Behaviors related to Human Neural Activity during Experimental Vigilance to Pain

虽然在“特发性”和“伤害性”疼痛综合征中都发现了对疼痛的警惕性异常增加， 对疼痛的实验性警觉的行为和神经特征知之甚少。我们提出 将人因研究（如空中交通管制员）中的连续绩效任务（CPT）调整为 研究疼痛的实验性警惕。在我们的任务中，受试者按下一个按钮， 当它们出现在一系列非目标非疼痛刺激中时，即CPTpain。 在CPTpain过程中，我们建议直接从大脑记录和分析局部场电位（LFP） 通过放置在大脑上的电极来治疗顽固性癫痫。这项技术是无与伦比的 功能磁共振成像的分辨率较低，但范围有限，因此是功能磁共振成像的补充，功能磁共振成像的分辨率较低，但可以检查整个大脑。 我们的假设是：错误和唤醒在CPT与痛苦的目标（CPTpain）介导的行为和 神经元的警觉性疼痛，并影响中央中风后疼痛（CePSP）。我们建议测试 假设：CPTpain中随时间推移的行为与神经激活和模块相互作用有关 在一个网络的警惕疼痛，而在中风后的行为变化确定的模块， 这对这种行为以及CePSP的发展和症状至关重要。像这样的网络 其特征在于模块，以及模块之间的连接，如通过它们的因果相互作用所识别的。 我们的初步数据显示，随着时间的推移，在CPTpain中检测到的非靶点和唤醒通常是 与疼痛加剧有关。这些数据还表明，对疼痛保持警惕的顶叶EEG特征是 与错误相关，这表明顶叶模块参与了警戒的分布式网络， 痛苦尽管这些LFP（或fMRI信号）的分析并不能证明模块对于警戒是必不可少的， 对于疼痛，如果模块的损伤影响行为，则该模块可以被识别为行为所必需的。 因此，我们建议研究中风解剖（通过结构MRI）和行为措施，在CPTpain， 急性中风患者。我们将使用霍普金斯开发的软件包来分析病变 （LDDMM）与我们的长期合作者希利斯博士，谁拥有广泛的经验，这个包的研究 关注最后，我们的初步数据表明，岛叶型患者的顶叶结构没有受到影响， 发生CePSP的卒中患者，但涉及未发生CePSP的岛叶卒中患者， 这表明CePSP的顶叶警戒相关机制。 这些研究的结果可以为警惕的神经科学构建可验证的假设， 疼痛，以及治疗与过度警觉相关的疼痛综合征的基于解剖学的疗法， 以及对疼痛的警惕性的客观仪器测试。警戒网络分析的潜力 网络分析对视觉神经科学的影响，以及对疼痛的发展， 新的手术和刺激疗法，用于治疗运动和精神疾病。

While abnormally increased Vigilance to pain is found in both ‘idiopathic’ and ‘nociceptive’ pain syndromes, the behavioral and neural characteristics of experimental Vigilance to pain are poorly understood. We propose to adapt a Continuous Performance Task (CPT) from Human Factors Research (e.g. air traffic controllers) to study Experimental Vigilance to pain. In our task, the subject pushes a button to indicate detection of painful target stimuli when they occur in a train of nontarget nonpainful stimuli, i.e. CPTpain. During a CPTpain, we propose to record and analyze local field potentials (LFP) directly from the brain through electrodes placed on the brain for the treatment of intractable epilepsy. This technique has unrivalled resolution but limited scope and so complements fMRI, which has lower resolution but surveys the whole brain. Our Premise is that: Errors and Arousal in a CPT with a painful target (CPTpain) mediate the behavioral and neural elements of Vigilance to pain, and affect Central Post Stroke Pain (CePSP). We propose to test the hypothesis that: Behaviors over time in a CPTpain are related to neural activations and interactions of modules in a network for Vigilance to pain, while changes in a behavior after a stroke identify the modules that are essential for that behavior, and for the development and symptoms of CePSP. Networks like this can be characterized by modules, and connections between modules as identified by their causal interactions. Our Preliminary Data shows that over time in a CPTpain detected nontargets and arousal are often associated with increased pain. These Data also suggest a Parietal EEG Signature for Vigilance to pain that is correlated with errors, suggesting that a Parietal module is involved in a distributed network for Vigilance to pain. Although these analyses of LFPs (or fMRI signals) do not prove that modules are essential for Vigilance to pain, a module can be identified as essential for a behavior if lesions of the module affect that behavior. Therefore, we propose to study stroke anatomy (by structural MRI) and behavioral measures in CPTpain in patients with acute strokes. We will use a software package developed at Hopkins for the analysis of lesions (LDDMM) with our long term collaborator, Dr. Hillis, who has broad experience with this package in studies of attention. Finally, our Preliminary Data demonstrates that Parietal structures are spared in patients with insular strokes who develop CePSP but are involved in patients with insular strokes who do not develop CePSP, which suggests a Parietal, Vigilance related mechanism for CePSP. The results of these proposed studies may frame testable hypotheses for the neuroscience of Vigilance to pain, and anatomically based therapies in the treatment of pain syndromes associated with Hypervigilance, and for an objective instrumented test of Vigilance to pain. The potential of analyses of networks for Vigilance to pain is suggested by the impact of network analyses on the neuroscience of vision, and on the development of novel surgical and stimulation therapies for the treatment of movement and psychiatric disorders.