Identifying Brain Activity Specifically Related to the Maintenance and Perceptual Consequence of Central Sensitization in Humans
Identifying Brain Activity Specifically Related to the Maintenance and Perceptual Consequence of Central Sensitization in Humans
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DOI：
10.1523/jneurosci.2638-08.2008
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发表时间：
2008-11-05
影响因子：
5.3
通讯作者：
Tracey, Irene
中科院分区：
文献类型：
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作者：
Lee, Michael C.;Zambreanu, Laura;Tracey, Irene
中枢敏化（CS）是指脊髓背角神经元兴奋性的增加，这种增加是由起始伤害性输入引起的，并且持续时间远远超过起始伤害性输入。在这里，功能性磁共振成像被用来检查脊髓上活动是否有助于人类 CS 的维持。使用交叉参数设计来区分和控制与 CS 期间经历的疼痛增加的后果相关的大脑活动。当CS期间的疼痛强度与正常状态匹配时，只有脑干内的活动（包括中脑桥脑网状结构和前丘脑）在CS期间保持增加。进一步的分析表明，仅在 CS 期间，孤立脑干区域的活动与伤害性刺激的力量呈正相关，而孤立丘脑区域的活动在 CS 或正常状态下都没有参数调节。此外，孤立脑干区域的平均活动仅在 CS 期间增加，而孤立丘脑区域的平均活动在两种状态下均增加，尽管在正常状态下增加较少。总之，这些发现表明脑干在维持人类 CS 方面发挥着特殊作用。关于与 CS 期间疼痛感知增加结果相关的大脑区域，我们发现只有皮质活动（主要在初级体感区域）与疼痛强度显着相关，疼痛强度可归因于所使用的伤害性刺激的力量和施加伤害性刺激的状态。
Central sensitization (CS) refers to an increase in the excitability of spinal dorsal horn neurons that results from, and far outlasts the initiating nociceptive input. Here, functional magnetic resonance imaging was used to examine whether supraspinal activity might contribute to the maintenance of CS in humans. A crossover parametric design was used to distinguish and control for brain activity that is related to the consequence of increased pain experienced during CS. When the intensity of pain during CS and normal states were matched, only activity within the brainstem, including the mesencephalic pontine reticular formation, and the anterior thalami remained increased during CS. Further analyses revealed that activity in the isolated brainstem area correlated positively with the force of noxious stimulation only during CS, whereas activity in the isolated thalamic area was not modulated parametrically in either CS or normal states. Additionally, the mean activity in the isolated brainstem area was increased only during CS, whereas the mean activity in the isolated thalamic area was increased in both states, albeit less so in the normal state. Together, these findings suggest a specific role of the brainstem for the maintenance of CS in humans. Regarding brain areas related to the consequence of increased pain perception during CS, we found that only cortical activity, mainly in the primary somatosensory area, was significantly correlated with intensity of pain that was attributable to both the force of noxious stimulation used and state in which noxious stimulation was applied.