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Projects

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Functional connectomics of chronic pain


Using resting state functional magnetic resonance imaging (fMRI), we are mapping connections that are related to the presence and severity of chronic pain in humans. We are particularly interested in motor cortical connections, which may underly impaired movement control in individuals with chronic pain, and may provide potential therapeutic targets. The interactive image below shows the strongest 1% of positive connections (red) and negative connections (blue) in the healthy brain (data from the 1000 Functional Connectome Project).

Hover over some example brain regions below to highlight their connections.

See also:

Kutch JJ , Yani MS, Cosand L, Kirages DJ, Rana M, Ashe-McNalley C, Labus JS, Farmer MA, Johnson KA, Ness TJ, Deutsch G, Harris RE, Apkarian AV, Clauw DJ, Mackey SC, Mullins C, Mayer EA, "Altered Neuromotor Connectivity in Men with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Neuroimaging Study", Neuroimage: Clinical, in press

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Brain connectivity controlling muscle synergies in humans


We are using a combination of electromyography (EMG), fMRI, and transcranial magnetic stimulation (TMS) to probe how the activation of multiple muscle synergies is controlled by large-scale brain networks in humans.

See also:

Asavasopon S, Rana M, Kirages DJ, Yani MS, Fisher BE, Hwang DH, Lohman EB, Berk LS, Kutch JJ "Cortical activation associated with muscle synergies of the human male pelvic floor", The Journal of Neuroscience, 34(41): 13811-13818, 2014. PDF Citations


Modulating brain motor networks


Using repetitive transcranial magnetic stimulation (rTMS), we are modulating specific medial motor cortex regions that belong to brain motor networks controlling pelvic floor muscles (PFM) during different movement conditions. We are particularly interested in understanding human responses to rTMS based on the characteristics of modulation in: (1) corticospinal excitability, (2) co-activation between PFM and other synergistic muscles, (3) resting state fMRI connectivity, and (4) pain self-rating in patients with chronic pelvic pain. For responders, repetitive stimulation combined with other interventions may result in higher pain reductions among patients with chronic pelvic pain, as shown in other pain conditions.


Physical therapy and brain network function


We are investigating the clinical parallels associated with studying muscle synergies and their related brain network function. Since our previous work has established the neural mechanisms of pelvic floor and hip muscle synergies; and other previous work has also shown pelvic floor synergistic activity with the trunk muscles, we are interested in exploring these mechanisms in patient populations. We are particularly interested in studying how muscle synergies differ in individuals with chronic pelvic pain as well as chronic low back pain. In a preliminary clinical case series, we are exploring physical therapy evaluation and treatment implications when patients with pelvic pain are evaluated for impairments related to pelvic floor and hip muscle performance, as measured with electromyography and force dynamometry.

See also:

Kutch JJ , Yani MS, Cosand L, Kirages DJ, Rana M, Ashe-McNalley C, Labus JS, Farmer MA, Johnson KA, Ness TJ, Deutsch G, Harris RE, Apkarian AV, Clauw DJ, Mackey SC, Mullins C, Mayer EA, "Altered Neuromotor Connectivity in Men with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Neuroimaging Study", Neuroimage: Clinical, in press

Roll SC, Rana M, Sigward SM, Yani MS, Kirages DJ, Kutch JJ (2015) "Reliability of Superficial Male Pelvic Floor Structural Measurements Using Linear-Array Transperineal Sonography". Ultrasound in Medicine & Biology 41:610-617. PDF

Asavasopon S, Rana M, Kirages DJ, Yani MS, Fisher BE, Hwang DH, Lohman EB, Berk LS, Kutch JJ "Cortical activation associated with muscle synergies of the human male pelvic floor", The Journal of Neuroscience, 34(41): 13811-13818, 2014. PDF Citations

Kilpatrick LA, Kutch JJ, Tillisch K, Nalibo BD, Labus JS, Jiang Z, Farmer MA, Apkarian AV, Mackey S, Martucci KT, Clauw DJ, Harris RE, Deutsch G, Ness TJ, Yang CC, Maravilla K, Mullins C, Mayer EA "Alterations in Resting State Oscillations and Connectivity in Sensory and Motor Networks in Women with Interstitial Cystitis/Painful Bladder Syndrome". The Journal of Urology 192: 947-955, 2014. PDF Citations