Sandoval Ortega, Raquel Adaia (2023). The Neural Correlates of Pain and Sleep in Health and Disease. (Thesis). Universität Bern, Bern
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23sandoval-ortega_ra.pdf - Thesis Available under License Creative Commons: Attribution (CC-BY 4.0). Download (6MB) | Preview |
Abstract
Chronic pain is endemic to the population, affecting on average one in every five individuals and incurring yearly costs of up to €300 billion in Europe alone. Despite the significant economic and societal impact of chronic pain, effective treatments remain elusive. Notably, nearly 90% of patients suffering from chronic pain report sleep disturbances. Interestingly, sleep disturbances exacerbate pain sensitivity, and good-quality sleep reduces pain ratings. The strong interplay between these two physiological processes, suggests that sleep has significant potential as a therapeutic approach for treating chronic pain. However, in order to use sleep as a therapy for chronic pain, it is necessary to identify and characterize the neural signatures of this interaction. The goal of this thesis was to identify neural correlates of the interaction between sleep and pain, with the objective of providing neural signatures that would assist in the use of sleep as a therapeutic approach for pain management. To achieve this aim, we used simultaneous intracranial recordings of the anterior cingulate (ACC) and the primary somatosensory (S1) cortices in mice. The electroencephalogram (EEG) aided to identify global patterns of activity, and the electromyogram (ECG) was used to measure autonomic nervous system activation. The evaluation of the effect of sleep on pain revealed that somatic information reached the ACC and S1 during sleep and that the characteristics of the stimulation, such as salience and valence, can be distinguished in sleep. Sleep strongly modulated the complex temporal dynamics in the delta, alpha and gamma bands observed in wake, although it kept features related to sensory processing and attention. Correlation of neural activity with heart rate measurements reduced the element of saliency, allowing to better separate noxious from non-noxious stimulation in both wake and sleep. Studying the effect of pain on sleep, we found that chronic pain temporarily altered the sleep phenotype but induced long-lasting changes in the ACC, S1 and EEG. Upon induction of chronic pain, a progressive slow-down of global activity captured in the EEG, as well as gamma and theta increases in the ACC were observed. These changes partially recapitulated the thalamocortical dysrhythmia phenotype described in individuals with chronic pain. Furthermore, chronic pain impaired the age-related increase in synchrony of slow oscillations, and exacerbated the age-related decrease in heart rate across all arousal states. In summary, this thesis contributes to the field of sleep and pain by presenting a comprehensive examination of the neurophysiological mechanisms underlying the interactions between these two physiological processes. The findings presented in this thesis provide a series of neurophysiological signatures that offer new insights into the complex relationship between sleep and pain.
| Item Type: | Thesis |
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| Dissertation Type: | Cumulative |
| Date of Defense: | 27 March 2023 |
| Subjects: | 600 Technology > 610 Medicine & health |
| Institute / Center: | 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Physiology |
| Depositing User: | Hammer Igor |
| Date Deposited: | 15 Jan 2025 08:37 |
| Last Modified: | 15 Jan 2025 23:25 |
| URI: | https://boristheses.unibe.ch/id/eprint/5740 |
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