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Mechanisms of individual differences in heterotopic noxious analgesia (DNIC), an fMRI study


Pain responses can be suppressed by heterotopic continuous noxious conditioning, e.g. continuous noxious cold stimulation.


These diffuse noxious inhibitory controls (DNIC) may be abnormal in migraine (Sandrini et al 2006). DNIC effects are modulated by a number of prefrontal cortical areas (Piché et al 2009) that could be dysfunctioning in migraine interictally.


We examined in healthy volunteers blood oxygenation level dependent (BOLD) responses in prefrontal cortex to repeated continuous noxious cold stimulation. The relationships between those responses and degree of inhibition of laser-induced pain during heterotopic cold stimulation were analyzed.


Our results show that cold-induced BOLD response in anterior cingulate, orbitofrontal and lateral prefrontal cortices predict cold-induced heterotopic analgesia and attenuation of cerebral BOLD responses to laser stimulation. Prefrontal responses to the onset of cold stimulation were strongly related to the subsequent DNIC effect.


We conclude that early responses to noxious conditioning are important for prediction of the analgesic DNIC effect. We hypothesize that this predictive effect of frontal cortices may be abnormal in chronic migraine.


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Vigàno, A., Bogdanov, V., Noirhomme, Q. et al. Mechanisms of individual differences in heterotopic noxious analgesia (DNIC), an fMRI study. J Headache Pain 14, P94 (2013).

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  • Migraine
  • Prefrontal Cortex
  • Frontal Cortex
  • fMRI Study
  • Chronic Migraine