Coding of Incisional Pain in the Brain: A Functional Magnetic Resonance Imaging Study in Human Volunteers
Coding of Incisional Pain in the Brain: A Functional Magnetic Resonance Imaging Study in Human Volunteers
复制标题
大脑切口痛的编码：人类志愿者的功能性磁共振成像研究
作者：
E. Pogatzki;C. Wagner;Anne M A Meinhardt;M. Burgmer;C. Beste;P. Zahn;B. Pfleiderer
本研究通过功能磁共振成像技术评估实验性手术切口后不同脑区的激活情况，并分析不同脑激活模式对切口后疼痛感知的病理生理作用。方法：30名男性志愿者（平均年龄±SD， 25±5岁）使用陶瓷黄牛刀片在右前臂掌侧切开实验性切口（4mm）， 14名志愿者（平均年龄±SD， 25±4岁）接受假手术。采用块设计的3T扫描仪在切开或假手术（2-4.5、4.5-10、24-29和44-49分钟）之前、期间（0-2分钟）和之后（2-4.5、4.5-10、24-29和44-49分钟）拍摄磁共振图像。通过数值疼痛量表进行主观疼痛评分。结果：功能性磁共振成像分析显示，在损伤期间和之后，在特定的大脑区域有明显的活动时间剖面。与接受假手术的受试者相比，在切口后观察到侧化（主要是切口对侧）和躯体感觉皮层、额叶皮层和边缘系统的大脑活动增加。脑活动高峰出现在切口后约2分钟，随后减弱。在前扣带皮层、岛叶皮层、丘脑、额叶皮层和体感皮层中，观察到诱发疼痛等级与大脑活动之间存在明显的相关性。结论：这些发现显示了不同的和明显的皮层和皮层下的激活模式在切开后的相关时间内。因此，疼痛敏感性对活动概况有影响。这可能对组织损伤后持续疼痛的编码具有重要意义，例如，术后患者的静息性疼痛。
Introduction:In this study, the activation of different brain areas after an experimental surgical incision was assessed by functional magnetic resonance imaging, and the pathophysiological role of distinct brain activation patterns for pain perception after incision was analyzed. Methods:Thirty male volunteers (mean age ± SD, 25 ± 5 yr) received an experimental incision (4 mm) within the volar aspect of the right forearm using a ceramic scalper blade, and 14 volunteers (mean age ± SD, 25 ± 4 yr) received a sham procedure. Magnetic resonance images were taken before, during (0–2 min), and after incision or sham procedure (2–4.5, 4.5–10, 24–29, and 44–49 min) at a 3T scanner using a block design. Subjective pain ratings by a numerical pain scale were performed between the scans. Results:Functional magnetic resonance imaging analysis showed a distinct temporal profile of activity within specific brain regions during and after the injury. Lateralization (predominantly contralateral to the incision) and increased brain activity of the somatosensory cortex, frontal cortex, and limbic system were observed in subjects after incision, when compared with individuals receiving sham procedure. Peak brain activation occurred about 2 min after incision and decreased subsequently. A distinct correlation between evoked pain ratings and brain activity was observed for the anterior cingulate cortex, insular cortex, thalamus, frontal cortex, and somatosensory cortex. Conclusion:These findings show different and distinct cortical and subcortical activation patterns over a relevant time period after incision. Pain sensitivity hereby has an influence on the activity profile. This may have important implications for encoding ongoing pain after a tissue injury, for example, resting pain in postoperative patients.
影响因子：
2.5
作者：
Casey, KL;Morrow, TJ;Minoshima, S
通讯作者：
Minoshima, S