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Neural Mechanisms of Offset Analgesia

  • Jiro Kurata
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1099)

Abstract

One feels a disproportionately large decrease of pain sensation on a slight decrease of thermal pain stimulus. Such phenomenon is termed offset analgesia and considered mediated by endogenous analgesic mechanisms. Offset analgesia was found attenuated in patients with neuropathic pain. We further found that such attenuation occurred in a more heterogeneous population of patients with chronic pain. By functional magnetic resonance imaging, we also found negative blood oxygenation level-dependent signals at those areas concerned with descending pain modulatory and reward systems during offset analgesia in the same cohort of patients. We propose that dysfunction of those systems, as revealed by attenuation of offset analgesia, might well be part of neural mechanisms of pain chronification.

Keywords

Offset analgesia Chronic pain Functional magnetic resonance imaging Descending pain modulatory system Reward system 

Notes

Acknowledgment

This work was supported by the Grants-in-Aid for Scientific Research (JP26460695). I thank Dr. Shigehito Sawamura for letting us use PATHWAY; and my co-workers, Drs. Koshi Makita, Hiroyuki Kobinata, Eri Ikeda, Shuo Zhang, Tianjiao Li, and Takashi Ota in accomplishing a series of studies presented here.

References

  1. 1.
    Grill JD, Coghill RC (2002) Transient analgesia evoked by noxious stimulus offset. J Neurophysiol 87:2205–2208CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Ligato D, Petersen KK, Morch CD, Arendt-Nielsen L (2018) Offset analgesia: the role of peripheral and central mechanisms. Eur J Pain 22:142–149CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Yelle MD, Oshiro Y, Kraft RA, Coghill RC (2009) Temporal filtering of nociceptive information by dynamic activation of endogenous pain modulatory systems. J Neurosci 29:10264–10271CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Niesters M, Hoitsma E, Sarton E, Aarts L, Dahan A (2011) Offset analgesia in neuropathic pain patients and effect of treatment with morphine and ketamine. Anesthesiology 115:1063–1071CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Kobinata H, Ikeda E, Zhang S, Li T, Makita K, Kurata J (2017) Disrupted offset analgesia distinguishes patients with chronic pain from healthy controls. Pain 158:1951–1959CrossRefPubMedCentralGoogle Scholar
  6. 6.
    Zhang S, Li T, Kobinata H, Ikeda E, Ota T, Kurata J (2018) Attenuation of offset analgesia is associated with suppression of descending pain modulatory and reward systems in patients with chronic pain. Mol Pain 14:1–15. DOI: 10.1177/1744806918767512CrossRefGoogle Scholar
  7. 7.
    Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, Gitelman DR (2004) Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci 24:10410–10415CrossRefPubMedCentralGoogle Scholar
  8. 8.
    Baliki MN, Geha PY, Fields HL, Apkarian AV (2010) Predicting value of pain and analgesia: nucleus accumbens response to noxious stimuli changes in the presence of chronic pain. Neuron 66:149–160CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain ClinicTokyo Medical and Dental University Hospital of MedicineBunkyo CityJapan

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