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Neural Mechanisms of Offset Analgesia
1Department of Anesthesiology and Pain Clinic, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo City, Tokyo, Japan. jkurata@plum.plala.or.jp.
Advances in Experimental Medicine and Biology
|October 12, 2018
Summary
Offset analgesia, a measure of pain modulation, is reduced in chronic pain patients. This suggests that impaired pain modulatory and reward systems contribute to the chronification of pain.
Area of Science:
- Neuroscience
- Pain Research
- Analgesia Mechanisms
Background:
- Offset analgesia is a phenomenon where pain sensation decreases disproportionately with a slight reduction in thermal pain stimulus.
- This effect is attributed to endogenous analgesic mechanisms.
- Previous studies indicated attenuated offset analgesia in neuropathic pain patients.
Purpose of the Study:
- To investigate offset analgesia in a broader population of chronic pain patients.
- To explore the neural correlates of offset analgesia using functional magnetic resonance imaging (fMRI).
- To determine the role of descending pain modulatory and reward systems in pain chronification.
Main Methods:
- Assessed offset analgesia in patients with chronic pain.
- Utilized functional magnetic resonance imaging (fMRI) to observe brain activity.
- Analyzed blood oxygenation level-dependent (BOLD) signals in specific brain regions.
Main Results:
- Offset analgesia was found to be attenuated in a heterogeneous group of chronic pain patients.
- fMRI revealed negative BOLD signals in areas associated with descending pain modulation and reward systems during offset analgesia.
- These findings suggest a link between impaired endogenous analgesia and brain circuitry involved in pain and reward.
Conclusions:
- Attenuation of offset analgesia is present in diverse chronic pain populations.
- Dysfunction in descending pain modulatory and reward systems may underlie the neural mechanisms of pain chronification.
- Offset analgesia serves as a potential biomarker for evaluating endogenous analgesic capacity and its relation to chronic pain states.
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