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Brain-heart pathways to blood pressure-related hypoalgesia.pdf (1.39 MB)

Brain-heart pathways to blood pressure-related hypoalgesia

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posted on 2023-06-09, 12:52 authored by Cristina Ottaviani, Sabrina Fagioli, Eugenio Mattei, Federica Censi, Louisa Edwards, Emiliano Macaluso, Marco Bozzali, Hugo CritchleyHugo Critchley, Giovanni Calcagnini
OBJECTIVE: High blood pressure (BP) is associated with reduced pain sensitivity, known as BP-related hypoalgesia. The underlying neural mechanisms remain uncertain, yet arterial baroreceptor signaling, occurring at cardiac systole, is implicated. We examined normotensives using functional neuroimaging (fMRI) and pain stimulation during distinct phases of the cardiac cycle to test the hypothesized neural mediation of baroreceptor-induced attenuation of pain. METHODS: Eighteen participants (10 women; 32.7 ± 6.5 years) underwent BP monitoring over one week at home, and individual pain thresholds were determined in the lab. Subsequently, participants were administered unpredictable painful and non-painful electrocutaneous shocks (stimulus type), timed to occur either at systole or diastole (cardiac phase) in an event-related design. After each trial, participants evaluated their subjective experience. RESULTS: Subjective pain was lower for painful stimuli administered at systole compared to diastole, F1, 2283 = 4.82; p = 0.03. Individuals with higher baseline BP demonstrated overall lower pain perception, F1, 2164 = 10.47; p < 0.0001. Within the brain, painful stimulation activated somatosensory areas, prefrontal cortex, cingulate cortex, posterior insula, amygdala, and the thalamus. Stimuli delivered during systole (concurrent with baroreceptor discharge) activated areas associated with heightened parasympathetic drive. No stimulus type x cardiac phase interaction emerged except for a small cluster located in the right parietal cortex. CONCLUSIONS: We confirm the negative associations between BP and pain, highlighting the antinociceptive impact of baroreceptor discharge. Neural substrates associated with baroreceptor/BP-related hypoalgesia include superior parietal lobule, precentral and lingual gyrus, regions typically involved in the cognitive aspects of pain experience.


Young Researcher Grant - CO; Italian Ministry of Health; GR2011-02348232


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  • Published

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  • Accepted version


Psychosomatic Medicine




Lippincott, Williams & Wilkins

Department affiliated with

  • BSMS Neuroscience Publications

Research groups affiliated with

  • Sackler Centre for Consciousness Science Publications

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