Document Detail

Prefrontal cortical hyperactivity in patients with sympathetically mediated chronic pain.
MedLine Citation:
PMID:  11578827     Owner:  NLM     Status:  MEDLINE    
Chronic pain continues to impose a large burden of suffering, yet its neural correlates remain poorly understood. In sympathetically mediated chronic pain (SMP), peripheral sympathetic blockade temporarily relieves this pain, so that related neural activity can be studied without perturbing sensory inputs. We used functional magnetic resonance imaging and thermal painful stimuli applied to the chronically painful body site, before and after sympathetic blockade, to examine the cortical network of chronic pain. The chronic SMP state was associated with a widely spread prefrontal hyperactivity, increased anterior cingulate activity and decreased activity in the thalamus contralateral to the body side suffering from SMP, but was unrelated to sensorimotor activity. Ineffective sympathetic blocks, i.e. blocks that did not diminish the SMP pain, did not change the cortical responses to the painful thermal stimulus; while effective placebo resulted in similar responses to those of effective blocks. These findings provide evidence for abnormal brain responses to pain in patients with chronic SMP, which engages prefrontal/limbic networks more extensively than in acute pain-states.
A V Apkarian; P S Thomas; B R Krauss; N M Szeverenyi
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neuroscience letters     Volume:  311     ISSN:  0304-3940     ISO Abbreviation:  Neurosci. Lett.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-01     Completed Date:  2001-12-04     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7600130     Medline TA:  Neurosci Lett     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  193-7     Citation Subset:  IM    
Department of Physiology, Northwestern University Medical School, 303 E. Chicago Avenue, Chicago, IL 60611, USA.
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MeSH Terms
Brain Mapping
Chronic Disease
Complex Regional Pain Syndromes / pathology,  physiopathology*
Functional Laterality / drug effects,  physiology
Gyrus Cinguli / pathology,  physiopathology
Hot Temperature / adverse effects
Hyperalgesia / pathology,  physiopathology
Magnetic Resonance Imaging
Middle Aged
Pain / pathology,  physiopathology*
Pain Threshold / drug effects,  physiology
Physical Stimulation / adverse effects
Prefrontal Cortex / pathology,  physiopathology*
Somatosensory Cortex / pathology,  physiopathology
Sympathetic Nervous System / drug effects,  pathology,  physiopathology*
Sympatholytics / pharmacology
Grant Support
Reg. No./Substance:

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