Neuroimaging Assessment of Pain

Luo, Jianxun; Zhu, Hui-Qi; Gou, Bo; Wang, Xueqiang

doi:10.1007/s13311-022-01274-z

Cited by 14 publications

(8 citation statements)

References 211 publications

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“…When interpreted in this way, these changes in brain activation linked to clinical outcomes may be the result of less need for protective function as the condition improves. These results provide further support for the link between pain experience and these clinical outcomes, as well as highlighting the sensitivity of neuroimaging as a tool for understanding potential mechanisms that may underlie IIPT treatment programs, or for tailoring individual treatment plans [28, 35], although self-report and subjective measures remain critical [36].…”

Section: Discussionmentioning

confidence: 92%

“…The thalamus and caudate have been identified as key regions in the neural signature of physical pain that is sensitive to pharmacological-induced anesthesia [9]. The thalamus specifically has been implicated in chronic pain in adults and may be related to arousal during painful stimulation [28]. Somewhat surprisingly given the change in overall pain scores, we did not observe a change in other regions in this well-defined pain network with the treatment, such as the somatosensory cortex or insula which are also sensitive to physical pain severity [29].…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study

Lepping,

Hoffart,

Bruce

et al. 2023

Preprint

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Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth. This study examined changes in brain activation associated with experiencing physical pain, and the observation of physical and emotional pain in others, by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youth (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain. Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus). These changes support interpretation that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.PerspectiveThis study examined changes in brain response to pain in youth experiencing chronic pain participating in intensive interdisciplinary pain treatment (IIPT). The novelty in this pilot study is the longitudinal neuroimaging findings in conjunction with established, clinically relevant behavioral and self-report measures of pain.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study

Lepping,

Hoffart,

Bruce

et al. 2023

Preprint

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“…Somatization, defined as the tendency of some individuals to experience and communicate somatic distress in response to psychosocial stress, occurs frequently in patients with major depression and related disorders, perhaps explaining these effects [ 59 ]. Chronic pain is also associated with changes in brain structure and function independent of depression, detectable through human brain imaging [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Genome wide association joint analysis reveals 99 risk loci for pain susceptibility and pleiotropic relationships with psychiatric, metabolic, and immunological traits

Mocci,

Ward,

Perry

et al. 2023

PLoS Genet

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Chronic pain is at epidemic proportions in the United States, represents a significant burden on our public health system, and is coincident with a growing opioid crisis. While numerous genome-wide association studies have been reported for specific pain-related traits, many of these studies were underpowered, and the genetic relationship among these traits remains poorly understood. Here, we conducted a joint analysis of genome-wide association study summary statistics from seventeen pain susceptibility traits in the UK Biobank. This analysis revealed 99 genome-wide significant risk loci, 65 of which overlap loci identified in earlier studies. The remaining 34 loci are novel. We applied leave-one-trait-out meta-analyses to evaluate the influence of each trait on the joint analysis, which suggested that loci fall into four categories: loci associated with nearly all pain-related traits; loci primarily associated with a single trait; loci associated with multiple forms of skeletomuscular pain; and loci associated with headache-related pain. Overall, 664 genes were mapped to the 99 loci by genomic proximity, eQTLs, and chromatin interaction and ~15% of these genes showed differential expression in individuals with acute or chronic pain compared to healthy controls. Risk loci were enriched for genes involved in neurological and inflammatory pathways. Genetic correlation and two-sample Mendelian randomization indicated that psychiatric, metabolic, and immunological traits mediate some of these effects.

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“…10 Optical sensing techniques, such as near infrared spectroscopy (NIRS), are well suited to explore questions pertaining to pain since they are noninvasive, painless and can be acquired during noxious stimuli. 11 The use of such methods for objective assessment of pain has widely been explored through measurement of hemodynamic responses in various brain regions via functional NIRS. [12][13][14][15] Optical spectroscopic methods have also been widely used to monitor and assess pain in exercise science and sports medicine.…”

Section: Introductionmentioning

confidence: 99%

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Kline,

Vishwanath,

Colbrunn

et al. 2024

J. Biomed. Opt.

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Shuntodynia is patient reported pain at the site of the implanted ventriculoperitoneal (VP) shunt. Pediatric hydrocephalus requiring shunt placement is a chronic and prevalent standard of care treatment and requires lifetime management. Shuntodynia is a subjective measure of shunt dysfunction. Quantitative, white-light tissue spectroscopy could be used to objectively identify this condition in the clinic.Aim: Pediatric subjects were recruited for optical sensing during routine clinical follow-up visits, post-VP shunt implantations. Acquired optical signals were translated into skin-hemodynamic signatures and were compared between subjects that reported shuntodynia versus those that did not.Approach: Diffuse reflectance spectroscopy (DRS) measurements were collected between 450 and 700 nm using a single-channel fiber-optical probe from (N ¼ 35) patients. Multiple reflectance spectra were obtained by the attending physician from regions both proximal and distal to the VP shunt sites and from a matched contralateral site for each subject. Acquired reflectance spectra were processed quantitatively into functional tissue optical endpoints. A two-way, repeated measures analysis of variance was used to assess whether and which of the optical variables were statistically separable, across subjects with shuntodynia versus those without.Results: Analyses indicated that intrapatient differences in vascular oxygen saturation measured between shunt sites relative to that obtained at the scar or contralateral sites was significantly lower in the pain group. We also find that the total hemoglobin concentrations at the shunt site were lowest relative to the other sites for subjects reporting pain. These findings suggest that shuntodynia pain arises in the scalp tissue around the implanted shunts and may be caused due to hypoxia and inflammation.Conclusions: Optically derived hemodynamic variables were statistically significantly different in subjects presenting with shuntodynia relative to those without. DRS could provide a viable mode in routine bedside monitoring of subjects with VP shunts for clinical management and assessment of shuntodynia.

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Neuroimaging Assessment of Pain

Cited by 14 publications

References 211 publications

Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study

Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study

Genome wide association joint analysis reveals 99 risk loci for pain susceptibility and pleiotropic relationships with psychiatric, metabolic, and immunological traits

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

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