Distinct brain mechanisms support spatial vs temporal filtering of nociceptive information

Nahman‐Averbuch, Hadas; Martucci, Katherine T.; Granovsky, Yelena; Weissman-Fogel, Irit; Yarnitsky, David; Coghill, Robert C.

doi:10.1016/j.pain.2014.07.008

Cited by 99 publications

(124 citation statements)

References 43 publications

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“…Previous fMRI studies have shown that the Periaqueductal Gray (PAG) of the brainstem and Rostral Ventral Medulla (RVM) are activated by an OA‐paradigm, but not during standard CPM‐paradigms (Nahman‐Averbuch et al., ), suggesting that OA and CPM activate different pain inhibitory systems. Moreover, several studies demonstrated that the facilitatory influences on spinal nociception that are emanated from the RVM are partly mediating the central sensitization (Millan, , Vo and Drummond, ), while the possible role of a peripheral mechanism involved in OA could explain differences in brain activation during OA and CPM (Nahman‐Averbuch et al., ).…”

Section: Introductionmentioning

confidence: 99%

Offset analgesia: The role of peripheral and central mechanisms

Ligato

Petersen

Mørch

et al. 2017

European Journal of Pain

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Background: Offset Analgesia (OA) can be evoked by a threeheat-stimulus train (T1-T2-T3), with T1 (5 s) and T3 (20 s) having the same temperature (e.g. 48°C) and T2 (5 s) being slightly higher (1-3°C). OA is defined as a disproportional pain reduction caused by the slight temperature decrease from T2 to T3. As the pain modulatory mechanisms behind OA are still poorly understood, the current study aimed to investigate the role of peripheral and central mechanisms by applying heat stimuli to the same location and to different unilateral and bilateral locations. Method: Young healthy volunteers participated in the study. A 'standard-OA' paradigm (48-49-48°C) was applied to the nondominant volar forearm (T1-T2-T3 applied on the same location). 'Unilateral-OA' trials were applied on three different locations of the non-dominant volar forearm (the same dermatome). 'Bilateral-OA' trials were applied by shifting T1-T2-T3 between dominant and nondominant volar forearms. A constant stimulus of 48°C was applied as control for the evoked pain. The pain intensities were continuously recorded using an electronic visual analogue scale. Results: The largest pain intensity reduction was reported for the 'standard-OA' paradigm (p < 0.001) compared with the control stimulus. Both 'Unilateral-OA' and 'Bilateral-OA' trials caused a significant pain reduction (p < 0.05) compared with the control; however, the pain reduction was less than that evoked by 'standard-OA' (p < 0.05). Conclusion: This study showed that OA could be elicited when the stimuli were applied both to the same and to different locations (ipsiand contralateral) indicating that peripheral as well as central mechanisms are involved in mediating OA. Significance: This study investigated offset analgesia by applying thermal painful stimuli to the ipsi-and bilateral forearms in healthy subjects and found that both peripheral and central mechanisms seem to mediate offset analgesia.

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Section: Introductionmentioning

confidence: 99%

Offset analgesia: The role of peripheral and central mechanisms

Ligato

Petersen

Mørch

et al. 2017

European Journal of Pain

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“…6,19,22,42 Indeed, several studies show that offset analgesia produces increased activity in the dorsolateral prefrontal cortex (DLPFC) and anterior insula, which mirrors the activity of brain regions activated in the modulation of pain by cognitive processes such as placebo, distraction, and meditation. Thus, Nahman-Averbuch and colleagues hypothesized that part of offset analgesia is mediated or amplified by cognitive processes associated to the prediction of the time course of pain.…”

Section: 0 Discussionmentioning

confidence: 99%

“…Thus, Nahman-Averbuch and colleagues hypothesized that part of offset analgesia is mediated or amplified by cognitive processes associated to the prediction of the time course of pain. 19 Additional research suggests an integral role of the cerebellum in offset analgesia. 11 In particular, Ruscheweyh et al discovered reduced offset analgesia in patients with cerebellar infarction compared to sex- and age- matched controls.…”

Section: 0 Discussionmentioning

confidence: 99%

“…10 Functional imaging and pharmacological studies indicate that CPM and offset analgesia rely on different mechanisms, with offset analgesia likely reflecting more brain derived pain modulation compared to descending spinal modulatory effects of CPM. 6,19,22,42 While less is known regarding the relevance of offset analgesia to the development of chronic pain, recent but limited evidence suggests that aging is also associated with reduced capacity to activate the temporal inhibitory mechanisms underlying this phenomenon. 20 …”

Section: 0 Introductionmentioning

confidence: 99%

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Loss of Temporal Inhibition of Nociceptive Information Is Associated With Aging and Bodily Pain

Naugle

Cruz-Almeida

Fillingim

et al. 2017

The Journal of Pain

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An age-related decline in endogenous pain inhibitory processes likely places older adults at an increased risk for chronic pain. Limited research indicates that older adults may be characterized by deficient offset analgesia, an inhibitory temporal sharpening mechanism that increases the detectability of minor decreases in noxious stimulus intensity. The primary purpose of the study was to examine age differences in offset analgesia in community-dwelling younger, middle-aged, and older adults. An additional aim of the study was to determine whether the magnitude of offset analgesia predicted self-reported bodily pain. Eighty-seven younger adults, 42 middle-aged adults, and 60 older adults completed 4 offset analgesia trials and 3 constant temperature trials in which a noxious heat stimulus was applied to the volar forearm for 40-sec. The offset trials consisted of three continuous phases: an initial 10-sec painful stimulus (S1), either a 1.0°C or 0.4°C increase in temperature from S1 for 10-sec (S2), and either a 1.0°C or 0.4°C decrease back to the initial testing temperature for 20-sec (S3). During each trial, subjects rated pain intensity continuously using an electronic visual analogue scale (0–100). All subjects also completed the SF-36 Health Survey including the Bodily Pain subscale. The results indicated that older and middle-aged adults demonstrated reduced offset analgesia compared to younger adults in the 1.0°C and 0.4°C offset trials. Furthermore, the magnitude of offset analgesia predicted self-reported bodily pain, with those exhibiting reduced offset analgesia reporting greater bodily pain. Dysfunction of this endogenous inhibitory system could increase the risk of developing chronic pain for middle-aged and older adults.

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“…Conditioned pain modulation (CPM) is a physiological phenomenon whereby pain evoked at one region of the body (e.g., foot) reduces pain perceived at another body location (e.g., hand) under healthy physiological conditions. CPM involves central nervous system processes at cortical, subcortical and brainstem levels [4]. This phenomenon is widely documented as being disrupted in patients with chronic pain, particularly patients with fibromyalgia, and is a primary indicator of dysregulated descending control of pain.…”

Section: Introductionmentioning

confidence: 99%

Cold Water Pressor Test Differentially Modulates Functional Network Connectivity in Fibromyalgia Patients Compared with Healthy Controls

Jarrahi¹,

Martucci²,

Nilakantan³

et al. 2018

2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Fibromyalgia is a multifaceted chronic pain condition of unknown etiology. Conditioned pain modulation (CPM) such as cold water pressor test of the foot, is widely documented as being disrupted in patients with fibromyalgia. To date, the mechanisms underlying such dysregulation of the descending control of pain in fibromyalgia remain poorly understood. In this study, we used ICA-based network analysis to comprehensively compare differences in functional network connectivity among relevant (nonartifactual) intrinsic connectivity brain networks during the resting state before and after cold pressor test in patients with fibromyalgia and healthy controls. The results revealed significant differences in functional connectivity between the two groups that included the networks that integrate cognitive control and attention systems with memory, emotion and brainstem regions. Specifically, functional connectivity involving central executive network was absent in patients with fibromyalgia compared with controls. Patients showed significant functional connectivity changes involving subcortical and brainstem networks with the sensorimotor and dorsal attention networks. Accordingly, aberrant CPM in patients with fibromyalgia may be due to the differences in functional connectivity involving the subcortical/brainstem regions, and is facilitated by the recruitment of the dorsal attention network in lieu of the central executive network. Future research replicating the present findings with larger sample size can shed more light on neurobiology of endogenous pain modulation in fibromyalgia.

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Distinct brain mechanisms support spatial vs temporal filtering of nociceptive information

Cited by 99 publications

References 43 publications

Offset analgesia: The role of peripheral and central mechanisms

Offset analgesia: The role of peripheral and central mechanisms

Loss of Temporal Inhibition of Nociceptive Information Is Associated With Aging and Bodily Pain

Cold Water Pressor Test Differentially Modulates Functional Network Connectivity in Fibromyalgia Patients Compared with Healthy Controls

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