Coordinate-based meta-analysis of experimentally induced and chronic persistent neuropathic pain - PubMed (original) (raw)

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Coordinate-based meta-analysis of experimentally induced and chronic persistent neuropathic pain

Ulrike Friebel et al. Neuroimage. 2011.

Abstract

Differences in brain activation in experimentally induced and chronic neuropathic pain conditions are useful for understanding central mechanisms leading to chronic neuropathic pain. Many mapping studies investigating both pain conditions are now available, and the latest tools for coordinate-based meta-analysis offer the possibility of random effects statistics. We performed a meta-analysis based on a literature search of published functional magnetic resonance imaging group studies to compare patterns of activity during experimentally induced and chronic neuropathic pain, for the later including four fibromyalgia studies. Stimulus-dependent activation in experimental pain was further divided into "thermal" and "non thermal" stimuli. A conjunction of experimentally induced and chronic neuropathic pain revealed activation of the bilateral secondary somatosensory cortex, right middle cingulate cortex, right inferior parietal lobe, supplementary motor area, right caudal anterior insula, and bilateral thalamus. Primary somatosensory activation was only observed during experimental non-thermal stimulation. Chronic neuropathic pain studies showed increased activation in the left secondary somatosensory cortex, anterior cingulate cortex, and right caudal anterior insula when compared to experimentally induced pain. Activation clusters in the anterior cingulate cortex and caudal anterior insula suggest a strong emotional contribution to the processing of chronic neuropathic pain.

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Figures

Fig. 1.

Fig. 1.

Top two image lines: Conjunction analysis of experimental and neuropathic pain. Bottom two image lines: Contrast between conditions. The conjunction as well as the contrast analyses of the conditions “experimentally induced” and “chronic neuropathic pain” projected on the SPM-render brain hemispheres (left and right side view) and slices of the single subject template from SPM. The conjunction analysis “experimental and chronic neuropathic pain” showed activation in bilateral SII, right SMA, bilateral MCC and right ACC, right insula and bilateral thalamus; coronal (y=14), axial (z=−3), sagittal (x=4). The contrast analysis of the conditions “experimental pain" – “chronic neuropathic pain” (red frame) showed activation of the right anterior insula (including right opercular gyrus) and left posterior insula, the right SMA and right MCC; axial (z=7), sagittal (x=12). The contrast analysis of the conditions “chronic neuropathic pain” – “experimental pain” (green frame) showed significant results in left SII, right mid-insula and left ACC; sagittal (x=−2), axial (z=9).

Fig. 2.

Fig. 2.

The conjunction as well as the contrast analyses of the conditions “thermal” and “non thermal” projected on the SPM-render brain hemispheres (left and right side view) and slices of the single subject template from SPM. The conjunction analysis, “thermal and non-thermal pain” showed significant results in bilateral SII, unilaterally activated SMA and MCC (both in the right hemisphere) and bilateral activation of the insula; axial (z=1), sagittal (x=6). The contrast analysis of the conditions “non thermal” – “thermal” (red frame) showed activation in right SI, bilateral SII, and right mid orbital gyrus; sagittal (x=44), coronal (y=−20). The opposite contrast “thermal” – “non thermal” (green frame) revealed activity in right SII, left middle/posterior insula, left ACC and MCC, right inferior frontal gyrus and bilateral thalamus; sagittal (x=−6), axial (z=7).

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