Pain perception in patients with chronic disorders of consciousness: What can limbic system tell us?

被引：24

作者：

Calabro, Rocco Salvatore ^{[1
]}

Naro, Antonino ^{[1
]}

Manuli, Alfredo ^{[1
]}

Leo, Antonino ^{[1
]}

De Luca, Rosaria ^{[1
]}

Lo Buono, Viviana ^{[1
]}

Russo, Margherita ^{[1
]}

Bramanti, Alessia ^{[1
]}

Bramanti, Placido ^{[1
]}

机构：

[1] IRCCS, Ctr Neurolesi Bonino Pulejo, SS 113,Contrada Casazza, I-98124 Messina, Italy

来源：

CLINICAL NEUROPHYSIOLOGY | 2017年 / 128卷 / 03期

关键词：

Limbic system; LORETA; MCS; UWS; HRV; Pain perception; ANTERIOR CINGULATE CORTEX; HEART-RATE-VARIABILITY; VEGETATIVE STATE; UNRESPONSIVE WAKEFULNESS; SOMATOSENSORY STIMULI; AUTONOMIC SYSTEM; BRAIN-FUNCTION; RECOVERY; SCALE; COMA;

D O I：

10.1016/j.clinph.2016.12.011

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: Although it is believed that patients with Unresponsive Wakefulness Syndrome (UWS) do not feel pain, recent neuroimaging and neurophysiologic studies have demonstrated some residual traces of nociceptive processing. Methods: To confirm this growing evidence, we evaluated 21 patients suffering from chronic disorders of consciousness (DOC) ( both UWS, n = 11, and Minimally Conscious State - MCS -, n = 10), using an Event-Related Potential (ERP) Low-Resolution Brain Electromagnetic Tomography (LORETA) approach, based on nociceptive repeated laser stimulation (RLS). We delivered laser stimuli to the dorsum of both hands and analysed the gamma-band LORETA activations and the ERP gamma-power magnitude induced by laser stimulation, as well as the heart rate variability (HRV). Results: We found partially preserved cortical activations and ERP gamma-power magnitude in all MCS and two UWS individuals. These effects were paralleled by a purposeful behaviour, and a reduced HRV concerning nociceptive stimulation, whereas the two UWS individuals showed no more than reflex behaviours, besides a strong limbic activation. Conclusions: Some UWS patients may somehow perceive the affective components of nociceptive stimulation. Significance: The diagnosis of functional locked-in syndrome should be taken into account when dealing with DOC differential diagnosis. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

引用

页码：454 / 462

页数：9

共 85 条

[11]

Camm AJ, 1996, CIRCULATION, V93, P1043

[12]

Candelieri A, 2011, HEALTHINF 2011: PROCEEDINGS OF THE INTERNATIONAL CONFERENCE ON HEALTH INFORMATICS, P138

[13] Pain issues in disorders of consciousness [J].

Chatelle, Camille ;

Thibaut, Aurore ;

Whyte, John ;

De Val, Marie Daniele ;

Laureys, Steven ;

Schnakers, Caroline .

BRAIN INJURY, 2014, 28 (09) :1202-1208

[14] A sensitive scale to assess nociceptive pain in patients with disorders of consciousness [J].

Chatelle, Camille ;

Majerus, Steve ;

Whyte, John ;

Laureys, Steven ;

Schnakers, Caroline .

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2012, 83 (12) :1233-1237

[15] How do you feel? Interoception: the sense of the physiological condition of the body [J].

Craig, AD .

NATURE REVIEWS NEUROSCIENCE, 2002, 3 (08) :655-666

[16] Cortical responses to salient nociceptive and not nociceptive stimuli in vegetative and minimal conscious state [J].

de Tommaso, Marina ;

Navarro, Jorge ;

Lanzillotti, Crocifissa ;

Ricci, Katia ;

Buonocunto, Francesca ;

Livrea, Paolo ;

Lancioni, Giulio E. .

FRONTIERS IN HUMAN NEUROSCIENCE, 2015, 9

[17] Pain in prolonged disorders of consciousness: Laser evoked potentials findings in patients with vegetative and minimally conscious states [J].

de Tommaso, Marina ;

Navarro, Jorge ;

Ricci, Katia ;

Lorenzo, Marta ;

Lanzillotti, Crocifissa ;

Colonna, Fabio ;

Resta, Maurizio ;

Lancioni, Giulio ;

Livrea, Paolo .

BRAIN INJURY, 2013, 27 (7-8) :962-972

[18] EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis [J].

Delorme, A ;

Makeig, S .

JOURNAL OF NEUROSCIENCE METHODS, 2004, 134 (01) :9-21

[19] Different beliefs about pain perception in the vegetative and minimally conscious states: a European survey of medical and paramedical professionals [J].

Demertzi, A. ;

Schnakers, C. ;

Ledoux, D. ;

Chatelle, C. ;

Bruno, M. -A. ;

Vanhaudenhuyse, A. ;

Boly, M. ;

Moonen, G. ;

Laureys, S. .

COMA SCIENCE: CLINICAL AND ETHICAL IMPLICATIONS, 2009, 177 :329-338

[20] Consciousness supporting networks [J].

Demertzi, Athena ;

Soddu, Andrea ;

Laureys, Steven .

CURRENT OPINION IN NEUROBIOLOGY, 2013, 23 (02) :239-244

← 1 2 3 4 5 6 7 8 9 →