Operculoinsular cortex encodes pain intensity at the earliest stages of cortical processing as indicated by amplitude of laser-evoked potentials in humans

Iannetti, Gian Domenico; Zambreanu, L.; Cruccu, G.; Tracey, Irene

doi:10.1016/j.neuroscience.2004.10.035

Cited by 191 publications

(156 citation statements)

References 41 publications

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“…Consistent with this view, Baumgärtner et al (2006) showed that the N1 wave can be recorded in anesthetized monkeys. Therefore, our results suggest that the correlation between the magnitude of the N1 wave and pain perception that was reported in two of our recent studies did not result from a relationship between the N1 wave and pain perception per se, but instead, was mostly determined by explicit or unavoidable (Iannetti et al, 2005) variations in the strength of the peripheral nociceptive input.…”

Section: Discussionsupporting

confidence: 54%

Characterizing the Cortical Activity through Which Pain Emerges from Nociception

Lee¹,

Mouraux²,

Iannetti³

2009

Journal of Neuroscience

138

115

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Nociception begins when A␦-and C-nociceptors are activated. However, the processing of nociceptive input by the cortex is required before pain can be consciously experienced from nociception. To characterize the cortical activity related to the emergence of this experience, we recorded, in humans, laser-evoked potentials elicited by physically identical nociceptive stimuli that were either perceived or unperceived. Infrared laser pulses, which selectively activate skin nociceptors, were delivered to the hand dorsum either as a pair of rapidly succeeding and spatially displaced stimuli (two-thirds of trials) or as a single stimulus (one-third of trials). After each trial, subjects reported whether one or two distinct painful pinprick sensations, associated with A␦-nociceptor activation, had been perceived. The psychophysical feedback after each pair of stimuli was used to adjust the interstimulus interval (ISI) of the subsequent pair: when a single percept was reported, ISI was increased by 40 ms; when two distinct percepts were reported, ISI was decreased by 40 ms. This adaptive algorithm ensured that the probability of perceiving the second stimulus of the pair tended toward 0.5. We found that the magnitude of the early-latency N1 wave was similar between perceived and unperceived stimuli, whereas the magnitudes of the later N2 and P2 waves were reduced when stimuli were unperceived. These findings suggest that the N1 wave represents an early stage of sensory processing related to the ascending nociceptive input, whereas the N2 and P2 waves represent a later stage of processing related, directly or indirectly, to the perceptual outcome of this nociceptive input.

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Section: Discussionsupporting

confidence: 54%

Characterizing the Cortical Activity through Which Pain Emerges from Nociception

Lee¹,

Mouraux²,

Iannetti³

2009

Journal of Neuroscience

138

115

View full text Add to dashboard Cite

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“…A cognitive-evaluative function of the parietal operculum is further confirmed by the parallel effects of a cognitive distracting task on the perceived intensity and the cerebral perfusion increase in the parietal operculum induced by the cold pressor test (Petrovic et al, 2000). Electrophysiological data in humans (Schlereth et al, 2003;Iannetti et al, 2005) and clinical observations in patients with cortical lesions (Greenspan et al, 1999) suggest the potential role of the parietal operculum as a nociceptive area that is activated very early after the onset of phasic noxious stimuli. More specifically, a recent functional imaging study by Kong et al (2008) suggested that the nocebo hyperalgesia is associated with an activation of the bilateral insula, operculum, ACC, and left S1/M1 as well as the left hippocampus.…”

Section: Discussionmentioning

confidence: 86%

Insular Cortex Activity Is Associated with Effects of Negative Expectation on Nociceptive Long-Term Habituation

Rodriguez-Raecke

Doganci²,

Breimhorst³

et al. 2010

J. Neurosci.

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It is generally accepted that acute painful experience is influenced by context information shaping expectation and modulating attention, arousal, stress, and mood. However, little is known about the nature, duration, and extent of this effect, particularly regarding the negative expectation. We used a standardized longitudinal pain paradigm and painful heat test stimuli in healthy participants over a time course of 8 consecutive days, inducing nociceptive habituation over time. Thirty-eight healthy volunteers were randomly assigned to two different groups. One group received the information that the investigators expected the pain intensity to increase over time (context group). The other group was not given any information (control group). All participants rated the pain intensity of the daily standardized pain paradigm on a visual analog scale. In agreement with previous studies the pain ratings in the control group habituated over time. However, the context group reported no change of pain ratings over time. Functional imaging data showed a difference between the two groups in the right parietal operculum. These data suggest that a negative context not only has an effect on immediate pain but can modulate perception of pain in the future even without experience/conditioning. Neuronally, this process is mediated by the right opercular region.

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“…Painrelated activity in the insula was predominately contralateral to thumb pressure. The absence of an increase in pain activation in the insula after the hypertonic infusion may have been a function of the use of noxious pressure (23), because others have previously reported intensity-dependent activations in the insula in response to thermal stimuli (24)(25)(26)(27).…”

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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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...

show abstract

Operculoinsular cortex encodes pain intensity at the earliest stages of cortical processing as indicated by amplitude of laser-evoked potentials in humans

Cited by 191 publications

References 41 publications

Characterizing the Cortical Activity through Which Pain Emerges from Nociception

Characterizing the Cortical Activity through Which Pain Emerges from Nociception

Insular Cortex Activity Is Associated with Effects of Negative Expectation on Nociceptive Long-Term Habituation

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

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