Neurology Department, University Hospital, St-Etienne, France.
Neuroimage. 2012 Mar;60(1):409-18. doi: 10.1016/j.neuroimage.2011.12.072. Epub 2012 Jan 5.
The role of operculo-insular region in the processing of somato-sensory inputs, painful or not, is now well established. However, available maps from previous literature show a substantial overlap of cortical areas activated by these stimuli, and the region referred to as the "secondary somatosensory area (SII)" is widely distributed in the parietal operculum. Differentiating SII from posterior insula cortex, which is anatomically contiguous, is not easy, explaining why the "operculo-insular" label has been introduced to describe activations by somatosensory stimuli in this cortical region. Based on the recent cyto-architectural parcellation of the human insular/SII cortices (Eickhoff et al., 2006, Kurth et al., 2010), the present study investigates with functional MRI (fMRI), whether these structural subdivisions could subserve distinct aspects of discriminative somato-sensory functions, including pain. Responses to five types of stimuli applied on the left hand of 25 healthy volunteers were considered: i) tactile stimuli; ii) passive movements; iii) innocuous cold stimuli; iv) non-noxious warm and v) heat pain. Our results show different patterns of activation depending on the type of somato-sensory stimulation. The posterior part of SII (OP1 area), contralateral to stimuli, was the only sub-region activated by all type of stimuli and might therefore be considered as a common cortical target for different types of somato-sensory inputs. Proprioceptive stimulation by passive finger movements activated the posterior part of SII (OP1 sub-region) bilaterally and the contralateral median part of insula (PreCG and MSG). Innocuous cooling activated the contralateral posterior part of SII (OP1) and the dorsal posterior and median part of insula (OP2, PostCG). Pain stimuli induced the most widespread and intense activation that was bilateral in SII (OP1, OP4) and distributed to all sub-regions of contralateral insula (except OP2) and to the anterior part of the ipsilateral insula (PreCG, MSG, ASG). However, the posterior granular part of insula contralateral to stimulus (Ig area) and the anterior part of SII bilaterally (OP4) were specifically activated during pain stimulation. This raises the question whether these latter areas could be the anatomical substrate of the sensory-discriminative processing of thermal pain.
岛盖-脑岛区域在体感输入(包括疼痛和非疼痛输入)的处理中起着重要作用,这一点现在已经得到了很好的证实。然而,来自先前文献的可用图谱显示,被这些刺激激活的皮质区域有很大的重叠,而被广泛称为“次级体感区(SII)”的区域广泛分布于顶叶脑岛。区分 SII 和解剖上相邻的后脑岛皮质并不容易,这也解释了为什么引入了“岛盖-脑岛”这一标签来描述该皮质区域体感刺激的激活。基于最近对人类脑岛/SII 皮质的细胞构筑分区(Eickhoff 等人,2006 年;Kurth 等人,2010 年),本研究使用功能磁共振成像(fMRI)研究了这些结构分区是否可以支持不同方面的体感功能(包括疼痛)的辨别。共考虑了 25 名健康志愿者左手接受的 5 种刺激类型:i)触觉刺激;ii)被动运动;iii)无害冷刺激;iv)非伤害性热刺激;v)热痛刺激。我们的结果显示,不同的体感刺激类型会产生不同的激活模式。与刺激相对应的 SII 后区(OP1 区)是唯一被所有刺激类型激活的亚区,因此可以被认为是不同类型体感输入的共同皮质靶区。被动手指运动引起的本体感觉刺激双侧激活了 SII 的后区(OP1 亚区)和对侧脑岛的中间部分(PreCG 和 MSG)。无害的冷却刺激激活了对侧 SII 的后区(OP1)和脑岛的背侧后区和中间部分(OP2 和 PostCG)。疼痛刺激引起的激活最广泛和强烈,在 SII(OP1 和 OP4)双侧以及对侧脑岛的所有亚区(除了 OP2)和同侧脑岛的前区(PreCG、MSG 和 ASG)都有分布。然而,刺激对侧脑岛的后颗粒部分(Ig 区)和双侧 SII 的前区(OP4)在疼痛刺激时特异性激活。这就提出了一个问题,即这些区域是否可能是热痛的感觉辨别处理的解剖学基础。
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