Implications of the putamen in pain and motor deficits in complex regional pain syndrome

Azqueta‐Gavaldon, Monica; Youssef, Andrew M.; Storz, Claudia; Lemme, Jordan; Schulte-Göcking, Heike; Becerra, Lino; Azad, Shahnaz Christina; Reiners, A.; Ertl‐Wagner, Birgit; Borsook, David; Upadhyay, Jaymin; Kraft, Eduard

doi:10.1097/j.pain.0000000000001745

Cited by 39 publications

(45 citation statements)

References 90 publications

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“…In addition, one notable aspect revealed by this study is that the SMN subregions could be influenced by abnormal inputs from or outputs to the putamen, a component of the striatum. Literature has shown that the striatum affects the neuronal pathways underlying the inhibition effect of nociceptive stimulation [36]. These effects are mediated by the striatal dopamine D2 receptors which are associated with pain inhibitory circuitry of the caudal trigeminal nucleus [37].…”

Section: Discussionmentioning

confidence: 99%

Impaired effective functional connectivity of the sensorimotor network in interictal episodic migraineurs without aura

Wei

Chen

et al. 2020

J Headache Pain

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Background Resting-state functional magnetic resonance imaging (Rs-fMRI) has confirmed sensorimotor network (SMN) dysfunction in migraine without aura (MwoA). However, the underlying mechanisms of SMN effective functional connectivity in MwoA remain unclear. We aimed to explore the association between clinical characteristics and effective functional connectivity in SMN, in interictal patients who have MwoA. Methods We used Rs-fMRI to acquire imaging data in 40 episodic patients with MwoA in the interictal phase and 34 healthy controls (HCs). Independent component analysis was used to profile the distribution of SMN and calculate the different SMN activity between the two groups. Subsequently, Granger causality analysis was used to analyze the effective functional connectivity between the SMN and other brain regions. Results Compared to the HCs, MwoA patients showed higher activity in the bilateral postcentral gyri (PoCG), but lower activity in the left midcingulate cortex (MCC). Moreover, MwoA patients showed decreased effective functional connectivity from the SMN to left middle temporal gyrus, right putamen, left insula and bilateral precuneus, but increased effective functional connectivity to the right paracentral lobule. There was also significant effective functional connectivity from the primary visual cortex, right cuneus and right putamen to the SMN. In the interictal period, there was positive correlation between the activity of the right PoCG and the frequency of headache. The disease duration was positively correlated with abnormal effective functional connectivity from the left PoCG to right precuneus. In addition, the headache impact scores were negatively correlated with abnormal effective functional connectivity from the left MCC to right paracentral lobule, as well as from the right precuneus to left PoCG. Conclusions These differential, resting-state functional activities of the SMN in episodic MwoA may contribute to the understanding of migraine-related intra- and internetwork imbalances associated with nociceptive regulation and chronification.

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Section: Discussionmentioning

confidence: 99%

Impaired effective functional connectivity of the sensorimotor network in interictal episodic migraineurs without aura

Wei

Chen

et al. 2020

J Headache Pain

View full text Add to dashboard Cite

show abstract

“…In addition, one notable aspect revealed by this study is that the SMN subregions could be in uenced by abnormal inputs from or outputs to the putamen, a component of the striatum. Literature has shown that the striatum affects the neuronal pathways underlying the inhibition effect of nociceptive stimulation [36]. These effects are mediated by the striatal dopamine D2 receptors which are associated with pain inhibitory circuitry of the caudal trigeminal nucleus [37].…”

Section: Discussionmentioning

confidence: 99%

Impaired Effective Functional Connectivity of the Sensorimotor Network in Interictal Episodic Migraineurs Without Aura

Wei

Chen

Chen³

et al. 2020

Preprint

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Abstract Background: Resting-state functional magnetic resonance imaging (Rs-fMRI) has confirmed sensorimotor network (SMN) dysfunction in migraine without aura (MwoA). However, the underlying mechanisms of SMN causal functional connectivity in MwoA remain unclear. We aimed to explore the association between clinical characteristics and effective functional connectivity in SMN, in interictal patients who have MwoA.Methods: We used Rs-fMRI to acquire imaging data in forty episodic patients with MwoA in the interictal phase and thirty-four healthy controls (HCs). Independent component analysis was used to profile the distribution of SMN and calculate the different SMN activity between the two groups. Subsequently, Granger causality analysis was used to analyze the effective causal connectivity between the SMN and other brain regions.Results: Compared to the HCs, MwoA patients showed higher activity in the bilateral postcentral gyri (PoCG) and supplementary motor areas, but lower activity in left Rolandic operculum/insula. Moreover, MwoA patients showed significantly causal connectivity from the SMN to the left calcarine sulcus, left middle temporal gyrus, right angular gyrus and right precuneus. There was also significant causal connectivity from the left calcarine sulcus, left inferior orbitofrontal cortex, right cuneus, right putamen and left inferior parietal lobule to the SMN. In the interictal period, there was positive correlation between the activity of the left PoCG and headache frequency (r = 0.410, p = 0.013), but negative correlation between the activity of the right PoCG and the impact of headache (r = -0.397, p = 0.016). In addition, the disease duration was directly proportional to the connectivity strength from the left PoCG to the right angular gyrus (r = 0.418, p = 0.011), and from the right PoCG to the left calcarine sulcus (r = 0.377, p = 0.023).Conclusions: These differential, resting-state functional activities of the SMN in episodic MwoA may contribute to the understanding of migraine-related intra- and internetwork imbalances associated with nociceptive regulation and chronification.

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“…A recent MRI-study showed a bilateral decrease in gray matter density in the putamen of CRPS patients. Additionally higher levels of pain and motor impairment were associated with an increased functional connectivity between the putamen and the pre−/postcentral gyri [4]. Based on these results there was evidence of a pathophysiological involvement of the basal ganglia for the development of clinical motor symptoms in CRPS.…”

Section: Case Reportmentioning

confidence: 71%

Diagnosis and therapy of functional tremor a systematic review illustrated by a case report

Bartl

Kewitsch

Hallett

et al. 2020

Neurol. Res. Pract.

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Background Diagnosis of functional movement disorders and specifically functional tremor (FT) (representing 50% of them) remains demanding. Additionally, due to heterogeneity of the disorders, structured concepts and guidelines for diagnosis and therapy are difficult to establish. Ascertaining the state of knowledge to derive instructions for operating procedures is the aim of this review. Main text Based on a standardized systematic literature research using the term “psychogenic tremor” in the MEDLINE database dating back ten years, 76 studies were evaluated. Conventional features of FT are variability of frequency and amplitude. Further, response to distraction by motor and cognitive tasks is a key diagnostic feature in differentiation between organic and functional origin. A variety of electrophysiological tests have been evaluated including surface electromyography and accelerometry to establish laboratory-supported criteria for diagnosing tremor. Also, finger tapping tests have been used to identify FT, showing positive potential as supplementary evidence. Imaging studies in general are mostly underpowered and imaging cannot be used on an individual basis. Therapeutic studies in FT often have a diagnostic component. Cognitive behavioral therapy should be the preferred psychological treatment independent of additional psychiatric symptoms. Other psychotherapeutic methods show lack of evidence concerning FT. Relaxation techniques and physiotherapy are an important additional feature, especially in children and adolescents. In regard to drug therapy, randomized and blinded trials are not available. A significant decrease in rating scales could be detected after active, not sham repetitive transcranial magnetic stimulation with a long-lasting effect. Also root magnetic stimulation seems to be effective. The clinical feature of tremor entrainment in FT can be used in combination with biofeedback as so-called tremor retrainment, using self-modulation of frequency and severity, to bring the movements under volitional control. Conclusion Diagnosis and treatment of FT is challenging and should include a combination of intensive clinical examination and targeted addition of standardized testing, especially electrophysiological methods. Often therapeutic effects have a diagnostic component. A multimodal strategy, considering psychological factors as a potential origin as well as maintaining effects seems to be most effective.

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Implications of the putamen in pain and motor deficits in complex regional pain syndrome

Cited by 39 publications

References 90 publications

Impaired effective functional connectivity of the sensorimotor network in interictal episodic migraineurs without aura

Impaired effective functional connectivity of the sensorimotor network in interictal episodic migraineurs without aura

Impaired Effective Functional Connectivity of the Sensorimotor Network in Interictal Episodic Migraineurs Without Aura

Diagnosis and therapy of functional tremor a systematic review illustrated by a case report

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