Specificity of Hemodynamic Brain Responses to Painful Stimuli: A functional near-infrared spectroscopy study

Yücel, Meryem A.; Aasted, Christopher M.; Petkov, Mihayl P.; Borsook, David; Boas, David A.; Becerra, Lino

doi:10.1038/srep09469

Cited by 116 publications

(162 citation statements)

References 45 publications

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“…The sensors over the medial sensorimotor cortex recorded the largest change in oxygenation and blood volume, but were unable to obtain adequate signal quality in enough subjects to reach statistical significance. These results agree with the processing of painful stimuli in both the sensorimotor and prefrontal cortices and correlates to observations made in other studies [3; 50]. …”

Section: Resultssupporting

confidence: 93%

Brain measures of nociception using near-infrared spectroscopy in patients undergoing routine screening colonoscopy

Becerra

Aasted

Boas

et al. 2016

Pain

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Colonoscopy is an invaluable tool for screening and diagnosis of many colonic diseases. For most colonoscopies, moderate sedation is used during the procedure. However, insufflation of the colon produces a nociceptive stimulus that is usually accompanied by facial grimacing/groaning while under sedation. The objective of the current study was to evaluate whether a nociceptive signal elicited by colonic insufflation could be measured from the brain. Seventeen otherwise healthy patients (age 54.8±9.1; 6 female) undergoing routine colonoscopy (i.e., no history of significant medical conditions) were monitored using near-infrared spectroscopy (NIRS). Moderate sedation was produced using standard clinical protocols for midazolam and meperidine, titrated to effect. NIRS data captured during the procedure was analyzed offline to evaluate the brains’ responses to nociceptive stimuli evoked by the insufflation events (defined by physician or observing patients’ facial responses). Analysis of NIRS data revealed a specific, reproducible prefrontal cortex activity corresponding to times when patients grimaced. The pattern of the activation is similar to that previously observed during nociceptive stimuli in awake healthy individuals, suggesting that this approach may be used to evaluate brain activity evoked by nociceptive stimuli under sedation, when there is incomplete analgesia. While some patients report recollection of procedural pain following the procedure, the effects of repeated nociceptive stimuli in surgical patients may contribute to postoperative changes including chronic pain. The results from this study indicate that NIRS may be a suitable technology for continuous nociceptive afferent monitoring in patients undergoing sedation and could have applications under sedation or anesthesia.

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Section: Resultssupporting

confidence: 93%

Brain measures of nociception using near-infrared spectroscopy in patients undergoing routine screening colonoscopy

Becerra

Aasted

Boas

et al. 2016

Pain

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“…This has implications for placement of probes with regard to signal detection and ease of placement in conditions such as evaluation of pain in clinical conditions (e.g., under anesthesia). We also have previously reported activation in the somatosensory cortex to nociceptive stimuli, confirming the nature of the parallel observations in the frontal lobe for the same stimulus using fNIRS [5]. …”

Section: Introductionsupporting

confidence: 88%

Frontal Lobe Hemodynamic Responses to Painful Stimulation: A Potential Brain Marker of Nociception

et al. 2016

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The purpose of this study was to use functional near-infrared spectroscopy (fNIRS) to examine patterns of both activation and deactivation that occur in the frontal lobe in response to noxious stimuli. The frontal lobe was selected because it has been shown to be activated by noxious stimuli in functional magnetic resonance imaging studies. The brain region is located behind the forehead which is devoid of hair, providing a relative ease of placement for fNIRS probes on this area of the head. Based on functional magnetic resonance imaging studies showing blood-oxygenation-level dependent changes in the frontal lobes, we evaluated functional near-infrared spectroscopy measures in response to two levels of electrical pain in awake, healthy human subjects (n = 10; male = 10). Each subject underwent two recording sessions separated by a 30-minute resting period. Data collected from 7 subjects were analyzed, containing a total of 38/36 low/high intensity pain stimuli for the first recording session and 27/31 pain stimuli for the second session. Our results show that there is a robust and significant deactivation in sections of the frontal cortices. Further development and definition of the specificity and sensitivity of the approach may provide an objective measure of nociceptive activity in the brain that can be easily applied in the surgical setting.

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“…Note that panels (c) and (d) are reproduced from our previous publication. 31 in PET-fMRI studies involving the placebo effect of migraine subjects and neuroinflammation of spinal cord injury subjects.…”

Section: Resultsmentioning

confidence: 99%

“…The results shown in this paper are obtained from the first 3 min of the electrical run to avoid any habituation effect. 31 …”

Section: Subjects and Experimental Designmentioning

confidence: 99%

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Short separation regression improves statistical significance and better localizes the hemodynamic response obtained by near-infrared spectroscopy for tasks with differing autonomic responses

et al. 2015

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Abstract. Autonomic nervous system response is known to be highly task-dependent. The sensitivity of nearinfrared spectroscopy (NIRS) measurements to superficial layers, particularly to the scalp, makes it highly susceptible to systemic physiological changes. Thus, one critical step in NIRS data processing is to remove the contribution of superficial layers to the NIRS signal and to obtain the actual brain response. This can be achieved using short separation channels that are sensitive only to the hemodynamics in the scalp. We investigated the contribution of hemodynamic fluctuations due to autonomous nervous system activation during various tasks. Our results provide clear demonstrations of the critical role of using short separation channels in NIRS measurements to disentangle differing autonomic responses from the brain activation signal of interest.

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Specificity of Hemodynamic Brain Responses to Painful Stimuli: A functional near-infrared spectroscopy study

Cited by 116 publications

References 45 publications

Brain measures of nociception using near-infrared spectroscopy in patients undergoing routine screening colonoscopy

Brain measures of nociception using near-infrared spectroscopy in patients undergoing routine screening colonoscopy

Frontal Lobe Hemodynamic Responses to Painful Stimulation: A Potential Brain Marker of Nociception

Short separation regression improves statistical significance and better localizes the hemodynamic response obtained by near-infrared spectroscopy for tasks with differing autonomic responses

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