Functional Connectivity of Prelimic Prefrontal Cortex and Rostral Ventromedial Medulla for Descending Pain Modulation

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Angela Smith ◽  
Austin Flohrschutz ◽  
Arthur Riegel ◽  
Tally Largent-Milnes ◽  
Todd Vanderah
Keyword(s):  
Prefrontal Cortex ◽  
Functional Connectivity ◽  
Pain Modulation ◽  
Rostral Ventromedial Medulla ◽  
Ventromedial Medulla ◽  
Descending Pain Modulation

scholarly journals Alterations in pain processing circuitries in episodic migraine

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Tiffani J. Mungoven ◽  
Kasia K. Marciszewski ◽  
Vaughan G. Macefield ◽  
Paul M. Macey ◽  
Luke A. Henderson ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Primary Motor Cortex ◽  
Episodic Migraine ◽  
Pain Modulation ◽  
Rostral Ventromedial Medulla ◽  
Activation Patterns ◽  
Dorsolateral Prefrontal ◽  
Ventromedial Medulla ◽  
Underlying Mechanisms ◽  
Cortical Regions

Abstract Background The precise underlying mechanisms of migraine remain unknown. Although we have previously shown acute orofacial pain evoked changes within the brainstem of individuals with migraine, we do not know if these brainstem alterations are driven by changes in higher cortical regions. The aim of this investigation is to extend our previous investigation to determine if higher brain centers display altered activation patterns and connectivity in migraineurs during acute orofacial noxious stimuli. Methods Functional magnetic resonance imaging was performed in 29 healthy controls and 25 migraineurs during the interictal and immediately (within 24-h) prior to migraine phases. We assessed activation of higher cortical areas during noxious orofacial heat stimulation using a thermode device and assessed whole scan and pain-related changes in connectivity. Results Despite similar overall pain intensity ratings between all three groups, migraineurs in the group immediately prior to migraine displayed greater activation of the ipsilateral nucleus accumbens, the contralateral ventrolateral prefrontal cortex and two clusters in the dorsolateral prefrontal cortex (dlPFC). Reduced whole scan dlPFC [Z + 44] connectivity with cortical/subcortical and brainstem regions involved in pain modulation such as the putamen and primary motor cortex was demonstrated in migraineurs. Pain-related changes in connectivity of the dlPFC and the hypothalamus immediately prior to migraine was also found to be reduced with brainstem pain modulatory areas such as the rostral ventromedial medulla and dorsolateral pons. Conclusions These data reveal that the modulation of brainstem pain modulatory areas by higher cortical regions may be aberrant during pain and these alterations in this descending pain modulatory pathway manifests exclusively prior to the development of a migraine attack.

scholarly journals Alterations in Pain Processing Circuitries in Episodic Migraine

2021 ◽  
Author(s):  
Tiffani J. Mungoven ◽  
Kasia K. Marciszewski ◽  
Vaughan G. Macefield ◽  
Paul M. Macey ◽  
Luke Henderson ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Primary Motor Cortex ◽  
Episodic Migraine ◽  
Pain Modulation ◽  
Rostral Ventromedial Medulla ◽  
Activation Patterns ◽  
Dorsolateral Prefrontal ◽  
Ventromedial Medulla ◽  
Underlying Mechanisms ◽  
Cortical Regions

Abstract BackgroundThe precise underlying mechanisms of migraine remain unknown. Although we have previously shown acute orofacial pain evoked changes within the brainstem of individuals with migraine, we do not know if these brainstem alterations are driven by changes in higher cortical regions. The aim of this investigation is to extend our previous investigation to determine if higher brain centers display altered activation patterns and connectivity in migraineurs during acute orofacial noxious stimuli. MethodsFunctional magnetic resonance imaging was performed in 29 healthy controls and 25 migraineurs during the interictal and immediately (within 24-hours) prior to migraine phases. We assessed activation of higher cortical areas during noxious orofacial stimulation and assessed whole scan and pain-related changes in connectivity. ResultsDespite similar overall pain intensity ratings between all three groups, migraineurs in the group immediately prior to migraine displayed greater activation of the ipsilateral nucleus accumbens, the contralateral ventrolateral prefrontal cortex and two clusters in the dorsolateral prefrontal cortex (dlPFC). Reduced whole scan connectivity dlPFC [Z+44] connectivity with cortical/subcortical and brainstem regions involved in pain modulation such as the putamen and primary motor cortex was demonstrated in migraineurs. Pain-related changes in connectivity of the dlPFC and the hypothalamus immediately prior to migraine was also found to be reduced with brainstem pain modulatory areas such as the rostral ventromedial medulla and dorsolateral pons. ConclusionsThese data reveal that the modulation of brainstem pain modulatory areas by higher cortical regions may be aberrant during pain and these alterations in this descending pain modulatory pathway manifests exclusively prior to the development of a migraine attack.

The periaqueductal gray and descending pain modulation: why should we study them and what role do they play in chronic pain?

2015 ◽  
Vol 114 (4) ◽  
pp. 2080-2083 ◽  
Author(s):  
Kasey S. Hemington ◽  
Marie-Andrée Coulombe
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Functional Connectivity ◽  
Recent Literature ◽  
Chronic Back Pain ◽  
Periaqueductal Gray ◽  
Pain Modulation ◽  
Pain Research ◽  
Descending Pain Modulation ◽  
Pain Patients

In this Neuro Forum we discuss the significance of a recent study by Yu et al. ( Neuroimage Clin 6: 100–108, 2014). The authors examined functional connectivity of a key node of the descending pain modulation pathway, the periaqueductal gray (PAG), in chronic back pain patients. Altered PAG connectivity to pain-related regions was found; we place results within the context of recent literature and emphasize the importance of understanding the descending component of pain in pain research.

scholarly journals Different modulation effects of 1 Hz and 20 Hz transcutaneous auricular vagus nerve stimulation on the functional connectivity of the periaqueductal gray in patients with migraine

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jin Cao ◽  
Yue Zhang ◽  
Hui Li ◽  
Zhaoxian Yan ◽  
Xian Liu ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Resting State ◽  
Vagus Nerve Stimulation ◽  
Cingulate Cortex ◽  
Periaqueductal Gray ◽  
Pain Modulation ◽  
Anterior Cingulate ◽  
Descending Pain Modulation

Abstract Background A growing body of evidence suggests that transcutaneous auricular vagus nerve stimulation (taVNS) may relieve symptoms of migraineurs. Frequency is one of the key stimulation parameters. The aim of this study is to investigate the modulation effect of taVNS frequency on the descending pain modulation system (DPMS) in patients with migraine. Methods Twenty-four episodic migraineurs without aura (21 females) were recruited for the single-blind, crossover, functional magnetic resonance imaging (fMRI) study. Each participant attended two separate fMRI scan sessions, one for 1 Hz and another for 20 Hz taVNS, in a random order. Seed-based functional connectivity analysis was applied using the ventrolateral periaqueductal gray (PAG) as the region of interest. Results Compared with the pre-taVNS resting state, continuous 1 Hz taVNS (during) produced a significant increase in functional connectivity between the PAG and the bilateral middle cingulate cortex (MCC), right precuneus, left middle frontal gyrus (MFG), and left cuneus. Compared with 20 Hz taVNS, 1 Hz taVNS produced greater PAG connectivity increases with the MCC, right precuneus/posterior cingulate cortex, left insula, and anterior cingulate cortex (ACC). A significant negative correlation was observed between the number of migraine attacks in the previous 4 weeks and the PAG-MCC functional connectivity in the pre-taVNS resting-state before 1 Hz taVNS. Conclusions Our findings suggest that taVNS with different frequencies may produce different modulation effects on the descending pain modulation system, demonstrating the important role of stimulation frequency in taVNS treatment.

scholarly journals The association between pain-induced autonomic reactivity and descending pain control is mediated by the periaqueductal grey

2020 ◽  
Author(s):  
Elena Makovac ◽  
Alessandra Venezia ◽  
David Hohenschurz-Schmidt ◽  
Ottavia Dipasquale ◽  
Jade B Jackson ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Functional Connectivity ◽  
Pain Control ◽  
Brain Regions ◽  
Pain Modulation ◽  
Autonomic Reactivity ◽  
Pain Mechanisms ◽  
Cold Pain ◽  
Periaqueductal Grey ◽  
Descending Pain Modulation

AbstractThere is a strict interaction between the autonomic nervous system (ANS) and pain, which might involve descending pain modulatory mechanisms. The periaqueductal grey (PAG) is involved both in descending pain modulation and ANS, but its role in mediating this relationship has not yet been explored.Here, we sought to determine brain regions mediating ANS and descending pain control associations. 30 participants underwent Conditioned Pain Modulation (CPM) assessments, in which they rated painful pressure stimuli applied to their thumbnail, either alone or with a painful cold contralateral stimulation. Differences in pain ratings between ‘pressure-only’ and ‘pressure+cold’ stimuli provided a measure of descending pain control. In 18 of the 30 participants, structural scans and two functional MRI assessments, one pain-free and one during cold-pain, were acquired. Heart Rate Variability (HRV) was simultaneously recorded.Low frequency HRV (LF-HRV) and the CPM score were negatively correlated; individuals with higher LF-HRV during pain reported reductions in pain during CPM. PAG-frontal medial cortex (FMC) and PAG-rostral ventro-medial medulla (RVM) functional connectivity correlated negatively with the CPM. Importantly, PAG-FMC functional connectivity mediated the strength of HRV-CPM association. CPM response magnitude was also negatively associated with PAG and positively associated with FMC grey matter volumes.Our multi-modal approach, using behavioral, physiological and MRI measures, provides important new evidence of interactions between ANS and descending pain mechanisms. ANS dysregulation and dysfunctional descending pain modulation are characteristics of chronic pain. We suggest that further investigation of body-brain interactions in chronic pain patients may catalyse the development of new treatments.

Sign in / Sign up

Export Citation Format

Share Document