Visualizing the Complex Brain Dynamics of Chronic Pain

Saab, Carl Y.

doi:10.1007/s11481-012-9378-8

Cited by 12 publications

(5 citation statements)

References 80 publications

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“…The underlying pathophysiology of FM is not completely understood, however, there is accumulating evidence that centralization of pain (Hawkins, ) causing abnormal pain processing (Petersel et al., ) plays a critical role. FM patients are found to have altered central processing of nociceptive input, believed to contribute to the presence of chronic pain (Saab, ; Smallwood et al., ).…”

Section: Introductionmentioning

confidence: 99%

Altered fMRI resting‐state connectivity in individuals with fibromyalgia on acute pain stimulation

Ichesco

Puiu

Hampson

et al. 2016

European Journal of Pain

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Background: Fibromyalgia is a chronic widespread pain condition, with patients commonly reporting other symptoms such as sleep difficulties, memory complaints and fatigue. The use of magnetic resonance imaging (MRI) in fibromyalgia has allowed for the detection of neural abnormalities, with alterations in brain activation elicited by experimental pain and alterations in resting state connectivity related to clinical pain. Methods: In this study, we sought to monitor state changes in resting brain connectivity following experimental pressure pain in fibromyalgia patients and healthy controls. Twelve fibromyalgia patients and 15 healthy controls were studied by applying discrete pressure stimuli to the thumbnail bed during MRI. Resting-state functional MRI scanning was performed before and immediately following experimental pressure pain. We investigated changes in functional connectivity to the thalamus and the insular cortex. Results: Acute pressure pain increased insula connectivity to the anterior cingulate and the hippocampus. Additionally, we observed increased thalamic connectivity to the precuneus/posterior cingulate cortex, a known part of the default mode network, in patients but not in controls. This connectivity was correlated with changes in clinical pain. Conclusions: These data reporting changes in resting-state brain activity following a noxious stimulus suggest that the acute painful stimuli may contribute to the alteration of the neural signature of chronic pain. What does this study/add?: In this study acute pain application shows an echo in functional connectivity and clinical pain changes in chronic pain.

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Section: Introductionmentioning

confidence: 99%

Altered fMRI resting‐state connectivity in individuals with fibromyalgia on acute pain stimulation

Ichesco

Puiu

Hampson

et al. 2016

European Journal of Pain

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“…One option is to use neurophysiological methods like electroencephalography (EEG), which reflects the electrical brain activity with high temporal resolution, and is related to structural and functional components of the pain experience and following pain attenuation after drug administration . EEG may generally be recorded as the spontaneous electrical activity or as evoked brain potentials (EPs).…”

Section: Introductionmentioning

confidence: 99%

Electroencephalography and analgesics

Malver

Brokjær

Staahl

et al. 2013

Brit J Clinical Pharma

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To assess centrally mediated analgesic mechanisms in clinical trials with pain patients, objective standardized methods such as electroencephalography (EEG) has many advantages. The aim of this review is to provide the reader with an overview of present findings in analgesics assessed with spontaneous EEG and evoked brain potentials (EPs) in humans. Furthermore, EEG methodologies will be discussed with respect to translation from animals to humans and future perspectives in predicting analgesic efficacy. We searched PubMed with MeSH terms 'analgesics' , 'electroencephalography' and 'evoked potentials' for relevant articles. Combined with a search in their reference lists 15 articles on spontaneous EEG and 55 papers on EPs were identified. Overall, opioids produced increased activity in the delta band in the spontaneous EEG, but increases in higher frequency bands were also seen. The EP amplitudes decreased in the majority of studies. Anticonvulsants used as analgesics showed inconsistent results. The N-methyl-D-aspartate receptor antagonist ketamine showed an increase in the theta band in spontaneous EEG and decreases in EP amplitudes. Tricyclic antidepressants increased the activity in the delta, theta and beta bands in the spontaneous EEG while EPs were inconsistently affected. Weak analgesics were mainly investigated with EPs and a decrease in amplitudes was generally observed. This review reveals that both spontaneous EEG and EPs are widely used as biomarkers for analgesic drug effects. Methodological differences are common and a more uniform approach will further enhance the value of such biomarkers for drug development and prediction of treatment response in individual patients.

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“…7,35,37 Although early functional magnetic resonance imaging (fMRI) studies of chronic pain focused on coactivated brain regions during specific tasks, such as the processing of experimental pain, recent studies have examined how activity among task-negative neural networks influences the experience of chronic and experimental pain. 38 One such network, the default mode network (DMN), has been hypothesized to potentially help highlight the complexities of pain mechanisms.…”

mentioning

confidence: 99%

Functional Connectivity of the Default Mode Network and Its Association With Pain Networks in Irritable Bowel Patients Assessed via Lidocaine Treatment

Letzen¹,

Craggs²,

Perlstein³

et al. 2013

The Journal of Pain

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The default mode network (DMN), a group of brain regions implicated in passive thought processes, has been proposed as a potentially informative neural marker to aid in novel treatment development. However, the DMN’s internal connectivity and its temporal relationship (ie, functional network connectivity) with pain-related neural networks in chronic pain conditions is poorly understood, as is the DMN’s sensitivity to analgesic effects. The current study assessed how DMN functional connectivity and its temporal association with 3 pain-related networks changed after rectal lidocaine treatment in irritable bowel syndrome patients. Eleven females with irritable bowel syndrome underwent a rectal balloon distension paradigm during functional magnetic resonance imaging in 2 conditions: natural history (ie, baseline) and lidocaine. Results showed increased DMN connectivity with pain-related regions during natural history and increased within-network connectivity of DMN structures under lidocaine. Further, there was a significantly greater lag time between 2 of the pain networks, those involved in cognitive and in affective pain processes, comparing lidocaine to natural history. These findings suggest that 1) DMN plasticity is sensitive to analgesic effects, and 2) reduced pain ratings via analgesia reflect DMN connectivity more similar to pain-free individuals. Findings show potential implications of this network as an approach for understanding clinical pain management techniques. Perspective This study shows that lidocaine, a peripheral analgesic, significantly altered DMN connectivity and affected its relationship with pain-related networks. These findings suggest that the DMN, which is hypothesized to represent non-goal-oriented activity, is sensitive to analgesic effects and could be useful to understand pain treatment mechanisms.

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Visualizing the Complex Brain Dynamics of Chronic Pain

Cited by 12 publications

References 80 publications

Altered fMRI resting‐state connectivity in individuals with fibromyalgia on acute pain stimulation

Altered fMRI resting‐state connectivity in individuals with fibromyalgia on acute pain stimulation

Electroencephalography and analgesics

Functional Connectivity of the Default Mode Network and Its Association With Pain Networks in Irritable Bowel Patients Assessed via Lidocaine Treatment

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