title: Central circuitry responsible for the divergent sympathetic responses to tonic muscle pain in humans.
abstract: Experimentally induced tonic muscle pain evokes divergent muscle vasoconstrictor responses, with some individuals exhibiting a sustained increase in muscle sympathetic nerve activity (MSNA), and others a sustained decrease. These patterns cannot be predicted from an individual's baseline physiological or psychological measures. The aim of this study was to investigate whether the different muscle sympathetic responses to tonic muscle pain were associated with differential changes in regional brain activity. Functional magnetic resonance imaging (fMRI) of the brain was performed concurrently with microelectrode recording of MSNA from the peroneal nerve during a 40-min infusion of hypertonic saline into the ipsilateral tibialis anterior muscle. MSNA increased in 26 and decreased in 11 of 37 subjects during tonic muscle pain. Within the prefrontal and cingulate cortices, precuneus, nucleus accumbens, caudate nucleus, and dorsomedial hypothalamus, blood oxygen level dependent (BOLD) signal intensity increased in the increasing-MSNA group and remained at baseline or decreased in the decreasing-MSNA group. Similar responses occurred in the dorsolateral pons and in the region of the rostral ventrolateral medulla. By contrast, within the region of the dorsolateral periaqueductal gray (dlPAG) signal intensity initially increased in both groups but returned to baseline levels only in the increasing-MSNA group. These results suggest that the divergent sympathetic responses to muscle pain result from activation of a neural pathway that includes the dlPAG, an area thought to be responsible for the behavioral and cardiovascular responses to psychological rather than physical stressors. Hum Brain Mapp 38:869-881, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: School of Medicine, Western Sydney University, Sydney, Australia.
authors.forename: Sophie
authors.initials: S
authors.lastname: Kobuch
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|School of Health Sciences, RMIT University, Melbourne, VIC, Australia.
authors.forename: Azharuddin
authors.initials: A
authors.lastname: Fazalbhoy
authors.affiliation: School of Medicine, Western Sydney University, Sydney, Australia.|Neuroscience Research Australia, Sydney, Australia.
authors.forename: Rachael
authors.initials: R
authors.lastname: Brown
authors.affiliation: Discipline of Anatomy and Histology, University of Sydney, Sydney, Australia.
authors.forename: Luke A
authors.initials: LA
authors.lastname: Henderson
authors.affiliation: School of Medicine, Western Sydney University, Sydney, Australia.|Neuroscience Research Australia, Sydney, Australia.
authors.forename: Vaughan G
authors.initials: VG
authors.lastname: Macefield
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D063806:Myalgia / Q000473:pathology* / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D010812:Physical Stimulation / Q000009:adverse effects; D011601:Psychophysics; D012119:Respiration; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: functional magnetic resonance imaging; muscle pain; muscle sympathetic nerve activity