Myofascial Trigger Points, Sensitization, and Chronic Musculoskeletal Pain
Sahar Swidan, Matthew Bennett in Advanced Therapeutics in Pain Medicine, 2020
Chronic musculoskeletal pain is highly prevalent and presents a major burden to individuals and society. Myofascial pain syndrome can be either acute or chronic and is highly associated with myofascial trigger points in the affected muscles. Spinal segmental sensitization is a hyperactive state of the dorsal horn caused by bombardment of nociceptive impulses from sensitized or damaged tissue including somatic structures or visceral structures. Individuals with chronic musculoskeletal pain conditions and concomitant depression have activation of brain regions related to emotions including the amygdala, anterior insula, and medial prefrontal cortex upon painful stimulation. However, in chronic musculoskeletal pain conditions, there appears to be a shift to a decrease in inhibition, presumably due to an imbalance of ON cell and OFF cell activity. Thus, in addition to the development of standardized diagnostic criteria, studies of sufficient size and power with quantitative outcome measures are sorely needed in order to improve the treatment of chronic musculoskeletal pain and myofascial trigger points.
Theories and facts about autism
Trevor Powell in Recognising Autism and Asperger's Syndrome, 2021
Theories about the mind of people with autism are described, including the theory of mind, weak central coherence, monotropism and executive functioning, empathising and systematising theories. There is an exploration of how autistic people compensate and develop special interests and restricted routines. The female presentation, with the tendency to camouflage and mask to blend in, is elaborated. Genetics and hormonal research, including the extreme male brain theory, neonatal testosterone levels and prevalence rates are explored. There is an examination of differences between autistic and neurotypical brains in terms of neural connectivity, synaptic pruning and structural differences in brain areas such as the cerebellum, corpus callosum, amygdala, fusiform area and anterior insula. The structural differences in the brains of both Albert Einstein and Temple Grandin are discussed.
Neuroimaging and posttraumatic stress disorder
Graeme Turner in Post Traumatic Stress Disorder, 2009
Neuroimaging provides a powerful way to investigate the structural and functional abnormalities associated with posttraumatic stress disorder (PTSD) and PTSD vulnerability. It can be used to identify mechanisms that mediate emotional processing in healthy individuals as well as the dysregulation of these processes in posttraumatic stress disorder (PTSD). Reviewed are neuroimaging findings in PTSD, with a focus on studies utilizing symptom provocation, cognitive activation, and functional connectivity. These studies identify neurocircuitry associated with PTSD, highlighting the role of the medial prefrontal cortex (mPFC), insula, amygdala, sublenticular extended amygdala (SLEA), and hippocampus, in mediating symptom formation in PTSD. In addition, psychological processes presently emerging as new foci in neuroimaging research relevant to PTSD, such as fear conditioning, habituation, extinction recall; cognitiveemotional interactions are also discussed. Findings linking neurocircuitry subserving these processes to the abnormalities associated with PTSD are highlighted, suggesting that mPFC is implicated in a number of these processes. Finally, a section on receptor imaging will discuss the differences in functional neurochemistry associated with PTSD.
Memory impairment in occipital periventricular hyperintensity patients is associated with reduced functional responses in the insula and Heschl's gyrus
Published in International Journal of Neuroscience, 2017
Dazhi Duan, Lin Shen, Congyang Li, Chun Cui, Tongsheng Shu, Jian Zheng
Objectives: The aim of this study was to investigate the cognitive impairments of occipital periventricular hyperintensity (OPVH) patients and their brain-wide functional alterations in large scale. Methods: The Mini-Mental State Examination (MMSE) was performed in 15 OPVH patients and 12 age-matched healthy controls to distinguish the cognitive impairment features of OPVH. Functional magnetic resonance imaging (fMRI) was applied with a delayed digital match memory task to identify the brain-wide functional alterations in OPVH patients. Results: The two groups were not statistically different in terms of demographic or cardiovascular risk factors. The OPVH group had significantly lower scores in global cognitive abilities, immediate memory and delayed memory as determined by the MMSE (p < 0.05). The fMRI results demonstrated that the insula, precentral gyrus and Heschl's gyrus of the OPVH group had decreased activation compared to the control group (p < 0.005, uncorrected). Multivariate analysis also showed that OPVH was negatively correlated with reduced activation in the insula, precentral gyrus and Heschl's gyrus (p < 0.005). Conclusion: OPVH affects the immediate and delayed memory. These changes are accompanied with decreased functional responses in the insula and Heschl's gyrus.
Two patterns of anterior insular cortex functional connectivity in bipolar disorder and schizophrenia
Published in The World Journal of Biological Psychiatry, 2018
Jian Li, Yanqing Tang, Fay Womer, Guoguang Fan, Qian Zhou, Wenge Sun, Ke Xu, Fei Wang
Objectives: Bipolar disorder (BD) and schizophrenia (SZ) share structural abnormalities in the anterior insula cortex (AIC). The AIC appears to have a crucial role in emotional processing and regulation and cognitive control in BD and SZ. Methods: Forty-six participants with BD, 68 with SZ and 66 healthy controls (HC) underwent functional magnetic resonance imaging scanning. Resting-state functional connectivity (rsFC) from AIC subregions (ventral and dorsal) was compared among the three groups. Results: Compared to HC group, both BD and SZ groups exhibited increased rsFC from the ventral AIC (vAIC) and dorsal AIC (dAIC) to bilateral frontal pole and thalamus, the left middle frontal gyrus and the hippocampus. Meanwhile, the BD group demonstrated increased rsFC from the vAIC to the perigenual anterior cingulate cortex, the SZ group presented increased rsFC from the vAIC and dAIC to the right caudate. Compared with the BD group, the SZ group showed significantly increased rsFC from the vAIC and dAIC to the left middle frontal gyrus. Conclusions: The shared AIC rsFC abnormalities in both BD and SZ support the importance of the AIC in the common pathophysiology of BD and SZ. There were also disorder-specific features of AIC rsFC, which might implicate potential avenues for differentiating during the early stages.
The obsessions of the green-eyed monster: jealousy and the female brain
Published in Sexual and Relationship Therapy, 2021
Nadine Steis, Silvia Oddo-Sommerfeld, Gerald Echterhoff, Aylin Thiel, Jürgen Thiel, Katja Briem, Angela Ciaramidaro, Christine M. Freitag, Axel Mecklinger, Katja Unterhorst, Aglaja Stirn
The present brain-imaging study assessed neural correlates of romantic jealousy in women who had suffered real infidelity by their partner. We predicted to find activation across different brain structures associated with the processing of negative emotions and cognitive processes as well as obsessive-compulsive behavior. FMRI scans were administered while participants listened to descriptions of their own or another person’s experience of infidelity and jealousy, or to nonsense words. In the self-experienced (vs. other-experienced) jealousy condition, activity was greater in areas commonly associated with the interaction between different negative emotions (i.e., insula, anterior cingulate cortex, medial prefrontal cortex) such as fear, anger, sadness and cognitive processes like rumination. Enhanced activity was also found in the fronto-striato-thalamo-frontal circuit, a network implicated in habit formation and obsessive-compulsive disorder. Activation in the above networks was not enhanced when participants listened to other-experienced infidelity reports, as indicated by comparisons with the neutral condition. We discuss implications for the understanding and treatment of jealousy.
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