Examinando por Autor "Kim, Jieun"

Mostrando 1 - 6 de 6
  • Publicación
    Acceso abierto
    Brain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea
    (2016-02) García, Ronald G.; Kim, Jieun; Sheehan, James D.; Beissner, Florian; Bianchi, Anna M.; Cerutti, Sergio; Kuo, Braden; Barbieri, Riccardo; Napadow, Vitaly; Sclocco, Roberta
    While autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects’ ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anticorrelated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target.
  • Publicación
    Acceso abierto
    Cyclic Vomiting Syndrome is characterized by altered functional brain connectivity of the insular cortex : A cross-comparison with migraine and healthy adults
    (2018-06) Ellingsen, Dan-Mikael; García, Ronald G.; Lee, Jeungchan; Lin, Richard L.; Kim, Jieun; Thurler, Andrea H; Castel, Shahar; Dimisko, Laurie; Rosen, Bruce R.; Hadjikhani, Nouchine; Kuo, Braden; Napadow, Vitaly
    Cyclic Vomiting Syndrome (CVS) has been linked to episodic migraine, yet little is known about the precise brain-based mechanisms underpinning CVS, and whether these associated conditions share similar pathophysiology. We investigated the functional integrity of salience (SLN) and sensorimotor (SMN) intrinsic connectivity networks in CVS, migraine and healthy controls using brain functional Magnetic Resonance Imaging. CVS, relative to both migraine and controls, showed increased SLN connectivity to middle/posterior insula, a key brain region for nausea and viscerosensory processing. In contrast, this same region showed diminished SMN connectivity in both CVS and migraine. These results highlight both unique and potentially shared pathophysiology between these conditions, and suggest a potential target for therapeutics in future studies.
  • Publicación
    Acceso abierto
    Fibromyalgia is characterized by altered frontal and cerebellar structural covariance brain networks
    (2015-03-04) Kim, Hyungjun; Kim, Jieun; Loggia, Marco L.; Cahalan, Christine M.; García, Ronald G.; Vangel, Mark G.; Wasan, Ajay D.; Edwards, Robert R.; Napadow, Vitaly
    Altered brain morphometry has been widely acknowledged in chronic pain, and recent studies have implicated altered network dynamics, as opposed to properties of individual brain regions, in supporting persistent pain. Structural covariance analysis determines the inter-regional association in morphological metrics, such as gray matter volume, and such structural associations may be altered in chronic pain. In this study, voxel-based morphometry structural covariance networks were compared between fibromyalgia patients (N=42) and age- and sex-matched pain-free adults (N=63).We investigated network topology using spectral partitioning,which can delineate local network submodules with consistent structural covariance. We also explored white matter connectivity between regions comprising these submodules and evaluated the association between probabilistic white matter tractography and pain-relevant clinical metrics. Our structural covariance network analysis noted more connections within the cerebellum for fibromyalgia patients, and more connections in the frontal lobe for healthy controls. For fibromyalgia patients, spectral partitioning identified a distinct submodule with cerebellar connections to medial prefrontal and temporal and right inferior parietal lobes, whose gray matter volume was associated with the severity of depression in these patients. Volume for a submodule encompassing lateral orbitofrontal, inferior frontal, postcentral, lateral temporal, and insular cortices was correlated with evoked pain sensitivity. Additionally, the number ofwhitematter fibers between specific submodule regionswas also associated with measures of evoked pain sensitivity and clinical pain interference. Hence, altered gray and white matter morphometry in cerebellar and frontal cortical regions may contribute to, or result from, pain-relevant dysfunction in chronic pain patients.
  • Publicación
    Acceso abierto
    Neuroimaging brainstem circuitry supporting cardiovagal response to pain : A combined heart rate variability/ultrahigh-field (7 T) functional magnetic resonance imaging study
    (2016-01) García, Ronald G.; Sclocco, Roberta; Beissner, Florian; Desbordes, Gaelle; Polimeni, Jonathan R.; Wald, Lawrence L.; Kettner, Norman W.; Kim, Jieun; Renvall, Ville; Bianchi, Anna M.; Cerutti, Sergio; Napadow, Vitaly; Barbieri, Riccardo
    Central autonomic control nuclei in the brainstem have been difficult to evaluate non-invasively in humans. We applied ultrahigh-field (7 T) functional magnetic resonance imaging (fMRI), and the improved spatial resolution it affords (1.2 mm isotropic), to evaluate putative brainstem nuclei that control and/or sense pain-evoked cardiovagal modulation (high-frequency heart rate variability (HF-HRV) instantaneously estimated through a point-process approach). The time-variant HF-HRV signal was used to guide the general linear model analysis of neuroimaging data. Sustained (6 min) pain stimulation reduced cardiovagal modulation, with the most prominent reduction evident in the first 2 min. Brainstem nuclei associated with pain-evoked HF-HRV reduction were previously implicated in both autonomic regulation and pain processing. Specifically, clusters consistent with the rostral ventromedial medulla, ventral nucleus reticularis (Rt)/nucleus ambiguus (NAmb) and pontine nuclei (Pn) were found when contrasting sustained pain versus rest. Analysis of the initial 2-min period identified Rt/NAmb and Pn, in addition to clusters consistent with the dorsal motor nucleus of the vagus/nucleus of the solitary tract and locus coeruleus. Combining high spatial resolution fMRI and high temporal resolution HF-HRV allowed for a non-invasive characterization of brainstem nuclei, suggesting that nociceptive afference induces pain-processing brainstem nuclei to function in concert with known premotor autonomic nuclei in order to affect the cardiovagal response to pain.
  • Publicación
    Acceso abierto
    The somatosensory link : S1 functional connectivity is altered by sustained pain and associated with clinical/autonomic dysfunction in fibromyalgia
    (2015-05) Kim, Jieun; Loggia, Marco L.; Cahalan, Christine M.; Harris, Richard E.; Beissner, Florian; García, Ronald G.; Kim, Hyungjun; Wasan, Ajay D.; Edwards, Robert R.; Napadow, Vitaly
    Objective—Fibromyalgia (FM) is a chronic functional pain syndrome characterized by widespread pain, significant pain catastrophizing, sympathovagal dysfunction, and amplified temporal summation for evoked pain. While several studies have found altered resting brain connectivity in FM, studies have not specifically probed the somatosensory system, and its role in both somatic and non-somatic FM symptomatology. Our objective was to evaluate resting primary somatosensory cortex (S1) connectivity, and explore how sustained, evoked deep-tissue pain modulates this connectivity.Methods—We acquired fMRI and electrocardiography data from FM patients and healthy controls (HC) during rest (REST) and sustained mechanical pressure pain (PAIN) over the lower leg. Functional connectivity associated with different S1 subregions was calculated, while S1leg (leg representation) connectivity was contrast between REST and PAIN, and correlated with clinically-relevant measures in FM. Results—At REST, FM showed decreased connectivity between multiple ipsilateral and cross-hemispheric S1 subregions, which was correlated with clinical pain severity. PAIN, compared to REST, produced increased S1legconnectivity to bilateral anterior insula in FM, but not in HC. Moreover, in FM, sustained pain-altered S1legconnectivity to anterior insula was correlated with clinical/behavioral pain measures and autonomic responses. Conclusion—Our study demonstrates that both somatic and non-somatic dysfunction in FM, including clinical pain, pain catastrophizing, autonomic dysfunction, and amplified temporal summation, are all closely linked with the degree to which evoked deep-tissue pain alters S1 connectivity to salience/affective pain processing regions. Additionally, diminished connectivity between S1 subregions at REST in FM may result from ongoing widespread clinical pain.
  • Publicación
    Acceso abierto
    The somatosensory link in fibromyalgia
    (2015-05) Kim, Jieun; Loggia, Marco L.; Cahalan, Christine M.; Harris, Richard E.; Beissner, Florian; García, Ronald G.; Kim, Hyungjun; Barbieri, Riccardo; Wasan, Ajay D.; Edwards, Robert R.; Napadow, Vitaly
    Objective.Fibromyalgia (FM) is a chronic func-tional pain syndrome characterized by widespread pain,significant pain catastrophizing, sympathovagal dysfunc-tion, and amplified temporal summation for evoked pain.While several studies have demonstrated altered restingbrain connectivity in FM, studies have not specificallyprobed the somatosensory system and its role in bothsomatic and nonsomatic FM symptoms. Our objective wasto evaluate resting primary somatosensory cortex (S1) con-nectivity and to explore how sustained, evoked deep tissuepain modulates this connectivity.Methods.We acquired functional magnetic reso-nance imaging and electrocardiography data on FMpatients and healthy controls during rest (the rest phase)and during sustained mechanical pressure–induced painover the lower leg (the pain phase). Functional connectiv-ity associated with different S1 subregions was calculated,while S1legconnectivity (representation of the leg in theprimary somatosensory cortex) was contrasted betweenthe rest phase and the pain phase and was correlated withclinically relevant measures in FM.Results.During the rest phase, FM patientsshowed decreased connectivity between multiple ipsilat-eral and cross-hemispheric S1 subregions, which wascorrelated with clinical pain severity. Compared to therest phase, the pain phase produced increased S1legconnectivity to the bilateral anterior insula in FMpatients, but not in healthy controls. Moreover, in FMpatients, sustained pain–altered S1legconnectivity tothe anterior insula was correlated with clinical/behavioral pain measures and autonomic responses.Conclusion.Our study demonstrates that bothsomatic and nonsomatic dysfunction in FM, includingclinical pain, pain catastrophizing, autonomic dysfunction,and amplified temporal summation, are closely linkedwith the degree to which evoked deep tissue pain alters S1 connectivity to salience/affective pain-processing regions. Additionally, diminished connectivity between S1 subregions during the rest phase in FM may result from ongoing widespread clinical pain.