Different Activation of Opercular and Posterior Cingulate Cortex (PCC) in Patients With Complex Regional Pain Syndrome (CRPS I) Compared With Healthy Controls During Perception of Electrically Induced Pain: A Functional MRI Study
OBJECTIVESAlthough the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor. METHODSTo look for the suspected alterations, 10 patients with CRPS affecting the left hand were e...
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| Veröffentlicht in: | The Clinical journal of pain 2010-05, Vol.26 (4), p.339-347 |
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| container_title | The Clinical journal of pain |
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| creator | Freund, Wolfgang Wunderlich, Arthur P Stuber, Gregor Mayer, Florian Steffen, Peter Mentzel, Martin Weber, Frank Schmitz, Bernd |
| description | OBJECTIVESAlthough the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor.
METHODSTo look for the suspected alterations, 10 patients with CRPS affecting the left hand were explored with functional magnetic resonance imaging during graded electrical painful stimulation of both hands subsequently and compared with healthy participants.
RESULTSActivation of the anterior insula, posterior cingulate cortex (PCC), and caudate nucleus was seen in patients during painful stimulation. Compared with controls, CRPS patients had stronger activation of the PCC during painful stimulation of the symptomatic hand. The comparison of insular/opercular activation between controls and patients with CRPS I during painful stimulation showed stronger (posterior) opercular activation in controls than in patients.
DISCUSSIONStronger PCC activation during painful stimulation may be interpreted as a correlate of motor inhibition during painful stimuli different from controls. Also, the decreased opercular activation in CRPS patients shows less sensory-discriminative processing of painful stimuli.These results show that changed cerebral pain processing in CRPS patients is less sensory-discriminative but more motor inhibition during painful stimuli. These changes are not limited to the diseased side but show generalized alterations of cerebral pain processing in chronic pain patients. |
| doi_str_mv | 10.1097/AJP.0b013e3181cb4055 |
| format | Article |
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METHODSTo look for the suspected alterations, 10 patients with CRPS affecting the left hand were explored with functional magnetic resonance imaging during graded electrical painful stimulation of both hands subsequently and compared with healthy participants.
RESULTSActivation of the anterior insula, posterior cingulate cortex (PCC), and caudate nucleus was seen in patients during painful stimulation. Compared with controls, CRPS patients had stronger activation of the PCC during painful stimulation of the symptomatic hand. The comparison of insular/opercular activation between controls and patients with CRPS I during painful stimulation showed stronger (posterior) opercular activation in controls than in patients.
DISCUSSIONStronger PCC activation during painful stimulation may be interpreted as a correlate of motor inhibition during painful stimuli different from controls. Also, the decreased opercular activation in CRPS patients shows less sensory-discriminative processing of painful stimuli.These results show that changed cerebral pain processing in CRPS patients is less sensory-discriminative but more motor inhibition during painful stimuli. These changes are not limited to the diseased side but show generalized alterations of cerebral pain processing in chronic pain patients.</description><identifier>ISSN: 0749-8047</identifier><identifier>EISSN: 1536-5409</identifier><identifier>DOI: 10.1097/AJP.0b013e3181cb4055</identifier><identifier>PMID: 20393270</identifier><identifier>CODEN: CJPAEU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Biological and medical sciences ; Biophysics ; Brain Mapping ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Electric Stimulation - adverse effects ; Female ; Functional Laterality - physiology ; Fundamental and applied biological sciences. Psychology ; Gyrus Cinguli - blood supply ; Gyrus Cinguli - physiopathology ; Hand - innervation ; Humans ; Image Processing, Computer-Assisted - methods ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Oxygen - blood ; Pain - etiology ; Pain - pathology ; Pain Measurement ; Pain Threshold - physiology ; Psychophysics ; Reflex Sympathetic Dystrophy - pathology ; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors ; Vertebrates: nervous system and sense organs</subject><ispartof>The Clinical journal of pain, 2010-05, Vol.26 (4), p.339-347</ispartof><rights>2010 Lippincott Williams & Wilkins, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4061-77d178498e82335cf4536c0f8f726b4815ad21e74113b02924b8173767ab4c5a3</citedby><cites>FETCH-LOGICAL-c4061-77d178498e82335cf4536c0f8f726b4815ad21e74113b02924b8173767ab4c5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22729952$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20393270$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Freund, Wolfgang</creatorcontrib><creatorcontrib>Wunderlich, Arthur P</creatorcontrib><creatorcontrib>Stuber, Gregor</creatorcontrib><creatorcontrib>Mayer, Florian</creatorcontrib><creatorcontrib>Steffen, Peter</creatorcontrib><creatorcontrib>Mentzel, Martin</creatorcontrib><creatorcontrib>Weber, Frank</creatorcontrib><creatorcontrib>Schmitz, Bernd</creatorcontrib><title>Different Activation of Opercular and Posterior Cingulate Cortex (PCC) in Patients With Complex Regional Pain Syndrome (CRPS I) Compared With Healthy Controls During Perception of Electrically Induced Pain: A Functional MRI Study</title><title>The Clinical journal of pain</title><addtitle>Clin J Pain</addtitle><description>OBJECTIVESAlthough the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor.
METHODSTo look for the suspected alterations, 10 patients with CRPS affecting the left hand were explored with functional magnetic resonance imaging during graded electrical painful stimulation of both hands subsequently and compared with healthy participants.
RESULTSActivation of the anterior insula, posterior cingulate cortex (PCC), and caudate nucleus was seen in patients during painful stimulation. Compared with controls, CRPS patients had stronger activation of the PCC during painful stimulation of the symptomatic hand. The comparison of insular/opercular activation between controls and patients with CRPS I during painful stimulation showed stronger (posterior) opercular activation in controls than in patients.
DISCUSSIONStronger PCC activation during painful stimulation may be interpreted as a correlate of motor inhibition during painful stimuli different from controls. Also, the decreased opercular activation in CRPS patients shows less sensory-discriminative processing of painful stimuli.These results show that changed cerebral pain processing in CRPS patients is less sensory-discriminative but more motor inhibition during painful stimuli. These changes are not limited to the diseased side but show generalized alterations of cerebral pain processing in chronic pain patients.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Biophysics</subject><subject>Brain Mapping</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Electric Stimulation - adverse effects</subject><subject>Female</subject><subject>Functional Laterality - physiology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gyrus Cinguli - blood supply</subject><subject>Gyrus Cinguli - physiopathology</subject><subject>Hand - innervation</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted - methods</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Oxygen - blood</subject><subject>Pain - etiology</subject><subject>Pain - pathology</subject><subject>Pain Measurement</subject><subject>Pain Threshold - physiology</subject><subject>Psychophysics</subject><subject>Reflex Sympathetic Dystrophy - pathology</subject><subject>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0749-8047</issn><issn>1536-5409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUd1u0zAUjhCIjcEbIOQbxHaR4b_ECXdVtrGioUUtiMvIcZzV4NrFdhh9YN6Ds7VjEpYsyz7fz_H5suw1wacE1-L97FN7intMmGakIqrnuCieZIekYGVecFw_zQ6x4HVeYS4OshcxfseYFLTCz7MDilnNqMCH2Z8zM446aJfQTCXzSybjHfIjut7ooCYrA5JuQK2PSQfjA2qMu4HnpFHjQ9K_0XHbNCfIONQCF3Qi-mbSCqrrjYXyQt-AorRQBsxy64bg1xodN4t2ieYn9zgZ9LBjXWpp02oLry4FbyM6mwIYohaa0ZuH3s6tVikYJa3dorkbJgX8O_0PaIYuJqfSzvLzYo6WaRq2L7Nno7RRv9qfR9nXi_MvzWV-df1x3syucsVxSXIhBiIqXle6oowVauQwTIXHahS07HlFCjlQogUnhPWY1pT3FRFMlEL2XBWSHWXvdrqb4H9OOqZubaLS1kqn_RQ7wVjJS1oxQPIdUgUfY9BjtwlmLcO2I7i7y7eDfLv_8wXam73B1K_18I_0ECgA3u4BMsJ8xiCdMvERRwWt64I--t96C8nGH3a61aFb3c-_w7BogaucYoJxAbccNvz6L41Kv0k</recordid><startdate>201005</startdate><enddate>201005</enddate><creator>Freund, Wolfgang</creator><creator>Wunderlich, Arthur P</creator><creator>Stuber, Gregor</creator><creator>Mayer, Florian</creator><creator>Steffen, Peter</creator><creator>Mentzel, Martin</creator><creator>Weber, Frank</creator><creator>Schmitz, Bernd</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</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>201005</creationdate><title>Different Activation of Opercular and Posterior Cingulate Cortex (PCC) in Patients With Complex Regional Pain Syndrome (CRPS I) Compared With Healthy Controls During Perception of Electrically Induced Pain: A Functional MRI Study</title><author>Freund, Wolfgang ; Wunderlich, Arthur P ; Stuber, Gregor ; Mayer, Florian ; Steffen, Peter ; Mentzel, Martin ; Weber, Frank ; Schmitz, Bernd</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4061-77d178498e82335cf4536c0f8f726b4815ad21e74113b02924b8173767ab4c5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Biophysics</topic><topic>Brain Mapping</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Electric Stimulation - adverse effects</topic><topic>Female</topic><topic>Functional Laterality - physiology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gyrus Cinguli - blood supply</topic><topic>Gyrus Cinguli - physiopathology</topic><topic>Hand - innervation</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted - methods</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Oxygen - blood</topic><topic>Pain - etiology</topic><topic>Pain - pathology</topic><topic>Pain Measurement</topic><topic>Pain Threshold - physiology</topic><topic>Psychophysics</topic><topic>Reflex Sympathetic Dystrophy - pathology</topic><topic>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Freund, Wolfgang</creatorcontrib><creatorcontrib>Wunderlich, Arthur P</creatorcontrib><creatorcontrib>Stuber, Gregor</creatorcontrib><creatorcontrib>Mayer, Florian</creatorcontrib><creatorcontrib>Steffen, Peter</creatorcontrib><creatorcontrib>Mentzel, Martin</creatorcontrib><creatorcontrib>Weber, Frank</creatorcontrib><creatorcontrib>Schmitz, Bernd</creatorcontrib><collection>Pascal-Francis</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>The Clinical journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Freund, Wolfgang</au><au>Wunderlich, Arthur P</au><au>Stuber, Gregor</au><au>Mayer, Florian</au><au>Steffen, Peter</au><au>Mentzel, Martin</au><au>Weber, Frank</au><au>Schmitz, Bernd</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Different Activation of Opercular and Posterior Cingulate Cortex (PCC) in Patients With Complex Regional Pain Syndrome (CRPS I) Compared With Healthy Controls During Perception of Electrically Induced Pain: A Functional MRI Study</atitle><jtitle>The Clinical journal of pain</jtitle><addtitle>Clin J Pain</addtitle><date>2010-05</date><risdate>2010</risdate><volume>26</volume><issue>4</issue><spage>339</spage><epage>347</epage><pages>339-347</pages><issn>0749-8047</issn><eissn>1536-5409</eissn><coden>CJPAEU</coden><abstract>OBJECTIVESAlthough the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor.
METHODSTo look for the suspected alterations, 10 patients with CRPS affecting the left hand were explored with functional magnetic resonance imaging during graded electrical painful stimulation of both hands subsequently and compared with healthy participants.
RESULTSActivation of the anterior insula, posterior cingulate cortex (PCC), and caudate nucleus was seen in patients during painful stimulation. Compared with controls, CRPS patients had stronger activation of the PCC during painful stimulation of the symptomatic hand. The comparison of insular/opercular activation between controls and patients with CRPS I during painful stimulation showed stronger (posterior) opercular activation in controls than in patients.
DISCUSSIONStronger PCC activation during painful stimulation may be interpreted as a correlate of motor inhibition during painful stimuli different from controls. Also, the decreased opercular activation in CRPS patients shows less sensory-discriminative processing of painful stimuli.These results show that changed cerebral pain processing in CRPS patients is less sensory-discriminative but more motor inhibition during painful stimuli. These changes are not limited to the diseased side but show generalized alterations of cerebral pain processing in chronic pain patients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>20393270</pmid><doi>10.1097/AJP.0b013e3181cb4055</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Biophysics Brain Mapping Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Electric Stimulation - adverse effects Female Functional Laterality - physiology Fundamental and applied biological sciences. Psychology Gyrus Cinguli - blood supply Gyrus Cinguli - physiopathology Hand - innervation Humans Image Processing, Computer-Assisted - methods Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Oxygen - blood Pain - etiology Pain - pathology Pain Measurement Pain Threshold - physiology Psychophysics Reflex Sympathetic Dystrophy - pathology Somesthesis and somesthetic pathways (proprioception, exteroception, nociception) interoception electrolocation. Sensory receptors Vertebrates: nervous system and sense organs |
| title | Different Activation of Opercular and Posterior Cingulate Cortex (PCC) in Patients With Complex Regional Pain Syndrome (CRPS I) Compared With Healthy Controls During Perception of Electrically Induced Pain: A Functional MRI Study |
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