Brain Activation During Accommodation to Painful Stimulation With FMRI - Full Text View

Purpose

Blood oxygen level dependant (BOLD) functional magnetic resonance imaging (FMRI) investigations of pain have provided substantial insight into the workings of the human brain. To date, however, the vast majority of studies have dealt with short painful stimulations. This work will expand the investigators knowledge of how longer stimulations are processed by comparing the activation pattern from a two minute painful stimulation with that of an 30-second painful stimulus. The investigators hypothesis that accommodation to the longer stimulation will be evident by either decreases in signal intensity in brain areas known to process pain, or by increasing activity in brain areas thought to be responsible for the modulation of painful perception.

Condition
Pain

Study Type:	Observational
Study Design:	Observational Model: Case-Only Time Perspective: Cross-Sectional
Official Title:	Brain Activation During Accommodation to Painful Stimulation With Functional Imaging of Pain

Resource links provided by NLM:

MedlinePlus related topics: MRI Scans

U.S. FDA Resources

Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:

To determine the areas of brain activity from a 2 minute long painful stimulation [ Time Frame: After a 2 minute long painful stimulation ] [ Designated as safety issue: No ]

Estimated Enrollment:	20
Study Start Date:	November 2010
Estimated Study Completion Date:	October 2011
Primary Completion Date:	June 2011 (Final data collection date for primary outcome measure)

Detailed Description:

Background: Over the past 14 years, BOLD FMRI studies have non-invasively shown that pain activates a matrix of areas, but that this activation decays during stimulation, possibly reflecting the body's ability to "accommodate" to the stimulation. The majority of these use short applications of pain lasting 1 to 30 seconds. However, investigators are now using stimulations much longer than the periods that were typical a few years ago. The effect of signal decay on the activation maps generated by these longer tasks is not known. Because the signal change in many of the subcortical areas involved in pain processing is low, errors in analysis due to neglecting the signal decay may induce significant artifact.

Materials and Methods: Using transcutaneous electrical nerve stimulation, 20 healthy volunteers will experience two different painful stimulations: a repeating 30-second long stimulation and a constant 2 minute stimulation. The brain activity for each will be determined and compared. In addition, the signal decay during each painful stimulation will be quantified and compared.

Significance: Investigators are using longer stimulations periods in an attempt to understand how the brain processes "real- life" pain instead of the artificial on-off pattern of earlier studies. However, significant attention has not been paid to the possible effect of accommodation on the stimulus and how this may impact the activity pattern found. In addition, proof of activation of pain-control areas like the periaquaductal gray while inverse changes are occurring in pain-perceiving areas has not been sought. This study will address both of these issues with a single BOLD FMRI experiment.

Eligibility

Ages Eligible for Study:	18 Years to 50 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes
Sampling Method:	Probability Sample

Study Population

Subjects will come from the general surrounding community.

Criteria

Inclusion Criteria:

Age 18 to 50
Right-handed
Male or female
Healthy individuals not taking any medication.

Exclusion Criteria:

Pregnancy
Diagnosed with any treated or untreated medical or neurological conditions
Using any prescription drugs, including antidepressants, pain medications, sedative medications, blood pressure medications, seizure medications, or antipsychotics. Oral contraceptives are permitted
Using any over-the-counter medications including aspirin, Tylenol, or herbal supplements
Using any illicit substances
Contraindications to magnetic resonance imaging.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01242540

Locations

United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15213

Sponsors and Collaborators

University of Pittsburgh

Investigators

Principal Investigator:

James W Ibinson, MD, PhD

University of Pittsburgh

More Information

Publications:

Ibinson JW, Small RH, Algaze A, Roberts CJ, Clark DL, Schmalbrock P. Functional magnetic resonance imaging studies of pain: an investigation of signal decay during and across sessions. Anesthesiology. 2004 Oct;101(4):960-9.

Peyron R, Laurent B, García-Larrea L. Functional imaging of brain responses to pain. A review and meta-analysis (2000). Neurophysiol Clin. 2000 Oct;30(5):263-88. Review.

Tracey I, Ploghaus A, Gati JS, Clare S, Smith S, Menon RS, Matthews PM. Imaging attentional modulation of pain in the periaqueductal gray in humans. J Neurosci. 2002 Apr 1;22(7):2748-52.

Seifert F, Bschorer K, De Col R, Filitz J, Peltz E, Koppert W, Maihöfner C. Medial prefrontal cortex activity is predictive for hyperalgesia and pharmacological antihyperalgesia. J Neurosci. 2009 May 13;29(19):6167-75.

Responsible Party:	Jim Ibinson, Clinical Instructor, University of Pittsburgh
ClinicalTrials.gov Identifier:	NCT01242540 History of Changes
Other Study ID Numbers:	PRO10020252
Study First Received:	November 15, 2010
Last Updated:	August 23, 2011
Health Authority:	United States: Institutional Review Board

Keywords provided by University of Pittsburgh:

Pain
Functional Magnetic Resonance Imaging

ClinicalTrials.gov processed this record on May 16, 2013