Forebrain In Processing/modulating Pain

Front 1

explain spinothalamic (ascending)

Back 1

second order neurons in dorsal horn crosses contralateral side then goes up to thalamus where it connects to 3rd order neuron .

Front 2

from thalamus 3rd order neurons

Back 2

go to ACC,insula,S1

Front 3

antero-lateral quadrant cordotomy

Back 3

gives pain relief only used in terminally ill cancer also pain returns after surgery
destroys part of spinal cord where spinothalamic tract ascends to thalamus

Front 4

other ascending nociceptive paths (3)

Back 4

spinoreticulothalamic,spinoparabrachial,parallel pain pathways

Front 5

spinoreticulothalamic

Back 5

synapses first in reticular part then goes to thalamus

Front 6

spinoparabrachial

Back 6

goes to parabrachial nucleus in brainstem then to amygdala or hypothalamus

Front 7

parallel pain pathways

Back 7

rise from subpopulation of primary afferent nociceptors
one transmits from deeper lamina (frm non peptide to lamina 2->#5) to basal ganglia

Front 8

pain processing widely distributed because

Back 8

many aspects to pain

Front 9

dimensions of pain (3)

Back 9

sensory discriminative (location,intensity,quality) ,affective-motivational(unpleasantness is affective and what will i do is motivational) ,cognitive-evaluation (meaning of pain)

Front 10

S1 neurons suited for _________and why(2)

Back 10

pain localization; small receptive fields and somatotopic representation

Front 11

the nociceptive neurons in thalamus (3)

Back 11

lateral,medial,posterior

Front 12

S1 gets input from

Back 12

lateral thalamus nociceptive neurons (VP) have small receptive fields

Front 13

lateral thalamus

Back 13

for sensory discriminative and transmits somatisization

Front 14

pain unpleasantness is in the (2)

Back 14

ACC,medial thalamus

Front 15

you can use ____to modulate affective dimension

Back 15

hypnosis

Front 16

affective dimension goes hand and hand with

Back 16

pain intensity, more pain the more unpleassentness

Front 17

can you separate the affective and intensity

Back 17

yes

Front 18

mood and affects on affective dimension

Back 18

bad mood caused more activity in ACC/medial thalamus

Front 19

medial thalamus

Back 19

for affective dimension,projects into ACC and has large receptive fields (not good for localizing)

Front 20

_____changes the overall meaning of stimulus

Back 20

affective dimension(doesnt modulate pain)

Front 21

cingulotomy

Back 21

for severe conditions not stroke patient more for OCD patients ie intractable pain. Doesnt decrease pain what it does is decrease bothersome/unpleasantness of pain. pain intensity still same

Front 22

penfield said pain_____

Back 22

does not originate from cortex,he stimulated all parts of cortex except insula (too deep)

Front 23

insula is the _____

Back 23

only part of cortex that is electrically stimulated 11/100 times would cause pain

Front 24

problem with lesion studies

Back 24

brain has high plasticity

Front 25

in epileptics to remove epileptic focus and avoid damage use

Back 25

intracortical electrodes

Front 26

the further posterior you are in the insula the ____amplitude you need

Back 26

lower

Front 27

insula

Back 27

internal representation of the physiological status of body

Front 28

input to insula via

Back 28

lamina 1 (the relay site for nociceptors)

Front 29

lamina 1(3points)

Back 29

tells insula about the physiological/physical state of the body. It receives inputs from nociceptors,but also other fibers like C fibers,it has specificity

Front 30

pain is a _____sensation

Back 30

homeostatic (need to do something about it like itch)

Front 31

dorsal horn collects branches of descending pathway also

Back 31

true

Front 32

descending pain pathway facilitates and inhibits pain what are transmitters for each

Back 32

facilitation: serotonin,CCK
inhibition:serotonin,opioids,noradrenaline,GABA

Front 33

whether serotonin facilitates or inhibits depends on

Back 33

the receptor on which its acting

Front 34

facilitation refers to

Back 34

the transmission from primary neuron to secondary

Front 35

attention can lead to and distraction to

Back 35

more pain;less pain

Front 36

not attending leads to (2)

Back 36

decreased pain intensity and unpleasantness (not as much though)

Front 37

S1 activation diminishes when

Back 37

don't attend ie distracted

Front 38

_________plays role in pain modulated by attentional state

Back 38

superior parietal cortex ->top down superior parietal synchronizes spikes in activity in a target population of neurons representing the attended object,this drives more effective representation

Front 39

how does distraction give less pain

Back 39

more inhibitory signals sent down and therefore less stuff going up to the brain to be interpreted

Front 40

emotions ____

Back 40

modulate pain

Front 41

negative emotions lead to

Back 41

more pain

Front 42

pain modulation by negative emotions

Back 42

regions in frontal cortex (lateral:punishment,medial:reward) talk to the PAG(important for modulation) goes to ACC then send signals down to spine to increase pain transmission therefore more comes up
*(positive is the same except affects medial part of frontal)

Front 43

endogenous ___

Back 43

modulates pain

Front 44

pain inhibition by endogenous for (4)

Back 44

-acute stress
-positive emotions
-distraction (cognition)
-competitive motivation

Front 45

pain facilitation by endogenous for

Back 45

adaptive:after injury need to promote rest and guard
maladaptive (no positive purpose) : negative emotions,chronic stress,cognition

Front 46

pain and nociception different

Back 46

true

Front 47

nociception

Back 47

can lead to pain but how much pain depends on many other factors:physical,cognitive,emotional factors

Front 48

fMRI cannot directly(but indirectly) measure ____

Back 48

neuronal activity

Front 49

fMRI measures

Back 49

neurons when activated state:CBF increases,oxy-Hb increases,deoxy-HB increases,oxy-hb/deoxyHb increases
CBF=cerebral blood flow

Front 50

deoxy Hb is_____ leads to ___

Back 50

paramagnetic;increase oxyHb/deoxy Hb which increases MR signal

Front 51

fMRI's bold contrast is

Back 51

blood oxygenation-level dependent

Front 52

PET=

Back 52

positron emission tomography.

Front 53

pros/cons of PET

Back 53

cons:expensive,need to use cyclo drugs (make radioactive materials)
pros:finds neurotransmitters/receptors

Front 54

less tracer bound for receptor availability or competitive binding site studies

Back 54

smaller signal,inference made is that either fewer receptors available or theres endogenous release