A brain-based pain facilitation mechanism contributes to painful diabetic polyneuropathy.

Journal article


Segerdahl, Andrew R., Themistocleous, Andreas C., Fido, Dean, Bennett, David L. and Tracey, Irene 2018. A brain-based pain facilitation mechanism contributes to painful diabetic polyneuropathy. Brain. https://doi.org/10.1093/brain/awx337
AuthorsSegerdahl, Andrew R., Themistocleous, Andreas C., Fido, Dean, Bennett, David L. and Tracey, Irene
Abstract

The descending pain modulatory system represents one of the oldest and most fundamentally important neurophysiological mechanisms relevant to pain. Extensive work in animals and humans has shown how a functional imbalance between the facilitatory and inhibitory components is linked to exacerbation and maintenance of persistent pain states. Forward translation of these findings into clinical populations is needed to verify the relevance of this imbalance. Diabetic polyneuropathy is one of the most common causes of chronic neuropathic pain; however, the reason why ∼25–30% of patients with diabetes develop pain is not known. The current study used a multimodal clinical neuroimaging approach to interrogate whether the sensory phenotype of painful diabetic polyneuropathy involves altered function of the ventrolateral periaqueductal grey—a key node of the descending pain modulatory system. We found that ventrolateral periaqueductal grey functional connectivity is altered in patients suffering from painful diabetic polyneuropathy; the magnitude of which is correlated to their spontaneous and allodynic pain as well as the magnitude of the cortical response elicited by an experimental tonic heat paradigm. We posit that ventrolateral periaqueductal grey-mediated descending pain modulatory system dysfunction may reflect a brain-based pain facilitation mechanism contributing to painful diabetic polyneuropathy.

KeywordsBrainstem; Diabetic neuropathy; Facilitation; Functional connectivity; Neuropathic pain; Pain
Year2018
JournalBrain
PublisherOxford Academic
ISSN00068950
14602156
Digital Object Identifier (DOI)https://doi.org/10.1093/brain/awx337
Web address (URL)http://hdl.handle.net/10545/622466
hdl:10545/622466
Publication dates15 Jan 2018
Publication process dates
Deposited28 Mar 2018, 14:44
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ContributorsUniversity of Oxford, Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK, Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK and Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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