THE BIOLOGY OF HUMAN CORTICAL PAIN RELATED ACTIVITY

人类皮质疼痛相关活动的生物学

• 批准号: 2830117
• 负责人: Fred Lenz
• 金额: $ 32.42万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2830117
• 关键词: attention; auditory stimulus; brain electrical activity; chronic pain; cingulate gyrus; clinical research; disease /disorder etiology; emotions; epilepsy; evoked potentials; human subject; hyperalgesia; implant; lasers; pain; pain threshold; parietal lobe /cortex; patient monitoring device; positron emission tomography; psychophysics; sensory signal detection; somesthetic sensory cortex; thalamus

DESCRIPTION (Adapted from the applicant's abstract) The long-term goal of these studies is to understand human cortical mechanisms of the sensory and affective dimensions of acute and chronic pain. Little is known about human cortical structures receiving nociceptive input; the role of attention in modulating input to these structures; or the functions of these cortical structures. Also, the human thalamic nuclei or cortical gyri where lesions lead to the development of central pain or where hyperactivity occurs in patients with central pain have not been clearly defined. Preliminary evidence indicates that potentials evoked by a pure pain stimulus are localized over human anterior cingulate cortex (ACC) and parasylvian cortex, which suggests that these areas receive nociceptive inputs. Lesions of the parietal operculum are associated with deficits of pain discrimination (sensory-discriminative aspect of pain) while lesions of the insula tend to be associated with deficits of the motivation to escape from painful stimuli (affective-motivational aspect of pain). The present study is designed to determine whether the human ACC, postcentral gyrus and parietal operculum receive nociceptive input. Cortical activity will be monitored over ACC, parasylvian and paracentral cortex during cutaneous stimulation with a carbon dioxide laser (laser evoked potentials - LEP) in epileptic patients with implanted subdural grids (Aim I). Stimulation with the laser evokes a pure pain sensation by selective activation of cutaneous nociceptors. The function of these nociceptive inputs will be assessed by psychophysical studies of patients with lesions of thalamus and cortex, but without central pain, to test the hypothesis that ACC and insula contribute to the affective aspect of pain while parietal operculum and SI contribute to the sensory aspect of pain (Aim II). LEPs will determine whether the lesions involve structures which receive nociceptive input. The hypothesis that lesions of pain and temperature signaling pathways result in central pain syndromes by producing increased activity of cortical areas normally receiving input from those pathways will then be tested (Aim III). PET studies will determine cortical areas that are hyperactive in response to stimuli which produce allodynia. These studies have unique potential to clarify the identity, function and pathophysiology of pain-signaling structures in human cortex.

描述（改编自申请人的摘要）这些的长期目标 研究的目的是了解人类大脑皮层的感觉和情感机制， 急性和慢性疼痛的维度。关于人类大脑皮层 接受伤害性输入的结构;注意力在调节 输入到这些结构;或者这些皮层结构的功能。还有， 人类丘脑核或皮质回，病变导致 发生中枢性疼痛或在患有 中枢性疼痛尚未明确定义。初步证据表明， 由纯疼痛刺激诱发的电位位于人的前部 扣带皮层（ACC）和侧裂旁皮层，这表明这些区域 接受伤害性输入。顶骨盖病变与 疼痛识别缺陷（疼痛的感觉识别方面） 虽然小脑的病变往往与小脑的缺陷有关， 逃避痛苦刺激的动机（情感动机方面） 疼痛）。本研究旨在确定人类ACC， 中央后回和顶叶盖接受伤害性输入。皮质 活动将在ACC、侧裂旁和中央旁皮层上进行监测， 用二氧化碳激光进行皮肤刺激（激光诱发电位， LEP）在植入硬膜下网格的癫痫患者中的应用（Aim I）。刺激 激光通过选择性激活 皮肤伤害感受器这些伤害性输入的功能将是 通过对丘脑病变患者的心理物理学研究进行评估， 皮层，但没有中枢疼痛，以检验ACC和ACC的假设， 有助于疼痛的情感方面，而顶骨盖和SI 有助于疼痛的感觉方面（目的II）。LEP将决定是否 损伤涉及接受伤害性输入的结构。的假设 疼痛和温度信号通路的损伤导致中枢疼痛 通过产生正常接收的皮层区域的活动增加而引起的综合征 然后将测试这些途径的投入（目标三）。PET研究将 确定对刺激做出反应的过度活跃的皮层区域， 产生异常性疼痛。这些研究具有独特的潜力，以澄清身份， 人类皮层疼痛信号结构的功能和病理生理学。