A Unique Representation of Heat Allodynia in the Human Brain

Lorenz, Jürgen; Cross, Donna; Minoshima, Shinsei; Morrow, Thomas; Paulson, Pamela E.; Casey, Kenneth L.

doi:10.1016/s0896-6273(02)00767-5

Cited by 209 publications

(157 citation statements)

References 58 publications

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“…Unlike the pregenual anterior cingulate cortex, which shows pain-related activations when pain sensitivity is enhanced or diminished, and consistent with the study reported here, pain-related activations in the lateral ventral orbitofrontal cortex only occur when pain sensitivity in humans is enhanced (20). Stimulation of the ventral orbitofrontal cortex in rats leads to inhibition of rostral ventromedial medulla off cells, facilitation of on cells, and decreased latency of the tail-flick response (22).…”

Section: Discussionsupporting

confidence: 89%

“…Many studies have demonstrated activation in the pregenual anterior cingulate cortex during conditions that modify pain responses such as anxiety, placebo, distraction, and capsaicin-induced hyperalgesia (17)(18)(19)(20). Thus, pregenual anterior cingulate cortex activity occurs when pain sensitivity changes, irrespective of whether sensitivity is enhanced or diminished.…”

Section: Discussionmentioning

confidence: 99%

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Unique, common, and interacting cortical correlates of thirst and pain

Farrell

Egan

Zamarripa

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

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This study used positron-emission tomography to establish the patterns of brain activity involved in the isolated and concurrent experiences of thirst and pain. Ten subjects were scanned while experiencing pain evoked with noxious pressure, while experiencing thirst after the infusion of hypertonic saline, and while experiencing pain when thirsty. After the onset of thirst, noxious pressure evoked more intense sensations of pain. Noxious pressure did not change subjective ratings of thirst. Thirst caused activation in the anterior cingulate (Brodmann area 32) and the insula. Enhanced pain responses were associated with increased activity in cortical regions that are known to correlate with pain intensity, and also with unique activity in the pregenual anterior cingulate and ventral orbitofrontal cortex. These findings suggest a role for limbic and prefrontal cortices in the modulation of pain during the experience of thirst.interoception ͉ neuroimaging S ensations determined by interoceptors guide behaviors that maintain homeostasis. Experiences such as thirst, hunger, pain, and temperature sensation reflect imbalances of the internal state and have important implications for survival (1, 2). Interoceptive sensations can occur in tandem and create conflicts that are not resolved by a single behavior. Prevailing circumstances determine which internal imbalance requires the most urgent attention. Interoception would be more consistent with survival if competing sensations were modified to reflect relative priorities. To investigate competing interoceptive sensations, we measured brain activity during painful pressure and thirst, both in isolation and occurring concurrently.Changes in sensations determined by interoceptors in response to changing environmental circumstances can be described as context-dependent responses (3). Both appetitive and aversive drives shape the state of an organism, and these drives must be reconciled to make the most adaptive behavioral choice. The juxtaposition of pain and thirst is particularly suited to the investigation of human brain activity associated with contextdependent changes in responses to competing drives. Both pain and thirst can be manipulated in a time frame compatible with imaging protocols, the former being particularly amenable to rapid onset and offset. There is evidence that the respective sensations are modified by contextual factors, although pain and thirst have yet to be examined contemporaneously. Finally, the concurrence of conditions likely to stimulate osmoreceptors and nociceptors would conceivably be associated with conflicting implications for behavioral responses. Drinking can be deferred without detrimental effect, but ultimately thirst must be sated to avoid desiccation. The acute onset of pain has more immediate implications for tissue integrity than the early experience of thirst. For example, during mild to moderate thirst, withdrawal from noxious stimuli would be more likely if thirst is decreased and͞or pain is increased. Furthermore, the opposit...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Unique, common, and interacting cortical correlates of thirst and pain

Farrell

Egan

Zamarripa

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

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“…More extensive areas of cingulate cortex have been reported for pain-related contrasts but are clearly not of sufficient consistency across studies to survive empirical scrutiny. A notable example is perigenual cingulate activity, which is reported more frequently for contrasts that include upregulated or downregulated pain states [Bantick et al, 2002;Lorenz et al, 2002]. The discrete locale of the ALE cingulate clusters may have important implications for cingulotomy as a treatment for intractable pain.…”

Section: Discussionmentioning

confidence: 99%

Brain activity associated with painfully hot stimuli applied to the upper limb: A meta‐analysis

Farrell

Laird

Egan

2005

Human Brain Mapping

114

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Abstract:The capacity of pain to alert against potential injury or focus attention on damaged tissue is enhanced by the intrinsically aversive nature of the experience. Finding methods to relieve pain will ultimately be facilitated by deeper understanding of the processes that contribute to the experience, and functional brain imaging has contributed substantially toward that end. An impressive body of literature has identified a distributed network of pain-related activity in the brain that is subject to considerable modulation by different stimulus parameters, contextual factors, and clinical conditions. The fundamental substrates of the pain network are yet to be distilled from the highly variable results of studies published thus far. Qualitative reviews of the pain-imaging literature have been contributory, but lack the greater surety of quantitative methods. We employ the activation likelihood estimation (ALE) meta-analytic technique to establish the most consistent activations among studies reporting brain responses subsequent to the application of noxious heat. A network of pain-related activity was replicated for stimuli to either upper limb that included two discernible regions of the mid-anterior cingulate cortex, bilateral thalami, insula, and opercula cortices, posterior parietal cortex, premotor cortex, supplementary motor area, and cerebellum. The findings of the meta-analysis resonate with other streams of information that continue to enhance our understanding of pain in the brain. The results also point toward new areas of research that may be fruitful for the exploration of central pain processing. Hum Brain Mapp 25:129 -139, 2005.

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“…48 Activation in the prefrontal cortex was found also by Schweinhardt et al 49 in their study on neuropathic pain patients, as well as in other studies on capsaicin-evoked allodynia in healthy volunteers. 50 As with many preclinical models of disease, there are always limitations regarding how well they mirror the patient condition. This is certainly the case for preclinical pain models.…”

Section: Are We Closer Toward Using Imaging For a Mechanism-based Clamentioning

confidence: 99%

Neuroimaging as a Tool for Pain Diagnosis and Analgesic Development

Wartolowska

Tracey

2009

Neurotherapeutics

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Summary:Neuroimaging makes it possible to study pain processing beyond the peripheral nervous system, at the supraspinal level, in a safe, noninvasive way, without interfering with neurophysiological processes. In recent years, studies using brain imaging methods have contributed to our understanding of the mechanisms responsible for the development and maintenance of chronic pain. Moreover, neuroimaging shows promising results for analgesic drug development and in characterizing different types of pain, bringing us closer to development of mechanism-based diagnoses and treatments for the chronic pain patient.

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A Unique Representation of Heat Allodynia in the Human Brain

Cited by 209 publications

References 58 publications

Unique, common, and interacting cortical correlates of thirst and pain

Unique, common, and interacting cortical correlates of thirst and pain

Brain activity associated with painfully hot stimuli applied to the upper limb: A meta‐analysis

Neuroimaging as a Tool for Pain Diagnosis and Analgesic Development

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