5,093 research outputs found

    Cerebral gray matter volume in patients with chronic migraine: correlations with clinical features

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    Abstract Background To date, few MRI studies have been performed in patients affected by chronic migraine (CM), especially in those without medication overuse. Here, we performed magnetic resonance imaging (MRI) voxel-based morphometry (VBM) analyses to investigate the gray matter (GM) volume of the whole brain in patients affected by CM. Our aim was to investigate whether fluctuations in the GM volumes were related to the clinical features of CM. Methods Twenty untreated patients with CM without a past medical history of medication overuse underwent 3-Tesla MRI scans and were compared to a group of 20 healthy controls (HCs). We used SPM12 and the CAT12 toolbox to process the MRI data and to perform VBM analyses of the structural T1-weighted MRI scans. The GM volume of patients was compared to that of HCs with various corrected and uncorrected thresholds. To check for possible correlations, patients’ clinical features and GM maps were regressed. Results Initially, we did not find significant differences in the GM volume between patients with CM and HCs (p < 0.05 corrected for multiple comparisons). However, using more-liberal uncorrected statistical thresholds, we noted that compared to HCs, patients with CM exhibited clusters of regions with lower GM volumes including the cerebellum, left middle temporal gyrus, left temporal pole/amygdala/hippocampus/pallidum/orbitofrontal cortex, and left occipital areas (Brodmann areas 17/18). The GM volume of the cerebellar hemispheres was negatively correlated with the disease duration and positively correlated with the number of tablets taken per month. Conclusion No gross morphometric changes were observed in patients with CM when compared with HCs. However, using more-liberal uncorrected statistical thresholds, we observed that CM is associated with subtle GM volume changes in several brain areas known to be involved in nociception/antinociception, multisensory integration, and analgesic dependence. We speculate that these slight morphometric impairments could lead, at least in a subgroup of patients, to the development and continuation of maladaptive acute medication usage

    State-dependent changes of connectivity patterns and functional brain network topology in Autism Spectrum Disorder

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    Anatomical and functional brain studies have converged to the hypothesis that Autism Spectrum Disorders (ASD) are associated with atypical connectivity. Using a modified resting-state paradigm to drive subjects' attention, we provide evidence of a very marked interaction between ASD brain functional connectivity and cognitive state. We show that functional connectivity changes in opposite ways in ASD and typicals as attention shifts from external world towards one's body generated information. Furthermore, ASD subject alter more markedly than typicals their connectivity across cognitive states. Using differences in brain connectivity across conditions, we classified ASD subjects at a performance around 80% while classification based on the connectivity patterns in any given cognitive state were close to chance. Connectivity between the Anterior Insula and dorsal-anterior Cingulate Cortex showed the highest classification accuracy and its strength increased with ASD severity. These results pave the path for diagnosis of mental pathologies based on functional brain networks obtained from a library of mental states

    Altered Excitability and Local Connectivity of mPFC-PAG Neurons in a Mouse Model of Neuropathic Pain

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    The medial prefrontal cortex (mPFC) plays a major role in both sensory and affective aspects of pain. There is extensive evidence that chronic pain produces functional changes within the mPFC. However, our understanding of local circuit changes to defined subpopulations of mPFC neurons in chronic pain models remains unclear. A major subpopulation of mPFC neurons project to the periaqueductal gray (PAG), which is a key midbrain structure involved in endogenous pain suppression and facilitation. Here, we used laser scanning photostimulation of caged glutamate to map cortical circuits of retrogradely labeled cortico-PAG (CP) neurons in layer 5 (L5) of mPFC in brain slices prepared from male mice having undergone chronic constriction injury (CCI) of the sciatic nerve. Whole-cell recordings revealed a significant reduction in excitability for L5 CP neurons contralateral to CCI in the prelimbic (PL), but not infralimbic (IL), region of mPFC. Circuit mapping showed that excitatory inputs to L5 CP neurons in both PL and IL arose primarily from layer 2/3 (L2/3) and were significantly reduced in CCI mice. Glutamate stimulation of L2/3 and L5 elicited inhibitory inputs to CP neurons in both PL and IL, but only L2/3 input was significantly reduced in CP neurons of CCI mice. We also observed significant reduction in excitability and L2/3 inhibitory input to CP neurons ipsilateral to CCI. These results demonstrating region and laminar specific changes to mPFC-PAG neurons suggest that a unilateral CCI bilaterally alters cortical circuits upstream of the endogenous analgesic network, which may contribute to persistence of chronic pain

    Role of the anterior insula in task-level control and focal attention

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    In humans, the anterior insula (aI) has been the topic of considerable research and ascribed a vast number of functional properties by way of neuroimaging and lesion studies. Here, we argue that the aI, at least in part, plays a role in domain-general attentional control and highlight studies (Dosenbach et al. 2006; Dosenbach et al. 2007) supporting this view. Additionally, we discuss a study (Ploran et al. 2007) that implicates aI in processes related to the capture of focal attention. Task-level control and focal attention may or may not reflect information processing supported by a single functional area (within the aI). Therefore, we apply a novel technique (Cohen et al. 2008) that utilizes resting state functional connectivity MRI (rs-fcMRI) to determine whether separable regions exist within the aI. rs-fcMRI mapping suggests that the ventral portion of the aI is distinguishable from more dorsal/anterior regions, which are themselves distinct from more posterior parts of the aI. When these regions are applied to functional MRI (fMRI) data, the ventral and dorsal/anterior regions support processes potentially related to both task-level control and focal attention, whereas the more posterior aI regions did not. These findings suggest that there exists some functional heterogeneity within aI that may subserve related but distinct types of higher-order cognitive processing

    Interaction of psychological, physiological and neuronal processes in functional dyspepsia

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    Functional dyspepsia is characterized by postprandial fullness, early satiation, epigastric pain, bloating, and nausea symptoms in the absence of structural changes in the gastrointestinal tract. Numerous works have been performed to identify the peripheral characteristics of functional dyspepsia and its association with dyspeptic symptoms, including changes of gastric motility, visceral sensitivity, secretion of hormones, functions of immune system. However, the pathophysiological mechanisms involved and standard treatment strategies are still lacking. The role of the dysfunction of the brain-gut axis and the effect of the food ingestion in the gastrointestinal symptoms of functional dyspepsia patients have therefore been attracting more interest in recent years. How the food is processed differently in the peripheral and in the central nervous system in functional dyspepsia has, however, received little attention in comparison to other functional gastrointestinal disorders. In this thesis, we used various approaches to examine the physiological and neuronal mechanisms in functional dyspepsia patients. We commenced by summarizing previous functional neuroimaging studies to establish their limitations. To bridge the resulting research gap, we investigated physiological and attentional responses to visual food cues, and measured the altered brain activity before and after the food ingestion in functional dyspepsia patients. In the paper I, we reviewed the current status of brain research related to functional dyspepsia and were able to clearly show a knowledge gap regarding neural mechanisms of food-related factors in functional dyspepsia patients. In paper II, we introduced how to design the neuroimaging study and interpret the results of it to clinicians. In paper III, we report findings of an eyetracking and behavioral study on functional dyspepsia patients. The patients showed 1) greater dyspeptic symptoms even after ingestion of a lower calorie and food intake from standard breakfast; 2) decreased pleasantness ratings to food images; and 3) reduced visual attention to food images in comparison to healthy controls. In paper IV, we report findings of a functional magnetic resonance imaging study during meal ingestion (yoghurt with different fat content and label info) in functional dyspepsia patients. The patients showed 1) greater abdominal pain, burning, and discomfort after high fat labeled yogurt ingestion than after low fat labeled yogurt ingestion irrespective of fat content, 2) increased activity in occipital areas before and after ingestion irrespective of fat content and label and increased activity in the middle frontal gyrus before ingestion, 3) increased functional connectivity between the insula and the precuneus after ingestion of yogurt with low fat label, and 4) greater nausea-related increased functional connectivity between the insula and the occipital gyrus after ingestion of high fat yogurt than of low fat yogurt. Furthermore, bidirectional influences between quality of life and depression, as mediated by dyspeptic symptoms and the impact of food craving on the amplitude of brain activity in the middle frontal gyrus, as mediated by depression in functional dyspepsia patients were recorded. In conclusion, the abnormal dietary behavior, reduced positive emotional response and visual attention to food images, and the role of cognitive perception of fat on the aggravation of dyspeptic symptoms should be considered in clinics and in research for functional dyspepsia

    Neural oscillations and connectivity characterizing the state of tonic experimental pain in humans

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    Pain is a complex phenomenon that is served by neural oscillations and connectivity involving different brain areas and frequencies. Here, we aimed to systematically and comprehensively assess the pattern of neural oscillations and connectivity characterizing the state of tonic experimental pain in humans. To this end, we applied 10-min heat pain stimuli consecutively to the right and left hand of 39 healthy participants and recorded electroencephalography. We systematically analyzed global and local measures of oscillatory brain activity, connectivity, and graph theory-based network measures during tonic pain and compared them to a nonpainful control condition. Local measures showed suppressions of oscillatory activity at alpha frequencies together with stronger connectivity at alpha and beta frequencies in sensorimotor areas during tonic pain. Furthermore, sensorimotor areas contralateral to stimulation showed significantly increased connectivity to a common area in the medial prefrontal cortex at alpha frequencies. Together, these observations indicate that the state of tonic experimental pain is associated with a sensorimotor-prefrontal network connected at alpha frequencies. These findings represent a step further toward understanding the brain mechanisms underlying long-lasting pain states in health and disease

    Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

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    Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications of key neurotransmitters such as norepinephrine, serotonin, glutamate, GABA or acetylcholine in IBS are poorly studied. The aim of this review is to evaluate the current evidence about neurotransmitter dysfunction in IBS and explore the potential therapeutic approaches. IBS patients with altered colorectal motility show augmented norepinephrine and acetylcholine levels in plasma and an increased sensitivity of central serotonin receptors. A decrease of colonic mucosal serotonin transporter and a downregulation of α2 adrenoceptors are also correlated with visceral hypersensitivity and an increase of 5-hydroxyindole acetic acid levels, enhanced expression of high affinity choline transporter and lower levels of GABA. Given these neurotransmitter dysfunctions, novel pharmacological approaches such as 5-HT3 receptor antagonists and 5-HT4 receptor agonists are being explored for IBS management, for their antiemetic and prokinetic effects. GABA-analogous medications are being considered to reduce visceral pain. Moreover, agonists and antagonists of muscarinic receptors are under clinical trials. Targeting neurotransmitter dysfunction could provide promising new approaches for IBS management

    Sub-cortical and brainstem sites associated with chemo-stimulated increases in ventilation in humans

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    We investigated the neural basis for spontaneous chemo-stimulated increases in ventilation in awake, healthy humans. Blood oxygen level dependent (BOLD) functional MRI was performed in nine healthy subjects using T2weighted echo planar imaging. Brain volumes (52 transverse slices, cortex to high spinal cord) were acquired every 3.9 s. The 30 min paradigm consisted of six, 5-min cycles, each cycle comprising 45 s of hypoxic-isocapnia, 45 s of isooxic-hypercapnia and 45 s of hypoxic-hypercapnia, with 55 s of non-stimulatory hyperoxic-isocapnia (control) separating each stimulus period. Ventilation was significantly (p < 0.001) increased during hypoxic-isocapnia, isooxic-hypercapnia and hypoxic-hypercapnia (17.0, 13.8, 24.9 L/min respectively) vs. control (8.4 L/min) and was associated with significant (p < 0.05, corrected for multiple comparisons) signal increases within a bilateral network that included the basal ganglia, thalamus, red nucleus, cerebellum, parietal cortex, cingulate and superior mid pons. The neuroanatomical structures identified provide evidence for the spontaneous control of breathing to be mediated by higher brain centres, as well as respiratory nuclei in the brainstem
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