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The modulation of central pain by vestibular stimulation and another study on human brain functionMcGeoch, Paul Duncan January 2010 (has links)
This thesis deals with a potential interaction between the vestibular system and the phenomenon of central pain. I provide behavioural and magnetoencephalographic (MEG) evidence that cold caloric vestibular stimulation (CVS) can alleviate central pain in some sufferers. I argue that activation of the parieto-insular vestibular cortex (PIVC) in central pain patients can act via the parabrachial nucleus in the brainstem to rebalance the integration of thermosensory input and suppress the perception of pain at the anterior cingulated cortex (ACC). This is consistent with the thermosensory disinhibition hypothesis, which proposes that central pain is a thermoregulatory disorder which results from the loss of the central inhibition of pain by cooling. I go on to propose that the PIVC and anatomically adjacent interoceptive cortex in the dorsal posterior insula (dpIns) share a number of similarities and that PIVC is best viewed as part of a wider interoceptive system. Based on the MEG data I suggest that low threshold C mechanoceptors may play a role in tactile allodynia in central pain. I also use the MEG data to propose that the disruption of interoceptive input to the dpIns could lead to tactile afferents priming the primary motor cortex to respond more rapidly to subsequent ACC activation. This effect may be mediated via a corollary branch of interoceptive input that runs not to the dpIns but to the fundus of the central sulcus. The final chapter contains additional research into the issue of body image, via investigations into apotemnophilia. I provide MEG and other evidence suggesting that it is a disorder of the right parietal lobe. I then propose a neurological explanation for a condition previously thought to be entirely psychological.
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