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Stimulating the human midbrain to reveal the link between pain and blood pressure

Stimulating the human midbrain to reveal the link between pain and blood pressure
Stimulating the human midbrain to reveal the link between pain and blood pressure
The periaqueductal grey area (PAG) in the midbrain is an important area for both cardiovascular control and modulation of pain. However, the precise relationship between pain and blood pressure is unknown. We prospectively studied 16 patients undergoing deep brain stimulation of the rostral PAG for chronic pain. Pre-operatively, post-operatively, and at 1 year, pain scores were assessed using both visual analogue scores and the McGill Pain Questionnaire. Patients were tested post-operatively to determine whether electrical stimulation of the PAG would modulate blood pressure. We found that the degree of analgesia induced by deep brain stimulation of the rostral PAG in man is related to the magnitude of reduction in arterial blood pressure. We found that this relationship is linear and is related to reduced activity of the sympathetic nervous system. Thus stimulation of the PAG may partly control pain by reducing sympathetic activity as predicted by William James over a century ago.
pain, deep brain stimulation, blood pressure, mcgill pain questionnaire, visual analogue score, periaqueductal grey, pag
0304-3959
349-359
Green, Alexander L.
099ecb5e-2d66-41f3-9d1b-dc723a9bb01f
Wang, Shouyan
fa12f1bf-cac9-4118-abdd-9d52f235b05c
Owen, Sarah
7fa5f850-4f6a-40a0-aabf-1793b941ae42
Xie, Kangning
1a33878c-bc51-4f8f-b91e-4eabf5d2fe50
Bittar, Richard G.
117cee5e-c896-457c-92ab-6b2135e9b7fc
Stein, John F.
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Paterson, David J.
cd51301d-9cfe-42de-81e1-aac2bfe0d5fd
Aziz, Tipu Z.
84768d79-fc87-4c3e-8955-d2e72ca5e6a0
Green, Alexander L.
099ecb5e-2d66-41f3-9d1b-dc723a9bb01f
Wang, Shouyan
fa12f1bf-cac9-4118-abdd-9d52f235b05c
Owen, Sarah
7fa5f850-4f6a-40a0-aabf-1793b941ae42
Xie, Kangning
1a33878c-bc51-4f8f-b91e-4eabf5d2fe50
Bittar, Richard G.
117cee5e-c896-457c-92ab-6b2135e9b7fc
Stein, John F.
341274f8-3eee-4614-958c-635e0b498d78
Paterson, David J.
cd51301d-9cfe-42de-81e1-aac2bfe0d5fd
Aziz, Tipu Z.
84768d79-fc87-4c3e-8955-d2e72ca5e6a0

Green, Alexander L., Wang, Shouyan, Owen, Sarah, Xie, Kangning, Bittar, Richard G., Stein, John F., Paterson, David J. and Aziz, Tipu Z. (2006) Stimulating the human midbrain to reveal the link between pain and blood pressure. Pain, 124 (3), 349-359. (doi:10.1016/j.pain.2006.05.005).

Record type: Article

Abstract

The periaqueductal grey area (PAG) in the midbrain is an important area for both cardiovascular control and modulation of pain. However, the precise relationship between pain and blood pressure is unknown. We prospectively studied 16 patients undergoing deep brain stimulation of the rostral PAG for chronic pain. Pre-operatively, post-operatively, and at 1 year, pain scores were assessed using both visual analogue scores and the McGill Pain Questionnaire. Patients were tested post-operatively to determine whether electrical stimulation of the PAG would modulate blood pressure. We found that the degree of analgesia induced by deep brain stimulation of the rostral PAG in man is related to the magnitude of reduction in arterial blood pressure. We found that this relationship is linear and is related to reduced activity of the sympathetic nervous system. Thus stimulation of the PAG may partly control pain by reducing sympathetic activity as predicted by William James over a century ago.

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More information

Published date: October 2006
Keywords: pain, deep brain stimulation, blood pressure, mcgill pain questionnaire, visual analogue score, periaqueductal grey, pag
Organisations: Human Sciences Group

Identifiers

Local EPrints ID: 46602
URI: http://eprints.soton.ac.uk/id/eprint/46602
ISSN: 0304-3959
PURE UUID: f2a6a396-578e-4af2-b95b-7a9e8bc90fca

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Date deposited: 12 Jul 2007
Last modified: 15 Mar 2024 09:25

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Contributors

Author: Alexander L. Green
Author: Shouyan Wang
Author: Sarah Owen
Author: Kangning Xie
Author: Richard G. Bittar
Author: John F. Stein
Author: David J. Paterson
Author: Tipu Z. Aziz

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