Control over brain activation and pain learned by using real-time functional MRI
Control over brain activation and pain learned by using real-time functional MRI
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DOI：
10.1073/pnas.0505210102
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发表时间：
2005-12-20
影响因子：
11.1
通讯作者：
Mackey, SC
中科院分区：
文献类型：
--
作者：
deCharms, RC;Maeda, F;Mackey, SC
如果一个人能够学会直接控制大脑中局部区域的激活，这种方法可能会提供对调节行为和认知的神经生理机制的控制，并可能提供一种不同的治疗疾病的途径。控制内源性疼痛调节系统是一个特别重要的目标，因为它可以为临床控制疼痛提供一种独特的机制。在这里，我们发现通过使用实时功能磁共振成像(RtfMRI)来指导训练，受试者能够学习控制嘴侧前扣带回皮质(RACC)的激活，这是一个被认为参与疼痛感知和调节的区域。当受试者故意诱导rACC功能磁共振激活的增加或减少时，由施加的伤害性热刺激引起的痛觉也有相应的变化。对照实验表明，在没有rtfMRI信息的情况下进行类似的训练，或者使用来自不同大脑区域的rtfIMRI信息，或者使用先前来自不同受试者的假rtfMRI信息，都没有观察到这种效果。慢性疼痛患者也接受了控制rACC激活的培训，并报告说，培训后慢性疼痛的持续水平有所下降。这些发现表明，经过适当的训练，个人可以自愿控制特定大脑区域的激活，自愿控制rACC中的激活导致控制疼痛感知，并且这些影响足够强大，足以影响严重的慢性临床疼痛。
If an individual can learn to directly control activation of localized regions within the brain, this approach might provide control over the neurophysiological mechanisms that mediate behavior and cognition and could potentially provide a different route for treating disease. Control over the endogenous pain modulatory system is a particularly important target because it could enable a unique mechanism for clinical control over pain. Here, we found that by using real-time functional MRI (rtfMRI) to guide training, subjects were able to learn to control activation in the rostral anterior cingulate cortex (rACC), a region putatively involved in pain perception and regulation. When subjects deliberately induced increases or decreases in rACC fMRI activation, there was a corresponding change in the perception of pain caused by an applied noxious thermal stimulus. Control experiments demonstrated that this effect was not observed after similar training conducted without rtfMRI information, or using rtfIMRI information derived from a different brain region, or sham rtfMRI information derived previously from a different subject. Chronic pain patients were also trained to control activation in rACC and reported decreases in the ongoing level of chronic pain after training. These findings show that individuals can gain voluntary control over activation in a specific brain region given appropriate training, that voluntary control over activation in rACC leads to control over pain perception, and that these effects were powerful enough to impact severe, chronic clinical pain.