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dc.contributor.authorMills, E.P.
dc.contributor.authorAlshelh, Z.
dc.contributor.authorKosanovic, D.
dc.contributor.authorDi Pietro, Flavia
dc.contributor.authorVickers, E.R.
dc.contributor.authorMacey, P.M.
dc.contributor.authorHenderson, L.A.
dc.identifier.citationMills, E.P. and Alshelh, Z. and Kosanovic, D. and Di Pietro, F. and Vickers, E.R. and Macey, P.M. and Henderson, L.A. 2020. Altered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations. Journal of Pain Research. 13: pp. 2223-2235.

Background: Chronic pain, particularly that following nerve injury, can occur in the absence of external stimuli. Although the ongoing pain is sometimes continuous, in many individuals the intensity of their pain fluctuates. Experimental animal studies have shown that the brainstem contains circuits that modulate nociceptive information at the primary afferent synapse and these circuits are involved in maintaining ongoing continuous neuropathic pain. However, it remains unknown if these circuits are involved in regulating fluctuations of ongoing neuropathic pain in humans.

Methods: We used functional magnetic resonance imaging to determine whether in 19 subjects with painful trigeminal neuropathy, brainstem pain-modulation circuitry function changes according to moment-to-moment fluctuations in spontaneous pain intensity as rated online over a 12-minute period.

Results: We found that when pain intensity was spontaneously high, connectivity strengths between regions of the brainstem endogenous pain-modulating circuitry—the midbrain periaque-ductal gray, rostral ventromedial medulla (RVM), and the spinal trigeminal nucleus (SpV)—were high, and vice-versa (when pain was low, connectivity was low). Additionally, sliding-window connectivity analysis using 50-second windows revealed a significant positive relationship between ongoing pain intensity and RVM-SpV connectivity over the duration of the 12-minute scan.

Conclusion: These data reveal that moment-to-moment changes in brainstem pain-modula-tion circuitry functioning likely contribute to fluctuations in spontaneous pain intensity in individuals with chronic neuropathic pain.

dc.subjectdynamic connectivity
dc.subjectfunctional connectivity
dc.subjectmidbrain periaqueductal gray matter
dc.subjectrostral ventromedial medulla
dc.subjectspinal trigeminal nucleus
dc.subjectspontaneous pain
dc.titleAltered brainstem pain-modulation circuitry connectivity during spontaneous pain intensity fluctuations
dc.typeJournal Article
dcterms.source.titleJournal of Pain Research
curtin.departmentCurtin Medical School
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidDi Pietro, Flavia [0000-0002-9642-0805]
curtin.contributor.researcheridDi Pietro, Flavia [P-5415-2018]
curtin.contributor.scopusauthoridDi Pietro, Flavia [6603432291]

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