Functional MR imaging of regional brain activation associated with the affective experience of pain
Functional MR imaging of regional brain activation associated with the affective experience of pain
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DOI：
10.2214/ajr.177.5.1771205
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发表时间：
2001-11-01
影响因子：
5
通讯作者：
Wexler, BE
中科院分区：
文献类型：
--
作者：
Fulbright, RK;Troche, CJ;Wexler, BE
目标。目前的模型认为，疼痛的体验既包括感觉成分，也包括情感成分。我们的目的是使用功能磁共振成像来确定大脑中与疼痛的情感维度有关的区域。12名健康成年人使用梯度回波平面回波技术进行功能性磁共振成像，同时先对一只脚进行冷加压测试，包括寒冷和疼痛任务，然后对另一只脚进行冷加压测试。冷任务包括应用冷水(14-20摄氏度)，而不是在痛苦的水平上。对于疼痛任务，然后将水温降低到痛苦的温度(8-14摄氏度)，然后降低到疼痛阈值(3-8摄氏度)。在寒冷和疼痛任务之前在室温下获得的图像作为基线任务。通过比较基线任务和冷任务，以及冷任务和疼痛任务，生成了大脑激活的复合图。结果：冷相关激活(p<；0.01)存在于双侧、外侧中央后回，位于足部初级运动感觉区下方和第二躯体感觉区附近。激活也见于额叶(双侧额中回和右侧额下回)、左侧前岛、左侧丘脑和前扣带回的上侧(同一切片位置可见)。与疼痛相关的激活(P<；0.01)包括扣带回的前部(可在四个层面上看到)；额上回，尤其是右侧；以及右侧的楔状回。结论：与疼痛的基本感觉处理相比，疼痛的情感维度激活了包括右侧额上回、右侧楔状回和大片前扣带回的皮质网络。
OBJECTIVE. Current models propose that the experience of pain includes both sensory and affective components. Our purpose was to use functional MR imaging to determine areas of the brain engaged by the affective dimension of pain.SUBJECTS AND METHODS. Twelve healthy adults underwent functional MR imaging using a gradient-echo echoplanar technique while a cold pressor test, consisting of cold and pain tasks, was applied first to one foot and then to the other. The cold task involved the application of cold water (14-20 degreesC) that was not at a painful level. For the pain task, the water temperature was then lowered to a painful temperature (8-14 degreesC) and subsequently to the pain threshold (3-8 degreesC). Images acquired at room temperature before the cold and pain tasks served as a baseline task. Composite maps of brain activation were generated by comparing the baseline task with the cold task and the cold task with the pain task. The significance of signal changes was estimated by randomization of individual activation maps.RESULTS. Cold-related activation (p < 0.01) was found in the postcentral gyrus bilaterally, laterally, and inferiorly to the primary motor-sensory area of the foot and at a site near the second somatosensory site. Activation also occurred in the frontal lobe (the bilateral middle frontal gyri and the right inferior frontal gyrus), the left anterior insula, the left thalamus, and the superior aspect of the anterior cingulate gyrus (seen at one slice location). Pain-related activation (p < 0.01) included the anterior cingulate gyrus (seen at four slice locations); the superior frontal gyrus, especially on the right; and the right cuneus.CONCLUSION. Compared with the basic sensory processing of pain, the affective dimension of pain activates a cortical network that includes the right superior frontal gyrus, the right cuneus, and a large area of the anterior cingulate gyrus.