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    A brain-based pain facilitation mechanism contributes to painful diabetic polyneuropathy.

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    Authors
    Segerdahl, Andrew R.
    Themistocleous, Andreas C.
    Fido, Dean cc
    Bennett, David L.
    Tracey, Irene
    Affiliation
    University of Oxford
    Issue Date
    2018-01-15
    
    Metadata
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    Abstract
    The descending pain modulatory system represents one of the oldest and most fundamentally important neurophysiological mechanisms relevant to pain. Extensive work in animals and humans has shown how a functional imbalance between the facilitatory and inhibitory components is linked to exacerbation and maintenance of persistent pain states. Forward translation of these findings into clinical populations is needed to verify the relevance of this imbalance. Diabetic polyneuropathy is one of the most common causes of chronic neuropathic pain; however, the reason why ∼25–30% of patients with diabetes develop pain is not known. The current study used a multimodal clinical neuroimaging approach to interrogate whether the sensory phenotype of painful diabetic polyneuropathy involves altered function of the ventrolateral periaqueductal grey—a key node of the descending pain modulatory system. We found that ventrolateral periaqueductal grey functional connectivity is altered in patients suffering from painful diabetic polyneuropathy; the magnitude of which is correlated to their spontaneous and allodynic pain as well as the magnitude of the cortical response elicited by an experimental tonic heat paradigm. We posit that ventrolateral periaqueductal grey-mediated descending pain modulatory system dysfunction may reflect a brain-based pain facilitation mechanism contributing to painful diabetic polyneuropathy.
    Citation
    Segerdahl, A. R. et al (2018) 'A brain-based pain facilitation mechanism contributes to painful diabetic polyneuropathy', Brain, 141 (2):357 .
    Publisher
    Oxford Academic
    Journal
    Brain
    URI
    http://hdl.handle.net/10545/622466
    DOI
    10.1093/brain/awx337
    Additional Links
    https://academic.oup.com/brain/article/141/2/357/4810409
    Type
    Article
    Language
    en
    ISSN
    00068950
    EISSN
    14602156
    ae974a485f413a2113503eed53cd6c53
    10.1093/brain/awx337
    Scopus Count
    Collections
    University of Derby Online (UDOL)

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