The Role of the Insular Cortex in Pain

Labrakakis, Charalampos

doi:10.3390/ijms24065736

Cited by 61 publications

(25 citation statements)

References 129 publications

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“…The posterior insula contributes to the sensory discriminative pain dimension (Lu et al, 2016), which aligns with findings showing posterior insula lesions induced long-term allodynia (innocuous stimulus-evoked pain) relief in rats (Benison et al, 2011). Conversely, the anterior insula is implicated in the affective motivational aspect, enabling improved emotional awareness of pain (Labrakakis, 2023;Lu et al, 2016).…”

Section: Discussionsupporting

confidence: 81%

“…The posterior insula contributes to the sensory discriminative pain dimension (Lu et al., 2016), which aligns with findings showing posterior insula lesions induced long‐term allodynia (innocuous stimulus‐evoked pain) relief in rats (Benison et al., 2011). Conversely, the anterior insula is implicated in the affective motivational aspect, enabling improved emotional awareness of pain (Labrakakis, 2023; Lu et al., 2016). Given the insula's structural and functional alterations in TTH and established sensory/affective pain processing roles, it may be a key region in TTH pathophysiology warranting consideration in future studies.…”

Section: Discussionmentioning

confidence: 99%

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Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

Parsaei,

Taebi,

Arvin

et al. 2024

J of Neuroscience Research

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Tension‐type headache (TTH) stands as the most prevalent form of headache, yet an adequate understanding of its underlying mechanisms remains elusive. This article endeavors to comprehensively review structural and functional magnetic resonance imaging (MRI) studies investigating TTH patients, to gain valuable insights into the pathophysiology of TTH, and to explore new avenues for enhanced treatment strategies. We conducted a systematic search to identify relevant articles examining brain MRI disparities between TTH individuals and headache‐free controls (HFC). Fourteen studies, encompassing 312 diagnosed TTH patients, were selected for inclusion. Among these, eight studies utilized conventional MRI, one employed diffusion tensor imaging, and five implemented various functional MRI modalities. Consistent findings across these studies revealed a notable increase in white matter hyperintensity (WMH) in TTH patients. Furthermore, the potential involvement of the specific brain areas recognized to be involved in different dimensions of pain perception including cortical regions (anterior and posterior cingulate cortex, prefrontal cortex, anterior and posterior insular cortex), subcortical regions (thalamus, caudate, putamen, and parahippocampus), cerebellum in TTH pathogenesis was identified. However, no significant association was established between TTH and intracranial abnormalities or total intracranial volume. In conclusion, these findings support the hypotheses regarding the role of central mechanisms in TTH pathophysiology and offer probable brain regions implicated in these mechanisms. Due to the scarce data on the precise role of these regions in the TTH, further preclinical and clinical investigations should be done to advance our knowledge and enhance targeted therapeutic options of TTH.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

Parsaei,

Taebi,

Arvin

et al. 2024

J of Neuroscience Research

View full text Add to dashboard Cite

show abstract

“…Functional changes in the anterior cingulate cortex [65] and insular cortex [66] are shown to facilitate nociception. Both areas could regulate neural activities in the rostral ventromedial medulla [28,29] and Vc [30,67] regions via direct or indirect descending inputs.…”

Section: Discussionmentioning

confidence: 99%

Effects of stress contagion on anxiogenic‐ and orofacial inflammatory pain‐like behaviors with brain activation in mice

Piriyaprasath

Hasegawa

Kakihara

et al. 2023

European J Oral Sciences

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The conditions of stress contagion are induced in bystanders without direct experiences of stressful events. This study determined the effects of stress contagion on masseter muscle nociception in mice. Stress contagion was developed in the bystanders after cohabitating with a conspecific mouse subjected to social defeat stress for 10 days. On Day 11, stress contagion increased anxiety-and orofacial inflammatory pain-like behaviors. The c-Fos and FosB immunoreactivities evoked by masseter muscle stimulation were increased in the upper cervical spinal cord, while c-Fos expressions were increased in the rostral ventromedial medulla, including the lateral paragigantocellular reticular nucleus and nucleus raphe magnus in stress contagion mice. The level of serotonin in the rostral ventromedial medulla was increased under stress contagion, while the number of serotonin positive cells was increased in the lateral paragigantocellular reticular nucleus. Stress contagion increased c-Fos and FosB expressions in the anterior cingulate cortex and insular cortex, both of which were positively correlated with orofacial inflammatory pain-like behaviors. The level of brain-derived neurotrophic factor was increased in the insular cortex under stress contagion. These results indicate that stress contagion can cause neural changes in the brain, resulting in increased masseter muscle nociception, as seen in social defeat stress mice.

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“…In contrast to the RLS-negative group, our study detected heightened betweenness centrality in the group afflicted by RLS. The insula's pivotal role in triggering the pain matrix network is well-documented (Labrakakis C 2023). Functioning as a hub within the cortex, the insula orchestrates complex sensations and emotions associated with migraine symptoms.…”

Section: Difference In Small-world Properties and Nodal Propertiesmentioning

confidence: 99%

Right-to-Left Shunt-associated Brain Functional Changes in Migraine: Evidences from a Resting-state FMRI Study

Cao,

Jiao,

Zhou

et al. 2024

Preprint

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Background: Migraine, a neurological disorder under perpetual investigation, has an elusive etiology. An potential association with Right-to-Left Shunt (RLS) exists, yet the precise nature of this connection remains unclear.This study employs the resting-state functional magnetic resonance imaging (rs-fMRI) technique to examine brain functional differences between the migraine patients with and without RLS, aiming at exploring RLS associated alterations in functional segregation and integration. Methods: This study included 32 migraine patients (14 patients with RLS and 18 without RLS), each undergoing rs-fMRI data acquisition. The amplitude of low-frequency fluctuation (ALFF) was employed to investigate functional segregation. Functional connectivity (FC) analysis was conducted to explore the functional integration across distinct brain regions. Graph theory-based network analysis was utilized to assess functional networks in migraine patients with RLS. Pearson correlation analysis further explored the relationship between RLS severity and various functional metrics.. Results: Compared with migraine patients without RLS, migraine patients with RLS exhibited a significant increase in the ALFF in the left middle occipital and superior occipital gyrus; As to FC, the reduced connectivity between the left rolandic operculum and the right middle cingulate gyrus was observed in migraine patients with RLS; Based on the brain networks analysis, migraine patients with RLS displayed higher values of the normalized clustering coefficient and greater betweenness centrality in specific regions, including the left precuneus, right insula, and right inferior temporal gyrus. Further, the study found positive correlations between ALFF values in the temporal lobes, thalamus, left middle occipital, and superior occipital gyrus and RLS severity. Conversely, negative correlations emerged between ALFF values in the right inferior frontal gyrus, middle frontal gyrus, and insula and RLS grading. Finally, the study identified a positive correlation between angular gyrus betweenness centrality and RLS severity. Conclusion: RLS-associated brain functional alterations in migraine consisted of local brain regions, connectivity, and networks involved in pain conduction and regulation did exist in migraine with RLS.

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The Role of the Insular Cortex in Pain

Cited by 61 publications

References 129 publications

Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

Effects of stress contagion on anxiogenic‐ and orofacial inflammatory pain‐like behaviors with brain activation in mice

Right-to-Left Shunt-associated Brain Functional Changes in Migraine: Evidences from a Resting-state FMRI Study

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