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Cortical representation of pain

Shigeyuki Kan, Satoru Miyauchi
Emerging evidence indicates that cortical midline structures (CMS) (which consist of the orbitomedial prefrontal cortex (OMPFC), dorsomedial prefrontal cortex (DMPFC), anterior cingulate cortex (ACC), and precuneus/posterior cingulate cortex (pC/PCC)) have a critical role in generating a model of the self. These regions also serve as hub regions for the default mode network (DMN) or salience network (SN). Furthermore, regions of the CMS overlap with pain-related regions such as the so-called "pain matrix," suggesting that pain has unique attributes compared to other sensations like vision...
March 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Igor Elman, David Borsook
Pain is essential for avoidance of tissue damage and for promotion of healing. Notwithstanding the survival value, pain brings about emotional suffering reflected in fear and anxiety, which in turn augment pain thus giving rise to a self-sustaining feedforward loop. Given such reciprocal relationships, the present article uses neuroscientific conceptualizations of fear and anxiety as a theoretical framework for hitherto insufficiently understood pathophysiological mechanisms underlying chronic pain. To that end, searches of PubMed-indexed journals were performed using the following Medical Subject Headings' terms: pain and nociception plus amygdala, anxiety, cognitive, fear, sensory, and unconscious...
2018: Frontiers in Psychiatry
Tribikram Thapa, Thomas Graven-Nielsen, Lucinda S Chipchase, Siobhan M Schabrun
OBJECTIVE: Homeostatic plasticity mechanisms regulate synaptic plasticity in the human brain. Impaired homeostatic plasticity may contribute to maladaptive synaptic plasticity and symptom persistence in chronic musculoskeletal pain. METHODS: We examined homeostatic plasticity in fifty individuals with chronic low back pain (cLBP) and twenty-five pain-free controls. A single block (7-min) of anodal transcranial direct current stimulation ('single tDCS'), or two subsequent blocks (7-min and 5-min separated by 3-min rest; 'double tDCS'), were randomised across two experimental sessions to confirm an excitatory response to tDCS applied alone, and evaluate homeostatic plasticity, respectively...
February 9, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
René Pelletier, Johanne Higgins, Daniel Bourbonnais
OBJECTIVE: Musculoskeletal disorders are associated with altered sensory, proprioceptive and cognitive processes. Sensory processes affect the internal cortical representation of the body in space, the body schema, which in turn influences motor control. The purpose of this study was to determine if participants with wrist/hand disorders had impaired performance on a task associated with the body schema, the Left/Right Judgement Task (LRJT) and secondly how LRJT performance, motor performance, disability, pain and related aspects are associated...
February 7, 2018: Musculoskeletal Science & Practice
Cora E Mukerji, Sarah Hope Lincoln, Laura M Tully, David Dodell-Feder, Christine I Hooker
Impairment in simulation, i.e., the generation of internal representations of experiences, may contribute to social dysfunction in schizophrenia spectrum disorders (SZ). Using a novel fMRI task, we identified neural representations generated during simulation of sensorimotor experiences and evaluated their associations with socioemotional function in 19 individuals with SZ and 24 psychiatrically-healthy controls (HC). Participants watched videos depicting a painful sensorimotor experience in the hand or foot of another person and were then asked to imagine how unpleasant it would be to undergo that experience themselves, eliciting simulation...
January 30, 2018: Psychiatry Research
J Andoh, C Milde, J W Tsao, H Flor
Cortical reorganization has been proposed as a major factor involved in phantom pain with prior nociceptive input to the deafferented region and input from the non-deafferented cortex creating neuronal activity that is perceived as phantom pain. There is substantial evidence that these processes play a role in neuropathic pain, although causal evidence is lacking. Recently it has been suggested that a maintenance of the cortical representation of the former hand area is related to phantom pain. Although interesting, evidence for this process is so far scarce...
November 16, 2017: Neuroscience
Burcu Dilek, Cigdem Ayhan, Gozde Yagci, Yavuz Yakut
STUDY DESIGN: Single-blinded randomized controlled trial. INTRODUCTION: Pain management is essential in the early stages of the rehabilitation of distal radius fractures (DRFx). Pain intensity at the acute stage is considered important for determining the individual recovery process, given that higher pain intensity and persistent pain duration negatively affect the function and cortical activity of pain response. Graded motor imagery (GMI) and its components are recent pain management strategies, established on a neuroscience basis...
November 6, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Nina Goossens, Sofie Rummens, Lotte Janssens, Karen Caeyenberghs, Simon Brumagne
Low back pain (LBP) coincides with sensorimotor impairments, e.g., reduced lumbosacral tactile and proprioceptive acuity and postural control deficits. Recent functional magnetic resonance imaging (fMRI) studies suggest that sensorimotor impairments in LBP may be associated with brain changes. However, no consensus exists regarding the relationship between functional brain changes and sensorimotor behavior in LBP. Therefore, this review critically discusses the available fMRI studies on brain activation related to non-nociceptive somatosensory stimulation and motor performance in individuals with LBP...
November 6, 2017: American Journal of Physical Medicine & Rehabilitation
R Nardone, F Brigo, Y Höller, L Sebastianelli, V Versace, L Saltuari, P Lochner, E Trinka
The sensory and motor cortical representation corresponding to the affected limb is altered in patients with complex regional pain syndrome (CRPS). Transcranial magnetic stimulation (TMS) represents a useful non-invasive approach for studying cortical physiology. If delivered repetitively, TMS can also modulate cortical excitability and induce long-lasting neuroplastic changes. In this review, we performed a systematic search of all studies using TMS to explore cortical excitability/plasticity and repetitive TMS (rTMS) for the treatment of CRPS...
October 3, 2017: Acta Neurologica Scandinavica
Elia Valentini, Valentina Nicolardi, Salvatore Maria Aglioti
Previous research suggests that prompting individuals to think on their own mortality affects their perception of painful somatic stimuli and related brain activity. Grounded on the assumption that reminders of mortality may recruit threat-defence mechanisms similar to the ones activated by painful nociceptive stimuli, we hypothesize that the effects exerted by linguistic reminders of death on pain perception and brain activity would be elicited by passive observation of death-related pictures vs. more generic threat-related pictures...
August 30, 2017: Biological Psychology
Martina Gandola, Maurilio Bruno, Laura Zapparoli, Gianluca Saetta, Elena Rolandi, Antonio De Santis, Giuseppe Banfi, Alberto Zerbi, Valerio Sansone, Eraldo Paulesu
The human trapeziometacarpal (TMC) joint has a crucial evolutionary importance as it permits rotation and opposition of the thumb to the other fingers. In chronic TMC joint osteoarthritis (i.e., rhizarthrosis), this motor ability, essential for pinching, grasping, and manipulating objects, may become difficult or impossible due to intolerable pain. Here, we assess whether patients with rhizarthrosis show signs of abnormal brain representation of hand movements. To this end, we studied 35 patients with rhizarthrosis, affecting predominantly one of the two hands, and 35 healthy subjects who underwent both behavioural and fMRI measures of brain activity during overtly executed or imagined thumb-to-finger-opposition movements...
October 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Rosario Privitera, Rolfe Birch, Marco Sinisi, Iordan R Mihaylov, Robert Leech, Praveen Anand
PURPOSE: The aim of this study was to measure the efficacy of a single 60 min application of capsaicin 8% patch in reducing chronic amputation stump and phantom limb pain, associated hypersensitivity with quantitative sensory testing, and changes in brain cortical maps using functional MRI (fMRI) scans. METHODS: A capsaicin 8% patch (Qutenza) treatment study was conducted on 14 patients with single limb amputation, who reported pain intensity on the Numerical Pain Rating Scale ≥4/10 for chronic stump or phantom limb pain...
2017: Journal of Pain Research
Edith Elgueta-Cancino, Siobhan Schabrun, Paul Hodges
Primary motor cortex (M1) organisation differs between individuals with and without chronic low back pain (CLBP), in parallel with motor and sensory impairments. This study investigated whether movement behaviour and tactile/pain sensation are related to M1 organisation in CLBP. Transcranial magnetic stimulation (TMS) was used to map the M1 representation of the erector spinae and multifidus muscles in 20 participants with and without CLBP. Cortical organisation was quantified by: map volume; center of gravity (CoG); number of peaks; and primary and secondary peak location...
July 17, 2017: Clinical Journal of Pain
Abeer F Almarzouki, Christopher A Brown, Richard J Brown, Matthew H K Leung, Anthony K P Jones
It is well known that the efficacy of treatment effects, including those of placebos, is heavily dependent on positive expectations regarding treatment outcomes. For example, positive expectations about pain treatments are essential for pain reduction. Such positive expectations not only depend on the properties of the treatment itself, but also on the context in which the treatment is presented. However, it is not clear how the preceding threat of pain will bias positive expectancy effects. One hypothesis is that threatening contexts trigger fearful and catastrophic thinking, reducing the pain-relieving effects of positive expectancy...
2017: PloS One
Laure Mazzola, François Mauguière, Jean Isnard
INTRODUCTION: Stereotactic stimulations of the insular cortex through intracranial electrodes aim at characterizing the semiology of insular seizures. These stimulations, carried out in the context of Stereo-Electro-Encephalography (SEEG) during presurgical monitoring of epilepsy, reproduce the ictal symptoms observed during the development of insular seizures. METHODS: The authors reviewed the results of insular stimulations performed in 222 patients admitted between 1997 and 2015 for presurgical SEEG exploration of atypical temporal or perisylvian epilepsy...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Qiaosheng Zhang, Toby Manders, Ai Phuong Tong, Runtao Yang, Arpan Garg, Erik Martinez, Haocheng Zhou, Jahrane Dale, Abhinav Goyal, Louise Urien, Guang Yang, Zhe Chen, Jing Wang
A hallmark feature of chronic pain is its ability to impact other sensory and affective experiences. It is notably associated with hypersensitivity at the site of tissue injury. It is less clear, however, if chronic pain can also induce a generalized site-nonspecific enhancement in the aversive response to nociceptive inputs. Here, we showed that chronic pain in one limb in rats increased the aversive response to acute pain stimuli in the opposite limb, as assessed by conditioned place aversion. Interestingly, neural activities in the anterior cingulate cortex (ACC) correlated with noxious intensities, and optogenetic modulation of ACC neurons showed bidirectional control of the aversive response to acute pain...
May 19, 2017: ELife
Yeon-Hee Lee, Kyung Mi Lee, Hyug-Gi Kim, Soo-Kyung Kang, Q-Schick Auh, Jyung-Pyo Hong, Yang-Hyun Chun
Complex regional pain syndrome (CRPS) is one of the most challenging chronic pain conditions and is characterized by burning pain, allodynia, hyperalgesia, autonomic changes, trophic changes, edema, and functional loss involving mainly the extremities. Until recently, very few reports have been published concerning CRPS involving the orofacial area. We report on a 50-year-old female patient who presented with unbearable pain in all of her teeth and hypersensitivity of the facial skin. She also reported intractable pain in both extremities accompanied by temperature changes and orofacial pain that increased when the other pains were aggravated...
August 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Li Min Chen
Human functional MRI studies in acute and various chronic pain conditions have revolutionized how we view pain, and have led to a new theory that complex multi-dimensional pain experience (sensory-discriminative, affective/motivational, and cognitive) is represented by concurrent activity in widely-distributed brain regions (termed a network or pain matrix). Despite these breakthrough discoveries, the specific functions proposed for these regions remain elusive, because detailed electrophysiological characterizations of these regions in the primate brain are lacking...
May 2, 2017: Neuroscience Bulletin
Emma Burns, Lucy S Chipchase, Siobhan M Schabrun
Purpose/aim: Recently, a novel measure of cortical disinhibition was identified using transcranial magnetic stimulation (TMS). This measure, described as post-silent period electromyographic (EMG) bursting, may inform on the corticomotor control of movement in health and disease; however, it has not been investigated for muscles outside the hand or in musculoskeletal conditions. Thus, the aim of this study was to investigate the temporal and spatial characteristics of "EMG bursting" in individuals with and without low back pain (LBP)...
May 16, 2017: International Journal of Neuroscience
Lars Büntjen, Jens-Max Hopf, Christian Merkel, Jürgen Voges, Stefan Knape, Hans-Jochen Heinze, Mircea Ariel Schoenfeld
Chronic pain is suggested to be linked to reorganization processes in the sensorimotor cortex. In the current study, the somatosensory representation of the extremities was investigated in a patient with a complex regional pain syndrome (CRPS) that initially occurred in the right hand and arm and spread later into the left hand and right leg. After the spread, magnetoencephalographic recordings in conjunction with somatosensory stimulation revealed that the clinical symptoms were associated with major changes in the primary somatosensory representation...
2017: Frontiers in Neurology
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