SomaSimple Discussion Lists  

Go Back   SomaSimple Discussion Lists > Persistent Pain Problems > PPP Management
Albums Quiz PubMed Gray's Anatomy Tags Online Journals Statistics

Notices

PPP Management How to help PPP patients.

Reply
 
Thread Tools Display Modes
Old 14-12-2016, 07:56 PM   #1
Jo Bowyer
ronin/matrix warrior
 
Jo Bowyer's Avatar
 
Join Date: Mar 2013
Location: Bedford UK
Age: 59
Posts: 6,438
Thanks: 1,975
Thanked 2,734 Times in 1,657 Posts
Default Ghosts in the Machine. Interoceptive Modeling for Chronic Pain Treatment

http://journal.frontiersin.org/artic...016.00314/full

Quote:
Pain is a complex and multidimensional perception, embodied in our daily experiences through interoceptive appraisal processes. The article reviews the recent literature about interoception along with predictive coding theories and tries to explain a missing link between the sense of the physiological condition of the entire body and the perception of pain in chronic conditions, which are characterized by interoceptive deficits. Understanding chronic pain from an interoceptive point of view allows us to better comprehend the multidimensional nature of this specific organic information, integrating the input of several sources from Gifford's Mature Organism Model to Melzack's neuromatrix. The article proposes the concept of residual interoceptive images (ghosts), to explain the diffuse multilevel nature of chronic pain perceptions. Lastly, we introduce a treatment concept, forged upon the possibility to modify the interoceptive chronic representation of pain through external input in a process that we call interoceptive modeling, with the ultimate goal of reducing pain in chronic subjects.
Update 03/04/2017

Visceral Influences on Brain and Behavior
http://www.sciencedirect.com/science...96627313001402

Quote:
Mental processes and their neural substrates are intimately linked to the homeostatic control of internal bodily state. There are a set of distinct interoceptive pathways that directly and indirectly influence brain functions. The anatomical organization of these pathways and the psychological/behavioral expressions of their influence appear along discrete, evolutionarily conserved dimensions that are tractable to a mechanistic understanding. Here, we review the role of these pathways as sources of biases to perception, cognition, emotion, and behavior and arguably the dynamic basis to the concept of self.
This has been posted elsewhere


Expectation violation and attention to pain jointly modulate neural gain in somatosensory cortex
http://www.sciencedirect.com/science...53811917302501

Abstract
Quote:
The neural processing and experience of pain are influenced by both expectations and attention. For example, the amplitude of event-related pain responses is enhanced by both novel and unexpected pain, and by moving the focus of attention towards a painful stimulus. Under predictive coding, this congruence can be explained by appeal to a precision-weighting mechanism, which mediates bottom-up and top-down attentional processes by modulating the influence of feedforward and feedback signals throughout the cortical hierarchy. The influence of expectation and attention on pain processing can thus be mapped onto changes in effective connectivity between or within specific neuronal populations, using a canonical microcircuit (CMC) model of hierarchical processing. We thus implemented a CMC within dynamic causal modelling (DCM) for magnetoencephalography in human subjects, to investigate how expectation violation and attention to pain modulate intrinsic (within-source) and extrinsic (between-source) connectivity in the somatosensory hierarchy. This enabled us to establish whether both expectancy and attentional processes are mediated by a similar precision-encoding mechanism within a network of somatosensory, frontal and parietal sources. We found that both unexpected and attended pain modulated the gain of superficial pyramidal cells in primary and secondary somatosensory cortex. This modulation occurred in the context of increased lateralized recurrent connectivity between somatosensory and fronto-parietal sources, driven by unexpected painful occurrences. Finally, the strength of effective connectivity parameters in S1, S2 and IFG predicted individual differences in subjective pain modulation ratings. Our findings suggest that neuromodulatory gain control in the somatosensory hierarchy underlies the influence of both expectation violation and attention on cortical processing and pain perception.


A colleague and I are currently dealing with a patient who has neuroendocrine immune issues and is fed parenterally due to inability to process solids and liquids. Water taken by mouth must be vented via a port connected to the stomach. The patient (who is still working!) has complex musculoskeletal pain in addition to that mediated via the enteric nervous system. They come in every six weeks or so and we talk. The current hospital based team are happy that the situation is stable and don't want to rock the boat. We are hoping that the family doctor will consider the possibility of a transfer to another hospital as this person feels as though they are in a state of suspended animation and wants to make progress.
__________________
Jo Bowyer
Chartered Physiotherapist Registered Osteopath.
"Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

Last edited by Jo Bowyer; 03-04-2017 at 10:09 AM. Reason: spelling
Jo Bowyer is online now   Reply With Quote
The Following 2 Users Say Thank You to Jo Bowyer For This Useful Post:
cathyph (15-12-2016), marcel (14-12-2016)
Old 15-12-2016, 02:13 PM   #2
amacs
A bear of little brain
 
amacs's Avatar
 
Join Date: Oct 2006
Location: UK
Posts: 2,027
Thanks: 1,014
Thanked 745 Times in 385 Posts
Default

Quote:
as this person feels as though they are in a state of suspended animation and wants to make progress
horrible place for a person to be. What is healthcare coming to?

Andy
__________________
"Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there is another way, if only he could stop bumping for a moment and think of it." A.A. Milne
amacs is offline   Reply With Quote
Old 15-12-2016, 03:26 PM   #3
Jo Bowyer
ronin/matrix warrior
 
Jo Bowyer's Avatar
 
Join Date: Mar 2013
Location: Bedford UK
Age: 59
Posts: 6,438
Thanks: 1,975
Thanked 2,734 Times in 1,657 Posts
Default

Quote:
horrible place for a person to be. What is healthcare coming to?
It is a horrible place, but the person wanted to stay alive and the current team found ways of making that happen. Now that the person wants to find ways of moving on they are wary of getting into a situation that might compromise management.
__________________
Jo Bowyer
Chartered Physiotherapist Registered Osteopath.
"Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi
Jo Bowyer is online now   Reply With Quote
The Following User Says Thank You to Jo Bowyer For This Useful Post:
amacs (15-12-2016)
Old 15-12-2016, 05:20 PM   #4
amacs
A bear of little brain
 
amacs's Avatar
 
Join Date: Oct 2006
Location: UK
Posts: 2,027
Thanks: 1,014
Thanked 745 Times in 385 Posts
Default

Quote:
Originally Posted by Jo Bowyer View Post
It is a horrible place, but the person wanted to stay alive and the current team found ways of making that happen. Now that the person wants to find ways of moving on they are wary of getting into a situation that might compromise management.
I can see how that has worked. I do think however as long as the individual understands the risks and benefits and is in a position to make an informed decision then we go with them on that journey (usually - there are I think exceptions) We cannot let our own fear of the outcome rule our decision making.

I dealt with an older endurance cyclist several years ago that when I screened him admitted to a diagnosis of HOCM - he was clear he wanted to participate in the event and after discussing with him what it would entail and making sure he understood the risk I could see no real choice but to not only endorse his entry but to admire his courage and encourage him on the way (I did keep the defib near at hand - more maybe for my sake than his). Others I discussed this with felt this was reckless action and placed him at unnecessary risk.

ANdy
__________________
"Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there is another way, if only he could stop bumping for a moment and think of it." A.A. Milne
amacs is offline   Reply With Quote
The Following User Says Thank You to amacs For This Useful Post:
Jo Bowyer (15-12-2016)
Old 15-12-2016, 11:03 PM   #5
Jo Bowyer
ronin/matrix warrior
 
Jo Bowyer's Avatar
 
Join Date: Mar 2013
Location: Bedford UK
Age: 59
Posts: 6,438
Thanks: 1,975
Thanked 2,734 Times in 1,657 Posts
Default

My colleague and I feel that much will rest on the shoulders of the family doctor, we both admire her work and feel sure that she will continue to support this individual whatever is decided.
__________________
Jo Bowyer
Chartered Physiotherapist Registered Osteopath.
"Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi
Jo Bowyer is online now   Reply With Quote
Old 16-12-2016, 09:24 AM   #6
amacs
A bear of little brain
 
amacs's Avatar
 
Join Date: Oct 2006
Location: UK
Posts: 2,027
Thanks: 1,014
Thanked 745 Times in 385 Posts
Default

A good GP is so very important in this kind of situation

A.
__________________
"Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there is another way, if only he could stop bumping for a moment and think of it." A.A. Milne
amacs is offline   Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
CT Do we need a shift towards a Multidisciplinary treatment for chronic pain? marcel General Discussion 0 16-06-2014 11:02 AM
Ref Hypnosis for the treatment of chronic pain mszlazak General Discussion 3 01-10-2013 02:32 AM
A Revolution in the Understanding of Pain and Treatment of Chronic Pain anoopbal The Performance Lab 27 09-09-2013 12:40 AM
Tip Targeting Cortical Representations in the Treatment of Chronic Pain marcel Neuro? Logical! 20 25-02-2012 07:53 PM


All times are GMT +2. The time now is 05:25 AM.


Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2017, vBulletin Solutions, Inc.
SomaSimple © 2004 - 2016