title: Pain-related autonomic response is modulated by the medial prefrontal cortex: An ECG-fMRI study in men.
abstract: BACKGROUND
  Our goal was to identify brain structures responsible for pain-related autonomic changes by the correlation of simultaneously acquired functional magnetic resonance imaging (fMRI) and electrocardiogram (ECG) data.
  
  
  METHODS
  Eighteen healthy men (age: 22.89 ± 1.96) were involved. Painful sensation was evoked by heat. Simultaneously recorded brain fMRI and ECG data during pain were compared to data acquired during a non-painful heat sensation. From the ECG data, time- and frequency domain parameters of heart rate variability (HRV) were extracted.
  
  
  RESULTS
  We found that: (1) among the common elements of both pain network and central autonomic network (CAN) only the medial prefrontal frontal cortex (MPFC) showed significant correlation with HRV; (2) the parasympathetic response to the painful stimuli showed a positive, while the sympathetic response a negative association with pain related BOLD-signal change observed in MPFC; (3) time domain parameters of HRV were negatively associated with MPFC activation.
  
  
  CONCLUSIONS
  The novelty of our study-compared to previous ECG-fMRI studies-is that we used pain as stimulus and investigated both frequency- and time-domain parameters of HRV. Compared to other stimuli used in earlier studies to activate the CAN, pain sensation can be standardized easier and might allow us to better understand the functional organization of CAN. The results of the current ECG-fMRI study may have direct clinical relevance in understanding the pathomechanisms of several clinical conditions.
  
  
  CONCLUSIONS
  There are some simultaneous ECG-fMRI and ECG-Positron Emission Tomography (PET) studies, but limited information is available about the pain-related brain function-HRV relations. The novelty of our study is that we used pain as stimulus to activate the central autonomic network and investigated both frequency- and time-domain parameters of HRV.
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: Gabor
authors.initials: G
authors.lastname: Perlaki
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary. Electronic address: gergo.orsi@gmail.com.
authors.forename: Gergely
authors.initials: G
authors.lastname: Orsi
authors.affiliation: MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Department of Neurosurgery, University of Pécs, Pécs, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Schwarcz
authors.affiliation: Pécs Diagnostic Centre, Pécs, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Bodi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Eniko
authors.initials: E
authors.lastname: Plozer
authors.affiliation: Pécs Diagnostic Centre, Pécs, Hungary.
authors.forename: Kristof
authors.initials: K
authors.lastname: Biczo
authors.affiliation: Pécs Diagnostic Centre, Pécs, Hungary.
authors.forename: Mihaly
authors.initials: M
authors.lastname: Aradi
authors.affiliation: MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Department of Neurosurgery, University of Pécs, Pécs, Hungary.
authors.forename: Tamas
authors.initials: T
authors.lastname: Doczi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Samuel
authors.initials: S
authors.lastname: Komoly
authors.affiliation: Heart Institute, University of Pécs, Pécs, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hejjel
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kovacs
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Janszky
mesh_terms: D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006358:Hot Temperature; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D017397:Prefrontal Cortex / Q000503:physiopathology*; D055815:Young Adult
keywords: Central autonomic nervous system; Heart rate variability; Magnetic resonance imaging; Medial prefrontal cortex; Pain; fMRI