Resolving the brainstem contributions to attentional analgesia

Brooks, Jonathan C. W. ORCID:, Davies, Wendy Elizabeth and Pickering, Anthony E. (2017) Resolving the brainstem contributions to attentional analgesia. Journal of Neuroscience, 37 (9). pp. 2279-2291. ISSN 0270-6474

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Previous human imaging studie manipulating attention or expectancy have identified the periaqueductal gray (PAG) as a key brainstem structure implicated in endogenous analgesia. However, animal studies indicate that PAG analgesia is mediated largely via caudal brainstem structures, such as the rostral ventromedial medulla (RVM) and locus coeruleus (LC). To identify their involvement in endogenous analgesia, we used brainstem optimized, whole-brain imaging to record responses to concurrent thermal stimulation (left forearm) and visual attention tasks of titrated difficulty in 20 healthy subjects. The PAG, LC, and RVM were anatomically discriminated using a probabilistic atlas. Pain ratings disclosed the anticipated analgesic interaction between task difficulty and pain intensity (p < 0.001). Main effects of noxious thermal stimulation were observed across several brain regions, including operculoinsular, primary somatosensory, and cingulate cortices, whereas hard task difficulty was represented in anterior insular, parietal, and prefrontal cortices. Permutation testing within the brainstem nuclei revealed the following: main effects of task in dorsal PAG and right LC; and main effect of temperature in RVM and a task × temperature interaction in right LC. Intrasubject regression revealed a distributed network of supratentorial brain regions and the RVM whose activity was linearly related to pain intensity. Intersubject analgesia scores correlated to activity within a distinct region of the RVM alone. These results identify distinct roles for a brainstem triumvirate in attentional analgesia: with the PAG activated by attentional load; specificRVMregions showing pronociceptive and antinociceptive processes (in line with previous animal studies); and the LC showing lateralized activity during conflicting attentional demands.

Item Type: Article
Additional Information: Funding Information: This work was supported by Wellcome Trust Wellcome Senior Clinical Research Fellow Grant 088373 to A.E.P., and Medical Research Council of the United Kingdom Award G0700238 to J.C.W.B.
Uncontrolled Keywords: attention,brainstem,endogenous analgesia,locus coeruleus,periaqueductal gray,rostral ventromedial medulla,neuroscience(all),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2800
Faculty \ School: Faculty of Social Sciences > School of Psychology
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Depositing User: LivePure Connector
Date Deposited: 07 Sep 2022 11:30
Last Modified: 21 Oct 2022 01:35
DOI: 10.1523/JNEUROSCI.2193-16.2016

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