Imaging CNS Modulation of Pain in Humans

Physiology ◽  
2008 ◽  
Vol 23 (6) ◽  
pp. 371-380 ◽  
Author(s):  
Ulrike Bingel ◽  
Irene Tracey
Keyword(s):  
Chronic Pain ◽  
Subjective Experience ◽  
Pain Perception ◽  
Survival Function ◽  
Human Experimentation ◽  
Major Focus ◽  
Pain Experience ◽  
Emotional Factors ◽  
Nociceptive Information ◽  
Nociceptive Input

Pain is a highly complex and subjective experience that is not linearly related to the nociceptive input. What is clear from anecdotal reports over the centuries and more recently from animal and human experimentation is that nociceptive information processing and consequent pain perception is subject to significant pro- and anti-nociceptive modulations. These modulations can be initiated reflexively or by contextual manipulations of the pain experience including cognitive and emotional factors. This provides a necessary survival function since it allows the pain experience to be altered according to the situation rather than having pain always dominate. The so-called descending pain modulatory network involving predominantly medial and frontal cortical areas, in combination with specific subcortical and brain stem nuclei appears to be one key system for the endogenous modulation of pain. Furthermore, recent findings from functional and anatomical neuroimaging support the notion that an altered interaction of pro- and anti-nociceptive mechanisms may contribute to the development or maintenance of chronic pain states. Research on the involved circuitry and implemented mechanisms is a major focus of contemporary neuroscientific research in the field of pain and should provide new insights to prevent and treat chronic pain states.

Participants with chronic pain do not perceive diet as a contributing factor to their pain: a survey-based study

2020 ◽  
Vol 10 (3) ◽  
pp. 195-204
Author(s):  
Rowena J Field ◽  
Fereshteh Pourkazemi ◽  
Kieron B Rooney
Keyword(s):  
Chronic Pain ◽  
Pain Perception ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Pain Experience ◽  
Habitual Diet

Aim: To explore the reported diet of Australians with chronic pain and their perceived role of food within their pain experience. Methods: A cross-sectional study of 50 participants reporting chronic pain was undertaken using pain and nutritional questionnaires as well as anthropometric measures. Results: Participants rated their diet between ‘good’ and ‘excellent' (76%) and one that promoted well-being (62%), however 74% were overweight or obese (average BMI 30) with multiple co-morbidities. There was no correlation between measures of dietary adherence and knowledge with reported pain. Conclusion: Participants generally reported their diets to be good, however, this was not reflected in their habitual diet. There was a low perceived role of food altering pain perception.

scholarly journals Pain experience and social support of endometriosis patients during the COVID-19 pandemic in Germany – results of a web-based cross-sectional survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256433
Author(s):  
Roxana Schwab ◽  
Katharina Anić ◽  
Kathrin Stewen ◽  
Mona W. Schmidt ◽  
Stefanie R. Kalb ◽  
...  
Keyword(s):  
Social Support ◽  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Perception ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Pain Experience ◽  
Social Distancing ◽  
Pain Disability

Background Endometriosis is a chronic pain condition in premenopausal women. Pain is mainly characterized by pain intensity and may induce disability in all areas of daily life. Nevertheless, pain is influenced by emotional and social factors as well. Social distancing measures or quarantine, as reaction to rapidly rising infections with the COVID-19 virus due to the SARS-CoV-2 pandemic, were implemented across Europe to prevent the spread of the virus and social distancing measures were imposed by the German government by beginning of March 2020 with initiation of the lockdown by the end of March 2020. The objective of this study was to assess, how social distancing measures during the lockdown impacted the various aspects of pain perception in a group of chronic pain patients, such as women suffering from endometriosis. Methods Between 6th to 27th April 2020, an online questionnaire was activated at internet platforms of endometriosis patients support groups. Participants were asked retrospectively at one time point about their visual pain intensity measured by the visual analogue scale (VAS) and pain disability via pain disability index (PDI) prior to initiation of social distancing measures in Germany (VASP, PDIP), as well as the pain intensity and pain disability since implementation of social distancing measures (VASI, PDII). Differences of VAS and PDI previous and after implementation of social distancing measures were displayed as ΔVAS and ΔPDI. Pain experience and social support were assessed by a 5-point Likert scale. Results 285 participants completed at least one question regarding pain intensity, disability, pain experience or social support. Dysmenorrhea, the symptom with the highest level of pain assessed by VAS, decreased significantly during the SARS-CoV-2 pandemic compared to the time period prior to social isolation (45.30% respondents experienced improvemenet vs 40.50% who experienced worsening; p = 0.025). The global physical impairment improved significantly (improvement of pain induced disability in 48.20% vs 40.90% with worsening of pain symptoms; p = 0.032) after the implementation of social distancing measures. Pain experience was negatively affected by social distancing measures, since frequency of pain awareness increased in 43.6% (p<0.001) of participants and 30.0% (p<0.001) more participants experienced pain as a threat. Verbalization of pain experience was reduced in 36.6% (p = 0.001) of participants and 14.6% (p = 0.91), 21.9% (p<0.001) and 31.5% (p<0.001) of participants reported less social support from their partner, family and friends. Conclusions Physical pain and disability on one hand and emotional and social pain experience on the other were differentially affected by the emerged emotional, social and health care constraints related to the SARS-CoV-2 pandemic.

scholarly journals Psychological factors and psychosocial interventions for cancer related pain

2017 ◽  
Vol 55 (2) ◽  
pp. 63-68 ◽  
Author(s):  
Andrada Ciucă ◽  
Adriana Băban
Keyword(s):  
Chronic Pain ◽  
Strong Evidence ◽  
Psychological Factors ◽  
Biopsychosocial Model ◽  
Psychosocial Interventions ◽  
Cognitive Factors ◽  
Related Factors ◽  
Pain Experience ◽  
Emotional Factors ◽  
Factors Influencing

Abstract The present paper is aimed at briefly presenting psychological factors involved in cancer related pain and what psychosocial interventions are efficient in reducing it. Cancer related pain is a complex experience and the most integrative and recommended approach is the biopsychosocial model. It has been proved that chronic pain is more strongly related to psychological factors than to treatment or illness related factors. Psychological factors influencing pain experience can be intuitively grouped starting with awareness of pain (i.e., attentional factor), then with evaluation of pain (i.e., cognitive factors) which is leading to feelings (i.e., emotional factors), and behaviours (i.e., coping strategies) regarding pain. Psychosocial interventions (i.e., skill based and education based interventions) have strong evidence that is effective in reducing cancer related pain.

Role of Ethnicity on Pain Perception, Fatigue, and Quality of Life in a Pediatric Chronic Pain Population

2007 ◽  
Author(s):  
Jeffrey I. Gold ◽  
Trina Haselrig ◽  
D. Colette Nicolaou ◽  
Katharine A. Belmont
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Perception ◽  
Pediatric Chronic Pain

scholarly journals Vitamin D Deficiency Induces Chronic Pain and Microglial Phenotypic Changes in Mice

2021 ◽  
Vol 22 (7) ◽  
pp. 3604
Author(s):  
Nicola Alessio ◽  
Carmela Belardo ◽  
Maria Consiglia Trotta ◽  
Salvatore Paino ◽  
Serena Boccella ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vitamin D ◽  
Chronic Pain ◽  
Vitamin D Deficiency ◽  
Morphological Analysis ◽  
Pain Perception ◽  
Ex Vivo ◽  
Ros Generation ◽  
Peroxisome Proliferator ◽  
Neuroprotective Effects

The bioactive form of vitamin .D, 1,25-dihydroxyvitamin D (1,25D3), exerts immunomodulatory actions resulting in neuroprotective effects potentially useful against neurodegenerative and autoimmune diseases. In fact, vitamin D deficiency status has been correlated with painful manifestations associated with different pathological conditions. In this study, we have investigated the effects of vitamin D deficiency on microglia cells, as they represent the main immune cells responsible for early defense at central nervous system (CNS), including chronic pain states. For this purpose, we have employed a model of low vitamin D intake during gestation to evaluate possible changes in primary microglia cells obtained from postnatal day(P)2-3 pups. Afterwards, pain measurement and microglia morphological analysis in the spinal cord level and in brain regions involved in the integration of pain perception were performed in the parents subjected to vitamin D restriction. In cultured microglia, we detected a reactive—activated and proliferative—phenotype associated with intracellular reactive oxygen species (ROS) generation. Oxidative stress was closely correlated with the extent of DNA damage and increased β-galactosidase (B-gal) activity. Interestingly, the incubation with 25D3 or 1,25D3 or palmitoylethanolamide, an endogenous ligand of peroxisome proliferator-activated-receptor-alpha (PPAR-α), reduced most of these effects. Morphological analysis of ex-vivo microglia obtained from vitamin-D-deficient adult mice revealed an increased number of activated microglia in the spinal cord, while in the brain microglia appeared in a dystrophic phenotype. Remarkably, activated (spinal) or dystrophic (brain) microglia were detected in a prominent manner in females. Our data indicate that vitamin D deficiency produces profound modifications in microglia, suggesting a possible role of these cells in the sensorial dysfunctions associated with hypovitaminosis D.

scholarly journals Can Residential Greenspace Exposure Improve Pain Experience? A Comparison between Physical Visit and Image Viewing

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 918
Author(s):  
Hansen Li ◽  
Xing Zhang ◽  
Shilin Bi ◽  
Yang Cao ◽  
Guodong Zhang
Keyword(s):  
Heart Rate ◽  
State Anxiety ◽  
Pain Threshold ◽  
Pain Perception ◽  
The State ◽  
Subjective Stress ◽  
Pain Experience ◽  
Scenic Beauty ◽  
Significant Difference ◽  
Pain Stimuli

Reducing the burden of pain via greenspace exposure is a rising research topic. However, insufficient evidence has been found in relation to the environmental effect itself. Residential greenspace, as a convenient but limited natural environment for urban dwellers, has benefits and services yet to be discovered. Therefore, the current study recruited 24 young adults to evaluate the effects of physical visit to, or image viewing of, residential greenspace on pain perception and related psychophysiological outcomes, via simulated pain. Pain threshold and tolerance were recorded via the level of pain stimuli, and pain intensity was evaluated using the Visual Analog Scale (VAS). The state scale of the State–Trait Anxiety Inventory (STAI-S) and two adjective pairs were employed to measure the state anxiety and subjective stress, respectively. Meanwhile, heart rate (HR), heart rate variability (HRV), and blood pressure (BP) were measured to investigate physiological responses. Besides, Scenic Beauty Estimation (SBE) was also employed to assess participants’ preference regarding the experimental environments. The results revealed that visiting the greenspace significantly increased the pain threshold and tolerance, while no significant effect was observed for image viewing. On the other hand, no significant difference was observed in pain-related psychophysiological indices between the experimental settings, but significantly negative associations were found between the scores of SBE and subjective stress and state anxiety. In conclusion, the current study brings experimental evidence of improving pain experience via residential greenspace exposure, while the related psychophysiological benefits require further investigation.

scholarly journals Test–retest reliability of laser evoked pain perception and fMRI BOLD responses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanzhi Bi ◽  
Xin Hou ◽  
Jiahui Zhong ◽  
Li Hu
Keyword(s):  
Resting State ◽  
Repeated Measures ◽  
Subjective Experience ◽  
Pain Perception ◽  
Primary Motor Cortex ◽  
Intraclass Correlation ◽  
Retest Reliability ◽  
Repeated Measures Design ◽  
Brain Responses ◽  
Test Retest Reliability

AbstractPain perception is a subjective experience and highly variable across time. Brain responses evoked by nociceptive stimuli are highly associated with pain perception and also showed considerable variability. To date, the test–retest reliability of laser-evoked pain perception and its associated brain responses across sessions remain unclear. Here, an experiment with a within-subject repeated-measures design was performed in 22 healthy volunteers. Radiant-heat laser stimuli were delivered on subjects’ left-hand dorsum in two sessions separated by 1–5 days. We observed that laser-evoked pain perception was significantly declined across sessions, coupled with decreased brain responses in the bilateral primary somatosensory cortex (S1), right primary motor cortex, supplementary motor area, and middle cingulate cortex. Intraclass correlation coefficients between the two sessions showed “fair” to “moderate” test–retest reliability for pain perception and brain responses. Additionally, we observed lower resting-state brain activity in the right S1 and lower resting-state functional connectivity between right S1 and dorsolateral prefrontal cortex in the second session than the first session. Altogether, being possibly influenced by changes of baseline mental state, laser-evoked pain perception and brain responses showed considerable across-session variability. This phenomenon should be considered when designing experiments for laboratory studies and evaluating pain abnormalities in clinical practice.

scholarly journals Pain anticipatory phenomena in patients with central poststroke pain: a magnetoencephalography study

2016 ◽  
Vol 116 (3) ◽  
pp. 1387-1395 ◽  
Author(s):  
Raghavan Gopalakrishnan ◽  
Richard C. Burgess ◽  
Scott F. Lempka ◽  
John T. Gale ◽  
Darlene P. Floden ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Visual Cues ◽  
Neural Substrates ◽  
Cognitive Networks ◽  
Therapeutic Approaches ◽  
Pain Experience ◽  
Time Frequency ◽  
Cognitive Components ◽  
Chronic Effects ◽  
Integrated Approaches

Central poststroke pain (CPSP) is characterized by hemianesthesia associated with unrelenting chronic pain. The final pain experience stems from interactions between sensory, affective, and cognitive components of chronic pain. Hence, managing CPSP will require integrated approaches aimed not only at the sensory but also the affective-cognitive spheres. A better understanding of the brain's processing of pain anticipation is critical for the development of novel therapeutic approaches that target affective-cognitive networks and alleviate pain-related disability. We used magnetoencephalography (MEG) to characterize the neural substrates of pain anticipation in patients suffering from intractable CPSP. Simple visual cues evoked anticipation while patients awaited impending painful (PS), nonpainful (NPS), or no stimulus (NOS) to their nonaffected and affected extremities. MEG responses were studied at gradiometer level using event-related fields analysis and time-frequency oscillatory analysis upon source localization. On the nonaffected side, significantly greater responses were recorded during PS. PS (vs. NPS and NOS) exhibited significant parietal and frontal cortical activations in the beta and gamma bands, respectively, whereas NPS (vs. NOS) displayed greater activation in the orbitofrontal cortex. On the affected extremity, PS (vs. NPS) did not show significantly greater responses. These data suggest that anticipatory phenomena can modulate neural activity when painful stimuli are applied to the nonaffected extremity but not the affected extremity in CPSP patients. This dichotomy may stem from the chronic effects of pain on neural networks leading to habituation or saturation. Future clinically effective therapies will likely be associated with partial normalization of the neurophysiological correlates of pain anticipation.

Cultural Considerations in the Management of Chronic Pain

CAND Journal ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 11-13
Author(s):  
Shakila Mohmand ◽  
Sumar Chams
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Cultural Competency ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Coping Mechanisms ◽  
Care Providers ◽  
Pain Experience ◽  
Cultural Considerations

Cultural competency within health care helps eliminate racial and ethnic health disparities. When assessing and treating patients with chronic pain, practitioners should feel confident in using information regarding a patient’s individual cultural beliefs due to their significant impact on the pain experience. Culture impacts perception, outlook, and communication of pain, as well as coping mechanisms. These are aspects of subjective history that influence important decisions regarding the management of chronic pain. Becoming more aware of what to look for and which questions to ask can allow naturopathic doctors and other health-care providers to continue improving therapeutic relationships and patient outcomes.

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