Ablation Procedures

Allam, Anthony K.; Michael, M. Benjamin Larkin; Shofty, Ben; Viswanathan, Ashwin

doi:10.1016/j.nec.2022.02.014

Cited by 3 publications

(2 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As for the MCC first pioneered in 1948 (Whitty et al 1952), the neurosurgical lesioning of this region (described as anterior cingulate cortex in these studies) has been performed to relieve intractable pain, particularly terminal cancer pain (Allam et al 2022). The apparent effects of cingulotomy not so much on nociceptive pain but on the suffering associated with it set the stage for recent approaches to both lesion and modulation of this brain region.…”

Section: Discussionmentioning

confidence: 99%

A surgery-informed precision approach to determining brain targets for real-time fMRI neurofeedback modulation in chronic pain

Liu,

Mi,

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective: Despite the promising results of neurofeedback with real-time functional magnetic resonance imaging (rt-fMRI-NF) in the treatment of various psychiatric and neurological disorders, few studies have investigated its effects in acute and chronic pain and with mixed results. The lack of clear neuromodulation targets, rooted in the still poorly understood neurophysiopathology of chronic pain, has probably contributed to these inconsistent findings. In contrast, functional neurosurgery (funcSurg) approaches targeting specific brain regions have been shown to reduce pain in a considerable number of patients with very severe chronic pain, however, their invasiveness limits their use to patients in critical situations. In this work, we sought to redefine, in an unbiased manner, rt-fMRI-NF future targets informed by the long tradition of funcSurg approaches. Methods: using independent systematic reviews, we identified the targets of the rt-fMRI-NF (in acute and chronic pain) and funcSurg (in chronic pain) studies and characterized their underlying functional networks using a subset of high spatial resolution resting-state fMRI data (7T MRI data from the Human Connectome Project). After applying principal component analysis to reduce the number of identified networks, we performed a quantitative functional and anatomical annotation of these networks with a large-scale meta-analytic approach. Finally, we characterized the functional networks defining their degree of overlap with canonical intrinsic brain networks (default mode, salience, and somatosensory), and their neurotransmitter profile. Results: As expected, the rt-fMRI-NF and funcSurg targets were different, except for the middle cingulate cortex, and showed different characteristics in terms of their functional connectivity. Our findings indicate that targets of rt-fMRI-NF primarily encompass hubs within the Default Mode Network and, to a lesser extent, within the Salience Network. In contrast, funcSurg targets predominantly involve hubs within the sensorimotor system (primarily the motor system), with less robust involvement of the Salience Network. Notably, 3 out of 4 derived funcSurg rs-fMRI networks correlated significantly with the distribution map of norepinephrine transporters, further supporting the functional relevance of the funcSurg networks as targets for the treatments of chronic pain. Conclusion: Key hubs of the sensorimotor networks, in particular the motor system, may represent promising targets for the therapeutic application of rt-fMRI-NF in chronic pain in particular in neuropathic pain patients. Our results also suggest that the antinociceptive effects of the funcSurg approaches could be, at least partially, linked to the restoration of abnormal noradrenergic system activation.

show abstract

Section: Discussionmentioning

confidence: 99%

A surgery-informed precision approach to determining brain targets for real-time fMRI neurofeedback modulation in chronic pain

Liu,

Mi,

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Hyperactivity of the ACC has been correlated with acute (Rainville et al 1997) and chronic pain (Hsieh et al 1995;J. P. Johansen, Fields, and Manning 2001;Joshua P. Johansen and Fields 2004), whereas manipulations that decreased ACC activity such as cingulotomy (Folt and White 1963;Allam et al 2022) or optogenetic inactivation (Elina et al 2021) reduced the unpleasantness of noxious stimuli without modifying nociception.…”

Section: Introductionmentioning

confidence: 99%

The Endogenous Opioid Met-Enkephalin Modulates Thalamo-Cortical Excitation Inhibition Balance in a Medial Thalamus-Anterior Cingulate Cortex Circuit

Arias-Hervert

Birdsong

2023

Preprint

View full text Add to dashboard Cite

Activation of opioid receptors in the anterior cingulate cortex (ACC) mediates aspects of analgesia induced by both exogenous and endogenous opioids. We have previously shown that opioids signaling disrupts both afferent excitatory and indirect inhibitory synaptic transmission from the medial thalamus (MThal) to the ACC, but the effects of endogenous opioids within this circuit remain poorly understood. The goal of the current study was to understand how the endogenous opioid, [Met]5-enkephalin (ME), modulates thalamic-driven excitatory and inhibitory synaptic transmission onto layer V pyramidal neurons in the ACC. We used pharmacology, brain slice electrophysiology and optogenetic stimulation to study opioid-mediated modulation of optically evoked glutamatergic and GABAergic transmission. The results revealed that ME inhibited both AMPA-mediated excitatory and GABA-mediated inhibitory synaptic transmission in the ACC. However, inhibitory transmission was more potently inhibited than excitatory transmission by ME. This preferential reduction in GABAA-mediated synaptic transmission was primarily due to the activation of delta opioid receptors by ME and resulted in a net disinhibition of MThal-ACC excitatory pathway. These results suggest that moderate concentrations of ME can lead to net excitation of ACC circuitry and that analgesia may be associated with disinhibition rather than inhibition of ACC subcircuits.

show abstract

The opioid peptide met-enkephalin modulates thalamo-cortical excitation inhibition balance in a medial thalamus-anterior cingulate cortex circuit

Arias-Hervert,

Birdsong

2024

Neuropharmacology

View full text Add to dashboard Cite

Ablation Procedures

Cited by 3 publications

References 43 publications

A surgery-informed precision approach to determining brain targets for real-time fMRI neurofeedback modulation in chronic pain

A surgery-informed precision approach to determining brain targets for real-time fMRI neurofeedback modulation in chronic pain

The Endogenous Opioid Met-Enkephalin Modulates Thalamo-Cortical Excitation Inhibition Balance in a Medial Thalamus-Anterior Cingulate Cortex Circuit

The opioid peptide met-enkephalin modulates thalamo-cortical excitation inhibition balance in a medial thalamus-anterior cingulate cortex circuit

Contact Info

Product

Resources

About