Department of Neural and Pain Sciences, University of Maryland School of Dentistry, W Baltimore Street, Baltimore, MD 21201, USA.
Department of Epidemiology & Public Health, Maryland Psychiatric Research Center, Wade Avenue, Catonsville, MD 21228, USA.
Curr Biol. 2024 May 6;34(9):1953-1966.e6. doi: 10.1016/j.cub.2024.03.021. Epub 2024 Apr 12.
Aberrant cognitive network activity and cognitive deficits are established features of chronic pain. However, the nature of cognitive network alterations associated with chronic pain and their underlying mechanisms require elucidation. Here, we report that the claustrum, a subcortical nucleus implicated in cognitive network modulation, is activated by acute painful stimulation and pain-predictive cues in healthy participants. Moreover, we discover pathological activity of the claustrum and a region near the posterior inferior frontal sulcus of the right dorsolateral prefrontal cortex (piDLPFC) in migraine patients during acute pain and cognitive task performance. Dynamic causal modeling suggests a directional influence of the claustrum on activity in this piDLPFC region, and diffusion weighted imaging verifies their structural connectivity. These findings advance understanding of claustrum function during acute pain and provide evidence of a possible circuit mechanism driving cognitive impairments in chronic pain.
异常的认知网络活动和认知缺陷是慢性疼痛的既定特征。然而，与慢性疼痛相关的认知网络改变的性质及其潜在机制仍需要阐明。在这里，我们报告说，大脑皮层下核，一个参与认知网络调节的亚皮质核，在健康参与者中，会被急性疼痛刺激和疼痛预测线索激活。此外，我们发现在偏头痛患者中，在急性疼痛和认知任务表现期间，右侧背外侧前额叶皮层（piDLPFC）的后下额下回附近的大脑皮层和一个区域会出现病理性活动。动态因果建模表明，大脑皮层对该 piDLPFC 区域活动的影响具有方向性，扩散加权成像验证了它们的结构连接。这些发现增进了我们对急性疼痛期间大脑皮层功能的理解，并提供了证据表明，在慢性疼痛中，可能存在一个驱动认知障碍的回路机制。
