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Cortical mechanisms of visual hypersensitivity in women at risk for chronic pelvic pain
Pain ( IF 5.9 ) Pub Date : 2022-06-01 , DOI: 10.1097/j.pain.0000000000002469
Matthew J Kmiecik 1, 2 , Frank F Tu 1, 2 , Rebecca L Silton 3 , Katlyn E Dillane 1 , Genevieve E Roth 1 , Steven E Harte 4 , Kevin M Hellman 1, 2
Affiliation  

Increased sensory sensitivity across non-nociceptive modalities is a common symptom of chronic pain conditions and is associated with chronic pain development. Providing a better understanding of the brain–behavior relationships that underlie multimodal hypersensitivity (MMH) may clarify the role of MMH in the development of chronic pain. We studied sensory hypersensitivity in a cohort of women (n = 147) who had diary confirmation of menstrual status and were enriched with risk factors for chronic pelvic pain, such as dysmenorrhea and increased bladder sensitivity. We administered 2 experimental tasks to evaluate the cross-modal relationship between visual and visceral sensitivity. Visual sensitivity was probed by presenting participants with a periodic pattern-reversal checkerboard stimulus presented across 5 brightness intensities during electroencephalography recording. Self-reported visual unpleasantness ratings for each brightness intensity were simultaneously assessed. Visceral sensitivity was evaluated with an experimental bladder-filling task associated with early clinical symptoms of chronic pelvic pain. Visually evoked cortical activity increased with brightness intensity across the entire scalp, especially at occipital electrode sites. Visual stimulation–induced unpleasantness was associated with provoked bladder pain and evoked primary visual cortex activity. However, the relationship between unpleasantness and cortical activity was moderated by provoked bladder pain. These results demonstrate that activity in the primary visual cortex is not greater in individuals with greater visceral sensitivity. We hypothesize that downstream interpretation or integration of this signal is amplified in individuals with visceral hypersensitivity. Future studies aimed at reducing MMH in chronic pain conditions should prioritize targeting of cortical mechanisms responsible for aberrant downstream sensory integration.



中文翻译:

有慢性盆腔疼痛风险的女性视觉过敏的皮质机制

非伤害性方式的感觉敏感性增加是慢性疼痛的常见症状,并且与慢性疼痛的发展相关。更好地了解多模式超敏反应 (MMH) 背后的大脑与行为关系可能会阐明 MMH 在慢性疼痛发展中的作用。我们研究了一组女性(n = 147)的感觉过敏症,这些女性通过日记确认了月经状况,并且富含慢性盆腔疼痛的危险因素,例如痛经和膀胱敏感性增加。我们执行了两项实验任务来评估视觉和内脏敏感性之间的跨模式关系。通过在脑电图记录期间向参与者提供 5 种亮度强度的周期性模式反转棋盘刺激来探测视觉敏感性。同时评估每个亮度强度的自我报告的视觉不愉快评级。通过与慢性盆腔疼痛的早期临床症状相关的实验性膀胱充盈任务来评估内脏敏感性。视觉诱发的皮层活动随着整个头皮的亮度强度而增加,尤其是在枕骨电极部位。视觉刺激引起的不愉快与诱发膀胱疼痛和诱发初级视觉皮层活动有关。然而,不愉快与皮质活动之间的关系会因膀胱疼痛而减弱。这些结果表明,内脏敏感性较高的个体初级视觉皮层的活动并不较高。我们假设该信号的下游解释或整合在患有内脏超敏反应的个体中被放大。未来旨在减少慢性疼痛状况中MMH的研究应优先针对负责异常下游感觉统合的皮层机制。

更新日期:2022-05-31
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