Cortical Mechanisms of Visual Hypersensitivity in Women at Risk for Chronic Pelvic Pain.
Cortical Mechanisms of Visual Hypersensitivity in Women at Risk for Chronic Pelvic Pain.
复制标题
有慢性盆腔疼痛风险的女性视觉过敏的皮质机制。
DOI：
10.1101/2020.12.03.20242032
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Hellman,KevinM
中科院分区：
文献类型：
--
作者：
Kmiecik,MatthewJ;Tu,FrankF;Silton,RebeccaL;Dillane,KatlynE;Roth,GenevieveE;Harte,StevenE;Hellman,KevinM
在非伤害性方式中增加的感觉敏感性是慢性疼痛病症的常见症状，并且与慢性疼痛发展相关。提供一个更好的了解大脑行为的关系，基础多模态超敏反应（MMH）可能澄清的作用，MMH在慢性疼痛的发展。我们研究了感觉超敏反应的妇女队列（n= 147）谁有日记确认月经状态，并与慢性盆腔疼痛的危险因素，如痛经和膀胱敏感性增加丰富。我们管理2个实验任务，以评估视觉和内脏敏感性之间的跨通道关系。视觉灵敏度进行了探讨，提出了参与者与周期性的模式反转棋盘刺激，在脑电图记录期间，在5个亮度强度。同时评估每个亮度强度的自我报告的视觉不愉快评级。内脏敏感性通过与慢性盆腔疼痛早期临床症状相关的实验性膀胱充盈任务进行评估。视觉诱发的皮层活动随着整个头皮的亮度强度而增加，尤其是在枕部电极部位。视觉刺激引起的不愉快与引起膀胱疼痛和诱发初级视觉皮层活动有关。然而，不愉快和皮质活动之间的关系是缓和引起膀胱疼痛。这些结果表明，在初级视觉皮层的活动是不是更大的个人与更大的内脏敏感性。我们假设，下游的解释或整合这一信号放大与内脏高敏感性的个人。未来的研究旨在减少MMH在慢性疼痛条件下应优先靶向负责异常下游感觉整合的皮质机制。
Increased sensory sensitivity across non-nociceptive modalities is a common symptom of chronic pain conditions and is associated with chronic pain development. Providing a better understanding of the brain–behavior relationships that underlie multimodal hypersensitivity (MMH) may clarify the role of MMH in the development of chronic pain. We studied sensory hypersensitivity in a cohort of women (n= 147) who had diary confirmation of menstrual status and were enriched with risk factors for chronic pelvic pain, such as dysmenorrhea and increased bladder sensitivity. We administered 2 experimental tasks to evaluate the cross-modal relationship between visual and visceral sensitivity. Visual sensitivity was probed by presenting participants with a periodic pattern-reversal checkerboard stimulus presented across 5 brightness intensities during electroencephalography recording. Self-reported visual unpleasantness ratings for each brightness intensity were simultaneously assessed. Visceral sensitivity was evaluated with an experimental bladder-filling task associated with early clinical symptoms of chronic pelvic pain. Visually evoked cortical activity increased with brightness intensity across the entire scalp, especially at occipital electrode sites. Visual stimulation–induced unpleasantness was associated with provoked bladder pain and evoked primary visual cortex activity. However, the relationship between unpleasantness and cortical activity was moderated by provoked bladder pain. These results demonstrate that activity in the primary visual cortex is not greater in individuals with greater visceral sensitivity. We hypothesize that downstream interpretation or integration of this signal is amplified in individuals with visceral hypersensitivity. Future studies aimed at reducing MMH in chronic pain conditions should prioritize targeting of cortical mechanisms responsible for aberrant downstream sensory integration.
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