Brain network correlates of tonic and chronic pain

强直性疼痛和慢性疼痛的大脑网络相关性

• 批准号: 230335848
• 负责人: Professor Dr. Markus Ploner
• 金额: --
• 依托单位: Neurologische Klinik und Poliklinik
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2013
• 资助国家: 德国
• 起止时间: 2012-12-31 至 2021-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/230335848?language=en
• 关键词: Brain; network; correlates; tonic; chronic

Pain is a complex and highly subjective experience, which subserves vital protective functions. However, in chronic pain states, ongoing pain no longer subserves protective functions but represents a pathological condition with devastating effects on quality of life. Recent evidence indicates that the brain is actively involved in the development and maintenance of chronic pain. However, the cerebral mechanisms of chronic pain are not fully understood. In the preceding project, we have therefore started to investigate the cerebral correlates of long-lasting experimental and clinical pain using electroencepahlography (EEG). The proposed project renewal builds upon the paradigms and analyses of the previous project and extends our approach from the assessment of pain-related brain activity to the comprehensive investigation of brain connectivity, i.e., how communication in the human brain relates to ongoing pain. In 100 patients suffering from chronic back pain and 100 healthy human subjects, we will assess neuronal communication using recent brain connectivity measures, which overcome field spread and volume conduction limitations of traditional EEG analyses. Based on these connectivity measures we will perform timely graph theory-based network analyses of brain connectivity during ongoing tonic and chronic pain. A thorough clinical and psychological assessment will allow for relating network measures of brain connectivity to the individual clinical and psychological characteristics. Based on our previous findings, we hypothesize that the current intensity of ongoing experimental and clinical pain is reflected by local gamma oscillations in medial prefrontal cortex, which represents an important node in a brain network connecting at beta and/or theta frequencies. We further hypothesize that chronic pain is associated with additional global changes of brain connectivity, e.g., a reduction in small-worldness. We expect that these global network changes reflect long-term pain-related disability rather than the current pain intensity and are therefore not observed in healthy controls. In a further step, we will use multivariate pattern analysis to test whether patterns of brain connectivity can be used to decode ongoing pain. This approach could help to establish neuronal markers of chronic pain, which might support the diagnosis and classification of chronic pain and the monitoring and optimization of pain therapy. The proposed project renewal, thus, promises novel insights into the brain mechanisms of pain with possible implications for the diagnosis and treatment of chronic pain.

疼痛是一种复杂且高度主观的体验，有助于重要的保护功能。然而，在慢性疼痛状态下，持续的疼痛不再具有保护功能，而是对生活质量具有破坏性影响的病理状态。最近的证据表明，大脑积极参与慢性疼痛的发展和维持。然而，慢性疼痛的脑机制尚未完全了解。因此，在前一个项目中，我们开始使用脑电图（EEG）研究长期实验和临床疼痛的大脑相关性。拟议的项目更新建立在以前项目的范式和分析的基础上，并将我们的方法从疼痛相关脑活动的评估扩展到脑连接的全面调查，即，人类大脑中的交流与持续疼痛的关系。在100例慢性背痛患者和100名健康受试者中，我们将使用最近的脑连接措施评估神经元通信，该措施克服了传统EEG分析的场扩散和体积传导限制。基于这些连通性测量，我们将在持续的紧张性和慢性疼痛期间对大脑连通性进行及时的基于图论的网络分析。全面的临床和心理评估将允许将大脑连接的网络测量与个人临床和心理特征相关联。基于我们以前的研究结果，我们假设，目前正在进行的实验和临床疼痛的强度是由内侧前额叶皮层，这代表了一个重要的节点，在β和/或θ频率连接的大脑网络中的局部伽马振荡反映。我们进一步假设，慢性疼痛与大脑连接的额外全球变化有关，例如，小世界的减少。我们预计，这些全球网络的变化反映了长期疼痛相关的残疾，而不是目前的疼痛强度，因此在健康对照组中没有观察到。在下一步中，我们将使用多变量模式分析来测试大脑连接的模式是否可以用来解码持续的疼痛。这种方法有助于建立慢性疼痛的神经标记物，这可能有助于慢性疼痛的诊断和分类以及疼痛治疗的监测和优化。因此，拟议的项目更新有望对疼痛的大脑机制产生新的见解，可能对慢性疼痛的诊断和治疗产生影响。