Regional Brain Activity Changes Associated with Fentanyl Analgesia Elucidated by Positron Emission Tomography
Abstract
Recent positron emission tomography (PET) studies have demonstrated areas of pain processing in the human brain. Given the inhibitory effects of opioids on neuronal activity, we predicted that fentanyl's analgesic effects would be associated with suppression of pain-evoked responses in these distinct brain areas. To test this, PET was used to measure cerebral blood flow responses, as reflections of regional neuronal activity, to painful and nonpainful thermal stimuli both in the absence and presence of fentanyl in humans. During each PET scan in nine healthy volunteers a tonic heat source was placed against the subject's left forearm, delivering a preset temperature of either 40 degrees C (nonpainful) or 47-48 degrees C (painful). Subjects underwent eight blood flow studies, each consisting of 50 mCi [15O]water injection and a PET scan. The first four studies were performed during placebo administration in the stimulus sequence: nonpainful, painful, painful, nonpainful. This sequence was then repeated during intravenous (i.v.) administration of fentanyl 1.5 micrograms/kg [corrected]. Significant differences in regional cerebral blood flow (rCBF) between the placebo and the fentanyl conditions during nonpainful and painful stimuli were identified using statistical parametric mapping. It was found that pain increased rCBF in the anterior cingulate, ipsilateral thalamus, prefrontal cortex, and contralateral supplementary motor area. Fentanyl increased rCBF in the anterior cingul…
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Brain regions associated with facilitating cognitive modulation of pain (ACC, OFC, insula) contain high concentrations of opioid receptors.
“Furthermore, brain regions associated with facilitating the cognitive modulation of pain, including the anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and insula, contain high concentrations of opioid receptors (Jones et al., 1991;Adler et al., 1997;Willoch et al., 1999;Casey et al., 2000;Willoch et al., 2004;Wager et al., 2007)”
From Mindfulness-meditation-based pain relief is not mediated by endogenous opioids (2016) · cites this paper as Adler et al., 1997
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- Authors
- Adler, L. J., Gyulai, F. E., Diehl, D. J., Mintun, M. A., Winter, P. M., & Firestone, L. L.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Firestone, Leonard L.
- ORCID
- Winter, Peter M.
- Venue
- Anesthesia & Analgesia
- Published
- 1997-01
- Volume
- 84
- Issue
- 1
- Pages
- 120-126
- ISSN
- 0003-2999 (ISSN-L)
- OpenAlex
- W2040477222
- Cited by
- 174
- References
- 30
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2020: 5 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 5
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anesthesia & Analgesia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- fentanyl, opioid analgesia, pain processing, regional cerebral blood flow, thermal pain, anterior cingulate cortex, thalamus, supplementary motor area, prefrontal cortex, posterior cingulate cortex, pain perception, brain activity changes
- MeSH terms
- Adult, Analgesics, Opioid, Brain, Cerebrovascular Circulation, Female, Fentanyl, Hot Temperature, Humans, Injections, Intravenous, Male, Pain, Pain Measurement, Perception, Tomography, Emission-Computed
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