Corticostriatal circuits in the transition to chronic back pain: The predictive role of reward learning

Löffler, Martin; Levine, Seth M.; Usai, Katrin; Desch, Simon; Kandić, Mina; Nees, Frauke; Flor, Herta

doi:10.1016/j.xcrm.2022.100677

Cited by 17 publications

(19 citation statements)

References 83 publications

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“…The data may have clinical implications. Reward learning has recently been shown to play a role in the transition of acute to chronic pain with a specific pattern of Nucleus accumbens activity in response to a cue predicting pain relief being predictive for chronification ( Löffler et al, 2022 ). This makes pain relief processing a potential leverage point for prevention strategies.…”

Section: Discussionmentioning

confidence: 99%

Evidence for dopaminergic involvement in endogenous modulation of pain relief

Desch

Schweinhardt

Seymour

et al. 2023

eLife

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Relief of ongoing pain is a potent motivator of behavior, directing actions to escape from or reduce potentially harmful stimuli. Whereas endogenous modulation of pain events is well characterized, relatively little is known about the modulation of pain relief and its corresponding neurochemical basis. Here we studied pain modulation during a probabilistic relief-seeking task (a 'wheel of fortune' gambling task), in which people actively or passively received reduction of a tonic thermal pain stimulus. We found that relief perception was enhanced by active decisions and unpredictability, and greater in high novelty-seeking trait individuals, consistent with a model in which relief is tuned by its informational content. We then probed the roles of dopaminergic and opioidergic signaling, both of which are implicated in relief processing, by embedding the task in a double-blinded cross-over design with administration of the dopamine precursor levodopa and the opioid receptor antagonist naltrexone. We found that levodopa enhanced each of these information-specific aspects of relief modulation but no significant effects of the opioidergic manipulation. These results show that dopaminergic signaling has a key role in modulating the perception of pain relief to optimize motivation and behavior.

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Section: Discussionmentioning

confidence: 99%

Evidence for dopaminergic involvement in endogenous modulation of pain relief

Desch

Schweinhardt

Seymour

et al. 2023

eLife

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“…Recent data confirms and emphasizes the importance of such functional networks. For example, it has been proposed that alterations in functional connectivity, specifically between the nucleus accumbens and the ventromedial prefrontal cortex, predict whether people with subacute back pain develop chronic pain (Baliki et al, 2012;Löffler et al, 2022). It is worth mentioning that functional connectivity is a type of analysis that is not restricted to fMRI data.…”

Section: Brain Imagingmentioning

confidence: 99%

Measuring pain and nociception: Through the glasses of a computational scientist. Transdisciplinary overview of methods

Kutafina

Becker²,

Namer³

2023

Front. Netw. Physiol.

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In a healthy state, pain plays an important role in natural biofeedback loops and helps to detect and prevent potentially harmful stimuli and situations. However, pain can become chronic and as such a pathological condition, losing its informative and adaptive function. Efficient pain treatment remains a largely unmet clinical need. One promising route to improve the characterization of pain, and with that the potential for more effective pain therapies, is the integration of different data modalities through cutting edge computational methods. Using these methods, multiscale, complex, and network models of pain signaling can be created and utilized for the benefit of patients. Such models require collaborative work of experts from different research domains such as medicine, biology, physiology, psychology as well as mathematics and data science. Efficient work of collaborative teams requires developing of a common language and common level of understanding as a prerequisite. One of ways to meet this need is to provide easy to comprehend overviews of certain topics within the pain research domain. Here, we propose such an overview on the topic of pain assessment in humans for computational researchers. Quantifications related to pain are necessary for building computational models. However, as defined by the International Association of the Study of Pain (IASP), pain is a sensory and emotional experience and thus, it cannot be measured and quantified objectively. This results in a need for clear distinctions between nociception, pain and correlates of pain. Therefore, here we review methods to assess pain as a percept and nociception as a biological basis for this percept in humans, with the goal of creating a roadmap of modelling options.

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“…In this issue of Cell Reports Medicine , using fMRI, Löffler et al. 1 demonstrate that different operant learning-related neural responses in the vmPFC-NAc pathway predict the transition from subacute back pain (SABP) to chronic back pain (CBP) and the maintenance of CBP ( Figure 1 ). They followed 50 SABP patients for 6 months and enrolled 29 CBP patients and 29 healthy individuals.…”

Section: Main Textmentioning

confidence: 99%

“…Treating and preventing chronic pain require our understanding of how it develops and maintains. Lo ¨ffler et al ( 2022) 1 demonstrate that distinct operant learning signals in the vmPFC-NAc pathway predict the development and maintenance of chronic back pain.…”

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confidence: 99%