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首页> 外文期刊>The Journal of Neuroscience: The Official Journal of the Society for Neuroscience >A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging.
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A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging.

机译：使用功能磁共振成像比较人脑干内脏和躯体疼痛的过程。

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Evidence from both human and animal studies has demonstrated a key role for brainstem centers in the control of ascending nociceptive input. Nuclei such as the rostral ventromedial medulla and periaqueductal gray (PAG) are able to both inhibit and facilitate the nociceptive response. It has been proposed that altered descending modulation may underlie many of the chronic pain syndromes (both somatic and visceral). We used functional magnetic resonance imaging to image the neural correlates of visceral and somatic pain within the brainstem. Ten healthy subjects were scanned twice at 3 tesla, during which they received matched, moderately painful, electrical stimuli to either the midline lower abdomen or rectum. Significant activation was observed in regions consistent with the PAG, nucleus cuneiformis (NCF), ventral tegmental area/substantia nigra, parabrachial nucleiucleus ceruleus, and red nucleus bilaterally to both stimuli. Marked spatial similarities in activation were observed for visceral and somatic pain, although significantly greater activation of the NCF (left NCF, p = 0.02; right NCF, p = 0.01; Student's paired t test, two-tailed) was observed in the visceral pain group compared with the somatic group. Right PAG activity correlated with anxiety during visceral stimulation (r = 0.74; p < 0.05, Pearson's r, two-tailed) but not somatic stimulation. We propose that the differences in NCF and right PAG activation observed may represent a greater nocifensive response and greater emotive salience of visceral over somatic pain.
机译：人类和动物研究的证据都表明，脑干中心在控制伤害性输入方面发挥着关键作用。核如延髓腹侧延髓和导水管周围的灰质（PAG）能够抑制和促进伤害感受性反应。已经提出，改变的递减调制可能是许多慢性疼痛综合症（躯体和内脏）的基础。我们使用功能磁共振成像来成像脑干内脏和躯体痛的神经相关性。十名健康受试者在3 tesla进行了两次扫描，在此期间，他们接受了与中线小腹或直肠相匹配的中度疼痛的电刺激。在与PAG，楔形核（NCF），腹侧被盖区/黑质，肱臂旁核/小核，以及两个刺激的双侧红核一致的区域中观察到显着激活。观察到内脏和躯体疼痛在激活方面有明显的空间相似性，尽管在内脏疼痛中观察到了NCF的激活明显更大（左NCF，p = 0.02;右NCF，p = 0.01;学生配对t检验，两尾）。组与躯体组相比。右PAG活性与内脏刺激期间的焦虑相关（r = 0.74; p <0.05，Pearson's r，两尾），但与体细胞刺激无关。我们建议观察到的NCF和右PAG激活的差异可能代表更大的伤害反应和内脏对躯体疼痛的情感显着性。

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