A positron emission tomography study of wind‐up pain in chronic postherniotomy pain

Kupers, Ron; Lonsdalel, Markus Nowak; Aasvang, Eske Kvanner; Kehletl, Henrik

doi:10.1016/j.ejpain.2011.01.003

Cited by 7 publications

(3 citation statements)

References 45 publications

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“…This finding also supports the network model of pain perception, implicating involvement of multiple brain regions rather than processing within a ''singular centre'' [19,24,41]. The existence of this network is confirmed in cross-modal imaging studies using PET [42]. However, the observed widespread increase in beta activity in the present study may also be contaminated by EMG sources due to cranial muscle contraction or clenching of teeth that certainly accompany the pain of uterine contractions.…”

Section: Discussionsupporting

confidence: 88%

Objective identification of pain due to uterine contraction during the first stage of labour using continuous EEG signals and SVM

et al. 2019

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This study aimed to assess the utility of electroencephalography (EEG) as an objective marker of pain during the first stage of labour. EEG and cardiotocography (CTG) data were obtained from 10 parturient women during their first stage of labour. The study subjects reported the extent of their pain experienced due to uterine contractions, which were recorded by the CTG tracing. Simultaneous 16-channel EEG traces were obtained for spectral analysis and a subsequent machine learning classification using Support Vector Machine (SVM) aiming to predict the pain experienced in relation to uterine contractions. It was found that pain due to uterine contraction correlated positively with relative delta and beta band activities and negatively with relative theta and alpha band activities of the EEG signals. SVM using the spectral activities, statistical and non-linear features of the EEG classified the state of pain with 83% accuracy using a classification model generalizable across subjects. Furthermore, dimension reduction using Principal Component Analysis (PCA) successfully reduced the number of features used in the classification while achieving a maximum classification accuracy of 84%. Continuous EEG affords the means to assess objectively maternal pain experienced during the active contraction phase of the first stage of labour. Monitoring of the pain experience using EEG signals may complement the clinical decision-making process behind administration of epidural anaesthesia during labour. We envision future studies to investigate EEG markers of pain in other clinical states, aiming to generalize the use of EEG as an objective method of pain assessment.

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Section: Discussionsupporting

confidence: 88%

Objective identification of pain due to uterine contraction during the first stage of labour using continuous EEG signals and SVM

et al. 2019

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“…This hypofrontality phenomenon has been related to pain- (Jarcho et al, 2012) or drug-related (Kalivas and Volkow, 2005) diminished dopaminergic tone with corresponding decrease in the tonic glutamatergic activity (West et al, 2003). Against the background of this diminished activity, acute pain (Kupers et al, 2011; Mathew, 2011; Ringel et al, 2008) and/or stress (Elsenbruch et al, 2010; Stoeter et al, 2007) in chronic pain patients or exposure to drugs (Volkow and Li, 2005) or drug-related cues (Childress et al, 1999; Garavan et al, 2000) in drug addicts produce strong activations in the PFC. Involvement of stress in this phenomenon is clinically manifested by a contribution to the “spiraling distress cycle” (Koob and Le Moal, 1997) whereby stress and negative affective states producing via cross-sensitization (Rome and Rome, 2000; Woolf and Thompson, 1991) additional deterioration of pain problems (Alba-Delgado et al, 2012).…”

Section: 7 Suicidality and Pain May Be Explained By Shared Neural mentioning

confidence: 99%

Pain and suicidality: Insights from reward and addiction neuroscience

Elman

Borsook

Volkow

2013

Progress in Neurobiology

175

131

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Suicidality is exceedingly prevalent in pain patients. Although the pathophysiology of this link remains unclear, it may be potentially related to the partial congruence of physical and emotional pain systems. The latter system’s role in suicide is also conspicuous during setbacks and losses sustained in the context of social attachments. Here we propose a model based on the neural pathways mediating reward and anti-reward (i.e., allostatic adjustment to recurrent activation of the reward circuitry); both are relevant etiologic factors in pain, suicide and social attachments. A comprehensive literature search on neurobiology of pain and suicidality was performed. The collected articles were critically reviewed and relevant data were extracted and summarized within four key areas: (1) physical and emotional pain, (2) emotional pain and social attachments, (3) pain-and suicide-related alterations of the reward and anti-reward circuits as compared to addiction, which is the premier probe for dysfunction of these circuits and (4) mechanistically informed treatments of co-occurring pain and suicidality. Pain-, stress- and analgesic drugs-induced opponent and proponent states of the mesolimbic dopaminergic pathways may render reward and anti-reward systems vulnerable to sensitization, cross-sensitization and aberrant learning of contents and contexts associated with suicidal acts and behaviors. These findings suggest that pain patients exhibit alterations in the brain circuits mediating reward (depressed function) and anti-reward (sensitized function) that may affect their proclivity for suicide and support pain and suicidality classification among other “reward deficiency syndromes” and a new proposal for “enhanced anti-reward syndromes”. We suggest that interventions aimed at restoring the balance between the reward and anti-reward networks in patients with chronic pain may help decreasing their suicide risk.

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“…For example, studies have indicated changes in contralateral thalamic activity with concurrent decrease in thalamic blood flow in patients with unilateral CNP [ 42 ]. However, some CNP conditions, such as mechanothermal allodynia, can be associated with increased thalamic activity [ 43 ].…”

Section: Chronic Neuropathic Pain and The Pain Matrixmentioning

confidence: 99%

The Roles of Imaging Biomarkers in the Management of Chronic Neuropathic Pain

Pricope

Tamba

Stanciu

et al. 2022

IJMS

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Chronic neuropathic pain (CNP) affects around 10% of the general population and has a significant social, emotional, and economic impact. Current diagnosis techniques rely mainly on patient-reported outcomes and symptoms, which leads to significant diagnostic heterogeneity and subsequent challenges in management and assessment of outcomes. As such, it is necessary to review the approach to a pathology that occurs so frequently, with such burdensome and complex implications. Recent research has shown that imaging methods can detect subtle neuroplastic changes in the central and peripheral nervous system, which can be correlated with neuropathic symptoms and may serve as potential markers. The aim of this paper is to review available imaging methods used for diagnosing and assessing therapeutic efficacy in CNP for both the preclinical and clinical setting. Of course, further research is required to standardize and improve detection accuracy, but available data indicate that imaging is a valuable tool that can impact the management of CNP.

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A positron emission tomography study of wind‐up pain in chronic postherniotomy pain

Cited by 7 publications

References 45 publications

Objective identification of pain due to uterine contraction during the first stage of labour using continuous EEG signals and SVM

Objective identification of pain due to uterine contraction during the first stage of labour using continuous EEG signals and SVM

Pain and suicidality: Insights from reward and addiction neuroscience

The Roles of Imaging Biomarkers in the Management of Chronic Neuropathic Pain

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