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平行皮质-脑干通路参与注意性镇痛。

Parallel cortical-brainstem pathways to attentional analgesia.

机构信息

School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol BS8 1TD, United Kingdom.

School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol BS8 1TD, United Kingdom; Anaesthesia, Pain and Critical Care Sciences, Bristol Medical School, University Hospitals Bristol, Bristol BS2 8HW, United Kingdom.

出版信息

Neuroimage. 2021 Feb 1;226:117548. doi: 10.1016/j.neuroimage.2020.117548. Epub 2020 Nov 11.

DOI:10.1016/j.neuroimage.2020.117548
PMID:33186712
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7836236/
Abstract

Pain demands attention, yet pain can be reduced by focusing attention elsewhere. The neural processes involved in this robust psychophysical phenomenon, attentional analgesia, are still being defined. Our previous fMRI study linked activity in the brainstem triad of locus coeruleus (LC), rostral ventromedial medulla (RVM) and periaqueductal grey (PAG) with attentional analgesia. Here we identify and model the functional interactions between these regions and the cortex in healthy human subjects (n = 57), who received painful thermal stimuli whilst simultaneously performing a visual attention task. RVM activity encoded pain intensity while contralateral LC activity correlated with attentional analgesia. Psycho-Physiological Interaction analysis and Dynamic Causal Modelling identified two parallel paths between forebrain and brainstem. These connections are modulated by attentional demand: a bidirectional anterior cingulate cortex (ACC) - right-LC loop, and a top-down influence of task on ACC-PAG-RVM. By recruiting discrete brainstem circuits, the ACC is able to modulate nociceptive input to reduce pain in situations of conflicting attentional demand.

摘要

疼痛需要引起关注，但通过将注意力转移到其他地方，疼痛可以减轻。参与这种强大的心理物理学现象，即注意力镇痛的神经过程仍在定义中。我们之前的 fMRI 研究将蓝斑核（LC）、延髓腹侧中缝核（RVM）和中脑导水管周围灰质（PAG）的脑干三联体的活动与注意力镇痛联系起来。在这里，我们在健康人类受试者（n=57）中识别和建模这些区域与大脑皮层之间的功能相互作用，这些受试者在同时执行视觉注意力任务时接受了疼痛的热刺激。RVM 活动编码疼痛强度，而对侧 LC 活动与注意力镇痛相关。心理生理相互作用分析和动态因果建模确定了大脑前脑和脑干之间的两条平行路径。这些连接受到注意力需求的调节：前扣带皮层（ACC）-右侧 LC 环的双向连接，以及任务对 ACC-PAG-RVM 的自上而下的影响。通过招募离散的脑干回路，ACC 能够调节伤害性输入，以减轻在注意力需求冲突的情况下的疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/d03e3d05e2f6/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/b0b513a29a7d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/b66f360e8677/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/57251d7104b7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/1eb2d1dfe2d2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/039e01e4831f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/d03e3d05e2f6/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/b0b513a29a7d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/b66f360e8677/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/57251d7104b7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/1eb2d1dfe2d2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/039e01e4831f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9282/7836236/d03e3d05e2f6/gr6.jpg

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