Cerebellar Transcranial Direct Current Stimulation (ctDCS) Ameliorates Phantom Limb Pain and Non-painful Phantom Limb Sensations

Bocci, Tommaso; Carolis, Giuliano De; Ferrucci, Roberta; Paroli, Mery; Mansani, F.; Priori, Alberto; Valeriani, Massimiliano; Sartucci, Ferdinando

doi:10.1007/s12311-019-01020-w

Cited by 37 publications

(32 citation statements)

References 61 publications

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“…In recent years, mounting evidence has shown that the cerebellum is not only involved in motor and coordinative functions, but is also involved in emotion, cognition, learning [30,31]. In addition, cerebellum has been demonstrated to respond to noxious stimuli and involve pain processing [31][32][33][34], but the specific function of cerebellum during pain processing and its role in pain disorder is not clear. In migraine, cerebellar activation was demonstrated not only in trigeminal nociception but also during a migraine episode [35,36].…”

Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee²,

Chou³

et al. 2020

J Headache Pain

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Background: The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10-30 headache days/month). Methods: We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity. Results: Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008). Conclusions: Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.

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Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee²,

Chou³

et al. 2020

J Headache Pain

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show abstract

“…ISCI-P patients revealed increased FC in the cerebellum posterior lobe, including right cerebellum VIIb and VIII compared with ISCI-N when the seed sites were located in left PI. Accumulating clinical evidences have demonstrated that the cerebellum played a crucial role in pain perception and modulation in humans [45,46]. The cerebellum participates in the regulation of pain mainly through three aspects: first, the cerebellum has a wealth of connections with the dorsolateral prefrontal cortex (DLPFC) [47,48], the brainstem and periaqueductal [49], and these regions are involved in descending pain modulatory pathways [50].…”

Section: Altered Functional Connectivity Of Insulamentioning

confidence: 99%

The Reorganization of Insular Subregions in Individuals with Below-Level Neuropathic Pain following Incomplete Spinal Cord Injury

Chen

et al. 2020

Neural Plasticity

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Objective. To investigate the reorganization of insular subregions in individuals suffering from neuropathic pain (NP) after incomplete spinal cord injury (ISCI) and further to disclose the underlying mechanism of NP. Method. The 3D high-resolution T1-weighted structural images and resting-state functional magnetic resonance imaging (rs-fMRI) of all individuals were obtained using a 3.0 Tesla MRI system. A comparative analysis of structure and function connectivity (FC) with insular subareas as seeds in 10 ISCI individuals with below-level NP (ISCI-P), 11 ISCI individuals without NP (ISCI-N), and 25 healthy controls (HCs) was conducted. Associations between the structural and functional alteration of insula subregions and visual analog scale (VAS) scores were analyzed using the Pearson correlation in SPSS 20. Results. Compared with ISCI-N patients, when the left posterior insula as the seed, ISCI-P showed increased FC in right cerebellum VIIb and cerebellum VIII, Brodmann 37 (BA 37). When the left ventral anterior insula as the seed, ISCI-P indicated enhanced FC in right BA18 compared with ISCI-N patients. These increased FCs positively correlated with VAS scores. Relative to HCs, ISCI-P presented increased FC in the left hippocampus when the left dorsal anterior insula was determined as the seed. There was no statistical difference in the volume of insula subregions among the three groups. Conclusion. Our study indicated that distinctive patterns of FC in each subregion of insula suggest that the insular subareas participate in the NP processing through different FC following ISCI. Further, insula subregions could serve as a therapeutic target for NP following ISCI.

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“…In recent years, mounting evidence has shown that the cerebellum is not only involved in motor and coordinative functions, but is also involved in emotion, cognition, learning [30,31]. In addition, cerebellum has been demonstrated to respond to noxious stimuli and involve pain processing [31,32,33,34], but the specific function of cerebellum during pain processing and its role in pain disorder is not clear. In migraine, cerebellar activation was demonstrated not only in trigeminal nociception but also during a migraine episode [35,36].…”

Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee

Chou

et al. 2020

Preprint

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Background: The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10–30 headache days/month). Methods: We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥ 50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity. Results: Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008). Conclusions: Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.

show abstract

Cerebellar Transcranial Direct Current Stimulation (ctDCS) Ameliorates Phantom Limb Pain and Non-painful Phantom Limb Sensations

Cited by 37 publications

References 61 publications

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

The Reorganization of Insular Subregions in Individuals with Below-Level Neuropathic Pain following Incomplete Spinal Cord Injury

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

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