A brain-based pain facilitation mechanism contributes to painful diabetic polyneuropathy.
Journal article
Authors | Segerdahl, Andrew R., Themistocleous, Andreas C., Fido, Dean, Bennett, David L. and Tracey, Irene |
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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. |
Keywords | Brainstem; Diabetic neuropathy; Facilitation; Functional connectivity; Neuropathic pain; Pain |
Year | 2018 |
Journal | Brain |
Publisher | Oxford Academic |
ISSN | 00068950 |
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 dates | 15 Jan 2018 |
Publication process dates | |
Deposited | 28 Mar 2018, 14:44 |
Rights | Archived with thanks to Brain |
Contributors | University 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 |
File | File Access Level Open |
File | File Access Level Open |
https://repository.derby.ac.uk/item/94728/a-brain-based-pain-facilitation-mechanism-contributes-to-painful-diabetic-polyneuropathy
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