pain

SSFN Webinar - Pain research

Maladaptive Neuroplasticity in Cortico-limbic Structures: Insights from Surgical Pain Relief in Chronic Neuropathic Facial Pain

Pain in the Brain: A Drink a Day Could Bring More Than You Bargain

The Role of GPCR Family Mrgprs in Itch, Pain, and Innate Immunity

Neuromodulation of subjective experience

Many psychoactive substances are used with the aim of altering experience, e.g. as analgesics, antidepressants or antipsychotics. These drugs act on specific receptor systems in the brain, including the opioid, serotonergic and dopaminergic systems. In this talk, I will summarise human drug studies targeting opioid receptors and their role for human experience, with focus on the experience of pain, stress, mood, and social connection. Opioids are only indicated for analgesia, due to their potential to cause addiction. When these regulations occurred, other known effects were relegated to side effects. This may be the cause of the prevalent myth that opioids are the most potent painkillers, despite evidence from head-to-head trials, Cochrane reviews and network meta-analyses that opioids are not superior to non-opioid analgesics in the treatment of acute or chronic non-cancer pain. However, due to the variability and diversity of opioid effects across contexts and experiences, some people under some circumstances may indeed benefit from prolonged treatment. I will present data on individual differences in opioid effects due to participant sex and stress induction. Understanding the effects of these commonly used medications on other aspects of the human experience is important to ensure correct use and to prevent unnecessary pain and addiction risk.

25 years of DBS beyond movement disorders: what challenges are we facing?; Directional DBS targeting of different nuclei in the thalamus for the treatment of pain

On Thursday, 23rd of February, we will host Veerle Visser-Vandewalle and Marie Krüger. Marie Krüger, MD, is is currently leading the stereotactic surgery unit in St. Gallen but is on her move to join the team at UCL / Queensquare London. She will discuss “Directional DBS targeting of different nuclei in the thalamus for the treatment of pain”. Veerle Visser-Vandewalle, MD, PhD, is the Head of the Department of Stereotactic and Functional Neurosurgery at University Hospital of Cologne. Beside his scientific presentation on “25 years of DBS beyond movement disorders: what challenges are we facing?”, she will also give us a glimpse at the “Person behind the science”. The talks will be followed by a shared discussion. You can register via talks.stimulatingbrains.org to receive the (free) Zoom link!

Love, death, and oxytocin: the challenges of mouse maternal care

Protocols for the social transfer of pain and analgesia in mice

We provide protocols for the social transfer of pain and analgesia in mice. We describe the steps to induce pain or analgesia (pain relief) in bystander mice with a 1-h social interaction with a partner injected with CFA (complete Freund’s adjuvant) or CFA and morphine, respectively. We detail behavioral tests to assess pain or analgesia in the untreated bystander mice. This protocol has been validated in mice and rats and can be used for investigating mechanisms of empathy. Highlights • A protocol for the rapid social transfer of pain in rodents • Detailed requirements for handling and housing conditions • Procedures for habituation, social interaction, and pain induction and assessment • Adaptable for social transfer of analgesia and may be used to study empathy in rodents https://doi.org/10.1016/j.xpro.2022.101756

How can we treat visceral pain?

Chronic pain is a leading cause of morbidity, common to patients with gastrointestinal diseases such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Most pain killers are largely ineffective against this type of pain or restricted for use in these patients due to gut related complications and risk of addition. A significant unmet clinical need therefore exists to develop novel non-opioid based visceral analgesics.

NEW TREATMENTS FOR PAIN: Unmet needs and how to meet them

“Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.- George Orwell, ‘1984’ " "Neuroscience has revealed the secrets of the brain and nervous system to an extent that was beyond the realm of imagination just 10-20 years ago, let alone in 1949 when Orwell wrote his prophetic novel. Understanding pain, however, presents a unique challenge to academia, industry and medicine, being both a measurable physiological process as well as deeply personal and subjective. Given the millions of people who suffer from pain every day, wishing only, “that it should stop”, the need to find more effective treatments cannot be understated." "‘New treatments for pain’ will bring together approximately 120 people from the commercial, academic, and not-for-profit sectors to share current knowledge, identify future directions, and enable collaboration, providing delegates with meaningful and practical ways to accelerate their own work into developing treatments for pain.

Untitled Seminar

G. Lopez-Bendito, Spain: “Spontaneous Activity in the Specification and Plasticity of Sensory Circuits”; R. Suarez , Australia: “Marsupials illuminate brain wiring”

Reprogramming the nociceptive circuit topology reshapes sexual behavior in C. elegans

In sexually reproducing species, males and females respond to environmental sensory cues and transform the input into sexually dimorphic traits. Yet, how sexually dimorphic behavior is encoded in the nervous system is poorly understood. We characterize the sexually dimorphic nociceptive behavior in C. elegans – hermaphrodites present a lower pain threshold than males in response to aversive stimuli, and study the underlying neuronal circuits, which are composed of the same neurons that are wired differently. By imaging receptor expression, calcium responses and glutamate secretion, we show that sensory transduction is similar in the two sexes, and therefore explore how downstream network topology shapes dimorphic behavior. We generated a computational model that replicates the observed dimorphic behavior, and used this model to predict simple network rewirings that would switch the behavior between the sexes. We then showed experimentally, using genetic manipulations, artificial gap junctions, automated tracking and optogenetics, that these subtle changes to male connectivity result in hermaphrodite-like aversive behavior in-vivo, while hermaphrodite behavior was more robust to perturbations. Strikingly, when presented with aversive cues, rewired males were compromised in finding mating partners, suggesting that the network topology that enables efficient avoidance of noxious cues would have a reproductive "cost". To summarize, we present a deconstruction of a sex-shared neural circuit that affects sexual behavior, and how to reprogram it. More broadly, our results are an example of how common neuronal circuits changed their function during evolution by subtle topological rewirings to account for different environmental and sexual needs.

An investigation of perceptual biases in spiking recurrent neural networks trained to discriminate time intervals

Magnitude estimation and stimulus discrimination tasks are affected by perceptual biases that cause the stimulus parameter to be perceived as shifted toward the mean of its distribution. These biases have been extensively studied in psychophysics and, more recently and to a lesser extent, with neural activity recordings. New computational techniques allow us to train spiking recurrent neural networks on the tasks used in the experiments. This provides us with another valuable tool with which to investigate the network mechanisms responsible for the biases and how behavior could be modeled. As an example, in this talk I will consider networks trained to discriminate the durations of temporal intervals. The trained networks presented the contraction bias, even though they were trained with a stimulus sequence without temporal correlations. The neural activity during the delay period carried information about the stimuli of the current trial and previous trials, this being one of the mechanisms that originated the contraction bias. The population activity described trajectories in a low-dimensional space and their relative locations depended on the prior distribution. The results can be modeled as an ideal observer that during the delay period sees a combination of the current and the previous stimuli. Finally, I will describe how the neural trajectories in state space encode an estimate of the interval duration. The approach could be applied to other cognitive tasks.

Learning from others, helping others learn: Cognitive foundations of distinctively human social learning

Learning does not occur in isolation. From parent-child interactions to formal classroom environments, humans explore, learn, and communicate in rich, diverse social contexts. Rather than simply observing and copying their conspecifics, humans engage in a range of epistemic practices that actively recruit those around them. What makes human social learning so distinctive, powerful, and smart? In this talk, I will present a series of studies that reveal the remarkably sophisticated inferential abilities that young children show not only in how they learn from others but also in how they help others learn. Children interact with others as learners and as teachers to learn and communicate about the world, about others, and even about the self. The results collectively paint a picture of human social learning that is far more than copying and imitation: It is active, bidirectional, and cooperative. I will end by discussing ongoing work that extends this picture beyond what we typically call “social learning”, with implications for building better machines that learn from and interact with humans.

Social neuroscience studies of racial ingroup bias in empathy

Empathy is supposed to play a functional role in prosocial behavior. However, there has been behavioral evidence that people do not empathize everyone equally. I’ll present studies that show brain imaging evidence for racial ingroup bias in empathy for pain. These studies reveal multiple-level neural mechanisms underlying racial ingroup bias in empathy. I’ll also discuss potential intervention of racial ingroup bias in empathy and its social implications.

Dissecting subcircuits underlying hippocampal function

Liset M de la Prida is a Physicist (1994) and PhD in Neuroscience (1998), who leads the Laboratorio de Circuitos Neuronales at the Instituto Cajal, Madrid, Spain (http://www.hippo-circuitlab.es). The main focus of her lab is to understand the function of the hippocampal circuits in the normal and the diseased brain, in particular oscillations and neuronal representations. She is a leading international expert in the study of the basic mechanisms of physiological ripples and epileptic fast ripples, with strong visibility as developer of novel groundbreaking electrophysiological tools. Dr. de la Prida serves as an Editor for prestigious journals including eLife, Journal of Neuroscience Methods and eNeuro, and has commissioning duties in the American Epilepsy Society, FENS and the Spanish Society for Neurosciences.

Basal ganglia diseases in childhood

Visualization and manipulation of our perception and imagery by BCI

We have been developing Brain-Computer Interface (BCI) using electrocorticography (ECoG) [1] , which is recorded by electrodes implanted on brain surface, and magnetoencephalography (MEG) [2] , which records the cortical activities non-invasively, for the clinical applications. The invasive BCI using ECoG has been applied for severely paralyzed patient to restore the communication and motor function. The non-invasive BCI using MEG has been applied as a neurofeedback tool to modulate some pathological neural activities to treat some neuropsychiatric disorders. Although these techniques have been developed for clinical application, BCI is also an important tool to investigate neural function. For example, motor BCI records some neural activities in a part of the motor cortex to generate some movements of external devices. Although our motor system consists of complex system including motor cortex, basal ganglia, cerebellum, spinal cord and muscles, the BCI affords us to simplify the motor system with exactly known inputs, outputs and the relation of them. We can investigate the motor system by manipulating the parameters in BCI system. Recently, we are developing some BCIs to visualize and manipulate our perception and mental imagery. Although these BCI has been developed for clinical application, the BCI will be useful to understand our neural system to generate the perception and imagery. In this talk, I will introduce our study of phantom limb pain [3] , that is controlled by MEG-BCI, and the development of a communication BCI using ECoG [4] , that enable the subject to visualize the contents of their mental imagery. And I would like to discuss how much we can control our cortical activities that represent our perception and mental imagery. These examples demonstrate that BCI is a promising tool to visualize and manipulate the perception and imagery and to understand our consciousness. References 1. Yanagisawa, T., Hirata, M., Saitoh, Y., Kishima, H., Matsushita, K., Goto, T., Fukuma, R., Yokoi, H., Kamitani, Y., and Yoshimine, T. (2012). Electrocorticographic control of a prosthetic arm in paralyzed patients. AnnNeurol 71, 353-361. 2. Yanagisawa, T., Fukuma, R., Seymour, B., Hosomi, K., Kishima, H., Shimizu, T., Yokoi, H., Hirata, M., Yoshimine, T., Kamitani, Y., et al. (2016). Induced sensorimotor brain plasticity controls pain in phantom limb patients. Nature communications 7, 13209. 3. Yanagisawa, T., Fukuma, R., Seymour, B., Tanaka, M., Hosomi, K., Yamashita, O., Kishima, H., Kamitani, Y., and Saitoh, Y. (2020). BCI training to move a virtual hand reduces phantom limb pain: A randomized crossover trial. Neurology 95, e417-e426. 4. Ryohei Fukuma, Takufumi Yanagisawa, Shinji Nishimoto, Hidenori Sugano, Kentaro Tamura, Shota Yamamoto, Yasushi Iimura, Yuya Fujita, Satoru Oshino, Naoki Tani, Naoko Koide-Majima, Yukiyasu Kamitani, Haruhiko Kishima (2022). Voluntary control of semantic neural representations by imagery with conflicting visual stimulation. arXiv arXiv:2112.01223.

The functional connectome across temporal scales

The view of human brain function has drastically shifted over the last decade, owing to the observation that the majority of brain activity is intrinsic rather than driven by external stimuli or cognitive demands. Specifically, all brain regions continuously communicate in spatiotemporally organized patterns that constitute the functional connectome, with consequences for cognition and behavior. In this talk, I will argue that another shift is underway, driven by new insights from synergistic interrogation of the functional connectome using different acquisition methods. The human functional connectome is typically investigated with functional magnetic resonance imaging (fMRI) that relies on the indirect hemodynamic signal, thereby emphasizing very slow connectivity across brain regions. Conversely, more recent methodological advances demonstrate that fast connectivity within the whole-brain connectome can be studied with real-time methods such as electroencephalography (EEG). Our findings show that combining fMRI with scalp or intracranial EEG in humans, especially when recorded concurrently, paints a rich picture of neural communication across the connectome. Specifically, the connectome comprises both fast, oscillation-based connectivity observable with EEG, as well as extremely slow processes best captured by fMRI. While the fast and slow processes share an important degree of spatial organization, these processes unfold in a temporally independent manner. Our observations suggest that fMRI and EEG may be envisaged as capturing distinct aspects of functional connectivity, rather than intermodal measurements of the same phenomenon. Infraslow fluctuation-based and rapid oscillation-based connectivity of various frequency bands constitute multiple dynamic trajectories through a shared state space of discrete connectome configurations. The multitude of flexible trajectories may concurrently enable functional connectivity across multiple independent sets of distributed brain regions.

Emerging therapeutic targets for migraine

Migraine is the third most prevalent disease worldwide and is estimated to affect upwards of 14% of the population. Our lab has used novel preclinical models to identify the delta opioid receptor (DOR) as a therapeutic target for multiple headache disorders, including migraine. We have also investigated the relationship between DOR with the pro-migraine peptide, CGRP. There is regional variation between the co-expression of DOR with CGRP or its receptor in the trigeminal complex. This work indicates that DOR agonists can moderate both CGRP release and signaling, thus regulating pro-migraine effects at two different levels. Recent work in our lab has also explored how cytoarchitectural changes in pain processing regions are critical for the maintenance of the chronic migraine state. We show that there is decreased neuronal complexity in two different models of migraine, and that restoration of tubulin dynamics, directly by HDAC6 inhibitor or indirectly by CGRP receptor antagonist, can inhibit migraine-associated symptoms. These studies provide fundamental information on how cytoskeletal dynamics are altered in chronic migraine, and form the basis for the development of HDAC6 inhibitors for headache treatment.

The neural basis of pain experience and its modulation by opioids

How the brain creates a painful experience remains a mystery. Solving this mystery is crucial to understanding the fundamental biological processes that underlie the perception of body integrity, and to creating better, non-addictive pain treatments. My laboratory’s goal is to resolve the neural basis of pain. We aim to understand the mechanisms by which our nervous system produces and assembles the sensory-discriminative, affective-motivational, and cognitive-evaluative dimensions of pain to create this unique and critically important experience. To capture every component of the pain experience, we examine the entirety of the pain circuitry, from sensory and spinal ascending pathways to cortical/subcortical circuits and brainstem descending pain modulation systems, at the molecular, cellular, circuit and whole-animal levels. For these studies, we have invented novel behavioral paradigms to interrogate the affective and cognitive dimensions of pain in mice while simultaneously imaging and manipulating nociceptive circuits. My laboratory also investigates how opioids suppress pain. Remarkably, despite their medical and societal significance, how opium poppy alkaloids such as morphine produce profound analgesia remains largely unexplained. By identifying where and how opioids act in neural circuits, we not only establish the mechanisms of action of one of the oldest drugs known to humans, but also reveal the critical elements of the pain circuitry for developing of novel analgesics and bringing an end to the opioid epidemic.

Selectively Silencing Nociceptor Sensory Neurons

Local anesthetics decrease the excitability of all neurons by blocking voltage-gated sodium channels non-selectively. We have developed a technology to silence only those sensory neurons – the nociceptors – that trigger pain, itch, and cough. I will tell you why and how we devised the strategy, the way we showed that it works, and will also discuss its implications for treating multiple human disorders.

Keeping axons alive after injury: Inhibiting programmed axon death

Activation of pro-degenerative protein SARM1 in response to diverse physical and disease-relevant injuries triggers programmed axon death. Original studies indicated substantially decreased levels of SARM1 were required for neuroprotection. However, we demonstrate that lowering SARM1 levels by 50% in Sarm1 haploinsufficient mice delays axon degeneration in vivo (after sciatic nerve transection), in vitro (in response to diverse traumatic, neurotoxic, and genetic triggers), and partially prevents neurite outgrowth defects in mice lacking pro-survival factor NMNAT2. We also demonstrate the capacity for Sarm1 antisense oligonucleotides to decrease SARM1 levels by more than 50% which delays or prevents programmed axon degeneration in vitro. Combining Sarm1 haploinsufficiency with antisense oligonucleotides further decreases SARM1 levels and prolongs protection after neurotoxic injuries. These data demonstrate that axon protection occurs in a Sarm1 gene-dose responsive manner and that SARM1 lowering agents have therapeutic potential. Thus, antisense oligonucleotide targeting of Sarm1 is a promising therapeutic strategy against diverse triggers of axon degeneration.

CrossTalk: Conversations at the Intersection of Science and Art

Anjan Chatterjee is a Professor of Neurology, Psychology, and Architecture and the founding Director of the Penn Center for Neuroaesthetics. His research explores the field of neuroaesthetics: how our brain experiences and responds to art. Lucas Kelly is a renowned visual artist, with work featured across several solo and group exhibitions, most notably in the survey of abstract painting “The Painted World” at PS1 Museum of Modern Art. As the inaugural Artist in Residence for the Penn Center for Neuroaesthetics, Lucas has collaborated with Anjan on a forthcoming exhibition, considering the emotions involved in aesthetic engagement informed by research. This event will feature a moderated conversation between Anjan and Lucas, discussing topics at the intersection of neuroscience and experience of visual art.

What Art can tell us about the Brain

Artists have been doing experiments on vision longer than neurobiologists. Some major works of art have provided insights as to how we see; some of these insights are so undamental that they can be understood in terms of the underlying neurobiology. For example, artists have long realized that color and luminance can play independent roles in visual perception. Picasso said, "Colors are only symbols. Reality is to be found in luminance alone." This observation has a parallel in the functional subdivision of our visual systems, where color and luminance are processed by the evolutionarily newer, primate-specific What system, and the older, colorblind, Where (or How) system. Many techniques developed over the centuries by artists can be understood in terms of the parallel organization of our visual systems. I will explore how the segregation of color and luminance processing are the basis for why some Impressionist paintings seem to shimmer, why some op art paintings seem to move, some principles of Matisse's use of color, and how the Impressionists painted "air". Central and peripheral vision are distinct, and I will show how the differences in resolution across our visual field make the Mona Lisa's smile elusive, and produce a dynamic illusion in Pointillist paintings, Chuck Close paintings, and photomosaics. I will explore how artists have figured out important features about how our brains extract relevant information about faces and objects, and I will discuss why learning disabilities may be associated with artistic talent.

Predator-prey interactions: the avian visual sensory perspective

My research interests are centered on animal ecology, and more specifically include the following areas: visual ecology, behavioral ecology, and conservation biology, as well as the interactions between them. My research is question-driven. I answer my questions in a comprehensive manner, using a combination of empirical, theoretical, and comparative approaches. My model species are usually birds, but I have also worked with fish, mammals, amphibians, and insects. ​I was fortunate to enrich my education by attending Universities in different parts of the world. I did my undergraduate, specialized in ecology and biodiversity, at the "Universidad Nacional de Cordoba", Argentina. My Ph.D. was in animal ecology and conservation biology at the "Universidad Complutense de Madrid", Spain. My two post-docs were focused on behavioral ecology; the first one at University of Oxford (United Kingdom), and the second one at University of Minnesota (USA). I was an Assistant Professor at California State University Long Beach for almost six years. I am now a Full Professor of Biological Sciences at Purdue University.

Selectively Silencing Nociceptor Sensory Neurons

Local anesthetics decrease the excitability of all neurons by blocking voltage-gated sodium channels non-selectively. We have developed a technology to silence only those sensory neurons – the nociceptors – that trigger pain, itch, and cough. I will tell you why and how we devised the strategy, the way we showed that it works, and will also discuss its implications for treating multiple human disorders.

The thalamus that speaks to the cortex: Spontaneous activity in the developing sensory circuits

Cluster Headache: Improving Therapy for the Worst Pain Experienced by Humans

Cluster headache is a brain disorder dominated clinically by dreadful episodes of excruciating pain with a circadian pattern and most often focused in bouts with circannual periodicity. As we have understood its neurobiology new therapies, including those directed at calcitonin gene-related peptide, are helpful improve the lives of sufferers.

Bedside to bench and back again, a path to translational pain research?

Pain has both a sensory and emotional component and is driven by activation of sensory neurones called nociceptors that are tuned to detect noxious stimuli in a process called nociception. Although nociception functions as a detect and protect mechanism. and is found in many organisms, this system becomes dysregulated in a number of conditions where chronic pain presents as a key symptom, for example osteoarthritis. Nociceptors do not innervate empty space though and do not act alone. Going beyond the neurone, other cell types, such as fibroblast-like synoviocytes interact with and modify the function of nociceptors, which is likely a key contributor to the chronification of pain. In this talk, I will look at how combining pre-clinical mouse work with human tissue and genetics might provide a way to accelerate new analgesics from bench to bedside, giving examples from our work in joint pain, bowel pain and labour pain.

Pain modulation in health and disease – top-down, bottom-up and their interaction

In this talk, Dr. Schweinhardt will discuss top-down (i.e. cerebral) modulation of the perception and processing of nociceptive stimuli using selected examples in chronic pain patients as well as healthy subjects. Data on activity-dependent central sensitization will be presented as a case of bottom-up pain modulation. Finally, Dr. Schweinhardt will present a new line of research with which she aims at studying the interaction of top-down and bottom-up pain modulation.

Learning in pain: probabilistic inference and (mal)adaptive control

Pain is a major clinical problem affecting 1 in 5 people in the world. There are unresolved questions that urgently require answers to treat pain effectively, a crucial one being how the feeling of pain arises from brain activity. Computational models of pain consider how the brain processes noxious information and allow mapping neural circuits and networks to cognition and behaviour. To date, they have generally have assumed two largely independent processes: perceptual and/or predictive inference, typically modelled as an approximate Bayesian process, and action control, typically modelled as a reinforcement learning process. However, inference and control are intertwined in complex ways, challenging the clarity of this distinction. I will discuss how they may comprise a parallel hierarchical architecture that combines pain inference, information-seeking, and adaptive value-based control. Finally, I will discuss whether and how these learning processes might contribute to chronic pain.

Anterior Cingulate inputs to nucleus accumbens control the social transfer of pain and analgesia

Empathy plays a critical role in social interactions, and many species, including rodents, display evolutionarily conserved behavioral antecedents of empathy. In both humans and rodents, the anterior cingulate cortex (ACC) encodes information about the affective state of others. However, little is known about which downstream targets of the ACC contribute to empathy behaviors. We optimized a protocol for the social transfer of pain behavior in mice and compared the ACC-dependent neural circuitry responsible for this behavior with the neural circuitry required for the social transfer of two related states: analgesia and fear. We found that a 1-hour social interaction between a bystander mouse and a cagemate experiencing inflammatory pain led to congruent mechanical hyperalgesia in the bystander. This social transfer led to activation of neurons in the ACC and several downstream targets, including the nucleus accumbens (NAc), which was revealed by monosynaptic rabies virus tracing to be directly connected to the ACC. Bidirectional manipulation of activity in ACC-to-NAc inputs influenced the acquisition of socially transferred pain. Further, the social transfer of analgesia also depended upon ACC-NAc inputs. By contrast, the social transfer of fear instead required activity in ACC projections to the basolateral amygdala. This shows that mice rapidly adopt the sensory-affective state of a social partner, regardless of the valance of the information (pain, fear, or pain relief). We find that the ACC generates specific and appropriate empathic behavioral responses through distinct downstream targets. More sophisticated understanding of evolutionarily conserved brain mechanisms of empathy will also expedite the development of new therapies for the empathy-related deficits associated with a broad range of neuropsychiatric disorders.

Life of Pain and Pleasure

The ability to experience pain is old in evolutionary terms. It is an experience shared across species. Acute pain is the body’s alarm system, and as such it is a good thing. Pain that persists beyond normal tissue healing time (3-4 months) is defined as chronic – it is the system gone wrong and it is not a good thing. Chronic pain has recently been classified as both a symptom and disease in its own right. It is one of the largest medical health problems worldwide with one in five adults diagnosed with the condition. The brain is key to the experience of pain and pain relief. This is the place where pain emerges as a perception. So, relating specific brain measures using advanced neuroimaging to the change patients describe in their pain perception induced by peripheral or central sensitization (i.e. amplification), psychological or pharmacological mechanisms has tremendous value. Identifying where amplification or attenuation processes occur along the journey from injury to the brain (i.e. peripheral nerves, spinal cord, brainstem and brain) for an individual and relating these neural mechanisms to specific pain experiences, measures of pain relief, persistence of pain states, degree of injury and the subject's underlying genetics, has neuroscientific and potential diagnostic relevance. This is what neuroimaging has afforded – a better understanding and explanation of why someone’s pain is the way it is. We can go ‘behind the scenes’ of the subjective report to find out what key changes and mechanisms make up an individual’s particular pain experience. A key area of development has been pharmacological imaging where objective evidence of drugs reaching the target and working can be obtained. We even now understand the mechanisms of placebo analgesia – a powerful phenomenon known about for millennia. More recently, researchers have been investigating through brain imaging whether there is a pre-disposing vulnerability in brain networks towards developing chronic pain. So, advanced neuroimaging studies can powerfully aid explanation of a subject’s multidimensional pain experience, pain relief (analgesia) and even what makes them vulnerable to developing chronic pain. The application of this goes beyond the clinic and has relevance in courts of law, and other areas of society, such as in veterinary care. Relatively far less work has been directed at understanding what changes in the brain occur during altered states of consciousness induced either endogenously (e.g. sleep) or exogenously (e.g. anaesthesia). However, that situation is changing rapidly. Our recent multimodal neuroimaging work explores how anaesthetic agents produce altered states of consciousness such that perceptual experiences of pain and awareness are degraded. This is bringing us fascinating insights into the complex phenomenon of anaesthesia, consciousness and even the concept of self-hood. These topics will be discussed in my talk alongside my ‘side-story’ of life as a scientist combining academic leadership roles with doing science and raising a family.

Myoclonus dystonia

The BHP Chronic Pain Health Integration Team: Helping those with chronic pain to access the support they need / A bit of a To and Fro with population pain science

Candy will provide an overview of Bristol Health Partners' Chronic Pain Health Integration Team which brings together clinicians, academics, patients and carers to focus on improving the lives of those with chronic pain and supporting those who provide chronic pain services or care. Tony will describe recent and ongoing studies that have been forward and reverse translating pain neuroscience from animal to human including functional imaging in patients, microneurography, industrial partnerships and trials of novel preventative approaches that are benefitting from the people, expertise and facilities available in Bristol and GW4.

HCN2: a key ion channel driving pain, migraine and tinnitus

Plasticity of Pain and Pleasure

What happens when the nervous system fails to adapt? Our perception of the world relies on a nervous system that learns and adapts to sensory information. Based on our experience we can predict what a wooden surface will feel like, that fire is hot, and that a gentle caress from a partner can be soothing. But our sensory experience of the world is not static – warm water can feel like fire on sunburned skin and the gentle brush of our clothes can be excruciating after an injury. In pathological conditions such as chronic pain, changes in nervous system function can cause normally innocuous sensory stimuli to be perceived as aversive or painful long after the initial injury has happened. These changes can sometimes be similar to the formation of a pain ‘memory’ that can modulate and distort our perception of sensory information. Our research program seeks to understand how fundamental processes that govern the formation and maintenance of plastic changes in the nervous system can lead to pathological conditions and how we can reverse engineer these changes to treat chronic conditions.

Deciphering the Dynamics of the Unconscious Brain Under General Anesthesia

General anesthesia is a drug-induced, reversible condition comprised of five behavioral states: unconsciousness, amnesia (loss of memory), antinociception (loss of pain sensation), akinesia (immobility), and hemodynamic stability with control of the stress response. Our work shows that a primary mechanism through which anesthetics create these altered states of arousal is by initiating and maintaining highly structured oscillations. These oscillations impair communication among brain regions. We illustrate this effect by presenting findings from our human studies of general anesthesia using high-density EEG recordings and intracranial recordings. These studies have allowed us to give a detailed characterization of the neurophysiology of loss and recovery of consciousness due to propofol. We show how these dynamics change systematically with different anesthetic classes and with age. As a consequence, we have developed a principled, neuroscience-based paradigm for using the EEG to monitor the brain states of patients receiving general anesthesia. We demonstrate that the state of general anesthesia can be rapidly reversed by activating specific brain circuits. Finally, we demonstrate that the state of general anesthesia can be controlled using closed loop feedback control systems. The success of our research has depended critically on tight coupling of experiments, signal processing research and mathematical modeling.

The precision of prediction errors in the auditory cortex

Awakening: Predicting external stimulation to force transitions between different brain states

Parallel ascending spinal pathways for affective touch and pain

Each day we experience myriad somatosensory stimuli: hugs from loved ones, warm showers, a mosquito bite, and sore muscles after a workout. These tactile, thermal, itch, and nociceptive signals are detected by peripheral sensory neuron terminals distributed throughout our body, propagated into the spinal cord, and then transmitted to the brain through ascending spinal pathways. Primary sensory neurons that detect a wide range of somatosensory stimuli have been identified and characterized. In contrast, very little is known about how peripheral signals are integrated and processed within the spinal cord and conveyed to the brain to generate somatosensory perception and behavioral responses. We tackled this question by developing new mouse genetic tools to define projection neuron (PN) subsets of the anterolateral pathway, a major ascending spinal cord pathway, and combining these new tools with advanced anatomical, physiological, and behavioral approaches. We found that Gpr83+ PNs, a newly identified subset of spinal cord output neurons, and Tacr1+ PNs are largely non-overlapping populations that innervate distinct sets of subnuclei within the lateral parabrachial nucleus (PBNL) of the pons in a zonally segregated manner. In addition, Gpr83+ PNs are highly sensitive to cutaneous mechanical stimuli, receive strong synaptic inputs from primary mechanosensory neurons, and convey tactile information bilaterally to the PBNL in a non-topographically organized manner. Remarkably, Gpr83+ mechanosensory limb of the anterolateral pathway controls behaviors associated with different hedonic values (appetitive or aversive) in a scalable manner. This is the first study to identify a dedicated spinal cord output pathway that conveys affective touch signals to the brain and to define parallel ascending circuit modules that cooperate to convey tactile, thermal and noxious cutaneous signals from the spinal cord to the brain. This study has also revealed exciting new therapeutic opportunities for developing treatments for neurological disorders associated with pain and affective touch.

Diagnostic algorithm for childhood onset chorea

Targeting the Endocannabinoid System for Management of Chemotherapy, HIV and Antiretroviral-Induced Neuropathic Pain

Chemotherapeutic drugs (used for treating cancer), HIV infection and antiretroviral therapy (ART) can independently cause difficult-to-manage painful neuropathy. Paclitaxel, a chemotherapeutic drug, for example is associated with high incidence of peripheral neuropathy, around 71% of the patients of which 27% of these develop neuropathic pain. Use of cannabis or phytocannabinoids has been reported to improve pain measures in patients with neuropathic pain, including painful HIV-associated sensory neuropathy and cancer pain. Phytocannabinoids and endocannabinoids, such as anandamide and 2-arachidonoylglycerol (2-AG), produce their effects via cannabinoid (CB) receptors, which are present both in the periphery and central nervous system. Endocannabinoids are synthesized in an “on demand” fashion and are degraded by various enzymes such as fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MGL). Various studies, including those from our group, suggest that there are changes in gene and protein expression of endocannabinoid molecules during chemotherapy-induced neuropathic pain (CINP), HIV and antiretroviral-induced neuropathic pain. Analysis of endocannabinoid molecule expression in the brain, spinal cord and paw skin using LC-MS/MS show that there is a specific deficiency of the endocannabinoids 2-AG and/or anandamide in the periphery during CINP. Various drugs including endocannabinoids, cannabidiol, inhibitors of FAAH and MGL, CB receptor agonists, desipramine and coadministered indomethacin plus minocycline have been found to either prevent the development and/or attenuate established CINP, HIV and antiretroviral-induced neuropathic pain in a CB receptor-dependent manner. The results available suggest that targeting the endocannabinoid system for prevention and treatment of CINP, HIV-associated neuropathic pain and antiretroviral-induced neuropathic pain is a plausible therapeutic option.

Neuro-immune interactions in pain and host defense

The Chiu laboratory focuses on neuro-immune interactions in pain, itch, and tissue inflammation. Dr. Chiu’s research has uncovered molecular interactions between the nervous system, the immune system and microbes that modulates host defense. He has found that sensory neurons can directly detect bacterial pathogens and their toxins to produce pain. Neurons in turn release neuropeptides that modulate immune cells in host defense. These interactions occur at major tissue barriers in the body including the gut, skin and lungs. In this talk, he will discuss these major neuro-immune interactions and how understanding them could lead to novel approaches to treat pain or inflammation.

The thalamus that speaks to the cortex: spontaneous activity in the developing brain

Our research team runs several related projects studying the cellular and molecular mechanisms involved in the development of axonal connections in the brain. In particular, our aim is to uncover the principles underlying thalamocortical axonal wiring, maintenance and ultimately the rewiring of connections, through an integrated and innovative experimental programme. The development of the thalamocortical wiring requires a precise topographical sorting of its connections. Each thalamic nucleus receives specific sensory information from the environment and projects topographically to its corresponding cortical. A second level of organization is achieved within each area, where thalamocortical connections display an intra-areal topographical organization, allowing the generation of accurate spatial representations within each cortical area. Therefore, the level of organization and specificity of the thalamocortical projections is much more complex than other projection systems in the CNS. The central hypothesis of our laboratory is that thalamocortical input influences and maintains the functional architecture of the sensory cortices. We also believe that rewiring and plasticity events can be triggered by activity-dependent mechanisms in the thalamus. Three major questions are been focused in the laboratory: i) the role of spontaneous patterns of activity in thalamocortical wiring and cortical development, ii) the role of the thalamus and its connectivity in the neuroplastic cortical changes following sensory deprivation, and iii) reprogramming thalamic cells for sensory circuit restoration. Within these projects we are using several experimental programmes, these include: optical imaging, manipulation of gene expression in vivo, cell and molecular biology, biochemistry, cell culture, sensory deprivation paradigms and electrophysiology. The results derived from our investigations will contribute to our understating of how reprogramming of cortical wiring takes place following brain damage and how cortical structure is maintained.

Social Exclusion Modifies the Behavioral Response and the Insular Representation of Physical Pain

COSYNE 2025

Altered parabrachial nucleus nociceptive processing may underlie central neuropathic pain in Parkinson’s disease

Altered ventral tegmental dopaminergic activity in chronic pain induced-depression

Antiallodynia and antihyperalgesia effects of Cerium oxide nanoparticles in treatment of chronic neuropathic pain in rats

Basolateral amygdala input to anterior cingulate cortex mediates pain-avoidance behaviors

Betaine Ameliorates Provoked and Ongoing Pain in Nerve-Injured Rats by regulating KIF17 mediated NR2B Activation and Neuroinflammation

Brainstem somatostatin-expressing cells control the emotional regulation of pain behavior

Cannabinoids effects on neural correlates of the pain modulation system in fibromyalgia syndrome

Centrally expressed Cav3.2 T-type calcium channel is critical for the initiation and maintenance of neuropathic pain

Circadian regulation of trigeminal pain circuits

Contribution of peripheral neuronal activity to spinal microglial reactivity in chronic pain

Daily record with portable EEG in SCI patients with neuropathic pain

Descending serotonergic facilitation contribution to DNIC analgesia in prolonged joint inflammatory pain

Downregulation of parvalbumin protein in dorsal horn interneurons elicits mechanical pain hypersensitivity

Dual PI3Kδ/γ inhibitor Duvelisib prevents development of chemotherapy induced neuropathic pain

The efficacy of Non-invasive Brain Stimulation techniques on Chronic Primary Pain disorders: a systematic review and meta-analysis

Empathic reaction for pain in high sensory processing sensitivity persons (HSP) – EEG study

Encoding of the unpleasantness of pain in cortico-striatal neurons of the Anterior Cingulate Cortex

Evaluation of TACAN as a new target for treating osteoarthritis pain

Examining calpain activity in Spinocerebellar Ataxia-3 through use of a novel fibre photometry methodology

Exploring neurophysiological and psychological pain biomarkers with machine learning

Exploring Pain and Nociception in a Valproate-induced mouse model of Autism Spectrum Disorder

Functional alterations of intrinsic networks at various stages of neuropathic pain and comorbidity development

Gene expression of the oxytocin receptor, c-Fos, and CGRP in the trigeminal ganglion in an orofacial pain model

AAV gene therapy delivering recombinant dimeric peptides targeting PICK1 fully relieve chronic neuropathic pain

The genetic downregulation of calpain 1 reverts spinal hyperexcitability in a neonate mouse model of complete spinal cord injury

Glial activation contributes to increased sensitivity of spinal TRPV1 receptors in paclitaxel induced neuropathic pain

Green light exposure elicits anti-inflammation, endogenous opioid release and lessens synaptic potentiation to relieve post-surgical pain in rats

The heterogeneity of synaptic NMDA receptor responses within individual lamina I pain processing neurons is conserved across sex and species

Identifying the molecular mechanism for the pain caused by lionfish venom

Identifying novel mediators of tumor-nerve interactions in cancer pain

Impact of long-term and short-term exposure of environmental enrichment on pain-related depression in adolescent mice

Impaired pain tolerance in aging: What role for local skin blood flow?

Inflammation triggers homeostatic processes in the trigeminal pain pathway

Inflammatory pain induces microglial deregulation within the mesocorticolimbic system: impact on Mu-Opioid Receptor internalisation and activation

MIF inhibitor (ISO-1) reduces pain hypersensitivity in a model of peripheral neuropathy

Integrative analysis of descending pain modulation pathways

Investigating the Effects of Flotation Restricted Environment Stimulation Therapy on Neural Networks in Chronic Pain Patients via Functional Magnetic Resonance Imaging

Involvement of 5-HT descending pathway in pain in a mouse model of Parkinsonism

Geometrical Features of Neural Trajectory as a Computational Motif for the Cue-Stimulus Integration of Pain

COSYNE 2023