Articles

Exploring the brain in pain: Activations, deactivations and their relation

Kong, Jian^a,b,*; Loggia, Marco L.^a,b,d; Zyloney, Carolyn^a; Tu, Peichi^a; LaViolette, Peter^a,b; Gollub, Randy L.^a,b,c

Author Information

^aDepartment of Psychiatry, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA

^bMGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA

^cMGH/MIT CRC Biomedical Imaging Core, Charlestown, MA, USA

^dDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

^*Corresponding author. Address: Department of Psychiatry, Massachusetts General Hospital (MGH), Harvard Medical School, Building 149, 13th Street, Suite 2661, Charlestown, MA 02129, USA. Tel.: +1 617 726 7893; fax: +1 617 726 4078.

E-mail address:[email protected]

Submitted June 27, 2009; revised September 25, 2009; accepted November 6, 2009.

Pain 148(2):p 257-267, February 2010. | DOI: 10.1016/j.pain.2009.11.008

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Abstract

The majority of neuroimaging studies on pain focuses on the study of BOLD activations, and more rarely on deactivations. In this study, in a relatively large cohort of subjects (N = 61), we assess (a) the extent of brain activation and deactivation during the application of two different heat pain levels (HIGH and LOW) and (b) the relations between these two directions of fMRI signal change. Furthermore, in a subset of our subjects (N = 12), we assess (c) the functional connectivity of pain-activated or -deactivated regions during resting states. As previously observed, we find that pain stimuli induce intensity dependent (HIGH pain > LOW pain) fMRI signal increases across the pain matrix. Simultaneously, the noxious stimuli induce activity decreases in several brain regions, including some of the ‘core structures’ of the default network (DMN). In contrast to what we observe with the signal increases, the extent of deactivations is greater for LOW than HIGH pain stimuli. The functional dissociation between activated and deactivated networks is further supported by correlational and functional connectivity analyses. Our results illustrate the absence of a linear relationship between pain activations and deactivations, and therefore suggest that these brain signal changes underlie different aspects of the pain experience.