Neuroimaging Chronic Pain: What Have We Learned?
Neuroimaging has provided evidence of structural and functional brain changes in the majority of chronic pain syndromes. To date, cLBP, FM, neuropathic pain and TMD have been the most widely studied pain syndromes using this technology. The expression that 'pain is in a patient's head' no longer reflects the idea that chronic pain is a largely psychological problem. Rather, it can now be taken more literally, because neuroimaging studies have repeatedly demonstrated extensive alterations in brain structure and function in chronic pain states. To date, we have accumulated a large amount of somewhat variable, yet overlapping, evidence indicating that altered brain mechanisms may, in many cases, greatly contribute to, if not wholly underlie, real pain sensations. Moreover, neuroimaging has shown that multiple regions of the brain are involved in a range of pain, sensory, motor, cognitive, motivational, memory, emotion and fear processes. Individual variability in the pain experience remains a challenge in the clinical care of chronic pain. Continued research and advances in neuroimaging technology are needed to further clarify brain mechanisms involved in chronic pain and to further develop novel brain-based treatment approaches for patients with chronic pain.
Conclusion
Neuroimaging has provided evidence of structural and functional brain changes in the majority of chronic pain syndromes. To date, cLBP, FM, neuropathic pain and TMD have been the most widely studied pain syndromes using this technology. The expression that 'pain is in a patient's head' no longer reflects the idea that chronic pain is a largely psychological problem. Rather, it can now be taken more literally, because neuroimaging studies have repeatedly demonstrated extensive alterations in brain structure and function in chronic pain states. To date, we have accumulated a large amount of somewhat variable, yet overlapping, evidence indicating that altered brain mechanisms may, in many cases, greatly contribute to, if not wholly underlie, real pain sensations. Moreover, neuroimaging has shown that multiple regions of the brain are involved in a range of pain, sensory, motor, cognitive, motivational, memory, emotion and fear processes. Individual variability in the pain experience remains a challenge in the clinical care of chronic pain. Continued research and advances in neuroimaging technology are needed to further clarify brain mechanisms involved in chronic pain and to further develop novel brain-based treatment approaches for patients with chronic pain.
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