Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation

Frontal lobe activity during pain is generally linked to attentional processing. We addressed the question of whether ‘bottom‐up’ processing and ‘top‐down’ modulation of nociceptive information dissociate anatomically within the frontal lobe by using PET scanning during painful thermal stimulation o...

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Veröffentlicht in:Brain (London, England : 1878) England : 1878), 2003-05, Vol.126 (5), p.1079-1091
Hauptverfasser: Lorenz, J., Minoshima, S., Casey, K. L.
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Minoshima, S.
Casey, K. L.
description Frontal lobe activity during pain is generally linked to attentional processing. We addressed the question of whether ‘bottom‐up’ processing and ‘top‐down’ modulation of nociceptive information dissociate anatomically within the frontal lobe by using PET scanning during painful thermal stimulation of normal and capsaicin‐treated skin. We showed recently that pain following normally non‐painful heat stimuli on chemically irritated skin (heat allodynia) uniquely engages extensive areas of the bilateral dorsolateral prefrontal (DLPFC), ventral/orbitofrontal (VOFC) and perigenual anterior cingulate (ACC) cortices. Here, we applied principal component analysis (PCA) and multiple regression analysis to study the covariance structure of the volumes of interest (VOI) activated specifically during heat allodynia in 14 male healthy subjects and evaluated the relationship of these VOI to ratings of pain intensity and affect. Results yielded a primary principal component (PC) that correlated positively with intensity and unpleasantness and accounted for activity in the medial thalamus, bilateral anterior insula, ventral striatum, perigenual ACC and bilateral VOFC. Activities in the right and left DLPFC loaded on separate PC and correlated negatively with perceived intensity and unpleasantness. The inter‐regional correlation of midbrain and medial thalamic activity was significantly reduced during high left DLPFC activity, suggesting that its negative correlation with pain affect may result from dampening of the effective connectivity of the midbrain–medial thalamic pathway. In contrast, right DLPFC activity was associated with a weakened relationship of the anterior insula with both pain intensity and affect. We propose that the DLPFC exerts active control on pain perception by modulating corticosubcortical and corticocortical pathways.
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L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-b85f6995e14214c5c9585b3a1130bab29d821c482af3364c8a1c4bee78e33ff93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>ACC = anterior cingulate cortex</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Capsaicin</topic><topic>DLPFC = dorsolateral prefrontal cortex</topic><topic>effective connectivity</topic><topic>functional neuroimaging</topic><topic>Hot Temperature - adverse effects</topic><topic>HPTc = heat pain threshold on sensitized skin</topic><topic>HPTn = heat pain threshold on normal skin</topic><topic>Humans</topic><topic>Hyperalgesia - physiopathology</topic><topic>Irritants</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Nociceptors - physiology</topic><topic>Pain - prevention &amp; control</topic><topic>pain modulation</topic><topic>PCA = principal component analysis</topic><topic>prefrontal cortex</topic><topic>Prefrontal Cortex - physiology</topic><topic>Principal Component Analysis</topic><topic>Psychophysics</topic><topic>rCBF = regional cerebral blood flow</topic><topic>Regional Blood Flow</topic><topic>Regression Analysis</topic><topic>Skin - blood supply</topic><topic>Skin - drug effects</topic><topic>Tomography, Emission-Computed</topic><topic>VAS = visual analogue scale</topic><topic>VOFC = ventral/orbitofrontal cortex</topic><topic>VOI = volume of interest</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lorenz, J.</creatorcontrib><creatorcontrib>Minoshima, S.</creatorcontrib><creatorcontrib>Casey, K. 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L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation</atitle><jtitle>Brain (London, England : 1878)</jtitle><addtitle>Brain</addtitle><date>2003-05-01</date><risdate>2003</risdate><volume>126</volume><issue>5</issue><spage>1079</spage><epage>1091</epage><pages>1079-1091</pages><issn>0006-8950</issn><eissn>1460-2156</eissn><coden>BRAIAK</coden><abstract>Frontal lobe activity during pain is generally linked to attentional processing. We addressed the question of whether ‘bottom‐up’ processing and ‘top‐down’ modulation of nociceptive information dissociate anatomically within the frontal lobe by using PET scanning during painful thermal stimulation of normal and capsaicin‐treated skin. 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The inter‐regional correlation of midbrain and medial thalamic activity was significantly reduced during high left DLPFC activity, suggesting that its negative correlation with pain affect may result from dampening of the effective connectivity of the midbrain–medial thalamic pathway. In contrast, right DLPFC activity was associated with a weakened relationship of the anterior insula with both pain intensity and affect. We propose that the DLPFC exerts active control on pain perception by modulating corticosubcortical and corticocortical pathways.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>12690048</pmid><doi>10.1093/brain/awg102</doi><tpages>13</tpages></addata></record>
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subjects ACC = anterior cingulate cortex
Adult
Biological and medical sciences
Capsaicin
DLPFC = dorsolateral prefrontal cortex
effective connectivity
functional neuroimaging
Hot Temperature - adverse effects
HPTc = heat pain threshold on sensitized skin
HPTn = heat pain threshold on normal skin
Humans
Hyperalgesia - physiopathology
Irritants
Male
Medical sciences
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Nociceptors - physiology
Pain - prevention & control
pain modulation
PCA = principal component analysis
prefrontal cortex
Prefrontal Cortex - physiology
Principal Component Analysis
Psychophysics
rCBF = regional cerebral blood flow
Regional Blood Flow
Regression Analysis
Skin - blood supply
Skin - drug effects
Tomography, Emission-Computed
VAS = visual analogue scale
VOFC = ventral/orbitofrontal cortex
VOI = volume of interest
title Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation
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