THE BIOLOGY OF HUMAN CORTICAL PAIN RELATED ACTIVITY

人类皮质疼痛相关活动的生物学

• 批准号: 2830117
• 负责人: Fred Lenz
• 金额: $ 32.42万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2830117
• 关键词: attention; auditory stimulus; brain electrical activity; chronic pain; cingulate gyrus; clinical research; disease /disorder etiology; emotions; epilepsy; evoked potentials; human subject; hyperalgesia; implant; lasers; pain; pain threshold; parietal lobe /cortex; patient monitoring device; positron emission tomography; psychophysics; sensory signal detection; somesthetic sensory cortex; thalamus

DESCRIPTION (Adapted from the applicant's abstract) The long-term goal of these studies is to understand human cortical mechanisms of the sensory and affective dimensions of acute and chronic pain. Little is known about human cortical structures receiving nociceptive input; the role of attention in modulating input to these structures; or the functions of these cortical structures. Also, the human thalamic nuclei or cortical gyri where lesions lead to the development of central pain or where hyperactivity occurs in patients with central pain have not been clearly defined. Preliminary evidence indicates that potentials evoked by a pure pain stimulus are localized over human anterior cingulate cortex (ACC) and parasylvian cortex, which suggests that these areas receive nociceptive inputs. Lesions of the parietal operculum are associated with deficits of pain discrimination (sensory-discriminative aspect of pain) while lesions of the insula tend to be associated with deficits of the motivation to escape from painful stimuli (affective-motivational aspect of pain). The present study is designed to determine whether the human ACC, postcentral gyrus and parietal operculum receive nociceptive input. Cortical activity will be monitored over ACC, parasylvian and paracentral cortex during cutaneous stimulation with a carbon dioxide laser (laser evoked potentials - LEP) in epileptic patients with implanted subdural grids (Aim I). Stimulation with the laser evokes a pure pain sensation by selective activation of cutaneous nociceptors. The function of these nociceptive inputs will be assessed by psychophysical studies of patients with lesions of thalamus and cortex, but without central pain, to test the hypothesis that ACC and insula contribute to the affective aspect of pain while parietal operculum and SI contribute to the sensory aspect of pain (Aim II). LEPs will determine whether the lesions involve structures which receive nociceptive input. The hypothesis that lesions of pain and temperature signaling pathways result in central pain syndromes by producing increased activity of cortical areas normally receiving input from those pathways will then be tested (Aim III). PET studies will determine cortical areas that are hyperactive in response to stimuli which produce allodynia. These studies have unique potential to clarify the identity, function and pathophysiology of pain-signaling structures in human cortex.

描述（根据申请人的摘要改编）这些的长期目标 研究是为了了解感觉和情感的人体皮质机制 急性和慢性疼痛的维度。关于人类皮质的知之甚少 接收伤害感受输入的结构；注意在调制中的作用 输入这些结构；或这些皮质结构的功能。还， 人丘脑核或皮质回旋，其中病变导致 中枢疼痛的发展或发生多动症的患者 中心疼痛尚未明确定义。初步证据表明 纯粹的疼痛刺激引起的电位位于人的前部 扣带回皮质（ACC）和帕拉斯维亚皮质，这表明这些区域 接收伤害性输入。顶叶的病变相关 疼痛歧视的缺陷（疼痛的感觉歧视方面） 绝缘的病变往往与 摆脱痛苦刺激的动机（情感动机方面 疼痛）。本研究旨在确定人类ACC是否是否 中心回和壁cul骨会接受伤害感受性输入。皮质 活动将在ACC，副词和侧室皮层中进行监测 用二氧化碳激光刺激皮肤刺激（激光诱发电位 - LEP）在植入后硬膜下网的癫痫患者中（AIM I）。刺激 用激光唤起纯粹的疼痛感觉，通过选择性激活 皮肤伤害感受器。这些伤害感受性输入的功能将是 通过丘脑病变患者和 皮质，但没有中心疼痛，可以检验ACC和Insula的假设 在顶叶和SI的同时促进疼痛的情感方面 有助于疼痛的感觉方面（AIM II）。 LEPS将确定是否 病变涉及接收伤害感受性输入的结构。假设 疼痛和温度信号通路的病变导致中心疼痛 综合征通过通常接受皮质区域的活动增加而产生综合征 然后将测试这些途径的输入（AIM III）。宠物研究将 确定响应于刺激的响应过度活跃的皮质区域 产生异常性。这些研究具有阐明身份的独特潜力， 人皮质中疼痛信号结构的功能和病理生理学。