Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations

Background: Chronic pain, particularly that following nerve injury, can occur in the absence of external stimuli. Although the ongoing pain is sometimes continuous, in many individuals the intensity of their pain fluctuates. Experimental animal studies have shown that the brainstem contains circuits...

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Main Authors: Mills, E.P., Alshelh, Z., Kosanovic, D., Di Pietro, Flavia, Vickers, E.R., Macey, P.M., Henderson, L.A.
Format: Journal Article
Language:English
Published: 2020
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1130280
http://hdl.handle.net/20.500.11937/84867
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author Mills, E.P.
Alshelh, Z.
Kosanovic, D.
Di Pietro, Flavia
Vickers, E.R.
Macey, P.M.
Henderson, L.A.
author_facet Mills, E.P.
Alshelh, Z.
Kosanovic, D.
Di Pietro, Flavia
Vickers, E.R.
Macey, P.M.
Henderson, L.A.
author_sort Mills, E.P.
building Curtin Institutional Repository
collection Online Access
description Background: Chronic pain, particularly that following nerve injury, can occur in the absence of external stimuli. Although the ongoing pain is sometimes continuous, in many individuals the intensity of their pain fluctuates. Experimental animal studies have shown that the brainstem contains circuits that modulate nociceptive information at the primary afferent synapse and these circuits are involved in maintaining ongoing continuous neuropathic pain. However, it remains unknown if these circuits are involved in regulating fluctuations of ongoing neuropathic pain in humans. Methods: We used functional magnetic resonance imaging to determine whether in 19 subjects with painful trigeminal neuropathy, brainstem pain-modulation circuitry function changes according to moment-to-moment fluctuations in spontaneous pain intensity as rated online over a 12-minute period. Results: We found that when pain intensity was spontaneously high, connectivity strengths between regions of the brainstem endogenous pain-modulating circuitry—the midbrain periaque-ductal gray, rostral ventromedial medulla (RVM), and the spinal trigeminal nucleus (SpV)—were high, and vice-versa (when pain was low, connectivity was low). Additionally, sliding-window connectivity analysis using 50-second windows revealed a significant positive relationship between ongoing pain intensity and RVM-SpV connectivity over the duration of the 12-minute scan. Conclusion: These data reveal that moment-to-moment changes in brainstem pain-modula-tion circuitry functioning likely contribute to fluctuations in spontaneous pain intensity in individuals with chronic neuropathic pain.
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spelling curtin-20.500.11937-848672021-08-13T04:02:27Z Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations Mills, E.P. Alshelh, Z. Kosanovic, D. Di Pietro, Flavia Vickers, E.R. Macey, P.M. Henderson, L.A. dynamic connectivity functional connectivity midbrain periaqueductal gray matter rostral ventromedial medulla spinal trigeminal nucleus spontaneous pain Background: Chronic pain, particularly that following nerve injury, can occur in the absence of external stimuli. Although the ongoing pain is sometimes continuous, in many individuals the intensity of their pain fluctuates. Experimental animal studies have shown that the brainstem contains circuits that modulate nociceptive information at the primary afferent synapse and these circuits are involved in maintaining ongoing continuous neuropathic pain. However, it remains unknown if these circuits are involved in regulating fluctuations of ongoing neuropathic pain in humans. Methods: We used functional magnetic resonance imaging to determine whether in 19 subjects with painful trigeminal neuropathy, brainstem pain-modulation circuitry function changes according to moment-to-moment fluctuations in spontaneous pain intensity as rated online over a 12-minute period. Results: We found that when pain intensity was spontaneously high, connectivity strengths between regions of the brainstem endogenous pain-modulating circuitry—the midbrain periaque-ductal gray, rostral ventromedial medulla (RVM), and the spinal trigeminal nucleus (SpV)—were high, and vice-versa (when pain was low, connectivity was low). Additionally, sliding-window connectivity analysis using 50-second windows revealed a significant positive relationship between ongoing pain intensity and RVM-SpV connectivity over the duration of the 12-minute scan. Conclusion: These data reveal that moment-to-moment changes in brainstem pain-modula-tion circuitry functioning likely contribute to fluctuations in spontaneous pain intensity in individuals with chronic neuropathic pain. 2020 Journal Article http://hdl.handle.net/20.500.11937/84867 10.2147/JPR.S252594 eng http://purl.org/au-research/grants/nhmrc/1130280 http://creativecommons.org/licenses/by-nc/3.0/ fulltext
spellingShingle dynamic connectivity
functional connectivity
midbrain periaqueductal gray matter
rostral ventromedial medulla
spinal trigeminal nucleus
spontaneous pain
Mills, E.P.
Alshelh, Z.
Kosanovic, D.
Di Pietro, Flavia
Vickers, E.R.
Macey, P.M.
Henderson, L.A.
Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
title Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
title_full Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
title_fullStr Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
title_full_unstemmed Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
title_short Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
title_sort altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
topic dynamic connectivity
functional connectivity
midbrain periaqueductal gray matter
rostral ventromedial medulla
spinal trigeminal nucleus
spontaneous pain
url http://purl.org/au-research/grants/nhmrc/1130280
http://hdl.handle.net/20.500.11937/84867