Normal laser-evoked cortical responses in patients with chronic hemibody pain
Background Patients with widespread unilateral chronic pain associated with recurrent herpes simplex virus (HSV) infections show functional and/or structural changes in the insula, anterior cingulate cortex, frontal and prefrontal cortices, as well as the thalamus, suggesting central dysfunction of...
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Veröffentlicht in: | European journal of pain 2015-09, Vol.19 (8), p.1168-1176 |
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creator | Kirveskari, E. Vartiainen, N.V. Kallio-Laine, K. Kalso, E. Forss, N. |
description | Background
Patients with widespread unilateral chronic pain associated with recurrent herpes simplex virus (HSV) infections show functional and/or structural changes in the insula, anterior cingulate cortex, frontal and prefrontal cortices, as well as the thalamus, suggesting central dysfunction of the pain system in these patients. Central pain has been associated with attenuated laser‐evoked cortical responses. We aimed to clarify whether the observed deficient activation of these areas to acute nociceptive stimuli is due to a lesion at a lower level of pain processing pathways.
Methods
We explored the functional integrity of the ascending nociceptive pathways by recording the cortical‐evoked responses to noxious laser stimulation using magnetoencephalography and electroencephalography in eight patients (age 41–51 years, mean 46) with recurrent HSV infections and a history of chronic, spontaneous, widespread unilateral pain, and in nine age‐matched healthy control subjects.
Results
The cortical‐evoked fields of the HSV patients originating from the secondary somatosensory and posterior parietal cortices, as well as the evoked potentials recorded from the midline, did not differ from those of the control subjects, indicating functionally intact ascending nociceptive pathways.
Conclusions
The present results show that our patients with chronic hemibody pain do not show signs of spinothalamic tract lesion. This indicates normal processing of sensory aspects of painful stimuli, while higher pain processing areas show altered activation. We conclude that normal laser‐evoked magnetic fields (LEF) or laser‐evoked potentials (LEP) may not exclude central pain condition. |
doi_str_mv | 10.1002/ejp.642 |
format | Article |
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Patients with widespread unilateral chronic pain associated with recurrent herpes simplex virus (HSV) infections show functional and/or structural changes in the insula, anterior cingulate cortex, frontal and prefrontal cortices, as well as the thalamus, suggesting central dysfunction of the pain system in these patients. Central pain has been associated with attenuated laser‐evoked cortical responses. We aimed to clarify whether the observed deficient activation of these areas to acute nociceptive stimuli is due to a lesion at a lower level of pain processing pathways.
Methods
We explored the functional integrity of the ascending nociceptive pathways by recording the cortical‐evoked responses to noxious laser stimulation using magnetoencephalography and electroencephalography in eight patients (age 41–51 years, mean 46) with recurrent HSV infections and a history of chronic, spontaneous, widespread unilateral pain, and in nine age‐matched healthy control subjects.
Results
The cortical‐evoked fields of the HSV patients originating from the secondary somatosensory and posterior parietal cortices, as well as the evoked potentials recorded from the midline, did not differ from those of the control subjects, indicating functionally intact ascending nociceptive pathways.
Conclusions
The present results show that our patients with chronic hemibody pain do not show signs of spinothalamic tract lesion. This indicates normal processing of sensory aspects of painful stimuli, while higher pain processing areas show altered activation. We conclude that normal laser‐evoked magnetic fields (LEF) or laser‐evoked potentials (LEP) may not exclude central pain condition.</description><identifier>ISSN: 1090-3801</identifier><identifier>EISSN: 1532-2149</identifier><identifier>DOI: 10.1002/ejp.642</identifier><identifier>PMID: 25523148</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Cerebral Cortex - physiopathology ; Chronic Pain - physiopathology ; Electromagnetic Fields ; Evoked Potentials ; Female ; Functional Laterality ; Herpes Simplex - complications ; Herpes Simplex - pathology ; Humans ; Laser-Evoked Potentials ; Lasers ; Magnetoencephalography ; Male ; Middle Aged ; Neural Pathways - physiopathology ; Nociceptors - pathology ; Pain Measurement ; Pain Threshold ; Somatosensory Cortex - physiopathology</subject><ispartof>European journal of pain, 2015-09, Vol.19 (8), p.1168-1176</ispartof><rights>2014 European Pain Federation ‐ EFIC</rights><rights>2014 European Pain Federation - EFIC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4252-5ff0a6515775d8c847d89a78f1acca12ddc5ecb3edb7d2d040343ccc6e36e51f3</citedby><cites>FETCH-LOGICAL-c4252-5ff0a6515775d8c847d89a78f1acca12ddc5ecb3edb7d2d040343ccc6e36e51f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fejp.642$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fejp.642$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25523148$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kirveskari, E.</creatorcontrib><creatorcontrib>Vartiainen, N.V.</creatorcontrib><creatorcontrib>Kallio-Laine, K.</creatorcontrib><creatorcontrib>Kalso, E.</creatorcontrib><creatorcontrib>Forss, N.</creatorcontrib><title>Normal laser-evoked cortical responses in patients with chronic hemibody pain</title><title>European journal of pain</title><addtitle>EJP</addtitle><description>Background
Patients with widespread unilateral chronic pain associated with recurrent herpes simplex virus (HSV) infections show functional and/or structural changes in the insula, anterior cingulate cortex, frontal and prefrontal cortices, as well as the thalamus, suggesting central dysfunction of the pain system in these patients. Central pain has been associated with attenuated laser‐evoked cortical responses. We aimed to clarify whether the observed deficient activation of these areas to acute nociceptive stimuli is due to a lesion at a lower level of pain processing pathways.
Methods
We explored the functional integrity of the ascending nociceptive pathways by recording the cortical‐evoked responses to noxious laser stimulation using magnetoencephalography and electroencephalography in eight patients (age 41–51 years, mean 46) with recurrent HSV infections and a history of chronic, spontaneous, widespread unilateral pain, and in nine age‐matched healthy control subjects.
Results
The cortical‐evoked fields of the HSV patients originating from the secondary somatosensory and posterior parietal cortices, as well as the evoked potentials recorded from the midline, did not differ from those of the control subjects, indicating functionally intact ascending nociceptive pathways.
Conclusions
The present results show that our patients with chronic hemibody pain do not show signs of spinothalamic tract lesion. This indicates normal processing of sensory aspects of painful stimuli, while higher pain processing areas show altered activation. We conclude that normal laser‐evoked magnetic fields (LEF) or laser‐evoked potentials (LEP) may not exclude central pain condition.</description><subject>Adult</subject><subject>Cerebral Cortex - physiopathology</subject><subject>Chronic Pain - physiopathology</subject><subject>Electromagnetic Fields</subject><subject>Evoked Potentials</subject><subject>Female</subject><subject>Functional Laterality</subject><subject>Herpes Simplex - complications</subject><subject>Herpes Simplex - pathology</subject><subject>Humans</subject><subject>Laser-Evoked Potentials</subject><subject>Lasers</subject><subject>Magnetoencephalography</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neural Pathways - physiopathology</subject><subject>Nociceptors - pathology</subject><subject>Pain Measurement</subject><subject>Pain Threshold</subject><subject>Somatosensory Cortex - physiopathology</subject><issn>1090-3801</issn><issn>1532-2149</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMlOwzAQQC0EYimIP0C5gYQCXuP0CBUUUNlBcLNce6IakjjYKdC_JyjAjdOMZp7e4SG0TfABwZgewktzkHG6hNaJYDSlhA-Xux0PccpyTNbQRowvGGMuMVtFa1QIygjP19HllQ-VLpNSRwgpvPtXsInxoXWmuwaIja8jxMTVSaNbB3Ubkw_XzhIzC752JplB5abeLrq3qzfRSqHLCFs_c4AeT08eRmfp5Hp8PjqapIZTQVNRFFhngggphc1NzqXNh1rmBdHGaEKtNQLMlIGdSkst5phxZozJgGUgSMEGaK_3NsG_zSG2qnLRQFnqGvw8KiKxkDQXGe_Q3R41wccYoFBNcJUOC0Ww-m6nunaqa9eROz_S-bQC-8f9xuqA_R74cCUs_vOok4ubXpf2tIstfP7ROryqTDIp1NPVWN0N74-fx9mtumRfYpqHnA</recordid><startdate>201509</startdate><enddate>201509</enddate><creator>Kirveskari, E.</creator><creator>Vartiainen, N.V.</creator><creator>Kallio-Laine, K.</creator><creator>Kalso, E.</creator><creator>Forss, N.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201509</creationdate><title>Normal laser-evoked cortical responses in patients with chronic hemibody pain</title><author>Kirveskari, E. ; Vartiainen, N.V. ; Kallio-Laine, K. ; Kalso, E. ; Forss, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4252-5ff0a6515775d8c847d89a78f1acca12ddc5ecb3edb7d2d040343ccc6e36e51f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cerebral Cortex - physiopathology</topic><topic>Chronic Pain - physiopathology</topic><topic>Electromagnetic Fields</topic><topic>Evoked Potentials</topic><topic>Female</topic><topic>Functional Laterality</topic><topic>Herpes Simplex - complications</topic><topic>Herpes Simplex - pathology</topic><topic>Humans</topic><topic>Laser-Evoked Potentials</topic><topic>Lasers</topic><topic>Magnetoencephalography</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neural Pathways - physiopathology</topic><topic>Nociceptors - pathology</topic><topic>Pain Measurement</topic><topic>Pain Threshold</topic><topic>Somatosensory Cortex - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kirveskari, E.</creatorcontrib><creatorcontrib>Vartiainen, N.V.</creatorcontrib><creatorcontrib>Kallio-Laine, K.</creatorcontrib><creatorcontrib>Kalso, E.</creatorcontrib><creatorcontrib>Forss, N.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kirveskari, E.</au><au>Vartiainen, N.V.</au><au>Kallio-Laine, K.</au><au>Kalso, E.</au><au>Forss, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Normal laser-evoked cortical responses in patients with chronic hemibody pain</atitle><jtitle>European journal of pain</jtitle><addtitle>EJP</addtitle><date>2015-09</date><risdate>2015</risdate><volume>19</volume><issue>8</issue><spage>1168</spage><epage>1176</epage><pages>1168-1176</pages><issn>1090-3801</issn><eissn>1532-2149</eissn><abstract>Background
Patients with widespread unilateral chronic pain associated with recurrent herpes simplex virus (HSV) infections show functional and/or structural changes in the insula, anterior cingulate cortex, frontal and prefrontal cortices, as well as the thalamus, suggesting central dysfunction of the pain system in these patients. Central pain has been associated with attenuated laser‐evoked cortical responses. We aimed to clarify whether the observed deficient activation of these areas to acute nociceptive stimuli is due to a lesion at a lower level of pain processing pathways.
Methods
We explored the functional integrity of the ascending nociceptive pathways by recording the cortical‐evoked responses to noxious laser stimulation using magnetoencephalography and electroencephalography in eight patients (age 41–51 years, mean 46) with recurrent HSV infections and a history of chronic, spontaneous, widespread unilateral pain, and in nine age‐matched healthy control subjects.
Results
The cortical‐evoked fields of the HSV patients originating from the secondary somatosensory and posterior parietal cortices, as well as the evoked potentials recorded from the midline, did not differ from those of the control subjects, indicating functionally intact ascending nociceptive pathways.
Conclusions
The present results show that our patients with chronic hemibody pain do not show signs of spinothalamic tract lesion. This indicates normal processing of sensory aspects of painful stimuli, while higher pain processing areas show altered activation. We conclude that normal laser‐evoked magnetic fields (LEF) or laser‐evoked potentials (LEP) may not exclude central pain condition.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25523148</pmid><doi>10.1002/ejp.642</doi><tpages>9</tpages></addata></record> |
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subjects | Adult Cerebral Cortex - physiopathology Chronic Pain - physiopathology Electromagnetic Fields Evoked Potentials Female Functional Laterality Herpes Simplex - complications Herpes Simplex - pathology Humans Laser-Evoked Potentials Lasers Magnetoencephalography Male Middle Aged Neural Pathways - physiopathology Nociceptors - pathology Pain Measurement Pain Threshold Somatosensory Cortex - physiopathology |
title | Normal laser-evoked cortical responses in patients with chronic hemibody pain |
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