Thalamic network under wakefulness after sleep onset and its coupling with daytime fatigue in insomnia disorder: An EEG-fMRI study.

BACKGROUND: Fatigue is the most common daytime impairment of insomnia disorder (ID). Thalamus is acknowledged as the key brain region closely associated with fatigue. However, the thalamus-based neurobiological mechanisms of fatigue in patients with ID remain unknown. METHODS: Forty-two ID patients and twenty-eight well-matched healthy controls (HCs) underwent simultaneous electroencephalography--functional magnetic resonance imaging. We calculated the functional connectivity (FC) between the thalamic seed and each voxel across the whole brain in two conditions of wakefulness--after sleep onset (WASO) and before sleep onset. A linear mixed effect model was used to determine the condition effect of the thalamic FC. The correlation between daytime fatigue and the thalamic connectivity was explored. RESULTS: After sleep onset, the connectivity with the bilateral thalamus was increased in the cerebellar and cortical regions. Compared with HCs, ID patients showed significantly lower FC between left thalamus and left cerebellum under the WASO condition. Furthermore, thalamic connectivity with cerebellum under the WASO condition was negatively correlated with Fatigue Severity Scale scores in the pooled sample. CONCLUSIONS: These findings contribute to an emerging framework that reveals the link between insomnia-related daytime fatigue and the altered thalamic network after sleep onset, further highlighting the possibility that this neural pathway is a therapeutic target for meaningfully mitigating fatigue.

Global Gene Knockout of Kcnip3 Enhances Pain Sensitivity and Exacerbates Negative Emotions in Rats.

The Ca2+-binding protein Kv channel interacting protein 3 (KChIP3) or downstream regulatory element antagonist modulator (DREAM), a member of the neuronal calcium sensor (NCS) family, shows remarkable multifunctional properties. It acts as a transcriptional repressor in the nucleus and a modulator of ion channels or receptors, such as Kv4, NMDA receptors and TRPV1 channels on the cytomembrane. Previous studies of Kcnip3 -/- mice have indicated that KChIP3 facilitates pain hypersensitivity by repressing Pdyn expression in the spinal cord. Conversely, studies from transgenic daDREAM (dominant active DREAM) mice indicated that KChIP3 contributes to analgesia by repressing Bdnf expression and attenuating the development of central sensitization. To further determine the role of KChIP3 in pain transmission and its possible involvement in emotional processing, we assessed the pain sensitivity and negative emotional behaviors of Kcnip3 -/- rats. The knockout rats showed higher pain sensitivity compared to the wild-type rats both in the acute nociceptive pain model and in the late phase (i.e., 2, 4 and 6 days post complete Freund's adjuvant injection) of the chronic inflammatory pain model. Importantly, Kcnip3 -/- rats displayed stronger aversion to the pain-associated compartment, higher anxiety level and aggravated depression-like behavior. Furthermore, RNA-Seq transcriptional profiling of the forebrain cortex were compared between wild-type and Kcnip3 -/- rats. Among the 68 upregulated genes, 19 genes (including Nr4a2, Ret, Cplx3, Rgs9, and Itgad) are associated with neural development or synaptic transmission, particularly dopamine neurotransmission. Among the 79 downregulated genes, 16 genes (including Col3a1, Itm2a, Pcdhb3, Pcdhb22, Pcdhb20, Ddc, and Sncaip) are associated with neural development or dopaminergic transmission. Transcriptional upregulation of Nr4a2, Ret, Cplx3 and Rgs9, and downregulation of Col3a1, Itm2a, Pcdhb3 and Ddc, were validated by qPCR analysis. In summary, our studies showed that Kcnip3 -/- rats displayed higher pain sensitivity and stronger negative emotions, suggesting an involvement of KChIP3 in negative emotions and possible role in central nociceptive processing.

[Advances of clinical study on acupuncture and moxibustion for treatment of cancer pain].

Cancer pain is one of the commonly-seen main clinical symptoms for the terminal cancer patient, and severely influences quality of life of the patient, which needs to be solved urgently. Application of analgesics is limited by its addiction and side effects. Acupuncture as one of TCM therapies with advantages of safety, effectiveness and no side effect is playing an important role in treatment of cancer pain. This article reviews recent 10 years' acupuncture and moxibustion methods for treatment of cancer pain, so as to better guide acupuncture and moxibustion treatment of cancer pain and provide necessary research data for future studies.

[Observation on the therapeutic effect of acupuncture at pain points on cancer pain].

OBJECTIVE: To search for a safe and effective method for alleviating cancer pain. METHODS: Sixty-six cases of late cancer with pain were first divided into 3 different degrees of pain, mild, moderate and severe, and then the patients with pain of each same degree were randomly divided into an acupuncture group treated by acupuncture at 3-5 of the most severe tender points, and a medication group treated with oral administration according to the WHO Three Step Administration Principle, i.e. the patients with mild pain took aspirin, moderate pain took codeine and severe pain took morphine. RESULTS: Both two methods could effectively control cancer pain. The total effective rate of 94.1% in the acupuncture group was significantly better than 87.5% in the medication group (P<0.05). CONCLUSION: The analgesic effect of acupuncture treatment is better than that of the Three Step Administration, with no adverse effect and addiction of analgesics.