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Physiology of the Pain System
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
The brain does not merely witness the nociceptive signal. It actively participates in constructing the nociceptive signal. The spinothalamic tract ultimately communicates with higher nociception processing centers within the brain. The lateral thalamic nuclei, SI, and SII somatosensory cortices play a sensory discriminative role. The medial thalamic nuclei, and anterior and medial cingulate cortices interpret the emotional significance of the stimuli via the limbic system. The insula, cerebellum, and prefrontal cortex contribute to memory and fear avoidance behaviors. The lentiform nucleus, and cerebellum are involved in reflexive motor responsiveness.2
Sensory System
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The thalamic nuclei are the main somatosensory relay nuclei. The ventral posterolateral nucleus of the thalamus is important for nociceptive stimuli. The other thalamic nuclei are involved in arousal, changes in affect, and learning and memory.
Brain Mechanisms of Persistent Pain States
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Donald D. Price, G. Nicholas Verne
Given the extensive rostro-caudal and bilateral representation of elevated neural activity in the spinal cord of CCI rats, a similar extensive representation of elevated activity would be expected in several brain areas of CCI rats. An extensive representation of increased neural activity in brains of CCI rats could have important functional implications for persistent pain conditions in humans. Regional increases in brain neural activity were examined in CCI rats by using the 2-DG method (14). The pattern of activation based on statistical analysis of group data revealed that significant increases in neural activity were found in all brain areas known to receive input from ascending pain-related pathways. Thus, increases in neural activity were found in central targets of the following known ascending pathways for pain (9,18,19): 1. spino-pontoamygdaloidpathway-ponime, parabrachial nucleus and amygdala; 2. spinohypothalamic pathway-\entral posteromedial and arcuate hypothalamic nuclei; 3. spinomesencephalic and spinoreticular pathways-deep layers of the superior colliculus, central grey matter, pontine reticular formation, medullary gigantocellular nucleus, and paragigan-tocellular nucleus; 4. spinothalamocortical pathways-ventral posterior lateral nucleus, posterior thalamic nucleus, hindlimb region of S-I and S-II somatosensory areas, anterior cingulate cortex, retrosplenial granular cortex.
Updated review on the link between cortical spreading depression and headache disorders
Published in Expert Review of Neurotherapeutics, 2021
Doga Vuralli, Hulya Karatas, Muge Yemisci, Hayrunnisa Bolay
Higher order cortical areas are related to processing and integration of multi-sensory information. Higher order thalamic nuclei receive inputs from deep cortical layers and relay information to separate cortical areas. Thereby higher order thalamic nuclei operate as a hub providing cortico-thalamo-cortical transmission of information [77]. Involvement of higher order cerebral cortical areas and/or thalamic nuclei by CSD could manifest aura like clinical symptoms. Somatosensory aura symptoms are mostly cheiro-oral type (sensory disturbances in the fingertips and perioral area, tongue and palate), which are not compatible with hand and finger somatotopy in the cortical homonculus [78]. Cheiro-oral syndromes are usually seen in thalamic lesions, since the representations of the acral parts of all digits, the tongue and the lips are in close proximity in the thalamic ventral posterior nucleus [10,79,80].
Waveform Window #50: A Novel Presentation of Deep Brain Stimulator (DBS) Artifact on Electroencephalogram (EEG) and Electrocardiogram (ECG)
Published in The Neurodiagnostic Journal, 2021
Mauricio F. Villamar, Ana C. Albuja
In DBS, electrodes are implanted stereotactically to target specific areas within the brain. These may include different thalamic nuclei or the globus pallidus interna. The electrodes are connected to a pulse generator that is implanted subcutaneously in the chest wall, similar to a pacemaker or a vagus nerve stimulator (VNS). In clinical practice, DBS was first used for the management of chronic pain and movement disorders such as Parkinson’s disease, essential tremor, and dystonia. More recent applications include treatment-resistant depression, obsessive-compulsive disorder, and other psychiatric indications. DBS of the anterior nucleus of the thalamus is approved by the U.S. Food and Drug Administration for the management of medication-refractory focal epilepsy (Dougherty 2018; Sisterson and Kokkinos 2020).
Time perception impairment following thalamic stroke: A case study
Published in Neuropsychological Rehabilitation, 2018
Joe Mole, Jill Winegardner, Donna Malley, Jessica Fish
A range of structures has consistently been related to time processing, such as the prefrontal cortex, supplementary motor area, anterior cingulate gyrus, parietal lobes and basal ganglia (see Grondin, 2010; Harrington, Haaland, & Knight, 1998, for a review). These structures appear to underpin the perception of time but also other cognitive functions particularly attentional and executive functions (Mioni, Grondin, & Stablum, 2014). A few reports of patients with thalamic lesions have documented disorientation in time (Kumral et al., 2007; Lee, Chu, Kim, & Roh, 2010; Spiegel, Wycis, Orchinik, & Freed, 1956). In most cases “limbic thalamic nuclei”, defined by reciprocal connections with limbic structures (see Schmahmann, 2003), were involved, such as the mediodorsal nucleus and the anteromedial nucleus. As the hippocampal diencephalic circuitry, often regarded as the “extended hippocampal system” (Aggleton & Brown, 1999), is critical for the formation of new memories, it is likely that the limbic thalamic nuclei have a role in forming memories that represent intervals of time. In these previous reports, disorientation in time was established on the basis of inability to estimate the exact clock time, date, season and length of time spent in a session (Kumral et al., 2007; Lee et al., 2010; Spiegel et al., 1956). However, these methods do not allow us to determine whether the time processing impairments observed were related to the process of storing time intervals or to another process within a cognitive model of time processing.