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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Continuous theta burst stimulation (cTBS) applied over the primary motor cortex (M1) can alleviate pain although the neural basis of this effect remains largely unknown. Besides, the primary somatosensory cortex (S1) is thought to play a pivotal role in the sensori-discriminative aspects of pain perception but the analgesic effect of cTBS applied over S1 remains controversial. To investigate cTBS-induced analgesia we characterized, in two separate experiments, the effect of cTBS applied either over M1 or S1 on the event-related brain potentials (ERPs) and perception elicited by nociceptive (CO2 laser stimulation) and non-nociceptive (transcutaneous electrical stimulation) somatosensory stimuli. All stimuli were delivered to the ipsilateral and contralateral hand. We found that both cTBS applied over M1 and cTBS applied over S1 significantly reduced the percept elicited by nociceptive stimuli delivered to the contralateral hand as compared to similar stimulation of the ipsilateral hand. In contrast, cTBS did not modulate the perception of non-nociceptive stimuli. Surprisingly, this side-dependent analgesic effect of cTBS was not reflected in the amplitude modulation of nociceptive ERPs. Indeed, both nociceptive (N160, N240 and P360 waves) and late-latency non-nociceptive (N140 and P200 waves) ERPs elicited by stimulation of the contralateral and ipsilateral hands were similarly reduced after cTBS, suggesting an unspecific effect, possibly due to habituation or reduced alertness. In conclusion, cTBS applied over M1 and S1 reduces similarly the perception of nociceptive inputs originating from the contralateral hand, but this analgesic effect is not reflected in the magnitude of nociceptive ERPs.
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PMID:Theta burst stimulation applied over primary motor and somatosensory cortices produces analgesia unrelated to the changes in nociceptive event-related potentials. 2397 82

Previous studies have suggested that looking at the hand can reduce the perception of pain and the magnitude of the ERPs elicited by nociceptive stimuli delivered onto the hand. In contrast, other studies have suggested that looking at the hand can increase tactile sensory discrimination performance, and enhance the magnitude of the ERPs elicited by tactile stimulation. These opposite effects could be related to differences in the crossmodal effects between vision, nociception, and touch. However, these differences could also be related to the use of different experimental designs. Importantly, most studies on the effects of vision on pain have relied on a mirror to create the illusion that the reflected hand is a direct view of the stimulated hand. Here, we compared the effects of direct versus mirror vision of the hand versus an object on the perception and ERPs elicited by non-nociceptive and nociceptive stimuli. We did not observe any significant effect of vision on the perceived intensity. However, vision of the hand did reduce the magnitude of the nociceptive N240 wave, and enhanced the magnitude of the non-nociceptive P200. Our results confirm that vision of the body differentially affects nociceptive and non-nociceptive processing, but question the robustness of visual analgesia.
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PMID:Looking at the hand modulates the brain responses to nociceptive and non-nociceptive somatosensory stimuli but does not necessarily modulate their perception. 2591 17

Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs) whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs) during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA) method revealed significant activations of the bilateral primary somatosensory (BA3), middle frontal gyrus (BA6) and anterior cingulate cortices (BA24). Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32), while for the P200 wave, activity was increased in the superior (BA22), middle (BA37), inferior temporal (BA19) gyri and superior parietal lobule (BA7). Hypnotic hypoalgesia in HHs, for N140 wave, showed reduced activity within medial and superior frontal gyri (BA9,8), paraippocampal gyrus (BA34), and postcentral gyrus (BA1), while for the P200, activity was reduced within middle and superior frontal gyri (BA9 and BA10), anterior cingulate (BA33), cuneus (BA19) and sub-lobar insula (BA13). These findings demonstrate that hypnotic suggestions can exert a top-down modulatory effect on attention/preconscious brain processes involved in pain perception.
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PMID:Pain modulation in waking and hypnosis in women: event-related potentials and sources of cortical activity. 2603 Apr 17

We evaluated the influence of hypnotizability, pain expectation, placebo analgesia in waking and hypnosis on tonic pain relief. We also investigated how placebo analgesia affects somatic responses (eye blink) and N100 and P200 waves of event-related potentials (ERPs) elicited by auditory startle probes. Although expectation plays an important role in placebo and hypnotic analgesia, the neural mechanisms underlying these treatments are still poorly understood. We used the cold cup test (CCT) to induce tonic pain in 53 healthy women. Placebo analgesia was initially produced by manipulation, in which the intensity of pain induced by the CCT was surreptitiously reduced after the administration of a sham analgesic cream. Participants were then tested in waking and hypnosis under three treatments: (1) resting (Baseline); (2) CCT-alone (Pain); and (3) CCT plus placebo cream for pain relief (Placebo). For each painful treatment, we assessed pain and distress ratings, eye blink responses, N100 and P200 amplitudes. We used LORETA analysis of N100 and P200 waves, as elicited by auditory startle, to identify cortical regions sensitive to pain reduction through placebo and hypnotic analgesia. Higher pain expectation was associated with higher pain reductions. In highly hypnotizable participants placebo treatment produced significant reductions of pain and distress perception in both waking and hypnosis condition. P200 wave, during placebo analgesia, was larger in the frontal left hemisphere while placebo analgesia, during hypnosis, involved the activity of the left hemisphere including the occipital region. These findings demonstrate that hypnosis and placebo analgesia are different processes of top-down regulation. Pain reduction was associated with larger EMG startle amplitudes, N100 and P200 responses, and enhanced activity within the frontal, parietal, and anterior and posterior cingulate gyres. LORETA results showed that placebo analgesia modulated pain-responsive areas known to reflect the ongoing pain experience.
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PMID:Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study. 2748 48

Little is known regarding inter-individual differences in attentional biases for pain-related information; more knowledge is crucial, since these biases have been associated with differences in pain processing as well as in predicting the risk of postoperative pain. The present study investigated EEG correlates of attentional bias patterns for pain-related information, with specific focus on avoidance- and vigilance-like behavior. Forty-one participants performed a dot-probe task, where neutral and pain-related words were used to create neutral, congruent, incongruent, and double (two pain-related words) trials. EEG was recorded, which was used to generate ERP's of the word-processing phase and the post-dot phase. Participants were placed in two subgroups based on the direction of their attentional bias (either positive; toward the pain-related words, or negative; away from pain-related words). Using t-profiles, four latency windows were identified on which the two subgroups differed significantly. These latency windows yield areas which correspond with the P1-N1 domain and the P3b for the word-processing phase, while the post-dot phase latency windows cover the areas of the P200 and the P3b. The two subgroups show differences on congruent, incongruent, and the double trials, but interestingly also on the neutral trials. Most notably, the area in the word-phase associated with the P3b is diminished in the subgroup showing a negative bias. The deflections associated with both early and late attentional components, including the P3B, as well as a positive deflection in the timeframe of proposed response evaluation processes differ significantly between subgroups. In this study we demonstrated that different attentional biases exist in the healthy population, by showing differences in ERP's. We also show differences in processing neutral trials, which suggests there are fundamental differences between these groups in processing words in general.
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PMID:Evidence for a Priori Existence of Attentional Bias Subgroups in Emotional Processing of Aversive Stimuli. 2855 10

Humans experience more stress about uncertain situations than certain situations. However, the neural mechanism underlying the uncertainty of a negative stimulus has not been determined. In the present study, event-related potential was recorded to examine neural responses during the dread of unpredictable pain. We used a cueing paradigm in which predictable cues were always followed by electric shocks, unpredictable cues by electric shocks at a 50/50 ratio and safe cues by no electric shock. Visual analogue scales following electric shocks were presented to quantify subjective anxiety levels. The behavioral results showed that unpredictable cues evoked high-level anxiety compared with predictable cues in both painful and unpainful stimulation conditions. More importantly, the ERPs results revealed that unpredictable cues elicited a larger P200 at parietal sites than predictable cues. In addition, unpredictable cues evoked larger P200 compared with safe cues at frontal electrodes and compared with predictable cues at parietal electrodes. In addition, larger P3b and LPP were observed during perception of safe cues compared with predictable cues at frontal and central electrodes. The similar P3b effect was also revealed in the left sites. The present study underlined that the uncertain dread of pain was associated with threat appraisal process in pain system. These findings on early event-related potentials were significant for a neural marker and development of therapeutic interventions.
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PMID:Dread of uncertain pain: An event-related potential study. 2883 7

Attending to pain-relevant information is crucial to protect us from physical harm. Behavioral studies have already suggested that during anticipation of pain somatosensory input at the body location under threat is prioritized. However, research using daily life cues for pain, especially movements, is lacking. Furthermore, to our knowledge, no studies have investigated cortical processing associated with somatosensory processing during threatened movements. The current study aims to investigate whether movements accompanying pain automatically steer attention toward somatosensory input at the threatened location, affecting somatosensory evoked potentials (SEPs). Healthy volunteers were cued to perform movements with the left or the right hand, and one of these movements could be accompanied by pain on the moving hand. During movement anticipation, a task-irrelevant tactile stimulus was presented to the threatened or pain-free hand to evoke SEPs. During anticipation of movements accompanying pain, the N120 component was increased for tactile stimuli at the threatened relative to the hand without pain. Moreover, the P200 SEP was enhanced during anticipation of movements accompanying pain relative to movements without pain, irrespective of which hand was stimulated. These findings show that the anticipation of pain-accompanying movements may affect the processing of somatosensory input, and that this is likely to be driven by attentional processes.
J Pain 2018 02
PMID:Attentional Modulation of Somatosensory Processing During the Anticipation of Movements Accompanying Pain: An Event-Related Potential Study. 2915 18

Pain serves to protect against bodily threat, and therefore initiates protective responses such as attending toward threat-relevant information. Since pain is often exacerbated by executing movements, these motor actions may serve as cues for pain. Up to date, however, pain-related attention during movement remains largely unexplored. While it has been shown that the preparation of a pain-related movement leads to enhanced processing of somatosensory information, it is unclear how the actual execution of a movement interacts with somatosensory attention. In the current study, we examined whether somatosensory processing is enhanced at a moving body part when the movement is expected to be associated with pain. Participants were asked to execute hand movements which were occasionally followed by a pain stimulus. To measure somatosensory attention, a task-irrelevant, innocuous tactile probe was presented on either hand to evoke a somatosensory evoked potential (SEP). The results showed an elevation of the N120 SEP at the hand performing a potentially painful movement, indicating heightened attention toward tactile information at the threatened moving hand compared to the non-threatened hand. Additionally, the P200 SEP also showed enlarged responses when performing a pain-related movement compared to a no-pain-related movement. These results show that not only the anticipation, but also the execution of pain-related movements, may modulate the processing of somatosensory input, driven by attentional processes.
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PMID:Somatosensory attentional modulations during pain-related movement execution. 3223 40


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