综述与专论:人类疼痛的神经网络表征
作者:
作者单位:

1)中国科学院心理研究所,中国科学院心理健康重点实验室,北京 100101;2)中国科学院大学心理学系,北京 100049

基金项目:

科技创新2030-“脑科学与类脑研究”重大项目(2022ZD0206400)和国家自然科学基金(32322035,32171078)资助。


Review: The Neural Network Representation of Pain in Humans
Author:
Affiliation:

1)CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Acadamy of Sciences, Beijing 100101, China;2)Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China

Fund Project:

This work was supported by grants from STI2030-Major Projects by the Ministry of Science and Technology of China (2022ZD0206400) and The National Natural Science Foundation of China (32322035, 32171078).

  • 摘要
  • | |
  • 访问统计
  • |
  • 参考文献 [95]
  • |
  • 相似文献 [20]
  • | | |
  • 文章评论
    摘要:

    疼痛是一种不愉快的感觉和情感体验,其涉及到多级神经加工过程,神经活动模式十分复杂。非侵入性脑功能成像技术可以实现在全脑水平上解析人类疼痛的神经机制。其中,功能磁共振成像(functional magnetic resonance imaging,fMRI)技术因具有高空间分辨率的优势,使其在探索人类疼痛的神经机制研究中得到了广泛的应用。本文聚焦于人类疼痛的fMRI研究,首先概述了疼痛相关的脑响应研究发现,梳理了与疼痛加工相关的多个脑区功能活动变化。然而,调节单一脑区的功能难以影响疼痛体验,提示疼痛加工涉及多脑区之间的协同作用。由此,本文综述了参与疼痛加工的脑区之间交互现象,这些研究揭示了多条神经通路以串行或并行的方式构成了复杂的疼痛神经网络,进而处理与疼痛相关的感觉、情绪和认知信息。基于上述研究,近年来不断更迭发展的超高场强fMRI及脑脊同步成像技术,助力人类疼痛研究深入到核团和脊髓层面,拓展了疼痛神经网络的精细度和全面性。综上,本文提出了人类疼痛的神经网络表征,并以此为基础指导神经调控技术调节异常的神经网络表征,进而实现缓解疼痛症状的目标。最后,本文讨论了当前疼痛神经表征研究的局限性,并提出了探索疼痛特异性表征,对比实验诱发性疼痛和临床自发性疼痛,以及疼痛个体化表征的研究展望。

    Abstract:

    Pain is an unpleasant sensory and emotional experience involving multi-level neural processing, with a highly complex neural activity pattern. Recent advancements in non-invasive brain functional imaging techniques have enhanced our understanding of the neural mechanisms underlying pain processing in humans at the whole-brain level. Functional magnetic resonance imaging (fMRI), in particular, plays an important role due to its high spatial resolution and has driven significant advancements in this field. This review focused on fMRI studies of pain in humans. We first summarized research that explored brain responses to pain and showing that pain processing involves neural activities across multiple brain regions, constituting the pain matrix, which includes the somatosensory cortex, thalamus, insula, anterior cingulate cortex, and other areas. However, modulating the activity of a single brain region has limited effects on pain experiences, suggesting that pain processing entails communications among multiple brain regions. Thus, we reviewed research investigating interactions between brain regions, finding that multiple neural pathways spanning the whole brain are involved in pain processing. Beyond interactions between pairs of regions, understanding how these interactions construct a pain-related network is crucial for fully comprehending the neural representation of pain. Two main approaches are used to describe neural networks across the whole brain. The first one is theory-driven, such as graph theory. Using this method, researchers explored how network properties evolve during pain processing and identified a tightly connected network that emerges during pain, encompassing the somatosensory, salience, and fronto-parietal networks, forming a pain-related super-system. As pain is modulated or diminishes, this system becomes less connected. The second approach relies on data-driven methods, such as methods based on independent component analysis or principal component analysis, and machine learning. These methods are not constrained by pre-defined brain networks. Advancements in machine learning have provided valuable insights, enabling researchers to develop pain biomarkers with promising clinical potential. Theory-driven and data-driven approaches provide complementary insights into our understanding of the neural mechanisms of pain. In recent years, two rapidly advancing and promising techniques have further enhanced the precision and comprehensiveness of pain neural network. One is ultra-high-field magnetic resonance imaging, and the other is simultaneous brain-spinal imaging. Ultra-high-field magnetic resonance imaging has overcome previous spatial resolution limitations in fMRI. In subcortical regions, it helps distinguish neural activities of different nuclei. In cortical regions, high resolution enables the differentiation of neural activities across cortical layers, thereby providing a more in-depth and detailed understanding of the neural mechanisms of pain. Simultaneous brain-spinal imaging technology enables the exploration of brain-spinal networks involved in pain processing, making it possible to construct a comprehensive neural network representation of pain throughout the entire central nervous system. Based on current findings, we suggested that in the clinical treatment of pain using neuromodulation techniques, the selection of stimulation targets could be guided by the pain neural network. Targeting hubs within the pain network could significantly impact the network and may efficiently influence pain experiences. Finally, we discussed the limitations of current research on the neural representation of pain and proposed future directions, including exploring pain-specific representation, systematically comparing experimental and clinical pain, and examining individualized neural representations.

    参考文献
    [1] Mazzola L, Isnard J, Peyron R, et al. Stimulation of the human cortex and the experience of pain: Wilder Penfield’s observations revisited. Brain, 2012, 135(Pt 2): 631-640
    [2] Liossi C. Procedure-related Cancer Pain in Children. London: CRC Press, 2018
    [3] Baron R, Maier C. Phantom limb pain: are cutaneous nociceptors and spinothalamic neurons involved in the signaling and maintenance of spontaneous and touch-evoked pain? A case report. Pain, 1995, 60(2): 223-228
    [4] Davis K D, Taylor S J, Crawley A P, et al. Functional MRI of pain- and attention-related activations in the human cingulate cortex. J Neurophysiol, 1997, 77(6): 3370-3380
    [5] Melzack R. From the gate to the neuromatrix. Pain, 1999, 82: S121~S126
    [6] Wager T D, Atlas L Y, Lindquist M A, et al. An fMRI-based neurologic signature of physical pain. N Engl J Med, 2013, 368(15): 1388-1397
    [7] Xu A, Larsen B, Baller E B, et al. Convergent neural representations of experimentally-induced acute pain in healthy volunteers: a large-scale fMRI meta-analysis. Neurosci Biobehav Rev, 2020, 112: 300-323
    [8] Woo C W, Schmidt L, Krishnan A, et al. Quantifying cerebral contributions to pain beyond nociception. Nat Commun, 2017, 8: 14211
    [9] Park H J, Friston K. Structural and functional brain networks: from connections to cognition. Science, 2013, 342(6158): 1238411
    [10] Makovac E, Dipasquale O, Jackson J B, et al. Sustained perturbation in functional connectivity induced by cold pain. Eur J Pain, 2020, 24(9): 1850-1861
    [11] Oliva V, Gregory R, Davies W E, et al. Parallel cortical-brainstem pathways to attentional analgesia. Neuroimage, 2021, 226: 117548
    [12] Bingel U, Lorenz J, Schoell E, et al. Mechanisms of placebo analgesia: rACC recruitment of a subcortical antinociceptive network. Pain, 2006, 120(1/2): 8-15
    [13] Yoshino A, Okamoto Y, Onoda K, et al. Sadness enhances the experience of pain via neural activation in the anterior cingulate cortex and amygdala: an fMRI study. Neuroimage, 2010, 50(3): 1194-1201
    [14] Sevel L S, O''''Shea A M, Letzen J E, et al. Effective connectivity predicts future placebo analgesic response: a dynamic causal modeling study of pain processing in healthy controls. Neuroimage, 2015, 110: 87-94
    [15] Sevel L S, Craggs J G, Price D D, et al. Placebo analgesia enhances descending pain-related effective connectivity: a dynamic causal modeling study of endogenous pain modulation. J Pain, 2015, 16(8): 760-768
    [16] Krummenacher P, Candia V, Folkers G, et al. Prefrontal cortex modulates placebo analgesia. Pain, 2010, 148(3): 368-374
    [17] Zheng W, Woo C W, Yao Z, et al. Pain-evoked reorganization in functional brain networks. Cereb Cortex, 2020, 30(5): 2804-2822
    [18] Li L, Di X, Zhang H, et al. Characterization of whole-brain task-modulated functional connectivity in response to nociceptive pain: a multisensory comparison study. Hum Brain Mapp, 2022, 43(3): 1061-1075
    [19] Wagner I C, Rütgen M, Hummer A, et al. Placebo-induced pain reduction is associated with negative coupling between brain networks at rest. Neuroimage, 2020, 219: 117024
    [20] Damascelli M, Woodward T S, Sanford N, et al. Multiple functional brain networks related to pain perception revealed by fMRI. Neuroinformatics, 2022, 20(1): 155-172
    [21] Deak B, Eggert T, Mayr A, et al. Intrinsic network activity reflects the fluctuating experience of tonic pain. Cereb Cortex, 2022, 32(18): 4098-4109
    [22] Lee J J, Kim H J, ?eko M, et al. A neuroimaging biomarker for sustained experimental and clinical pain. Nat Med, 2021, 27(1): 174-182
    [23] Aristi G, O''''Grady C, Bowen C, et al. Top-down threat bias in pain perception is predicted by intrinsic structural and functional connections of the brain. Neuroimage, 2022, 258: 119349
    [24] Tu Y, Zhang B, Cao J, et al. Identifying inter-individual differences in pain threshold using brain connectome: a test-retest reproducible study. Neuroimage, 2019, 202: 116049
    [25] Ploner M, Lee M C, Wiech K, et al. Prestimulus functional connectivity determines pain perception in humans. Proc Natl Acad Sci USA, 2010, 107(1): 355-360
    [26] Spisak T, Kincses B, Schlitt F, et al. Pain-free resting-state functional brain connectivity predicts individual pain sensitivity. Nat Commun, 2020, 11(1): 187
    [27] Kucyi A, Salomons T V, Davis K D. Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks. Proc Natl Acad Sci USA, 2013, 110(46): 18692-18697
    [28] Kucyi A, Davis K D. The dynamic pain connectome. Trends Neurosci, 2015, 38(2): 86-95
    [29] Pei Y, Peng J, Zhang Y, et al. Aberrant functional connectivity and temporal variability of the dynamic pain connectome in patients with low back related leg pain. Sci Rep, 2022, 12(1): 6324
    [30] Bosma R L, Kim J A, Cheng J C, et al. Dynamic pain connectome functional connectivity and oscillations reflect multiple sclerosis pain. Pain, 2018, 159(11): 2267-2276
    [31] Rogachov A, Bhatia A, Cheng J C, et al. Plasticity in the dynamic pain connectome associated with ketamine-induced neuropathic pain relief. Pain, 2019, 160(7): 1670-1679
    [32] Lee J J, Lee S, Lee D H, et al. Functional brain reconfiguration during sustained pain. eLife, 2022, 11: e74463
    [33] Robinson L F, Atlas L Y, Wager T D. Dynamic functional connectivity using state-based dynamic community structure: method and application to opioid analgesia. Neuroimage, 2015, 108: 274-291
    [34] Hutchison R M, Womelsdorf T, Allen E A, et al. Dynamic functional connectivity: promise, issues, and interpretations. Neuroimage, 2013, 80: 360-378
    [35] Preti M G, Bolton T A, Van De Ville D. The dynamic functional connectome: state-of-the-art and perspectives. Neuroimage, 2017, 160: 41-54
    [36] Yuan Y, Zhang L, Li L, et al. Distinct dynamic functional connectivity patterns of pain and touch thresholds: a resting-state fMRI study. Behav Brain Res, 2019, 375: 112142
    [37] Ploner M, Schmitz F, Freund H J, et al. Parallel activation of primary and secondary somatosensory cortices in human pain processing. J Neurophysiol, 1999, 81(6): 3100-3104
    [38] Khoshnejad M, Piché M, Saleh S, et al. Serial processing in primary and secondary somatosensory cortex: a DCM analysis of human fMRI data in response to innocuous and noxious electrical stimulation. Neurosci Lett, 2014, 577: 83-88
    [39] Kanda M, Nagamine T, Ikeda A, et al. Primary somatosensory cortex is actively involved in pain processing in human. Brain Res, 2000, 853(2): 282-289
    [40] Coghill R C. The distributed nociceptive system: a framework for understanding pain. Trends Neurosci, 2020, 43(10): 780-794
    [41] Lu H, van Zijl P C M. A review of the development of Vascular-Space-Occupancy (VASO) fMRI. Neuroimage, 2012, 62(2): 736-742
    [42] Robertson R V, Crawford L S, Meylakh N, et al. Regional hypothalamic, amygdala, and midbrain periaqueductal gray matter recruitment during acute pain in awake humans: a 7-Tesla functional magnetic resonance imaging study. Neuroimage, 2022, 259: 119408
    [43] Gan Z, Gangadharan V, Liu S, et al. Layer-specific pain relief pathways originating from primary motor cortex. Science, 2022, 378(6626): 1336-1343
    [44] Huber L, Handwerker D A, Jangraw D C, et al. High-resolution CBV-fMRI allows mapping of laminar activity and connectivity of cortical input and output in human M1. Neuron, 2017, 96(6): 1253-1263.e7
    [45] Melzack R, Wall P D. Pain mechanisms: a new theory. Science, 1965, 150(3699): 971-979
    [46] Cohen-Adad J, Gauthier C J, Brooks J C, et al. BOLD signal responses to controlled hypercapnia in human spinal cord. Neuroimage, 2010, 50(3): 1074-1084
    [47] Finsterbusch J, Sprenger C, Büchel C. Combined T2*-weighted measurements of the human brain and cervical spinal cord with a dynamic shim update. Neuroimage, 2013, 79: 153-161
    [48] Islam H, Law C S W, Weber K A, et al. Dynamic per slice shimming for simultaneous brain and spinal cord fMRI. Magn Reson Med, 2019, 81(2): 825-838
    [49] Tinnermann A, Büchel C, Cohen-Adad J. Cortico-spinal imaging to study pain. Neuroimage, 2021, 224: 117439
    [50] Geuter S, Büchel C. Facilitation of pain in the human spinal cord by nocebo treatment. J Neurosci, 2013, 33(34): 13784-13790
    [51] Tinnermann A, Büchel C, Haaker J. Observation of others’ painful heat stimulation involves responses in the spinal cord. Sci Adv, 2021, 7(14): eabe8444
    [52] Eippert F, Finsterbusch J, Bingel U, et al. Direct evidence for spinal cord involvement in placebo analgesia. Science, 2009, 326(5951): 404
    [53] Sprenger C, Finsterbusch J, Büchel C. Spinal cord-midbrain functional connectivity is related to perceived pain intensity: a combined spino-cortical FMRI study. J Neurosci, 2015, 35(10): 4248-4257
    [54] Tinnermann A, Geuter S, Sprenger C, et al. Interactions between brain and spinal cord mediate value effects in nocebo hyperalgesia. Science, 2017, 358(6359): 105-108
    [55] Tinnermann A, Sprenger C, Büchel C. Opioid analgesia alters corticospinal coupling along the descending pain system in healthy participants. eLife, 2022, 11: e74293
    [56] Fontaine D, Hamani C, Lozano A. Efficacy and safety of motor cortex stimulation for chronic neuropathic pain: critical review of the literature. J Neurosurg, 2009, 110(2): 251-256
    [57] Katayama Y, Fukaya C, Yamamoto T. Poststroke pain control by chronic motor cortex stimulation: neurological characteristics predicting a favorable response. J Neurosurg, 1998, 89(4): 585-591
    [58] Fagundes-Pereyra W J, Teixeira M J, Reyns N, et al. Motor cortex electric stimulation for the treatment of neuropathic pain. Arq Neuropsiquiatr, 2010, 68(6): 923-929
    [59] Raslan A M, Nasseri M, Bahgat D, et al. Motor cortex stimulation for trigeminal neuropathic or deafferentation pain: an institutional case series experience. Stereotact Funct Neurosurg, 2011, 89(2): 83-88
    [60] Nguyen J P, Lefaucher J P, Le Guerinel C, et al. Motor cortex stimulation in the treatment of central and neuropathic pain. Arch Med Res, 2000, 31(3): 263-265
    [61] Nguyen J P, Nizard J, Keravel Y, et al. Invasive brain stimulation for the treatment of neuropathic pain. Nat Rev Neurol, 2011, 7(12): 699-709
    [62] Nuti C, Peyron R, Garcia-Larrea L, et al. Motor cortex stimulation for refractory neuropathic pain: four year outcome and predictors of efficacy. Pain, 2005, 118(1/2): 43-52
    [63] Peyron R, Garcia-Larrea L, Deiber M P, et al. Electrical stimulation of precentral cortical area in the treatment of central pain: electrophysiological and PET study. Pain, 1995, 62(3): 275-286
    [64] Hamani C, Fonoff E T, Parravano D C, et al. Motor cortex stimulation for chronic neuropathic pain: results of a double-blind randomized study. Brain, 2021, 144(10): 2994-3004
    [65] Tsubokawa T, Katayama Y, Yamamoto T, et al. Chronic motor cortex stimulation in patients with thalamic pain. J Neurosurg, 1993, 78(3): 393-401
    [66] Tsubokawa T, Katayama Y, Yamamoto T, et al. Chronic motor cortex stimulation for the treatment of central pain. Acta Neurochir Suppl, 1991, 52: 137-139
    [67] Seminowicz D A, Moayedi M. The dorsolateral prefrontal cortex in acute and chronic pain. J Pain, 2017, 18(9): 1027-1035
    [68] Egorova N, Yu R, Kaur N, et al. Neuromodulation of conditioned placebo/nocebo in heat pain: anodal vs cathodal transcranial direct current stimulation to the right dorsolateral prefrontal cortex. Pain, 2015, 156(7): 1342-1347
    [69] Wrigley P J, Gustin S M, McIndoe L N, et al. Longstanding neuropathic pain after spinal cord injury is refractory to transcranial direct current stimulation: a randomized controlled trial. Pain, 2013, 154(10): 2178-2184
    [70] O''''Connell N E, Cossar J, Marston L, et al. Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study. Clin J Pain, 2013, 29(1): 26-34
    [71] Knotkova H, Hamani C, Sivanesan E, et al. Neuromodulation for chronic pain. Lancet, 2021, 397(10289): 2111-2124
    [72] Tu Y, Wilson G, Camprodon J, et al. Manipulating placebo analgesia and nocebo hyperalgesia by changing brain excitability. Proc Natl Acad Sci USA, 2021, 118(19): e2101273118
    [73] Tu Y, Cao J, Guler S, et al. Perturbing fMRI brain dynamics using transcranial direct current stimulation. Neuroimage, 2021, 237: 118100
    [74] Su Q, Song Y, Zhao R, et al. A review on the ongoing quest for a pain signature in the human brain. Brain Sci Adv, 2019, 5(4): 274-287
    [75] Mouraux A, Iannetti G D. The search for pain biomarkers in the human brain. Brain, 2018, 141(12): 3290-3307
    [76] Su Q, Qin W, Yang Q Q, et al. Brain regions preferentially responding to transient and iso-intense painful or tactile stimuli. Neuroimage, 2019, 192: 52-65
    [77] Tu Y, Li Z, Zhang L, et al. Pain-preferential thalamocortical neural dynamics across species. Nat Hum Behav, 2024, 8(1): 149-163
    [78] Woolf C J, Salter M W. Neuronal plasticity: increasing the gain in pain. Science, 2000, 288(5472): 1765-1769
    [79] Ossipov M H, Morimura K, Porreca F. Descending pain modulation and chronification of pain. Curr Opin Support Palliat Care, 2014, 8(2): 143-151
    [80] Jensen K B, Kosek E, Petzke F, et al. Evidence of dysfunctional pain inhibition in fibromyalgia reflected in rACC during provoked pain. Pain, 2009, 144(1/2): 95-100
    [81] López-Solà M, Woo C W, Pujol J, et al. Towards a neurophysiological signature for fibromyalgia. Pain, 2017, 158(1): 34-47
    [82] Coulombe M A, Lawrence K S, Moulin D E, et al. Lower functional connectivity of the periaqueductal gray is related to negative affect and clinical manifestations of fibromyalgia. Front Neuroanat, 2017, 11: 47
    [83] Baliki M N, Apkarian A V. Nociception, pain, negative moods, and behavior selection. Neuron, 2015, 87(3): 474-491
    [84] Hashmi J A, Baliki M N, Huang L, et al. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 2013, 136(Pt 9): 2751-2768
    [85] Loggia M L, Kim J, Gollub R L, et al. Default mode network connectivity encodes clinical pain: an arterial spin labeling study. Pain, 2013, 154(1): 24-33
    [86] Kucyi A, Moayedi M, Weissman-Fogel I, et al. Enhanced medial prefrontal-default mode network functional connectivity in chronic pain and its association with pain rumination. J Neurosci, 2014, 34(11): 3969-3975
    [87] Baliki M N, Petre B, Torbey S, et al. Corticostriatal functional connectivity predicts transition to chronic back pain. Nat Neurosci, 2012, 15(8): 1117-1119
    [88] Baliki M N, Geha P Y, Fields H L, et al. Predicting value of pain and analgesia: nucleus accumbens response to noxious stimuli changes in the presence of chronic pain. Neuron, 2010, 66(1): 149-160
    [89] Baliki M N, Chialvo D R, Geha P Y, et al. Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J Neurosci, 2006, 26(47): 12165-12173
    [90] Liu J, Zhao L, Lei F, et al. Disrupted resting-state functional connectivity and its changing trend in migraine suffers. Hum Brain Mapp, 2015, 36(5): 1892-1907
    [91] Finnerup N B, Nikolajsen L, Rice A S C. Transition from acute to chronic pain: a misleading concept?. Pain, 2022, 163(9): e985-e988
    [92] Dubois J, Adolphs R. Building a science of individual differences from fMRI. Trends Cogn Sci, 2016, 20(6): 425-443
    [93] Gordon E M, Laumann T O, Gilmore A W, et al. Precision functional mapping of individual human brains. Neuron, 2017, 95(4): 791-807.e7
    [94] Laumann T O, Gordon E M, Adeyemo B, et al. Functional system and areal organization of a highly sampled individual human brain. Neuron, 2015, 87(3): 657-670
    [95] Kohoutová L, Atlas L Y, Büchel C, et al. Individual variability in brain representations of pain. Nat Neurosci, 2022, 25(6): 749-759
    引证文献
    网友评论
    网友评论
    分享到微博
    发 布
引用本文

易阳洋,涂毅恒.综述与专论:人类疼痛的神经网络表征[J].生物化学与生物物理进展,2024,51(10):2357-2368

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2024-06-22
  • 最后修改日期:2024-08-08
  • 接受日期:2024-08-03
  • 在线发布日期: 2024-08-04
  • 出版日期: 2024-10-20