Schulz Enrico, May Elisabeth S, Postorino Martina, Tiemann Laura, Nickel Moritz M, Witkovsky Viktor, Schmidt Paul, Gross Joachim, Ploner Markus
Department of Neurology, Technische Universität München, 81675 Munich, Germany TUM - Neuroimaging Center, Technische Universität München, 81675 Munich, Germany.
Department of Theoretical Methods, Institute of Measurement Science, Slovak Academy of Sciences, 84219 Bratislava, Slovak Republic.
Cereb Cortex. 2015 Nov;25(11):4407-14. doi: 10.1093/cercor/bhv043. Epub 2015 Mar 8.
Under physiological conditions, momentary pain serves vital protective functions. Ongoing pain in chronic pain states, on the other hand, is a pathological condition that causes widespread suffering and whose treatment remains unsatisfactory. The brain mechanisms of ongoing pain are largely unknown. In this study, we applied tonic painful heat stimuli of varying degree to healthy human subjects, obtained continuous pain ratings, and recorded electroencephalograms to relate ongoing pain to brain activity. Our results reveal that the subjective perception of tonic pain is selectively encoded by gamma oscillations in the medial prefrontal cortex. We further observed that the encoding of subjective pain intensity experienced by the participants differs fundamentally from that of objective stimulus intensity and from that of brief pain stimuli. These observations point to a role for gamma oscillations in the medial prefrontal cortex in ongoing, tonic pain and thereby extend current concepts of the brain mechanisms of pain to the clinically relevant state of ongoing pain. Furthermore, our approach might help to identify a brain marker of ongoing pain, which may prove useful for the diagnosis and therapy of chronic pain.
在生理条件下,瞬间疼痛发挥着重要的保护功能。另一方面,慢性疼痛状态下的持续性疼痛是一种病理状态,会导致广泛的痛苦,其治疗效果仍不尽人意。持续性疼痛的脑机制在很大程度上尚不清楚。在本研究中,我们对健康人类受试者施加不同程度的持续性疼痛热刺激,获取连续的疼痛评分,并记录脑电图,以将持续性疼痛与脑活动联系起来。我们的结果表明,持续性疼痛的主观感受由内侧前额叶皮质中的伽马振荡选择性编码。我们进一步观察到,参与者所体验到的主观疼痛强度的编码与客观刺激强度以及短暂疼痛刺激的编码有根本区别。这些观察结果表明内侧前额叶皮质中的伽马振荡在持续性、紧张性疼痛中发挥作用,从而将当前关于疼痛脑机制的概念扩展到临床上相关的持续性疼痛状态。此外,我们的方法可能有助于识别持续性疼痛的脑标志物,这可能对慢性疼痛的诊断和治疗有用。