Predictive mechanisms linking brain opioids to chronic pain vulnerability and resilience

Jones, Anthony; Brown, Christopher

doi:10.1111/bph.13840

Cited by 13 publications

(13 citation statements)

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“…Chronic pain is associated with changes in brain structure and function (17)(18)(19) and increased activity in brain regions involved in emotional processing of pain (20).…”

Section: A Target Of Considerable Interest For the Development Of Novmentioning

confidence: 99%

Acceptability and usability of smartphone-based brainwave entrainment technology used by individuals with chronic pain in a home setting

Locke

Brooks

Arendsen

et al. 2020

British Journal of Pain

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Background: Brainwave entrainment (BWE) using rhythmic visual or auditory stimulation has many potential clinical applications, including the management of chronic pain, where there is a pressing need for novel, safe and effective treatments. The aim of this study was to gain qualitative feedback on the acceptability and usability of a novel BWE smartphone application, to ensure it meets the needs and wishes of end users. Methods: Fifteen participants with chronic pain used the application at home for 4 weeks. Semi-structured telephone interviews were then carried out. A template analysis approach was used to interpret the findings, with an initial coding template structured around the constructs of a theoretical framework for assessing acceptability of healthcare interventions. Structured data analysis generated a final modified coding structure, capturing themes generated across participants’ accounts. Results: The four main themes were ‘approach to trying out the app: affective attitude and ethicality’, ‘perceived effectiveness’, ‘opportunity costs and burden’ and ‘intervention coherence and self-efficacy’. All participants were willing to engage with the technology and welcomed it as an alternative approach to medications. Participants appreciated the simplicity of design and the ability to choose between visual or auditory stimulation. All the participants felt confident in using the application. Conclusion: The findings demonstrate preliminary support for the acceptability and usability of the BWE application. This is the first qualitative study of BWE to systematically assess these issues.

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“…Chronic pain is associated with changes in brain structure and function (17)(18)(19) and increased activity in brain regions involved in emotional processing of pain (20).…”

Section: A Target Of Considerable Interest For the Development Of Novmentioning

confidence: 99%

Acceptability and usability of smartphone-based brainwave entrainment technology used by individuals with chronic pain in a home setting

Locke

Brooks

Arendsen

et al. 2020

British Journal of Pain

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“…Despite the indisputable evidence regarding the contribution of the opioid system to pain modulation, some studies have also suggested that the activity of opioid receptors is more associated with the learning prediction over time rather than the painful outcome [ 54 ]. Moreover, the role of the opioid system in inhibition of fear acquisition has been previously reported by one study that showed the administration of the MOR antagonist naloxone in healthy subjects increases fear acquisition and changes activation profile in the amygdala [ 52 ].…”

Section: Changes In the Endogenous Modulatory Systems Functioning mentioning

confidence: 99%

“…Bidirectional modulation of the ventral striatum is important to reduce or increase nociception, which depends on opioidergic connections from the ACC. Remarkably, it has also been reported that the connectivity between ventral striatum and PFC predicts the prognosis of chronic pain [ 59 ], and (4) all cortical inputs converge to the PAG-RVM-spinal cord, which facilitates or inhibits nociception [ 46 , 54 ]. However, there are still many questions that must be addressed regarding the mechanisms of opioid-induced analgesia, especially in patients with chronic pain syndromes, which have started to be exposed in the last 20 years.…”

Section: Changes In the Endogenous Modulatory Systems Functioning mentioning

confidence: 99%

The Contribution of Endogenous Modulatory Systems to TMS- and tDCS-Induced Analgesia: Evidence from PET Studies

DosSantos

Oliveira

Ferreira

et al. 2018

Pain Research and Management

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Chronic pain is an important public health issue. Moreover, its adequate management is still considered a major clinical problem, mainly due to its incredible complexity and still poorly understood pathophysiology. Recent scientific evidence coming from neuroimaging research, particularly functional magnetic resonance (fMRI) and positron emission tomography (PET) studies, indicates that chronic pain is associated with structural and functional changes in several brain structures that integrate antinociceptive pathways and endogenous modulatory systems. Furthermore, the last two decades have witnessed a huge increase in the number of studies evaluating the clinical effects of noninvasive neuromodulatory methods, especially transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which have been proved to effectively modulate the cortical excitability, resulting in satisfactory analgesic effects with minimal adverse events. Nevertheless, the precise neuromechanisms whereby such methods provide pain control are still largely unexplored. Recent studies have brought valuable information regarding the recruitment of different modulatory systems and related neurotransmitters, including glutamate, dopamine, and endogenous opioids. However, the specific neurocircuits involved in the analgesia produced by those therapies have not been fully elucidated. This review focuses on the current literature correlating the clinical effects of noninvasive methods of brain stimulation to the changes in the activity of endogenous modulatory systems.

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“…Pain expectations can be experimentally manipulated through administration of a sham analgesic using a number experimental placebo procedures (Morton, Brown, Watson, El-Deredy, & Jones, 2010b; Wager, 2004; Watson et al, 2009a) or by eliciting cue-evoked expectations and testing the resultant pain report (Atlas, Bolger, Lindquist, & Wager, 2010; Brown, Seymour, Boyle, El-Deredy, & Jones, 2008a). The modulation of pain by expectation has received a significant amount of attention, which is reflected in recent meta-analyses and reviews (Amanzio, Benedetti, Porro, Palermo, & Cauda, 2013; Atlas & Wager, 2012; Brown et al, 2011; Finniss, Kaptchuk, Miller, & Benedetti, 2010; Jones & Brown, 2017; Petersen et al, 2014; Price, Finniss, & Benedetti, 2008). Expectations also change pain-related neural activity (Wager et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

A comparison between the neural correlates of laser and electric pain stimulation and their modulation by expectation

Hird¹,

Talmi²,

Jones³

et al. 2017

Preprint

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BackgroundPain is modulated by expectation. Event-related potential (ERP) studies of the influence of expectation on pain typically utilise laser heat stimulation to provide a controllable nociceptive-specific stimulus. Short painful electric stimulation has a number of practical advantages, but is less nociceptive-specific. We compared the modulation of electric versus laser-evoked pain by expectation, and their corresponding pain-evoked and anticipatory ERPs.New MethodWe developed understanding of recognised methods of laser and electric stimulation. We tested whether pain perception and neural activity induced by electric stimulation was modulated by expectation, whether this expectation elicited anticipatory neural correlates, and how these measures compared to those associated with laser stimulation. We elicited cue-evoked expectations of high and low pain and compared subjective ratings and corresponding ERPs in response to the delivery of laser and electric stimulation in a within-participant design.ResultsDespite sensory and affective differences between laser and electric pain, intensity ratings and pain-evoked potentials were modulated equivalently by expectation, though ERPs only correlated with pain ratings in the laser pain condition. Anticipatory correlates significantly differentiated pain intensity expectation to laser but not electric pain.Comparison with Existing MethodPrevious studies have consistently shown that laser-evoked potentials are modulated by expectation. We extend this by showing electric pain-evoked potentials are equally modulated by expectation, within the same participants. We also show a difference between the pain types in anticipation.ConclusionsThough laser-evoked potentials express a stronger relationship with pain perception, both laser and electric stimulation may be used to study the modulation of pain-evoked potentials by expectation. Anticipatory-evoked potentials are elicited by both pain types, but they may reflect different processes and did not correlate with pain perception.

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Predictive mechanisms linking brain opioids to chronic pain vulnerability and resilience

Abstract: This article is part of a themed section on Emerging Areas of Opioid Pharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.14/issuetoc.

Cited by 13 publications

References 131 publications

Acceptability and usability of smartphone-based brainwave entrainment technology used by individuals with chronic pain in a home setting

Acceptability and usability of smartphone-based brainwave entrainment technology used by individuals with chronic pain in a home setting

The Contribution of Endogenous Modulatory Systems to TMS- and tDCS-Induced Analgesia: Evidence from PET Studies

A comparison between the neural correlates of laser and electric pain stimulation and their modulation by expectation

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