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Introduction: Primary dysmenorrhea (PDM) is a common condition among women of reproductive age, characterized by menstrual pain in the absence of any organic causes. Previous research has established a link between the A118G polymorphism in the mu-opioid receptor (OPRM1) gene and pain experience in PDM. Specifically, carriers of the G allele have been found to exhibit maladaptive functional connectivity between the descending pain modulatory system and the motor system in young women with PDM. This study aims to explore the potential relationship between the OPRM1 A118G polymorphism and changes in white matter in young women with PDM. Methods: The study enrolled 43 individuals with PDM, including 13 AA homozygotes and 30 G allele carriers. Diffusion tensor imaging (DTI) scans were performed during both the menstrual and peri-ovulatory phases, and tract-based spatial statistics (TBSS) and probabilistic tractography were used to explore variations in white matter microstructure related to the OPRM1 A118G polymorphism. The short-form McGill Pain Questionnaire (MPQ) was used to access participants' pain experience during the MEN phase. Results: Two-way ANOVA on TBSS analysis revealed a significant main effect of genotype, with no phase effect or phase-gene interaction detected. Planned contrast analysis showed that during the menstrual phase, G allele carriers had higher fractional anisotropy (FA) and lower radial diffusivity in the corpus callosum and the left corona radiata compared to AA homozygotes. Tractographic analysis indicated the involvement of the left internal capsule, left corticospinal tract, and bilateral medial motor cortex. Additionally, the mean FA of the corpus callosum and the corona radiata was negatively correlated with MPQ scales in AA homozygotes, but this correlation was not observed in G allele carriers. No significant genotype difference was found during the pain-free peri-ovulary phase. Discussion: OPRM1 A118G polymorphism may influence the connection between structural integrity and dysmenorrheic pain, where the G allele could impede the pain-regulating effects of the A allele. These novel findings shed light on the underlying mechanisms of both adaptive and maladaptive structural neuroplasticity in PDM, depending on the specific OPRM1 polymorphism.
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PURPOSE: This work investigates the effects of flow acceleration in the superior sagittal sinus on slice-dependent variations in venous oxygen saturation (SvO2 ) estimations using susceptibility-based MR oximetry. METHODS: Three-dimensional multiple gradient-echo images, with first-order flow compensation along the anterior-posterior readout direction for the first echo, were acquired twice from 15 healthy volunteers. For all slices, phases within the superior sagittal sinus were fitted using linear regression across four TEs to obtain the Pearson's correlation coefficients (PCCs), the largest of which corresponded to minimum acceleration influence. SvO2 derived from odd echoes on this slice was used to assess interscan difference, and compared with the central 15th slice for slice-dependent difference, both using Bland-Altman analysis. Within-scan interslice SvO2 consistency was examined versus PCC. Multislice-averaged SvO2 values were then computed from slices with PCCs above a certain threshold. RESULTS: Slice-dependent difference in SvO2 varied from -16.2% to 21.5% at two SDs, in agreement with a recent report, and about twice larger than interscan differences for the automatically selected slice (-7.5% to 10.3%) and for the central 15th slice (-8.0% to 8.8%). For slices with PCCs higher than -0.98, interslice SvO2 deviations were all found to be less than 5.0%. Multislice-averaged SvO2 with PCCs higher than -0.98 further reduced interscan difference to -4.7% to 8.2%. CONCLUSION: Slice-dependent variations in SvO2 may partly be explained by the effects of flow acceleration. Our method may enable conventional 3D multiple gradient echo to be used for SvO2 estimations in the presence of pulsatile flow.
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Oxígeno , Seno Sagital Superior , Aceleración , Humanos , Imagen por Resonancia Magnética , OximetríaRESUMEN
Humor has been considered an effective emotion regulation strategy, and some behavioral studies have examined its superior effects on negative emotion regulation. However, its neural mechanisms remain unknown. Our functional magnetic resonance imaging study directly compared the emotion regulation effects and neural bases of humorous coping (reappraisal) and ordinary reappraisal following exposure to negative pictures. The behavioral results suggested that humorous reappraisal was more effective in downregulating negative emotions and upregulating positive emotions both in the short and long term. We also found 2 cooperative neural pathways involved in coping with negative stimuli by means of humor: the "hippocampal-thalamic-frontal pathway" and the "amygdala-cerebellar pathway." The former is associated with the restructuring of mental representations of negative situations and accompanied by an insightful ("Aha!") experience, while the latter is associated with humorous emotional release and accompanied by an expression of laughter ("Haha!"). Furthermore, the degree of hippocampal functional connectivity with both the thalamus and frontal cortex was positively correlated with changes in positive emotion, and this result implied that the degree of emotion regulation could be strongly directly related to the depth of cognitive reconstruction. These findings highlight that regulating negative emotions with humor involves cognitive restructuring and the release of positive emotions.
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Adaptación Psicológica/fisiología , Encéfalo/fisiología , Reestructuración Cognitiva/métodos , Emociones/fisiología , Red Nerviosa/fisiología , Ingenio y Humor como Asunto/psicología , Adulto , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Masculino , Red Nerviosa/diagnóstico por imagen , Pesimismo/psicología , Estimulación Luminosa/efectos adversos , Estimulación Luminosa/métodos , Adulto JovenRESUMEN
AIMS: To investigate the functional connectivity (FC) in nonacute sciatica and the neuronal correlation of acupuncture analgesia. METHODS: A prospective study employing resting-state functional magnetic resonance imaging was conducted. Twelve sciatica patients were enrolled to receive six or 18 acupoints of acupuncture treatment twice a week for 4 weeks. Regional homogeneity (ReHo) and seed-based FC were performed. RESULTS: Regional homogeneity analysis demonstrated a greater alteration in the right posterior cingulate cortex (PCC) during the pre-acupuncture phase than during the postacupuncture phase. Compared to that of healthy controls, the PCC-seeded FC (default mode network, DMN) of sciatica patients exhibited hyperconnectivity of PCC-FC with the PCC-bilateral insula, cerebellum, inferior parietal lobule, right medial prefrontal cortex, and dorsal anterior cingulate cortex during the pre-acupuncture phase as well as hypoconnectivity of PCC-FC with the right cerebellum, left precuneus, and left dorsal medial prefrontal cortex during the postacupuncture phase. Correlation analysis between PCC-seeded FC and behavior measurements revealed a positive association with the duration of sciatica in the right inferior parietal lobule prior to acupuncture treatment. CONCLUSIONS: Acupuncture in chronic sciatica patients is associated with normalized DMN activity and modulation of descending pain processing. The changes in the subclinical endophenotype of brain FC after acupuncture treatment may provide clues for understanding the mechanism of acupuncture-mediated analgesia in chronic pain.
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Terapia por Acupuntura/métodos , Mapeo Encefálico/métodos , Imagen por Resonancia Magnética/métodos , Nocicepción/fisiología , Ciática , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Femenino , Giro del Cíngulo/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Ciática/fisiopatología , Ciática/terapiaRESUMEN
OBJECTIVES: Evidence of plastic changes in tinnitus has been demonstrated in functional brain imaging. Although repetitive transcranial magnetic stimulation (rTMS) has been shown to decrease steady-state auditory evoked fields (SSAEFs) in tinnitus, the long-term consequence remained unknown. In addition, association between plastic changes as reflected by hemispheric asymmetry and tinnitus handicap inventory (THI) before and after rTMS have not been addressed. METHODS: Twelve tinnitus patients received rTMS and 12 received sham stimulation. Another 12 healthy participants served as the normal hearing controls. Patients responded to the THI before the 1st session and at one month after the final session of rTMS/sham stimulation. Changes in brain activity were assessed by measuring SSAEFs. RESULTS: SSAEFs remained decreased one month after rTMS compared to before treatment, along with a significant reduction in THI score. There was no significant effect between the index of hemispheric asymmetry and THI score. CONCLUSIONS: The current study objectively demonstrated the long-term effects of rTMS on tinnitus using SSAEFs. A longitudinal study to develop an index using SSAEFs to assess the subjective severity of tinnitus is warranted. SIGNIFICANCE: This study suggests the possible use of SSAEFs to assess the long-term effects of rTMS on tinnitus.
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Potenciales Evocados Auditivos , Acúfeno/fisiopatología , Estimulación Magnética Transcraneal/métodos , Adulto , Anciano , Corteza Cerebral/fisiopatología , Femenino , Lateralidad Funcional , Humanos , Masculino , Persona de Mediana Edad , Acúfeno/terapia , Estimulación Magnética Transcraneal/efectos adversosRESUMEN
Traditional Chinese medicine (TCM) practitioners assess body constitution (BC) as a treatment basis for maintaining body homeostasis. We investigated patterns in spontaneous brain activity in different BC groups using resting-state functional magnetic resonance imaging (rsfMRI) and determined the relationship between these patterns and quality of life (QOL). Thirty-two healthy individuals divided into two groups (body constitution questionnaire (BCQ)-gentleness [BCQ-G] and BCQ-deficiency [BCQ-D]) based on the body constitution questionnaire (BCQ) underwent rsfMRI to analyze regional homogeneity (ReHo) and the amplitude of low-frequency fluctuation (ALFF). The World Health Organization Quality of Life Instruments (brief edition) scale was used to evaluate the QOL. The BCQ-G group (n = 18) had significantly greater ReHo values in the right postcentral gyrus and lower ALFF values in the brainstem than the BCQ-D group (n = 14). In the BCQ-D group, decreased ReHo of the postcentral gyrus correlated with better physiological functioning; increased ALFF in the brainstem correlated with poor QOL. BCQ-subgroup analysis revealed a nonsignificant correlation between ReHo and Yang deficiency/phlegm and stasis (Phl & STA). Nonetheless, the BCQ-D group showed a positive correlation between ALFF and Phl & STA in the parahippocampus. This study identified differences between BCQ-G and BCQ-D types of healthy adults based on the rsfMRI analysis. The different BCQ types with varied brain endophenotypes may elucidate individualized TCM treatment strategies.
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Primary dysmenorrhea (PDM), painful menstruation without organic causes, is the most prevalent gynecological problem in women of reproductive age. Dysmenorrhea later in life often co-occurs with many chronic functional pain disorders, and chronic functional pain disorders exhibit altered large-scale connectedness between distributed brain regions. It is unknown whether the young PDM females exhibit alterations in the global and local connectivity properties of brain functional networks. Fifty-seven otherwise healthy young PDM females and 62 age- and education-matched control females participated in the present resting-state functional magnetic resonance imaging study. We used graph theoretical network analysis to investigate the global and regional network metrics and modular structure of the resting-state brain functional networks in young PDM females. The functional network was constructed by the interregional functional connectivity among parcellated brain regions. The global and regional network metrics and modular structure of the resting-state brain functional networks were not altered in young PDM females at our detection threshold (medium to large effect size differences [Cohen's d ≥ 0.52]). It is plausible that the absence of significant changes in the intrinsic functional brain architecture allows young PDM females to maintain normal psychosocial outcomes during the pain-free follicular phase.
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Encéfalo , Dismenorrea , Imagen por Resonancia Magnética , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Mapeo Encefálico , Dismenorrea/diagnóstico por imagen , Dismenorrea/fisiopatología , Femenino , Humanos , TaiwánRESUMEN
OBJECTIVE: Recent functional MRI (fMRI) studies show that brain activity, including the default mode network (DMN), can be modulated by acupuncture. Conventional means to enhance the neurophysiological 'dose' of acupuncture, including an increased number of needles and manual needle manipulation, are expected to enhance its physiological effects. The aim of this study was to compare the effects of both methods on brain activity. METHODS: 58 healthy volunteers were randomly assigned into four groups that received single needle acupuncture (SNA, n=15) or transcutaneous electrical nerve stimulation (TENS, n=13) as active controls, or enhanced acupuncture by way of three needle acupuncture (TNA, n=17) or SNA plus manual stimulation (SNA+MS, n=13). Treatment-associated sensations were evaluated using a visual analogue scale. Central responses were recorded before, during, and after treatment at LI4 on the left hand using resting state fMRI. RESULTS: TNA and SNA+MS induced DMN-insula activity and extensive DMN activity compared to SNA, despite comparable levels of de qi sensation. The TNA and SNA+MS groups exhibited a delayed and enhanced modulation of the DMN, which was not observed followed SNA and TENS. Furthermore, TNA increased precuneus activity and increased the DMN-related activity of the cuneus and left insula, while SNA+MS increased activity in the right insula. CONCLUSIONS: The results showed that conventional methods to enhance the acupuncture dose induce different DMN modulatory effects. TNA induces the most extensive DMN modulation, compared with other methods. Conventional methods of enhancing the acupuncture dose could potentially be applied as a means of modulating brain activity.
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Terapia por Acupuntura/métodos , Red Nerviosa/fisiología , Sensación/fisiología , Terapia por Acupuntura/instrumentación , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Mapeo Encefálico/métodos , Femenino , Mano/diagnóstico por imagen , Mano/fisiología , Humanos , Imagen por Resonancia Magnética , Masculino , Agujas , Descanso/fisiología , Estimulación Eléctrica Transcutánea del Nervio/métodos , Escala Visual AnalógicaRESUMEN
Primary dysmenorrhea (PDM) is the most prevalent gynecological problem. Many key brain systems are engaged in pain processing. In light of dynamic communication within and between systems (or networks) in shaping pain experience and behavior, the intra-regional functional connectivity (FC) in the hub regions of the systems may be altered and the functional interactions in terms of inter-regional FCs among the networks may be reorganized to cope with the repeated stress of menstrual pain in PDM. Forty-six otherwise healthy PDM subjects and 49 age-matched, healthy female control subjects were enrolled. Intra- and inter-regional FC were assessed using regional homogeneity (ReHo) and ReHo-seeded FC analyses, respectively. PDM women exhibited a trait-related ReHo reduction in the ventromedial prefrontal cortex, part of the default mode network (DMN), during the periovulatory phase. The trait-related hypoconnectivity of DMN-salience network and hyperconnectivity of DMN-executive control network across the menstrual cycle featured a dynamic transition from affective processing of pain salience to cognitive modulation. The altered DMN-sensorimotor network may be an ongoing representation of cumulative menstrual pain. The findings indicate that women with long-term PDM may develop adaptive neuroplasticity and functional reorganization with a network shift from affective processing of salience to the cognitive modulation of pain.
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Encéfalo/fisiopatología , Dismenorrea/fisiopatología , Red Nerviosa/fisiopatología , Dolor/fisiopatología , Adulto , Encéfalo/diagnóstico por imagen , Conectoma/métodos , Dismenorrea/etiología , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Dolor/diagnóstico por imagenRESUMEN
The aim of this study was to investigate the autonomic responses and central manifestations by peripheral FIR stimulation. Ten subjects (mean ± SD age 26.2 ± 3.52 years) received FIR stimulation at left median nerve territory for 40 min. Electrocardiograph was continuously recorded and heart rate variability (HRV) were analyzed. By using a 3 T-MRI scanner, three sessions of resting-state functional magnetic resonance images (fMRI) were acquired, namely, before (baseline-FIR), immediately after (IA-FIR) and 15 min after FIR was turned off (Post-FIR). The fractional amplitude of low-frequency (0.01-0.08 Hz) fluctuation (fALFF) of each session to evaluate the intensity of resting-brain activity in each session was analyzed. Our results showed that FIR stimulation induced significant HRV responses such as an increasing trend of nLF and LF/HF ratio, while FIR increased fALFF in right superior front gyrus, middle frontal gyrus and decreased the resting brain activity at fusiform gyrus, extrastriae cortex, inferior temporal gyrus and middle temporal gyrus, especially 15 min after FIR was turned off. We conclude that the central manifestation and the autonomic responses are prominent during and after FIR stimulation, which provide important mechanistic explanation on human disorder treated by such energy medicine.
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Frecuencia Cardíaca , Imagen por Resonancia Magnética , Adulto , Encéfalo , Mapeo Encefálico , Electrocardiografía , Femenino , Voluntarios Sanos , Humanos , Rayos Infrarrojos , Masculino , Adulto JovenRESUMEN
Body image is the internal representation of an individual's own physical appearance. Individuals with gender identity disorder (GID), commonly referred to as transsexuals (TXs), are unable to form a satisfactory body image due to the dissonance between their biological sex and gender identity. We reasoned that changes in the resting-state functional connectivity (rsFC) network would neurologically reflect such experiential incongruence in TXs. Using graph theory-based network analysis, we investigated the regional changes of the degree centrality of the rsFC network. The degree centrality is an index of the functional importance of a node in a neural network. We hypothesized that three key regions of the body representation network, i.e., the primary somatosensory cortex, the superior parietal lobule and the insula, would show a higher degree centrality in TXs. Twenty-three pre-treatment TXs (11 male-to-female and 12 female-to-male TXs) as one psychosocial group and 23 age-matched healthy cissexual control subjects (CISs, 11 males and 12 females) were recruited. Resting-state functional magnetic resonance imaging was performed, and binarized rsFC networks were constructed. The TXs demonstrated a significantly higher degree centrality in the bilateral superior parietal lobule and the primary somatosensory cortex. In addition, the connectivity between the right insula and the bilateral primary somatosensory cortices was negatively correlated with the selfness rating of their desired genders. These data indicate that the key components of body representation manifest in TXs as critical function hubs in the rsFC network. The negative association may imply a coping mechanism that dissociates bodily emotion from body image. The changes in the functional connectome may serve as representational markers for the dysphoric bodily self of TXs.
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Imagen Corporal , Red Nerviosa/fisiopatología , Corteza Somatosensorial/fisiopatología , Transexualidad/fisiopatología , Adulto , Mapeo Encefálico , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Adulto JovenRESUMEN
Individuals with gender identity disorder (GID), who are commonly referred to as transsexuals (TXs), are afflicted by negative psychosocial stressors. Central to the psychological complex of TXs is the conviction of belonging to the opposite sex. Neuroanatomical and functional brain imaging studies have demonstrated that the GID is associated with brain alterations. In this study, we found that TXs identify, when viewing male-female couples in erotic or non-erotic ("neutral") interactions, with the couple member of the desired gender in both situations. By means of functional magnetic resonance imaging, we found that the TXs, as opposed to controls (CONs), displayed an increased functional connectivity between the ventral tegmental area, which is associated with dimorphic genital representation, and anterior cingulate cortex subregions, which play a key role in social exclusion, conflict monitoring and punishment adjustment. The neural connectivity pattern suggests a brain signature of the psychosocial distress for the gender-sex incongruity of TXs.
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Encéfalo/fisiopatología , Transexualidad/fisiopatología , Transexualidad/psicología , Adulto , Nivel de Alerta , Mapeo Encefálico , Literatura Erótica , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Conducta Sexual , Adulto JovenRESUMEN
Dysmenorrhea is the most prevalent gynecological disorder in women of child-bearing age. Dysmenorrhea is associated with central sensitization and functional and structural changes in the brain. Our recent brain morphometry study disclosed that dysmenorrhea is associated with trait-related abnormal gray matter (GM) changes, even in the absence of menstrual pain, indicating that the adolescent brain is vulnerable to menstrual pain. Here we report rapid state-related brain morphological changes, ie, between pain and pain-free states, in dysmenorrhea. We used T1-weighted anatomic magnetic resonance imaging to investigate regional GM volume changes between menstruation and periovulatory phases in 32 dysmenorrhea subjects and 32 age- and menstrual cycle-matched asymptomatic controls. An optimized voxel-based morphometry analysis was conducted to disclose the possible state-related regional GM volume changes across different menstrual phases. A correlation analysis was also conducted between GM differences and the current menstrual pain experience in the dysmenorrhea group. Compared with the periovulatory phase, the dysmenorrhea subjects revealed greater hypertrophic GM changes than controls during the menstruation phase in regions involved in pain modulation, generation of the affective experience, and regulation of endocrine function, whereas atrophic GM changes were found in regions associated with pain transmission. Volume changes in regions involved in the regulation of endocrine function and pain transmission correlated with the menstrual pain experience scores. Our results demonstrated that short-lasting cyclic menstrual pain is associated not only with trait-related but also rapid state-related structural alterations in the brain. Considering the high prevalence rate of menstrual pain, these findings mandate a great demand to revisit dysmenorrhea with regard to its impact on the brain and other clinical pain conditions.
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Encéfalo/patología , Encéfalo/fisiopatología , Dismenorrea/patología , Adulto , Mapeo Encefálico , Femenino , Humanos , Imagenología Tridimensional , Imagen por Resonancia Magnética , Pruebas Psicológicas , Análisis de Regresión , Adulto JovenRESUMEN
The neuromagnetic index of hemispheric asymmetry in terms of ipsilateral/contralateral ratio at acute stage was previously revealed to prognosticate the 1-month hearing outcome of acute unilateral idiopathic sudden sensorineural hearing loss (ISSNHL), showing a dynamic relationship between top- and down-levels of auditory pathway. However, the prognostic effect of reorganization pattern for the long-term results remained elusive. This study aimed to probe the prognosticating relevance of hemispheric asymmetry to the hearing at chronic stage of ISSNHL. Using magnetoencephalography (MEG), inter-hemispheric differences in peak dipole of N100m responses to monaural tones were evaluated in 21 controls and 21 ISSNHL patients at initial and final (12 months later) stages. Predictive value of hemispheric asymmetry was assessed by correlating hearing level and ipsilateral/contralateral ratio (I/C) of N100m latency and amplitude. Healthy-side dominance of N100m was observed in ISSNHL initially, and remained in three final prognostic subgroups (complete, partial, and no recovery) of ISSNHL. The initial I/C(amplitude) on affected-ear stimulation strongly correlated with the hearing level of final stage in ISSNHL. However, there was no prognostic effect of hemispheric asymmetry pattern for the 12-month hearing improvement. The heterogeneity between neuromagnetic index and hearing levels possibly echoed different pathogeneses of ISSNHL. Since a restored hearing status did not necessarily lead toward a normal functional organization, the dynamics of hemispheric asymmetry could actually index a central resilient reorganization in the brain for sound processing in ISSNHL. Our finding showed not only a clinically relevant measure to predict final hearing of ISSNHL, but also a linkage between central plasticity and cochlear lesion. This finding suggests a new perspective, and perhaps new interventions, to diagnose and treat unilateral ISSNHL.
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Corteza Auditiva/fisiopatología , Mapeo Encefálico/métodos , Diagnóstico por Computador/métodos , Potenciales Evocados Auditivos , Pérdida Auditiva Súbita/diagnóstico , Pérdida Auditiva Súbita/fisiopatología , Magnetoencefalografía/métodos , Adulto , Anciano , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pronóstico , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Índice de Severidad de la EnfermedadRESUMEN
The effect of temporal interference of physiological signals on time-lag effective connectivity, derived from a functional network connectivity tool box (FNC), was examined by a blood-oxygen-level-dependent functional MRI study of action. The known effect of physiological signals on time-lag FNC was verified by (a) comparison of time-lag FNC analyses without and with retrospective image-based correction (RETROICOR) and (b) the other time-lag FNC analysis including the ventricular component related to the cerebrospinal fluid with dominant physiological effects. Twenty-five right-handed normal individuals performed motor task with motor response by the right middle/index fingers. Behavioral data of the reaction time (RT) and physiological signals (electrocardiogram, respiration, and pulsation) were recorded during neuroimaging studies of a 2-s repetition time at 3T. After standard image preprocessing, RETROICOR of the physiological effects and group independent component analysis (ICA), five action-related components were selected from 59 ICA components according to spatial extension involving known functional correlates of visuomotor tasks. Time-lag FNC was constructed by calculating the maximal correlation coefficients among five selected components. Attenuation of the physiological effect at 0.02-0.25 Hz was an average of 0.63 dB after RETROICOR (P<0.0005). Results of FNC analyses without and with RETROICOR were compatible with the action networks using the right hand. On the basis of the time-lag FNC after RETROICOR, the connectivity among the ventricular component and other components of action network attenuated. The FNC map with RETROICOR was more explicable with known action networks, for example interhemispheric inhibition. The effects of physiological signals significantly misled the interpretation of time-lag FNC in terms of direction and connectivity strength.
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Mapeo Encefálico , Encéfalo/fisiología , Vías Nerviosas/fisiología , Desempeño Psicomotor/fisiología , Respiración , Adulto , Encéfalo/irrigación sanguínea , Señales (Psicología) , Electrocardiografía , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Vías Nerviosas/irrigación sanguínea , Oxígeno/sangre , Estimulación Luminosa , Tiempo de Reacción/fisiología , Estudios Retrospectivos , Factores de Tiempo , Adulto JovenRESUMEN
Placebo analgesia is a psychosocial context effect that is rarely studied in visceral pain. Patients with irritable bowel syndrome (IBS) exhibit visceral hyperalgesia and heightened affective/cognitive brain region activation during visceral stimuli. Psychological factors alter the pain and brain activation pattern, and these changes are more pronounced in IBS patients. Expectation constitutes the major neuropsychological mechanism in the placebo effect. This study confirmed the heightened affective/cognitive brain responses in IBS patients during visceral placebo analgesia using a placebo model with expectation, which was enhanced by suggestion and conditioning. Seventeen IBS patients and 17 age-/sex-matched controls were enrolled. Psychophysical inventories (Hospital Anxiety and Depression Scale [HADS], visual analogue scale, and short-form McGill questionnaire) were completed. Brain activity during placebo intervention and anticipation was assessed in response to rectal distension using 3T-functional magnetic resonance imaging. Suggestion-/conditioning-enhanced placebo was used to convince controls/patients of the efficacy of a newly developed intravenous drug (saline, in actuality) for the relief of rectal distension-induced visceral pain. A comparable visceral placebo analgesia was observed in IBS patients and control subjects. IBS patients demonstrated a higher HADS-anxiety score, which was predictive of a weak placebo effect. Suggestion-/conditioning-enhanced placebo evoked more activity in affective/cognitive brain regions (insula, midcingulate cortex, and ventrolateral prefrontal cortex [VLPFC]) in IBS patients than in healthy controls. VLPFC was also more active during anticipation in IBS patients. In conclusion, IBS patients and control subjects achieved comparable placebo analgesia during experimentally induced rectal pain. The visceral placebo analgesia produced heightened activity in affective/cognitive brain regions in IBS patients.
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Afecto/fisiología , Cognición/fisiología , Síndrome del Colon Irritable/psicología , Dolor Visceral/psicología , Dolor Visceral/terapia , Adulto , Femenino , Humanos , Síndrome del Colon Irritable/complicaciones , Masculino , Persona de Mediana Edad , Efecto Placebo , Dolor Visceral/etiología , Adulto JovenRESUMEN
Visceral pain/discomfort is the cardinal complaints and treatment targets for functional gastrointestinal disorders (FGID). However, effective treatment for such pain is limited and often associated with high placebo effects. The mechanisms of placebo effects in visceral pain are unclear. We used functional neuroimaging to study the central representations of the placebo effect and its anticipation during esophageal pain in healthy adults. Fourteen subjects were enrolled. Pain extent, psychophysical inventories [Pain Catastrophizing Scale (PAS), visual analogue scale (VAS) and short-form McGill questionnaire], and brain activity upon placebo intervention and upon anticipation were assessed in response to esophageal balloon distension. Large reductions of pain extent, VAS rating, short-form McGill questionnaire scores, and brain activity in the visceral pain matrix [thalamus, somatosensory cortices, insula, prefrontal cortex (PFC), anterior cingulate cortex] were observed upon placebo treatment. The aforementioned brain areas and the bilateral amygdala were significantly correlated with decreased pain extent and VAS in response to placebo. The ventral lateral PFC (VLPFC) was associated with increased activity during anticipation of visceral pain. PAS cannot predict the placebo effect in visceral pain. In conclusion, pronounced placebo analgesia was coupled with prominent changes of brain activity in visceral pain matrix, which are thus likely involved in high placebo efficacy during the treatment of visceral pain in FGID. VLPFC activation during the anticipation of placebo analgesia suggests top-down control in the modulation of pain experience.
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Mapeo Encefálico , Encéfalo/fisiopatología , Esófago , Dolor/tratamiento farmacológico , Dolor/patología , Placebos/uso terapéutico , Adulto , Encéfalo/irrigación sanguínea , Cateterismo/efectos adversos , Esófago/inervación , Femenino , Lateralidad Funcional , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Oxígeno/sangre , Dolor/etiología , Dimensión del Dolor/métodos , Efecto Placebo , Psicofísica , Adulto JovenRESUMEN
BACKGROUND: Somatic Marker Hypothesis (SMH), based on clinical observations, delineates neuronal networks for interpreting consciousness generation and decision-making. The Iowa gambling task (IGT) was designed to verify the SMH. However, more and more behavioral and brain imaging studies had reported incongruent results that pinpointed a need to re-evaluate the central representations of SMH. The current study used event-related fMRI (functional Magnetic Resonance Imaging) to examine neural correlates of anticipation vs. outcome, wins vs. losses, and differential decks' contingencies of IGT. RESULTS: Behavioral results showed a prominent effect of frequency in driving choices. The insula and basal ganglia were activated during the anticipation phase while the inferior parietal lobule was activated during the outcome phase. The activation of medial prefrontal cortex was especially targeted during the high punishment contingencies. The data suggest that under uncertainty the normal decision makers can become myopic. CONCLUSION: The insula and basal ganglia might play a vital role in long-term guidance of decision-making. Inferior parietal lobule might participate in evaluating the consequence and medial prefrontal cortex may service the function of error monitoring.
Asunto(s)
Encéfalo/fisiología , Toma de Decisiones/fisiología , Juego de Azar/psicología , Pruebas Neuropsicológicas , Adulto , Ganglios Basales/fisiología , Corteza Cerebral/fisiología , Emociones/fisiología , Femenino , Juegos Experimentales , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Lóbulo Parietal/fisiología , Corteza Prefrontal/fisiología , Teoría Psicológica , Castigo/psicología , Asunción de RiesgosRESUMEN
Postmovement beta-rebounds induced by different intermovement intervals were investigated using magnetoencephalography in 14 healthy participants to test the hypothesis that postmovement motor cortical deactivation over the primary motor cortex depends on movement-related cognitive demands. Shorter latency and lower amplitude in postmovement beta-rebounds over the contralateral primary motor cortex were noted in the short-movement interval movement (repetitive finger lifting). Greater latency span of postmovement beta-rebounds jittering using single-trial analysis in the long-movement interval movement (discrete finger lifting) was observed. The study elucidates that the temporal interval between two adjacent movements reflecting different degrees of cognitive demands can affect postmovement motor cortical deactivation in terms of postmovement beta-rebounds latency and amplitude, and latency span of postmovement beta-rebounds jittering. Postmovement motor cortical deactivation can reflect cognitive demands in addition to motor and somatosensory processing.
Asunto(s)
Cognición/fisiología , Potenciales Evocados Motores/fisiología , Corteza Motora/fisiología , Movimiento/fisiología , Adulto , Femenino , Dedos/inervación , Dedos/fisiología , Humanos , Magnetoencefalografía , Masculino , Vías Nerviosas/fisiología , Tiempo de Reacción/fisiología , Corteza Somatosensorial/fisiología , Factores de TiempoRESUMEN
The extraction of event-related oscillatory neuromagnetic activities from single-trial measurement is challenging due to the non-phase-locked nature and variability from trial to trial. The present study presents a method based on independent component analysis (ICA) and the use of a template-based correlation approach to extract Rolandic beta rhythm from magnetoencephalographic (MEG) measurements of right finger lifting. A single trial recording was decomposed into a set of coupled temporal independent components and corresponding spatial maps using ICA and the reactive beta frequency band for each trial identified using a two-spectrum comparison between the postmovement interval and a reference period. Task-related components survived dual criteria of high correlation with both the temporal and the spatial templates with an acceptance rate of about 80%. Phase and amplitude information for noise-free MEG beta activities were preserved not only for optimal calculation of beta rebound (event-related synchronization) but also for profound penetration into subtle dynamics across trials. Given the high signal-to-noise ratio (SNR) of this method, various methods of source estimation were used on reconstructed single-trial data and the source loci coherently anchored in the vicinity of the primary motor area. This method promises the possibility of a window into the intricate brain dynamics of motor control mechanisms and the cortical pathophysiology of movement disorder on a trial-by-trial basis.