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Behavioral/Systems/Cognitive Chronic Pain and the Emotional Brain: Specific Brain

Summary: Behavioral/Systems/Cognitive
Chronic Pain and the Emotional Brain: Specific Brain
Activity Associated with Spontaneous Fluctuations of
Intensity of Chronic Back Pain
Marwan N. Baliki,1 Dante R. Chialvo,1 Paul Y. Geha,1 Robert M. Levy,2 R. Norman Harden,5 Todd B. Parrish,3 and
A. Vania Apkarian1,4
1Departments of Physiology, 2Neurosurgery, 3Radiology, and 4Anesthesia, and 5Rehabilitation Institute of Chicago, Lurie Cancer Center, Northwestern
University, Feinberg School of Medicine, Chicago, Illinois 60611
Living with unrelenting pain (chronic pain) is maladaptive and is thought to be associated with physiological and psychological modifi-
spontaneous pain of chronic back pain (CBP) in two separate groups of patients (n 13 and n 11), and contrast brain activity between
spontaneous pain and thermal pain (CBP and healthy subjects, n 11 each). Continuous ratings of fluctuations of spontaneous pain
during functional magnetic resonance imaging were separated into two components: high sustained pain and increasing pain. Sustained
high pain of CBP resulted in increased activity in the medial prefrontal cortex (mPFC; including rostral anterior cingulate). This mPFC
activity was strongly related to intensity of CBP, and the region is known to be involved in negative emotions, response conflict, and
detection of unfavorable outcomes, especially in relation to the self. In contrast, the increasing phase of CBP transiently activated brain
regions commonly observed for acute pain, best exemplified by the insula, which tightly reflected duration of CBP. When spontaneous
pain of CBP was contrasted to thermal stimulation, we observe a double-dissociation between mPFC and insula with the former corre-
lating only to intensity of spontaneous pain and the latter correlating only to pain intensity for thermal stimulation. These findings


Source: Apkarian, A. Vania - Department of Physiology, Northwestern University


Collections: Biology and Medicine