subset of the brain electrical parameters of the EEG. (C) Thirdly, imaging procedures are summarized that focus on brain structures involved in the processing of pain states and belong to the main imaging procedures of magnetic resonance imaging (MRI/fMRI) and positron emission tomography (PET). Finally, these different approaches are summarized in a discussion, and some research and methodological suggestions are made as to how this research could be improved in the future.
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Affiliation(s)
- Wolfgang H. R. Miltner
- Institute of Psychology, Friedrich Schiller University of Jena, Jena, Thuringia, Germany
| | - Marcel Franz
- Institute of Psychology, Friedrich Schiller University of Jena, Jena, Thuringia, Germany
| | - Ewald Naumann
- Institute of Psychology, University of Trier, Trier, Rhineland-Palatinate, Germany
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2
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Bastuji H, Cadic-Melchior A, Ruelle-Le Glaunec L, Magnin M, Garcia-Larrea L. Functional connectivity between medial pulvinar and cortical networks as a predictor of arousal to noxious stimuli during sleep. Eur J Neurosci 2024; 59:570-583. [PMID: 36889675 DOI: 10.1111/ejn.15958] [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: 10/13/2022] [Revised: 02/21/2023] [Accepted: 03/04/2023] [Indexed: 03/10/2023]
Abstract
The interruption of sleep by a nociceptive stimulus is favoured by an increase in the pre-stimulus functional connectivity between sensory and higher level cortical areas. In addition, stimuli inducing arousal also trigger a widespread electroencephalographic (EEG) response reflecting the coordinated activation of a large cortical network. Because functional connectivity between distant cortical areas is thought to be underpinned by trans-thalamic connections involving associative thalamic nuclei, we investigated the possible involvement of one principal associative thalamic nucleus, the medial pulvinar (PuM), in the sleeper's responsiveness to nociceptive stimuli. Intra-cortical and intra-thalamic signals were analysed in 440 intracranial electroencephalographic (iEEG) segments during nocturnal sleep in eight epileptic patients receiving laser nociceptive stimuli. The spectral coherence between the PuM and 10 cortical regions grouped in networks was computed during 5 s before and 1 s after the nociceptive stimulus and contrasted according to the presence or absence of an arousal EEG response. Pre- and post-stimulus phase coherence between the PuM and all cortical networks was significantly increased in instances of arousal, both during N2 and paradoxical (rapid eye movement [REM]) sleep. Thalamo-cortical enhancement in coherence involved both sensory and higher level cortical networks and predominated in the pre-stimulus period. The association between pre-stimulus widespread increase in thalamo-cortical coherence and subsequent arousal suggests that the probability of sleep interruption by a noxious stimulus increases when it occurs during phases of enhanced trans-thalamic transfer of information between cortical areas.
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Affiliation(s)
- Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab, Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, France
- Centre du Sommeil, Hospices Civils de Lyon, Bron, France
| | - Andéol Cadic-Melchior
- Central Integration of Pain (NeuroPain) Lab, Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, France
| | - Lucien Ruelle-Le Glaunec
- Central Integration of Pain (NeuroPain) Lab, Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, France
| | - Michel Magnin
- Central Integration of Pain (NeuroPain) Lab, Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, France
| | - Luis Garcia-Larrea
- Central Integration of Pain (NeuroPain) Lab, Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, France
- Centre d'évaluation et de traitement de la douleur, Hôpital Neurologique, Lyon, France
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3
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Yan Y, Zhu M, Cao X, Xu G, Shen W, Li F, Zhang J, Luo L, Zhang X, Zhang D, Liu T. Thalamocortical Circuit Controls Neuropathic Pain via Up-regulation of HCN2 in the Ventral Posterolateral Thalamus. Neurosci Bull 2023; 39:774-792. [PMID: 36538279 PMCID: PMC10169982 DOI: 10.1007/s12264-022-00989-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 09/07/2022] [Indexed: 12/24/2022] Open
Abstract
The thalamocortical (TC) circuit is closely associated with pain processing. The hyperpolarization-activated cyclic nucleotide-gated (HCN) 2 channel is predominantly expressed in the ventral posterolateral thalamus (VPL) that has been shown to mediate neuropathic pain. However, the role of VPL HCN2 in modulating TC circuit activity is largely unknown. Here, by using optogenetics, neuronal tracing, electrophysiological recordings, and virus knockdown strategies, we showed that the activation of VPL TC neurons potentiates excitatory synaptic transmission to the hindlimb region of the primary somatosensory cortex (S1HL) as well as mechanical hypersensitivity following spared nerve injury (SNI)-induced neuropathic pain in mice. Either pharmacological blockade or virus knockdown of HCN2 (shRNA-Hcn2) in the VPL was sufficient to alleviate SNI-induced hyperalgesia. Moreover, shRNA-Hcn2 decreased the excitability of TC neurons and synaptic transmission of the VPL-S1HL circuit. Together, our studies provide a novel mechanism by which HCN2 enhances the excitability of the TC circuit to facilitate neuropathic pain.
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Affiliation(s)
- Yi Yan
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Mengye Zhu
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Xuezhong Cao
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Gang Xu
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Wei Shen
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Fan Li
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Jinjin Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Lingyun Luo
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China
| | - Xuexue Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China.
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China.
| | - Daying Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
- Institute of Pain Medicine, Jiangxi Academy of Clinical and Medical Sciences, Nanchang, 330006, China.
- Key Laboratory of Neuropathic Pain, Healthcare Commission of Jiangxi Province, Nanchang, 330006, China.
| | - Tao Liu
- Center for Experimental Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
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Argaman Y, Granovsky Y, Sprecher E, Sinai A, Yarnitsky D, Weissman-Fogel I. Resting-state functional connectivity predicts motor cortex stimulation-dependent pain relief in fibromyalgia syndrome patients. Sci Rep 2022; 12:17135. [PMID: 36224244 PMCID: PMC9556524 DOI: 10.1038/s41598-022-21557-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/28/2022] [Indexed: 01/04/2023] Open
Abstract
MRI-based resting-state functional connectivity (rsFC) has been shown to predict response to pharmacological and non-pharmacological treatments for chronic pain, but not yet for motor cortex transcranial magnetic stimulation (M1-rTMS). Twenty-seven fibromyalgia syndrome (FMS) patients participated in this double-blind, crossover, and sham-controlled study. Ten daily treatments of 10 Hz M1-rTMS were given over 2 weeks. Before treatment series, patients underwent resting-state fMRI and clinical pain evaluation. Significant pain reduction occurred following active, but not sham, M1-rTMS. The following rsFC patterns predicted reductions in clinical pain intensity after the active treatment: weaker rsFC of the default-mode network with the middle frontal gyrus (r = 0.76, p < 0.001), the executive control network with the rostro-medial prefrontal cortex (r = 0.80, p < 0.001), the thalamus with the middle frontal gyrus (r = 0.82, p < 0.001), and the pregenual anterior cingulate cortex with the inferior parietal lobule (r = 0.79, p < 0.001); and stronger rsFC of the anterior insula with the angular gyrus (r = - 0.81, p < 0.001). The above regions process the attentional and emotional aspects of pain intensity; serve as components of the resting-state networks; are modulated by rTMS; and are altered in FMS. Therefore, we suggest that in FMS, the weaker pre-existing interplay between pain-related brain regions and networks, the larger the pain relief resulting from M1-rTMS.
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Affiliation(s)
- Yuval Argaman
- grid.6451.60000000121102151Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
| | - Yelena Granovsky
- grid.6451.60000000121102151Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel ,grid.413731.30000 0000 9950 8111Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Elliot Sprecher
- grid.413731.30000 0000 9950 8111Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Alon Sinai
- grid.413731.30000 0000 9950 8111Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
| | - David Yarnitsky
- grid.6451.60000000121102151Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel ,grid.413731.30000 0000 9950 8111Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Irit Weissman-Fogel
- grid.18098.380000 0004 1937 0562Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Mao CP, Wilson G, Cao J, Meshberg N, Huang Y, Kong J. Abnormal Anatomical and Functional Connectivity of the Thalamo-sensorimotor Circuit in Chronic Low Back Pain: Resting-state Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Study. Neuroscience 2022; 487:143-154. [PMID: 35134490 PMCID: PMC8930700 DOI: 10.1016/j.neuroscience.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/29/2022]
Abstract
Thalamocortical dysfunction is thought to underlie the pathophysiology of chronic pain revealed by electroencephalographic studies. The thalamus serves as a primary relay center to transmit sensory information and motor impulses via dense connections with the somatosensory and motor cortex. In this study, diffusion tensor imaging (DTI) (probabilistic tractography) and resting-state functional magnetic resonance imaging (functional connectivity) were used to characterize the anatomical and functional integrity of the thalamo-sensorimotor pathway in chronic low back pain (cLBP). Fifty-four patients with cLBP and 54 healthy controls were included. The results suggested significantly increased anatomical connectivity of the left thalamo-motor pathway characterized by probabilistic tractography in patients with cLBP. Moreover, there was significantly altered resting-state functional connectivity (rsFC) of bilateral thalamo-motor/somatosensory pathways in patients with cLBP as compared to healthy controls. We also detected a significant correlation between pain intensity during the MRI scan and rsFC of the right thalamo-somatosensory pathway in cLBP. Our findings highlight the involvement of the thalamo-sensorimotor circuit in the pathophysiology of cLBP.
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Affiliation(s)
- Cui Ping Mao
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Georgia Wilson
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Jin Cao
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Nathaniel Meshberg
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Yiting Huang
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA.
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6
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Valeriani M, Liguori S, Vollono C, Testani E, Bangrazi S, Petti F, Liguori A, Germanotta M, Padua L, Pazzaglia C. Homotopic reduction in laser-evoked potential amplitude and laser-pain rating by abdominal acupuncture. Eur J Pain 2020; 25:659-667. [PMID: 33259079 DOI: 10.1002/ejp.1701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The neural mechanism underlying the analgesic effect of acupuncture is largely unknown. We aimed at investigating the effect of abdominal acupuncture (AA) on the laser-evoked potential (LEP) amplitude and laser-pain rating to stimulation of body parts either homotopic or heterotopic to the treated acupoint. METHODS Laser-evoked potentials were recorded from 13 healthy subjects to stimulation of the right wrist (RW), left wrist (LW) and right foot (RF). LEPs were obtained before, during and after the AA stimulation of an abdominal area corresponding to the representation of the RW. Subjective laser-pain rating was collected after each LEP recording. RESULTS The amplitude of the N2/P2 LEP component was significantly reduced during AA and 15 min after needle removal to both RW (F = 4.14, p = .02) and LW (F = 5.48, p = .008) stimulation, while the N2/P2 amplitude to RF stimulation (F = 0.94, p = .4) remained unchanged. Laser-pain rating was reduced during AA and 15 min after needle removal only to RW stimulation (F = 5.67, p = .007). CONCLUSION Our findings showing an AA effect on LEP components to both the ipsilateral and contralateral region homotopic to the treated area, without any LEP change to stimulation of a heterotopic region, suggest that the AA analgesia is mediated by a segmental spinal mechanism. SIGNIFICANCE Although abdominal acupuncture has demonstrated to be effective in the reduction in laser-evoked potential (LEP) amplitude and laser-pain rating, the exact mechanism of this analgesic effect is not known. In the current study, we found that treatment of an area in the "turtle representation" of the body led to a topographical pattern of LEP amplitude inhibition that can be mediated by a segmental spinal mechanism.
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Affiliation(s)
- Massimiliano Valeriani
- Department of Neuroscience, Pediatric Hospital Bambino Gesù, IRCCS, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | | | - Catello Vollono
- Neurofisiopatologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | | | | | | | - Luca Padua
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Kuner R, Kuner T. Cellular Circuits in the Brain and Their Modulation in Acute and Chronic Pain. Physiol Rev 2020; 101:213-258. [PMID: 32525759 DOI: 10.1152/physrev.00040.2019] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic, pathological pain remains a global health problem and a challenge to basic and clinical sciences. A major obstacle to preventing, treating, or reverting chronic pain has been that the nature of neural circuits underlying the diverse components of the complex, multidimensional experience of pain is not well understood. Moreover, chronic pain involves diverse maladaptive plasticity processes, which have not been decoded mechanistically in terms of involvement of specific circuits and cause-effect relationships. This review aims to discuss recent advances in our understanding of circuit connectivity in the mammalian brain at the level of regional contributions and specific cell types in acute and chronic pain. A major focus is placed on functional dissection of sub-neocortical brain circuits using optogenetics, chemogenetics, and imaging technological tools in rodent models with a view towards decoding sensory, affective, and motivational-cognitive dimensions of pain. The review summarizes recent breakthroughs and insights on structure-function properties in nociceptive circuits and higher order sub-neocortical modulatory circuits involved in aversion, learning, reward, and mood and their modulation by endogenous GABAergic inhibition, noradrenergic, cholinergic, dopaminergic, serotonergic, and peptidergic pathways. The knowledge of neural circuits and their dynamic regulation via functional and structural plasticity will be beneficial towards designing and improving targeted therapies.
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Affiliation(s)
- Rohini Kuner
- Institute of Pharmacology, Heidelberg University, Heidelberg, Germany; and Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
| | - Thomas Kuner
- Institute of Pharmacology, Heidelberg University, Heidelberg, Germany; and Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
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8
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Bastuji H, Lamouroux P, Villalba M, Magnin M, Garcia‐Larrea L. Local sleep spindles in the human thalamus. J Physiol 2020; 598:2109-2124. [DOI: 10.1113/jp279045] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/20/2020] [Indexed: 12/30/2022] Open
Affiliation(s)
- Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab – Lyon Neuroscience Research Center Université Claude Bernard INSERM U1028; CNRS, UMR5292 Bron France
- Centre du Sommeil & Service de Neurologie Fonctionnelle et d’Épileptologie Hospices Civils de Lyon Lyon France
| | - Pierre Lamouroux
- Central Integration of Pain (NeuroPain) Lab – Lyon Neuroscience Research Center Université Claude Bernard INSERM U1028; CNRS, UMR5292 Bron France
| | - Manon Villalba
- Central Integration of Pain (NeuroPain) Lab – Lyon Neuroscience Research Center Université Claude Bernard INSERM U1028; CNRS, UMR5292 Bron France
| | - Michel Magnin
- Central Integration of Pain (NeuroPain) Lab – Lyon Neuroscience Research Center Université Claude Bernard INSERM U1028; CNRS, UMR5292 Bron France
| | - Luis Garcia‐Larrea
- Central Integration of Pain (NeuroPain) Lab – Lyon Neuroscience Research Center Université Claude Bernard INSERM U1028; CNRS, UMR5292 Bron France
- Centre d’évaluation et de traitement de la douleur Hôpital Neurologique Lyon France
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9
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Kodama K, Takamoto K, Nishimaru H, Matsumoto J, Takamura Y, Sakai S, Ono T, Nishijo H. Analgesic Effects of Compression at Trigger Points Are Associated With Reduction of Frontal Polar Cortical Activity as Well as Functional Connectivity Between the Frontal Polar Area and Insula in Patients With Chronic Low Back Pain: A Randomized Trial. Front Syst Neurosci 2019; 13:68. [PMID: 31798422 PMCID: PMC6863771 DOI: 10.3389/fnsys.2019.00068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022] Open
Abstract
Background Compression of myofascial trigger points (MTrPs) in muscles is reported to reduce chronic musculoskeletal pain. Although the prefrontal cortex (PFC) is implicated in development of chronic pain, the mechanisms of how MTrP compression at low back regions affects PFC activity remain under debate. In this study, we investigated effects of MTrP compression on brain hemodynamics and EEG oscillation in subjects with chronic low back pain. Methods The study was a prospective, randomized, parallel-group trial and an observer and subject-blinded clinical trial. Thirty-two subjects with chronic low back pain were divided into two groups: subjects with compression at MTrPs (n = 16) or those with non-MTrPs (n = 16). Compression at MTrP or non-MTrP for 30 s was applied five times, and hemodynamic activity (near-infrared spectroscopy; NIRS) and EEGs were simultaneously recorded during the experiment. Results The results indicated that compression at MTrPs significantly (1) reduced subjective pain (P < 0.05) and increased the pressure pain threshold (P < 0.05), (2) decreased the NIRS hemodynamic activity in the frontal polar area (pPFC) (P < 0.05), and (3) increased the current source density (CSD) of EEG theta oscillation in the anterior part of the PFC (P < 0.05). CSD of EEG theta oscillation was negatively correlated with NIRS hemodynamic activity in the pPFC (P < 0.05). Furthermore, functional connectivity in theta bands between the medial pPFC and insula cortex was significantly decreased in the MTrP group (P < 0.05). The functional connectivity between those regions was positively correlated with subjective low back pain (P < 0.05). Discussion The results suggest that MTrP compression at the lumbar muscle modulates pPFC activity and functional connectivity between the pPFC and insula, which may relieve chronic musculoskeletal pain. Trial registration This trial was registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000033913) on 27 August 2018, at https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000038660.
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Affiliation(s)
- Kanae Kodama
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kouichi Takamoto
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan.,Department of Sports and Health Sciences, Faculty of Human Sciences, University of East Asia, Shimonoseki, Japan
| | - Hiroshi Nishimaru
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Jumpei Matsumoto
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yusaku Takamura
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Shigekazu Sakai
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Taketoshi Ono
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hisao Nishijo
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
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10
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Adamantidis AR, Gutierrez Herrera C, Gent TC. Oscillating circuitries in the sleeping brain. Nat Rev Neurosci 2019; 20:746-762. [DOI: 10.1038/s41583-019-0223-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2019] [Indexed: 12/20/2022]
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11
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Guédon A, Thiebaut JB, Benichi S, Mikol J, Moxham B, Plaisant O. Dejerine-Roussy syndrome: Historical cases. Neurology 2019; 93:624-629. [PMID: 31570637 DOI: 10.1212/wnl.0000000000008209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/05/2019] [Indexed: 11/15/2022] Open
Abstract
On June 7, 1906, Jules Dejerine (1849-1917) and Gustave Roussy (1874-1948) presented to the Société de Neurologie de Paris the first description of the thalamic syndrome with serial-section microscopic images. They also provided the first account of central poststroke pain (CPSP). They suggested that pain is one of the primary symptoms of the syndrome, although one of their own patients ("Hud") did not have pain. Several contemporary studies have highlighted the involvement of the anterior part of the pulvinar (PuA) in patients with CPSP of thalamic origin. Two historical observations (cases Jos and Hud) are reviewed here using the Morel nuclei staining atlas (2007). Dejerine and Roussy proposed the "irritative theory" to explain CPSP of thalamic origin and, in line with the most recent literature, they invoked the involvement of the PuA. When matching images for the Jos and Hud cases with the Morel atlas, it appears that the lesions involved what Dejerine then termed the noyau externe; that is, the ventral posterolateral nucleus and the PuA. In the Jos case, the lesion extended medially to what Dejerine termed the noyau médian de Luys; that is, the central medial-parafascicular nuclei, whereas in the Hud case the lesion extended more inferiorly. From the finding in the Hud case, one can hypothesize that impairment of the PuA alone does not assure pain. The work of Dejerine and Roussy, based on clinico-anatomical correlations, remains relevant to this day.
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Affiliation(s)
- Alexis Guédon
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Jean-Baptiste Thiebaut
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Sandro Benichi
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Jacqueline Mikol
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Bernard Moxham
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Odile Plaisant
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France.
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12
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Luo H, Huang Y, Xiao X, Dai W, Nie Y, Geng X, Green AL, Aziz TZ, Wang S. Functional dynamics of thalamic local field potentials correlate with modulation of neuropathic pain. Eur J Neurosci 2019; 51:628-640. [PMID: 31483893 DOI: 10.1111/ejn.14569] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/15/2019] [Accepted: 08/23/2019] [Indexed: 12/24/2022]
Abstract
Understanding the functional dynamics of neural oscillations in the sensory thalamus is essential for elucidating the perception and modulation of neuropathic pain. Local field potentials were recorded from the sensory thalamus of twelve neuropathic pain patients. Single and combinational neural states were defined by the activity state of a single or paired oscillations. Relationships between the duration or occurrence rate of neural state and pre-operative pain level or pain relief induced by deep brain stimulation were evaluated. Results showed that the occurrence rate of the single neural state of low-beta oscillation was significantly correlated with pain relief. The duration and occurrence rate of combinational neural states of the paired low-beta with delta, theta, alpha, high-beta or low-gamma oscillations were more significantly correlated with pain relief than the single neural states. Moreover, these significant combinational neural states formed a local oscillatory network with low-beta oscillation as a key node. The results also showed correlations between measures of combinational neural states and subjective pain level as well. The duration of combinational neural states of paired alpha with delta or theta oscillations and the occurrence rate of neural states of the paired delta with low-beta or low-gamma oscillations were significantly correlated with pre-operative pain level. In conclusion, this study revealed that the integration of oscillations and the functional dynamics of neural states were differentially involved in modulation and perception of neuropathic pain. The functional dynamics could be biomarkers for developing neural state-dependent deep brain stimulation for neuropathic pain.
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Affiliation(s)
- Huichun Luo
- School of Biomedical Engineering, University of Science and Technology of China, Hefei, China.,Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China.,Neural and Intelligence Engineering Center, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Yongzhi Huang
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Xiao Xiao
- Neural and Intelligence Engineering Center, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Wenjing Dai
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
| | - Yingnan Nie
- Neural and Intelligence Engineering Center, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Xinyi Geng
- Neural and Intelligence Engineering Center, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Alexander L Green
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Tipu Z Aziz
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Shouyan Wang
- Neural and Intelligence Engineering Center, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
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13
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Vierck C. Mechanisms of Below-Level Pain Following Spinal Cord Injury (SCI). THE JOURNAL OF PAIN 2019; 21:262-280. [PMID: 31493490 DOI: 10.1016/j.jpain.2019.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/05/2019] [Accepted: 08/07/2019] [Indexed: 12/18/2022]
Abstract
Mechanisms of below-level pain are discoverable as neural adaptations rostral to spinal injury. Accordingly, the strategy of investigations summarized here has been to characterize behavioral and neural responses to below-level stimulation over time following selective lesions of spinal gray and/or white matter. Assessments of human pain and the pain sensitivity of humans and laboratory animals following spinal injury have revealed common disruptions of pain processing. Interruption of the spinothalamic pathway partially deafferents nocireceptive cerebral neurons, rendering them spontaneously active and hypersensitive to remaining inputs. The spontaneous activity among these neurons is disorganized and unlikely to generate pain. However, activation of these neurons by their remaining inputs can result in pain. Also, injury to spinal gray matter results in a cascade of secondary events, including excitotoxicity, with rostral propagation of excitatory influences that contribute to chronic pain. Establishment and maintenance of below-level pain results from combined influences of injured and spared axons in the spinal white matter and injured neurons in spinal gray matter on processing of nociception by hyperexcitable cerebral neurons that are partially deafferented. A model of spinal stenosis suggests that ischemic injury to the core spinal region can generate below-level pain. Additional questions are raised about demyelination, epileptic discharge, autonomic activation, prolonged activity of C nocireceptive neurons, and thalamocortical plasticity in the generation of below-level pain. PERSPECTIVE: An understanding of mechanisms can direct therapeutic approaches to prevent development of below-level pain or arrest it following spinal cord injury. Among the possibilities covered here are surgical and other means of attenuating gray matter excitotoxicity and ascending propagation of excitatory influences from spinal lesions to thalamocortical systems involved in pain encoding and arousal.
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Affiliation(s)
- Chuck Vierck
- Department of Neuroscience, University of Florida College of Medicine and McKnight Brain Institute, Gainesville, Florida.
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14
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Update on structured pain assessment for the documentation of diagnosis-independent symptoms and signs associated with pain. Schmerz 2019; 34:16-23. [PMID: 30649626 DOI: 10.1007/s00482-018-0354-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Concerning the diagnosis and therapy of pain syndromes, standardized descriptions similar to those used in the examination of psychopathological findings via the system produced by the AMDP ("Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie", i. e., the working group establishing standardized methodology and documentation within psychiatry) are still lacking. Therefore, the authors of this article have founded a working group to establish standardized methodology and documentation for symptoms and signs associated with pain, although not at a diagnosis-specific level, in order to promote standardization in the documentation of pain and rating of the symptoms associated with a given set of medical results. This article presents a system for documenting the symptoms and signs associated with pain globally and independently of the diagnosis (Structured Pain Assessment System) with nomenclature that is inspired by the AMDP system. The objective of this working group is to develop documentation for a uniform multidimensional pain assessment (with defined terminology) that serves as a comparable and unified standard in the field.
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15
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Abstract
Clinical neurophysiologic investigation of pain pathways in humans is based on specific techniques and approaches, since conventional methods of nerve conduction studies and somatosensory evoked potentials do not explore these pathways. The proposed techniques use various types of painful stimuli (thermal, laser, mechanical, or electrical) and various types of assessments (measurement of sensory thresholds, study of nerve fiber excitability, or recording of electromyographic reflexes or cortical potentials). The two main tests used in clinical practice are quantitative sensory testing and pain-related evoked potentials (PREPs). In particular, PREPs offer the possibility of an objective assessment of nociceptive pathways. Three types of PREPs can be distinguished depending on the type of stimulation used to evoke pain: laser-evoked potentials, contact heat evoked potentials, and intraepidermal electrical stimulation evoked potentials (IEEPs). These three techniques investigate both small-diameter peripheral nociceptive afferents (mainly Aδ nerve fibers) and spinothalamic tracts without theoretically being able to differentiate the level of lesion in the case of abnormal results. In routine clinical practice, PREP recording is a reliable method of investigation for objectifying the existence of a peripheral or central lesion or loss of function concerning the nociceptive pathways, but not the existence of pain. Other methods, such as nerve fiber excitability studies using microneurography, more directly reflect the activities of nociceptive axons in response to provoked pain, but without detecting or quantifying the presence of spontaneous pain. These methods are more often used in research or experimental study design. Thus, it should be kept in mind that most of the results of neurophysiologic investigation performed in clinical practice assess small fiber or spinothalamic tract lesions rather than the neuronal mechanisms directly at the origin of pain and they do not provide objective quantification of pain.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- Excitabilité Nerveuse et Thérapeutique, Faculté de Médecine de Créteil, Université Paris-Est-Créteil, Hôpital Henri Mondor, Créteil, France; Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France.
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16
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Garcia-Larrea L, Bastuji H. Pain and consciousness. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:193-199. [PMID: 29031510 DOI: 10.1016/j.pnpbp.2017.10.007] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 01/18/2023]
Abstract
The aversive experience we call "pain" results from the coordinated activation of multiple brain areas, commonly described as a "pain matrix". This is not a fixed arrangement of structures but rather a fluid system composed of several interacting networks: A 'nociceptive matrix' includes regions receiving input from ascending nociceptive systems, and ensures the bodily characteristics of physical pain. A further set of structures receiving secondary input supports the 'salience' attributes of noxious stimuli, triggers top-down cognitive controls, and -most importantly- ensures the passage from pre-conscious nociception to conscious pain. Expectations and beliefs can still modulate the conscious experience via activity in supramodal regions with widespread cortical projections such as the ventral tegmental area. Intracortical EEG responses in humans show that nociceptive cortical processing is initiated in parallel in sensory, motor and limbic areas; it progresses rapidly to the recruitment of anterior insular and fronto-parietal networks, and finally to the activation of perigenual, posterior cingulate and hippocampal structures. Functional connectivity between sensory and high-level networks increases during the first second post-stimulus, which may be determinant for access to consciousness. A model is described, progressing from unconscious sensori-motor and limbic processing of spinothalamic and spino-parabrachial input, to an immediate sense of awareness supported by coordinated activity in sensorimotor and fronto-parieto-insular networks, and leading to full declarative consciousness through integration with autobiographical memories and self-awareness, involving posterior cingulate and medial temporal areas. This complete sequence is only present during full vigilance states. We contend, however, that even in unconscious subjects, repeated limbic and vegetative activation by painful stimuli via spino-amygdalar pathways can generate implicit memory traces and stimulus-response abnormal sequences, possibly contributing to long-standing anxiety or hyperalgesic syndromes in patients surviving coma.
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Affiliation(s)
- Luis Garcia-Larrea
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Universite Claude Bernard, Bron F-69677, France; Neurological Hospital Pain Center (CETD), Hôpital Neurologique, Hospices Civils De Lyon, Bron F-69677, France Lyon, France.
| | - Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Universite Claude Bernard, Bron F-69677, France; Hypnology Unit, Functional Neurology and Epileptology Department, Hôpital Neurologique, Hospices Civils De Lyon, Bron, F-69677, France
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17
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Gent TC, Bassetti CLA, Adamantidis AR. Sleep-wake control and the thalamus. Curr Opin Neurobiol 2018; 52:188-197. [PMID: 30144746 DOI: 10.1016/j.conb.2018.08.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/02/2018] [Indexed: 01/23/2023]
Abstract
Sleep is an essential component of animal behavior, controlled by both circadian and homeostatic processes. Typical brain oscillations for sleep and wake states are distinctive and reflect recurrent activity amongst neural circuits spanning localized to global brain regions. Since the original discovery of hypothalamic centers controlling both sleep and wakefulness, current views now implicate networks of neuronal and non-neuronal cells distributed brain-wide. Yet the mechanisms of sleep-wake control remain unclear. In light of recent studies, here we review experimental evidence from lesional, correlational, pharmacological and genetics studies, which support a role for the thalamus in several aspects of sleep-wake states. How these thalamo-cortical network mechanisms contribute to other executive functions such as memory consolidation and cognition, remains an open question with direct implications for neuro-psychiatric diseases and stands as a future challenge for basic science and healthcare research.
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Affiliation(s)
- Thomas C Gent
- Centre for Experimental Neurology, Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Claudio LA Bassetti
- Centre for Experimental Neurology, Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland; Department of Biomedical Research, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Antoine R Adamantidis
- Centre for Experimental Neurology, Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland; Department of Biomedical Research, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland.
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18
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Bastuji H, Frot M, Perchet C, Hagiwara K, Garcia-Larrea L. Convergence of sensory and limbic noxious input into the anterior insula and the emergence of pain from nociception. Sci Rep 2018; 8:13360. [PMID: 30190593 PMCID: PMC6127143 DOI: 10.1038/s41598-018-31781-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/22/2018] [Indexed: 01/19/2023] Open
Abstract
Two parallel di-synaptic routes convey nociceptive input to the telencephalon: the spino-thalamic system projecting principally to the posterior insula, and the spino-parabrachial pathway reaching the amygdalar nucleus. Interplay between the two systems underlies the sensory and emotional aspects of pain, and was explored here in humans with simultaneous recordings from the amygdala, posterior and anterior insulae. Onsets of thermo-nociceptive responses were virtually identical in the posterior insula and the amygdalar complex, but no significant functional connectivity was detected between them using coherence analysis. Anterior insular sectors responded with ~30 ms delay relative to both the posterior insula and the amygdala. While intra-insular functional correlation was significant during the whole analysis period, coherence between the anterior insula and the amygdala became significant after 700 ms of processing. Phase lags indicated information transfer initially directed from the amygdalar complex to the insula. Parallel but independent activation of sensory and limbic nociceptive networks appear to converge in the anterior insula in less than one second. While the anterior insula is often considered as providing input into the limbic system, our results underscore its reverse role, i.e., receiving and integrating very rapidly limbic with sensory input, to initiate a perceptual decision on the stimulus 'painfulness'.
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Affiliation(s)
- Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS. UMR5292, Université Claude Bernard, Bron, F-69677, France.
- Unité d'Hypnologie, Service de Neurologie Fonctionnelle et d'Épileptologie, Hôpital Neurologique, Hospices Civils de Lyon, Bron, F-69677, France.
| | - Maud Frot
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS. UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Caroline Perchet
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS. UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Koichi Hagiwara
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS. UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Luis Garcia-Larrea
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS. UMR5292, Université Claude Bernard, Bron, F-69677, France
- Centre d'évaluation et de traitement de la douleur, Hôpital Neurologique, Lyon, France
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19
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Bastuji H. Michel Jouvet as a clinical neurophysiologist and neurologist. Sleep Med 2018; 49:73-77. [PMID: 30145123 DOI: 10.1016/j.sleep.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
While the world reputation of Michel Jouvet in sleep research is based on his huge work on sleep and paradoxical sleep, especially in cats, a far less-known part of his activity was dedicated to investigate and take care of patients with neurological diseases. Indeed, he was also a physician, specialized in neurophysiology and working at the neurological hospital of Lyon. He was most interested first in patients with disorders of consciousness and secondly in those with sleep/wake disorders, and especially in modafinil for the treatment of patients with narcolepsy and idiopathic hypersomnia.
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Affiliation(s)
- Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center; INSERM U1028; CNRS, UMR5292; Université Claude Bernard, Bron, France; Service de Neurologie Fonctionnelle et d'Épileptologie, Hôpital Neurologique, Hospices Civils de Lyon, France; Service de Médecine du Sommeil et des Maladies Respiratoires, Hôpital Croix-Rousse, Hospices Civils de Lyon, France.
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20
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Grömer TW, Käfferlein W, Menger B, Dohrenbusch R, Kappis B, Maihöfner C, Kornhuber J, Philipsen A, Müller HHO. [The AMDS system for the documentation of symptoms and signs associated with pain]. Schmerz 2017; 31:610-618. [PMID: 28801855 DOI: 10.1007/s00482-017-0241-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The authors present a system for nomenclature and documentation of symptoms and signs associated with pain. The system was compiled in a staged process by the study group for methods and documentation of pain-associated symptoms and signs (Arbeitsgemeinschaft für Methodik und Dokumentation von Schmerzbefunden [AMDS]). The suggested items were elaborated from terms used in current national and international guidelines and classifications and in part integrated into superordinate terms. The items that were built up by this approach aim to reflect the broad spectrum of pain diseases. The items for the description of pain-associated symptoms and signs are divided into the areas of algesiomotor, psychoalgesiological and somatoalgesiological findings. The aim is the documentation of a multidimensional algesiological description of findings with defined terminology, which can serve as a comparable and unified standard, particularly in the field of pain assessment. The AMDS system should enable a systematic description of pain, which is a reliable foundation for diagnostics, therapy planning and expert case evaluation.
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Affiliation(s)
- Teja W Grömer
- Praxisklinik Dres. Käfferlein, Grömer und Kollegen, Heinrichsdamm 6, 96047, Bamberg, Deutschland. .,Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Deutschland.
| | - Wolfgang Käfferlein
- Praxisklinik Dres. Käfferlein, Grömer und Kollegen, Heinrichsdamm 6, 96047, Bamberg, Deutschland
| | - Björn Menger
- IMB Kassel, Landgraf-Karl-Straße 21, Kassel, 34131, Deutschland
| | - Ralf Dohrenbusch
- Abteilung für Methodenlehre, Diagnostik und Evaluation, Institut für Psychologie, Kaiser-Karl-Ring 9, Bonn, 53111, Deutschland
| | - Bernd Kappis
- Klinik für Anästhesiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, Mainz, 55131, Deutschland
| | - Christian Maihöfner
- Neurologie, Klinikum Fürth, Jakob-Henle-Straße 1, Fürth, 90766, Deutschland.,Neurologische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 10, Erlangen, 91054, Deutschland
| | - Johannes Kornhuber
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Deutschland
| | - Alexandra Philipsen
- Fakultät für Medizin und Gesundheitswissenschaften, Universitätsklinik für Psychiatrie und Psychotherapie Karl-Jaspers-Klinik, Medizinischer Campus, Universität Oldenburg, Hermann-Ehlers-Straße 7, Bad Zwischenahn, 26160, Deutschland
| | - Helge H O Müller
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Deutschland.,Fakultät für Medizin und Gesundheitswissenschaften, Universitätsklinik für Psychiatrie und Psychotherapie Karl-Jaspers-Klinik, Medizinischer Campus, Universität Oldenburg, Hermann-Ehlers-Straße 7, Bad Zwischenahn, 26160, Deutschland
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21
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Bastuji H, Frot M, Perchet C, Magnin M, Garcia-Larrea L. Pain networks from the inside: Spatiotemporal analysis of brain responses leading from nociception to conscious perception. Hum Brain Mapp 2016; 37:4301-4315. [PMID: 27391083 DOI: 10.1002/hbm.23310] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/19/2016] [Accepted: 06/27/2016] [Indexed: 12/11/2022] Open
Abstract
Conscious perception of painful stimuli needs the contribution of an extensive cortico-subcortical network, and is completed in less than one second. While initial activities in operculo-insular and mid-cingulate cortices have been extensively assessed, the activation timing of most areas supporting conscious pain has barely been studied. Here we used intracranial EEG to investigate the dynamics of 16 brain regions (insular, parietal, prefrontal, cingulate, hippocampal and limbic) during the first second following nociceptive-specific laser pulses. Three waves of activation could be defined according to their temporal relation with conscious perception, ascertained by voluntary motor responses. Pre-conscious activities were recorded in the posterior insula, operculum, mid-cingulate and amygdala. Antero-insular, prefrontal and posterior parietal activities started later and developed during time-frames consistent with conscious voluntary reactions. Responses from hippocampus, perigenual and perisplenial cingulate developed latest and persisted well after conscious perception occurred. Nociceptive inputs reach simultaneously sensory and limbic networks, probably through parallel spino-thalamic and spino-parabrachial pathways, and the initial limbic activation precedes conscious perception of pain. Access of sensory information to consciousness develops concomitant to fronto-parietal activity, while late-occurring responses in the hippocampal region, perigenual and posterior cingulate cortices likely underlie processes linked to memory encoding, self-awareness and pain modulation. Hum Brain Mapp 37:4301-4315, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.,Unité D'Hypnologie, Service De Neurologie Fonctionnelle Et D'Épileptologie, Hôpital Neurologique, Hospices Civils De Lyon, Bron, F-69677, France
| | - Maud Frot
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Caroline Perchet
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Michel Magnin
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Luis Garcia-Larrea
- Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.,Centre D'évaluation Et De Traitement De La Douleur, Hôpital Neurologique, Lyon, France
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Claude L, Chouchou F, Prados G, Castro M, De Blay B, Perchet C, García-Larrea L, Mazza S, Bastuji H. Sleep spindles and human cortical nociception: a surface and intracerebral electrophysiological study. J Physiol 2015; 593:4995-5008. [PMID: 26377229 DOI: 10.1113/jp270941] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/23/2015] [Indexed: 01/05/2023] Open
Abstract
KEY POINTS Sleep spindle are usually considered to play a major role in inhibiting sensory inputs. Using nociceptive stimuli in humans, we tested the effect of spindles on behavioural, autonomic and cortical responses in two experiments using surface and intracerebral electroencephalographic recordings. We found that sleep spindles do not prevent arousal reactions to nociceptive stimuli and that autonomic reactivity to nociceptive inputs is not modulated by spindle activity. Moreover, neither the surface sensory, nor the insular evoked responses were modulated by the spindle, as detected at the surface or within the thalamus. The present study comprises the first investigation of the effect of spindles on nociceptive information processing and the results obtained challenge the classical inhibitory effect of spindles. ABSTRACT Responsiveness to environmental stimuli declines during sleep, and sleep spindles are often considered to play a major role in inhibiting sensory inputs. In the present study, we tested the effect of spindles on behavioural, autonomic and cortical responses to pain, in two experiments assessing surface and intracerebral responses to thermo-nociceptive laser stimuli during the all-night N2 sleep stage. The percentage of arousals remained unchanged as a result of the presence of spindles. Neither cortical nociceptive responses, nor autonomic cardiovascular reactivity were depressed when elicited within a spindle. These results could be replicated in human intracerebral recordings, where sleep spindle activity in the posterior thalamus failed to depress the thalamocortical nociceptive transmission, as measured by sensory responses within the posterior insula. Hence, the assumed inhibitory effect of spindles on sensory inputs may not apply to the nociceptive system, possibly as a result of the specificity of spinothalamic pathways and the crucial role of nociceptive information for homeostasis. Intriguingly, a late scalp response commonly considered to reflect high-order stimulus processing (the 'P3' potential) was significantly enhanced during spindling, suggesting a possible spindle-driven facilitation, rather than attenuation, of cortical nociception.
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Affiliation(s)
- Léa Claude
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Florian Chouchou
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Germán Prados
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Maïté Castro
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Barbara De Blay
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Caroline Perchet
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Luis García-Larrea
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Stéphanie Mazza
- Université Lumière Lyon 2, Laboratoire d'Etude des Mécanismes Cognitifs (EMC), Bron, France
| | - Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France.,Unité d'Hypnologie, Service de Neurologie Fonctionnelle et d'Épileptologie, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
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