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Open AccessJournal ArticleDOI

Filtering the reality: Functional dissociation of lateral and medial pain systems during sleep in humans

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TLDR
While the lateral operculo‐insular system subserving sensory analysis of somatic stimuli remained active during paradoxical‐REM sleep, mid‐anterior cingulate processes related to orienting and avoidance behavior were suppressed, explaining why nociceptive stimuli can be either neglected or incorporated into dreams without awakening the subject.
Abstract
Behavioral reactions to sensory stimuli during sleep are scarce despite preservation of sizeable cortical responses. To further understand such dissociation, we recorded intracortical field potentials to painful laser pulses in humans during waking and all-night sleep. Recordings were obtained from the three cortical structures receiving 95% of the spinothalamic cortical input in primates, namely the parietal operculum, posterior insula, and mid-anterior cingulate cortex. The dynamics of responses during sleep differed among cortical sites. In sleep Stage 2, evoked potential amplitudes were similarly attenuated relative to waking in all three cortical regions. During paradoxical, or rapid eye movements (REM), sleep, opercular and insular potentials remained stable in comparison with Stage 2, whereas the responses from mid-anterior cingulate abated drastically, and decreasing below background noise in half of the subjects. Thus, while the lateral operculo-insular system subserving sensory analysis of somatic stimuli remained active during paradoxical-REM sleep, mid-anterior cingulate processes related to orienting and avoidance behavior were suppressed. Dissociation between sensory and orienting-motor networks might explain why nociceptive stimuli can be either neglected or incorporated into dreams without awakening the subject.

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Citations
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Journal ArticleDOI

Pain matrices and neuropathic pain matrices: A review

TL;DR: The pain matrix is conceptualised here as a fluid system composed of several interacting networks, including posterior parietal, prefrontal and anterior insular areas, which ensures the bodily specificity of pain and is the only one whose destruction entails selective pain deficits.
Journal ArticleDOI

Pain and consciousness.

TL;DR: It is contended that even in unconscious subjects, repeated limbic and vegetative activation by painful stimuli via spino‐amygdalar pathways can generate implicit memory traces and stimulus‐response abnormal sequences, possibly contributing to long‐standing anxiety or hyperalgesic syndromes in patients surviving coma.
Journal ArticleDOI

Heterogeneity of arousals in human sleep: A stereo-electroencephalographic study

TL;DR: The results suggest that the human cortex does not shift from sleep to wake in an abrupt binary way, and stereotyped arousals at the thalamic level seem to be associated with different patterns of cortical arousals due to various regulation factors.
Journal ArticleDOI

Concussion/mild traumatic brain injury-related chronic pain in males and females: A diagnostic modelling study.

TL;DR: Examining the multidimensional construct of pain in concussion/mTBI through a sex lens garners new directions for future longitudinal research on the pain mechanisms involved in postconcussion syndrome.
Journal ArticleDOI

Pain and sleep: from reaction to action.

TL;DR: This patient exhibited finger lifts in response to stimulations delivered during paradoxical (REM) sleep, suggesting that during PS, not only the processing of sensory inputs but also the capacity for the sleeper to intentionally indicate his perception could be preserved under particular circumstances is suggested.
References
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Book ChapterDOI

Chapter 10 Brainstem and thalamic relays

TL;DR: The chapter reviews that the major recipient of ascending nociceptive information from the spinal cord and trigeminal nucleus is the thalamus, which processes and relays this information to several cortical sites.
Journal ArticleDOI

Laser evoked potentials and carbamazepine in epileptic patients.

TL;DR: The lack of a CBZ-induced dampening of LEPs suggests that small-f fibre pathways, compared to large-fibre, might be less susceptible to AED's toxic effect.
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