Approximation to pain‐signaling network in humans by means of migraine

Hosp, Jonas A.; Reisert, Marco; Kageneck, Charlotte von; Rijntjes, Michel; Weiller, Cornelius

doi:10.1002/hbm.25261

Cited by 7 publications

(5 citation statements)

References 76 publications

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“…In recent years, a growing number of brain imaging studies have provided important insights into the brain mechanisms underlying migraine. Migraine appears to be a specific model that is involved in the network and underlying mechanisms of brain processing of pain signals, while being associated with sensory, emotional, autonomic and cognitive ( 41 , 42 ). For example, abnormalities in pain regulation in brain regions such as hypothalamus, brainstem, periaqueductal gray, and raphe magnus ( 43 , 44 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of acupuncture on the modulation of functional brain regions in migraine: A meta-analysis of fMRI studies

Huang²,

Yao³

et al. 2023

Front. Neurol.

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BackgroundAcupuncture, a traditional Chinese medicine therapy, is an effective migraine treatment, especially in improving pain. In recent years, many acupuncture brain imaging studies have found significant changes in brain function following acupuncture treatment of migraine, providing a new perspective to elucidate the mechanism of action of acupuncture.ObjectiveTo analyse and summarize the effects of acupuncture on the modulation of specific patterns of brain region activity changes in migraine patients, thus providing a mechanism for treating migraine by acupuncture.MethodsChinese and English articles published up to May 2022 were searched in three English databases (PubMed, Embase and Cochrane) and four Chinese databases (China national knowledge infrastructure, CNKI; Chinese Biomedical Literature database, CBM; the Chongqing VIP database, VIP; and the Wanfang database, WF). A neuroimaging meta-analysis on ALFF, ReHo was performed on the included studies using Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software. Subgroup analyses were used to compare differences in brain regions between acupuncture and other groups. Meta-regression was used to explore the effect of demographic information and migraine alterations on brain imaging outcomes. Linear models were drawn using MATLAB 2018a, and visual graphs for quality evaluation were produced using R and RStudio software.ResultsA total of 7 studies comprising 236 patients in the treatment group and 173 in the control group were included in the meta-analysis. The results suggest that acupuncture treatment helps to improve pain symptoms in patients with migraine. The left angular gyrus is hyperactivation, and the left superior frontal gyrus and the right superior frontal gyrus are hypoactivated. The migraine group showed hyperactivation in the corpus callosum compared to healthy controls.ConclusionAcupuncture can significantly regulate changes in brain regions in migraine patients. However, due to the experimental design of neuroimaging standards are not uniform, the results also have some bias. Therefore, to better understand the potential mechanism of acupuncture on migraine, a large sample, multicenter controlled trial is needed for further study. In addition, the application of machine learning methods in neuroimaging studies could help predict the efficacy of acupuncture and screen migraine patients suitable for acupuncture treatment.

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Section: Discussionmentioning

confidence: 99%

Effect of acupuncture on the modulation of functional brain regions in migraine: A meta-analysis of fMRI studies

Huang²,

Yao³

et al. 2023

Front. Neurol.

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“…It is anatomically divided into a "cognitive" (anterior) insula, receiving input from the anterior cingulate cortex, and a "sensorimotor" (posterior) insula, receiving input from somatosensory cortices. Nociceptive input is initially processed in the posterior insula based on pain intensity and location before being relayed to the anterior insula for emotional mediation [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The insula is intricately connected to modulatory brainstem centers through the tracts of the central sulcus, namely the insular cortex to locus coeruleus and insular cortex to subthalamic nucleus tracts. Since neither of these tracts exhibits connections to the thalamus, it is improbable that they serve as conduits for pain-related signals [ 8 ]. Instead, they are more likely to represent a secondary descending system, complementing the well-established dorsal pathway that is subject to regulation by pre- and orbito-frontal cortical regions.…”

Section: Introductionmentioning

confidence: 99%

“…This aligns with the hypothesis of "top-down" modulation driven by the anterior insula under the control of the anterior cingulate cortex. While rodent models suggest an anterior origin for these connections, in humans, they originate from the posterior insula, implying a potential link between descending insula-driven pain modulation and objective pain intensity [ 8 ]. Experimental validation of this hypothesis is required.…”

Section: Introductionmentioning

confidence: 99%

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The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review

McBenedict,

Petrus,

Pires

et al. 2024

Cureus

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Chronic pain affects a substantial portion of the global population, significantly impacting quality of life and well-being. This condition involves complex mechanisms, including dysfunction of the autonomic nervous system, which plays a crucial role in pain perception. The insula, a key brain region involved in pain processing, plays a critical role in pain perception and modulation. Lesions in the insula can result in pain asymbolia, where pain perception remains intact but emotional responses are inappropriate. The insula is anatomically and functionally divided into anterior and posterior regions, with the posterior insula processing nociceptive input based on intensity and location before relaying it to the anterior insula for emotional mediation. Understanding the insula's intricate role in pain processing is crucial, as it is involved in encoding prediction errors and mediating emotional dimensions of pain perception. The focus of this review was on synthesizing existing literature on the role of the insula in chronic pain and associated structural changes. The goal was to integrate findings from various sources to provide a comprehensive overview of the topic. The search strategy included a combination of Medical Subject Headings (MeSH) and relevant keywords related to insula and chronic pain. The following databases were surveyed: PubMed, Embase, Scopus, and Web of Science. We identified a total of 2515 articles, and after following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline based on eligibility criteria, 46 articles were used to synthesize this review. Our study highlights the pivotal role of the insula in chronic pain processing and associated structural changes, integrating findings from diverse studies and neuroimaging investigations. Beyond mere pain sensation, the insula contributes to emotional awareness, attention, and salience detection within the pain network. Various chronic pain conditions reveal alterations in insular activity and connectivity, accompanied by changes in gray matter volume and neurochemical profiles. Interventions targeting the insula show promise in alleviating chronic pain symptoms. However, further research is needed to understand underlying mechanisms, which can aid in developing more effective therapeutic interventions for pain.

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“…Moreover, an increase in free interstitial fluid resulting from the loss of axons and cell bodies leads to an elevated “V-CSF” 13 . In contrast to NODDI, DMI is not constrained to hard a priori assumptions and therefore more suited to the assessment of pathologically altered microstructure 12 , where it has already been successfully applied in clinical research 14 – 16 .…”

Section: Introductionmentioning

confidence: 99%

Disentangling nigral and putaminal contribution to motor impairment and levodopa response in Parkinson’s disease

Schröter

Rijntjes

Urbach

et al. 2022

npj Parkinsons Dis.

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The extent to which the degeneration of the substantia nigra (SN) and putamen each contribute to motor impairment in Parkinson’s disease (PD) is unclear, as they are usually investigated using different imaging modalities. To examine the pathophysiological significance of the SN and putamen in both motor impairment and the levodopa response in PD using diffusion microstructure imaging (DMI). In this monocentric retrospective cross-sectional study, DMI parameters from 108 patients with PD and 35 healthy controls (HC) were analyzed using a voxel- and region-based approach. Linear models were applied to investigate the association between individual DMI parameters and Movement Disorder Society Unified Parkinson’s Disease Rating Scale-Part 3 performance in ON- and OFF-states, as well as the levodopa response, controlling for age and sex. Voxel- and region-based group comparisons of DMI parameters between PD and HC revealed significant differences in the SN and putamen. In PD, a poorer MDS-UPDRS-III performance in the ON-state was associated with increased free fluid in the SN (b-weight = 65.79, p = 0.004) and putamen (b-weight = 86.00, p = 0.006), and contrariwise with the demise of cells in both structures. The levodopa response was inversely associated with free fluid both in the SN (b-weight = −83.61, p = 0.009) and putamen (b-weight = −176.56, p < 0.001). Interestingly, when the two structures were assessed together, the integrity of the putamen, but not the SN, served as a predictor for the levodopa response (b-weight = −158.03, p < 0.001). Structural alterations in the SN and putamen can be measured by diffusion microstructure imaging in PD. They are associated with poorer motor performance in the ON-state, as well as a reduced response to levodopa. While both nigral and putaminal integrity are required for good performance in the ON-state, it is putaminal integrity alone that determines the levodopa response. Therefore, the structural integrity of the putamen is crucial for the improvement of motor symptoms to dopaminergic medication, and might therefore serve as a promising biomarker for motor staging.

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Approximation to pain‐signaling network in humans by means of migraine

Cited by 7 publications

References 76 publications

Effect of acupuncture on the modulation of functional brain regions in migraine: A meta-analysis of fMRI studies

Effect of acupuncture on the modulation of functional brain regions in migraine: A meta-analysis of fMRI studies

The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review

Disentangling nigral and putaminal contribution to motor impairment and levodopa response in Parkinson’s disease

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