The Prefrontal Cortex Revisited

The prefrontal cortex also plays a key role in pain processing, or the feeling of pain itself in the brain. It is also really important for emotional control and our mental health. So it’s vitally involved in how you feel and how you interact with others. And your spine can impact this!

The prefrontal cortex is said to be the seat of our intelligence

Stress affects your health

By shutting down your normal prefrontal cortex functions, stress has a negative impact on your emotional state and your mental health. Stress shuts down the prefrontal cortex’s natural control over your autonomic nervous system, your endocrine system and even your immune system, which can result in chronically high levels of inflammation in your body.

References

1. Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology. 2012;22(5):768-776.
2. Haavik Taylor H, Murphy B. Cervical spine manipulation alters sensorimotor integration: A somatosensory evoked potential study. Clinical Neurophysiology 2007;118(2):391-402.
3. Haavik Taylor H, Murphy B. Altered Central Integration of Dual Somatosensory Input Following Cervical Spine Manipulation. Journal of Manipulative & Physiological Therapeutics. 2010;33 (3):178-188.
4. Haavik Taylor H, Murphy B. The effects of spinal manipulation on central integration of dual somatosensory input observed following motor training: A crossover study. Journal of Manipulative & Physiological Therapeutics. 2010;33 (4):261-272.
5. Haavik H, Niazi IK, Holt K, Murphy B. Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients: A Preliminary Study. J Manipulative Physiol Ther. Mar – Apr 2017;40(3):127-138.
6. Lelic D, Niazi IK, Holt K, et al. Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study. Neural Plast. 2016;2016:3704964.
7. Funahashi S, Andreau JM. Prefrontal cortex and neural mechanisms of executive function. J Physiol Paris. Dec 2013;107(6):471-482.
8. Roberts AC, Robbins TW, Weiskrantz LE. The prefrontal cortex: executive and cognitive functions: Oxford University Press; 1998.
9. Koechlin E. Prefrontal executive function and adaptive behavior in complex environments. Current Opinion in Neurobiology. 2016;37:1-6.
10. Domenech P, Koechlin E. Executive control and decision-making in the prefrontal cortex. Current opinion in behavioral sciences. 2015;1:101-106.
11. Faw B. Pre-frontal executive committee for perception, working memory, attention, long-term memory, motor control, and thinking: A tutorial review. Consciousness and cognition. 2003;12(1):83-139.
12. Kul’chyns’kyi AB, Kyjenko VM, Zukow W, Popovych IL. Causal neuro-immune relationships in patients with chronic pyelonephritis and cholecystitis. correlations between parameters EEG, HRV and white blood cell count. Open Medicine. 2017;12(1):201-213.
13. Lorenz J, Minoshima S, Casey K. Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation. Brain. 2003;126(5):1079-1091.
14. Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. European Journal of Pain: Ejp. 2005;9(4):463-484.
15. Apkarian AV, Sosa Y, Sonty S, et al. Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density. The Journal of Neuroscience. 2004;24(46):10410-10415.
16. Arnsten AFT, Raskind MA, Taylor FB, Connor DF. blair. Neurobiology of Stress. 1/1/January 2015 2015;1:89-99.
17. Eden AS, Schreiber J, Anwander A, et al. Emotion regulation and trait anxiety are predicted by the microstructure of fibers between amygdala and prefrontal cortex. Journal of Neuroscience. 2015;35(15):6020-6027.
18. Etkin A, Büchel C, Gross JJ. The neural bases of emotion regulation. Nature reviews neuroscience. 2015;16(11):693.
19. Ghosal S, Hare BD, Duman RS. Prefrontal cortex GABAergic deficits and circuit dysfunction in the pathophysiology and treatment of chronic stress and depression. Current opinion in behavioral sciences. 2017;14:1-8.
20. Johnston-Wilson NL, Sims CD, Hofmann JP, et al. Disease-specific alterations in frontal cortex brain proteins in schizophrenia, bipolar disorder, and major depressive disorder. Molecular Psychiatry. 04/19/online 2000;5:142.
21. Motzkin JC, Philippi CL, Wolf RC, Baskaya MK, Koenigs M. Ventromedial prefrontal cortex is critical for the regulation of amygdala activity in humans. Biological psychiatry. 2015;77(3):276-284.
22. Critchley Hugo D, Harrison Neil A. Visceral Influences on Brain and Behavior. Neuron. 2013/02/20/ 2013;77(4):624-638.
23. Machado S, Cunha M, Velasques B, et al. Sensorimotor integration: basic concepts, abnormalities related to movement disorders and sensorimotor training-induced cortical reorganization. Rev Neurol. 2010;51(7):427-436.
24. Thayer JF. Vagal tone and the inflammatory reflex. Cleve Clin J Med. 2009;76(Suppl 2):S23-26.
25. Ahern GL, Sollers JJ, Lane RD, et al. Heart rate and heart rate variability changes in the intracarotid sodium amobarbital test. Epilepsia. 2001;42(7):912-921.
26. Berthoud H-R, Neuhuber WL. Functional and chemical anatomy of the afferent vagal system. Autonomic Neuroscience. 2000;85(1-3):1-17.
27. Thayer JF, Sternberg EM. Neural aspects of immunomodulation: focus on the vagus nerve. Brain, behavior, and immunity. 2010;24(8):1223-1228.
28. Bankenahally R, Krovvidi H. Autonomic nervous system: anatomy, physiology, and relevance in anaesthesia and critical care medicine. Bja Education. 2016;16(11):381-387.
29. Ohira H, Matsunaga M, Osumi T, et al. Vagal nerve activity as a moderator of brain–immune relationships. Journal of Neuroimmunology. 2013;260(1-2):28-36.
30. McCraty R, Shaffer F. Heart rate variability: new perspectives on physiological mechanisms, assessment of self-regulatory capacity, and health risk. Global advances in health and medicine. 2015;4(1):46-61.
31. Hänsel A, Von Känel R. The ventro-medial prefrontal cortex: a major link between the autonomic nervous system, regulation of emotion, and stress reactivity? BioPsychoSocial Medicine. 2008;2(1):21.
32. Diorio D, Viau V, Meaney MJ. The role of the medial prefrontal cortex (cingulate gyrus) in the regulation of hypothalamic-pituitary-adrenal responses to stress. Journal of Neuroscience. 1993;13(9):3839-3847.
33. Cole MW, Yarkoni T, Repovš G, Anticevic A, Braver TS. Global connectivity of prefrontal cortex predicts cognitive control and intelligence. Journal of Neuroscience. 2012;32(26):8988-8999.
34. Barbey AK, Colom R, Grafman J. Dorsolateral prefrontal contributions to human intelligence. Neuropsychologia. 2013;51(7):1361-1369.
35. Seminowicz DA, Moayedi M. The dorsolateral prefrontal cortex in acute and chronic pain. The Journal of Pain. 2017;18(9):1027-1035.
36. Fierro B, De Tommaso M, Giglia F, Giglia G, Palermo A, Brighina F. Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) during capsaicin-induced pain: modulatory effects on motor cortex excitability. Experimental brain research. 2010;203(1):31-38.
37. Gross A, Miller J, D’Sylva J, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther. Aug 2010;15(4):315-333.
38. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. The spine journal. 2004;4(3):335-356.
39. Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Annals of internal medicine. 2012;156(1_Part_1):1-10.
40. Kuczynski JJ, Schwieterman B, Columber K, Knupp D, Shaub L, Cook CE. Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain: a systematic review of the literature. International Journal of Sports Physical Therapy. 2012;7(6):647.
41. Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L. Efficacy of spinal manipulation for chronic headache: a systematic review. Journal of manipulative and physiological therapeutics. 2001;24(7):457-466.
42. Arco AD, Mora F. Neurotransmitters and prefrontal cortex–limbic system interactions: implications for plasticity and psychiatric disorders. Journal of Neural Transmission. 2009/08/01 2009;116(8):941-952.
43. Moench KM, Wellman CL. Review article: Stress-induced alterations in prefrontal dendritic spines: Implications for post-traumatic stress disorder. Neuroscience Letters. 8/5/5 August 2015 2015;601:41-45.
44. Fuster JM. The Prefrontal Cortex Makes the Brain a Preadaptive System. Proceedings of the IEEE. 2014;102(4):417-426.
45. Chan T, Kyere K, Davis BR, et al. The Role of the Medial Prefrontal Cortex in Innate Fear Regulation in Infants, Juveniles, and Adolescents. The Journal of Neuroscience. 2011;31(13):4991.
46. Davidson RJ. Anxiety and affective style: role of prefrontal cortex and amygdala. Biological Psychiatry. 2002;51(1):68-80.
47. Monk CS, Telzer EH, Mogg K, et al. Amygdala and ventrolateral prefrontal cortex activation to masked angry faces in children and adolescents with generalized anxiety disorder. Archives of General Psychiatry. 2008;65(5):568-576.
48. Andrewes DG, Jenkins LM. The role of the amygdala and the ventromedial prefrontal cortex in emotional regulation: implications for post-traumatic stress disorder. Neuropsychology review. 2019:1-24.
49. Dixon ML, Thiruchselvam R, Todd R, Christoff K. Emotion and the prefrontal cortex: an integrative review. Psychological bulletin. 2017;143(10):1033.
50. Hiser J, Koenigs M. The multifaceted role of the ventromedial prefrontal cortex in emotion, decision making, social cognition, and psychopathology. Biological Psychiatry. 2018;83(8):638-647.
51. Bar-On R, Tranel D, Denburg NL, Bechara A. Emotional and social intelligence. Social neuroscience: key readings. 2004;223:52.
52. Thayer JF, Åhs F, Fredrikson M, Sollers JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neuroscience & Biobehavioral Reviews. 2012;36(2):747-756.
53. Arnsten AF. Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience. 2009;10(6):410.
54. Danese A, Moffitt TE, Harrington H, et al. Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Archives of pediatrics & adolescent medicine. 2009;163(12):1135-1143.
55. Danese A, Pariante CM, Caspi A, Taylor A, Poulton R. Childhood maltreatment predicts adult inflammation in a life-course study. Proceedings of the National Academy of Sciences. 2007;104(4):1319-1324.
56. Danese A, Caspi A, Williams B, et al. Biological embedding of stress through inflammation processes in childhood. Molecular psychiatry. 2011;16(3):244-246.
57. Kiecolt-Glaser JK, Gouin J-P, Hantsoo L. Close relationships, inflammation, and health. Neuroscience & Biobehavioral Reviews. 2010;35(1):33-38.
58. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine. 2019;56(6):774-786.
59. Pavlov VA, Tracey KJ. The vagus nerve and the inflammatory reflex—linking immunity and metabolism. Nature Reviews Endocrinology. 2012;8(12):743.
60. Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic medicine. 2009;71(2):243.
61. Naudé PJ, Roest AM, Stein DJ, de Jonge P, Doornbos B. Anxiety disorders and CRP in a population cohort study with 54,326 participants: The LifeLines study. The World Journal of Biological Psychiatry. 2018;19(6):461-470.
62. White J, Kivimäki M, Jokela M, Batty GD. Association of inflammation with specific symptoms of depression in a general population of older people: The English Longitudinal Study of Ageing. Brain, behavior, and immunity. 2017;61:27-30.
63. Melhem NM, Munroe S, Marsland A, et al. Blunted HPA axis activity prior to suicide attempt and increased inflammation in attempters. Psychoneuroendocrinology. 2017;77:284-294.
64. Leonard BE. Inflammation and depression: a causal or coincidental link to the pathophysiology? Acta neuropsychiatrica. 2018;30(1):1-16.
65. Köhler-Forsberg O, Buttenschøn HN, Tansey KE, et al. Association between C-reactive protein (CRP) with depression symptom severity and specific depressive symptoms in major depression. Brain, behavior, and immunity. 2017;62:344-350.
66. Tayefi M, Shafiee M, Kazemi-Bajestani SMR, et al. Depression and anxiety both associate with serum level of hs-CRP: a gender-stratified analysis in a population-based study. Psychoneuroendocrinology. 2017;81:63-69.
67. Tabatabaeizadeh S-A, Abdizadeh MF, Meshkat Z, et al. There is an association between serum high-sensitivity C-reactive protein (hs-CRP) concentrations and depression score in adolescent girls. Psychoneuroendocrinology. 2018;88:102-104.
68. Smagula SF, Ancoli-Israel S, Barrett-Connor E, et al. Inflammation, sleep disturbances, and depressed mood among community-dwelling older men. Journal of psychosomatic research. 2014;76(5):368-373.
69. Serrats J, Grigoleit J-S, Alvarez-Salas E, Sawchenko PE. Pro-inflammatory immune-to-brain signaling is involved in neuroendocrine responses to acute emotional stress. Brain, behavior, and immunity. 2017;62:53-63.
70. Serafini G, Pompili M, Seretti ME, et al. The role of inflammatory cytokines in suicidal behavior: a systematic review. European Neuropsychopharmacology. 2013;23(12):1672-1686.
71. O’Donovan A, Rush G, Hoatam G, et al. Suicidal ideation is associated with elevated inflammation in patients with major depressive disorder. Depression and anxiety. 2013;30(4):307-314.
72. Pavlov VA, Wang H, Czura CJ, Friedman SG, Tracey KJ. The cholinergic anti-inflammatory pathway: a missing link in neuroimmunomodulation. Molecular medicine. 2003;9(5):125-134.
73. Adams J, Peng W, Cramer H, et al. The Prevalence, Patterns, and Predictors of Chiropractic Use Among US Adults: Results From the 2012 National Health Interview Survey. Spine (Phila Pa 1976). Dec 1 2017;42(23):1810-1816.