Becerra Lino, Bishop James, Barmettler Gabi, Kainz Vanessa, Burstein Rami, Borsook David
Pain/Analgesia Imaging Neuroscience (P.A.I.N.) Group, Department of Anesthesia, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
Pain/Analgesia Imaging Neuroscience (P.A.I.N.) Group, Department of Anesthesia, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
Brain Res. 2017 Apr 1;1660:36-46. doi: 10.1016/j.brainres.2017.02.001. Epub 2017 Feb 3.
Advances in our understanding of the human pain experience have shifted much of the focus of pain research from the periphery to the brain. Current hypotheses suggest that the progression of migraine depends on abnormal functioning of neurons in multiple brain regions. Accordingly, we sought to capture functional brain changes induced by the application of an inflammatory cocktail known as inflammatory soup (IS), to the dura mater across multiple brain networks. Specifically, we aimed to determine whether IS alters additional neural networks indirectly related to the primary nociceptive pathways via the spinal cord to the thalamus and cortex. IS comprises an acidic combination of bradykinin, serotonin, histamine and prostaglandin PGE2 and was introduced to basic pain research as a tool to activate and sensitize peripheral nociceptors when studying pathological pain conditions associated with allodynia and hyperalgesia. Using this model of intracranial pain, we found that dural application of IS in awake, fully conscious, rats enhanced thalamic, hypothalamic, hippocampal and somatosensory cortex responses to mechanical stimulation of the face (compared to sham synthetic interstitial fluid administration). Furthermore, resting state MRI data revealed altered functional connectivity in a number of networks previously identified in clinical chronic pain populations. These included the default mode, sensorimotor, interoceptive (Salience) and autonomic networks. The findings suggest that activation and sensitization of meningeal nociceptors by IS can enhance the extent to which the brain processes nociceptive signaling, define new level of modulation of affective and cognitive responses to pain; set new tone for hypothalamic regulation of autonomic outflow to the cranium; and change cerebellar functions.
我们对人类疼痛体验理解的进展已将疼痛研究的重点从外周转移至大脑。当前假说表明偏头痛的进展取决于多个脑区神经元的异常功能。因此,我们试图捕捉通过向硬脑膜施加一种名为炎性汤(IS)的炎性混合物在多个脑网络中诱发的脑功能变化。具体而言,我们旨在确定IS是否会改变通过脊髓至丘脑和皮层与初级伤害感受通路间接相关的其他神经网络。IS由缓激肽、血清素、组胺和前列腺素PGE2的酸性组合构成,在研究与异常性疼痛和痛觉过敏相关的病理性疼痛状况时,作为激活和致敏外周伤害感受器的一种工具被引入基础疼痛研究。利用这种颅内疼痛模型,我们发现,在清醒、完全有意识的大鼠中向硬脑膜施加IS会增强丘脑、下丘脑、海马体和体感皮层对面部机械刺激的反应(与假手术组给予合成组织间液相比)。此外,静息态MRI数据显示,在先前临床慢性疼痛人群中确定的一些网络中,功能连接发生了改变。这些网络包括默认模式、感觉运动、内感受(突显)和自主神经网络。研究结果表明,IS对脑膜伤害感受器的激活和致敏可增强大脑处理伤害性信号的程度,定义对疼痛的情感和认知反应的新调节水平;为下丘脑对流向颅骨的自主神经输出的调节设定新基调;并改变小脑功能。