Korean J Pain.  2010 Sep;23(3):159-165. 10.3344/kjp.2010.23.3.159.

Neuroimaging Studies of Chronic Pain

Affiliations
  • 1Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
  • 2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea. pain@snu.ac.kr
  • 3Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Korea.

Abstract

The evolution of brain imaging techniques over the last decade has been remarkable. Along with such technical developments, research into chronic pain has made many advances. Given that brain imaging is a non-invasive technique with great spatial resolution, it has played an important role in finding the areas of the brain related to pain perception as well as those related to many chronic pain disorders. Therefore, in the near future, brain imaging techniques are expected to be the key to the discovery of many unknown etiologies of chronic pain disorders and to the subjective diagnoses of such disorders.

Keyword

brain imaging; chronic pain

MeSH Terms

Brain
Chronic Pain
Neuroimaging
Pain Perception

Figure

  • Fig. 1 This illustration shows the areas in the brain that process some discriminative components of pain perception, including affective processing, attentional processing, and sensory processing. The thalamus, insula, hippocampus, orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and posterior parietal cortex (PPC) are distinctly active during the attentional processing of pain perception. During sensory processing, the primary and secondary somatosensory cortices (S1, S2) and the insula are involved. The activity of the insula, inferior frontal gyrus (IFG), OFC, ventrolateral prefrontal cortex (VLPFC), DLPFC, posterior cingulate cortex (PCC) and ACC were distinct during the affective processing of pain. Many researchers hold that the S2 area is also involved in this process.


Reference

1. Epictetus . Discourses of epictetus. 2006. Sioux Falls: NuVision Publications, LLC;p. 98.
2. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006; 10:287–333. PMID: 16095934.
Article
3. Kim B. KHIDI statistics brief. 2008. vol. 1. Seoul: Korea Health Industry Development Institute;p. 5.
4. Gustorff B, Dorner T, Likar R, Grisold W, Lawrence K, Schwarz F, et al. Prevalence of self-reported neuropathic pain and impact on quality of life: a prospective representative survey. Acta Anaesthesiol Scand. 2008; 52:132–136. PMID: 17976220.
Article
5. Campbell LC, Clauw DJ, Keefe FJ. Persistent pain and depression: a biopsychosocial perspective. Biol Psychiatry. 2003; 54:399–409. PMID: 12893114.
Article
6. Nicholson B, Verma S. Comorbidities in chronic neuropathic pain. Pain Med. 2004; 5(Suppl 1):S9–S27. PMID: 14996227.
Article
7. Vogt BA. Pain and emotion interactions in subregions of the cingulate gyrus. Nat Rev Neurosci. 2005; 6:533–544. PMID: 15995724.
Article
8. Broggi G. Pain and psycho-affective disorders. Neurosurgery. 2008; 62(6 Suppl 3):901–919. PMID: 18695578.
Article
9. Maletic V, Raison CL. Neurobiology of depression, fibromyalgia and neuropathic pain. Front Biosci. 2009; 14:5291–5338. PMID: 19482616.
Article
10. Turk DC, Audette J, Levy RM, Mackey SC, Stanos S. Assessment and treatment of psychosocial comorbidities in patients with neuropathic pain. Mayo Clin Proc. 2010; 85(3 Suppl):S42–S50. PMID: 20194148.
Article
11. Apkarian AV, Baliki MN, Geha PY. Towards a theory of chronic pain. Prog Neurobiol. 2009; 87:81–97. PMID: 18952143.
Article
12. Tracey I. Neuroimaging of pain mechanisms. Curr Opin Support Palliat Care. 2007; 1:109–116. PMID: 18685351.
Article
13. Ochsner KN, Zaki J, Hanelin J, Ludlow DH, Knierim K, Ramachandran T, et al. Your pain or mine? Common and distinct neural systems supporting the perception of pain in self and other. Soc Cogn Affect Neurosci. 2008; 3:144–160. PMID: 19015105.
Article
14. Tracey I. Imaging pain. Br J Anaesth. 2008; 101:32–39. PMID: 18556697.
Article
15. May A. Neuroimaging: visualising the brain in pain. Neurol Sci. 2007; 28(Suppl 2):S101–S107. PMID: 17508154.
Article
16. Seifert F, Maihöfner C. Central mechanisms of experimental and chronic neuropathic pain: findings from functional imaging studies. Cell Mol Life Sci. 2009; 66:375–390. PMID: 18791842.
Article
17. Chiapparini L, Grazzi L, Ferraro S, Mandelli ML, Usai S, Andrasik F, et al. Functional-MRI evaluation of pain processing in chronic migraine with medication overuse. Neurol Sci. 2009; 30(Suppl 1):S71–S74. PMID: 19415430.
Article
18. Baliki MN, Chialvo DR, Geha PY, Levy RM, Harden RN, Parrish TB, et al. Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J Neurosci. 2006; 26:12165–12173. PMID: 17122041.
Article
19. Burgmer M, Pogatzki-Zahn E, Gaubitz M, Stüber C, Wessoleck E, Heuft G, et al. Fibromyalgia unique temporal brain activation during experimental pain: a controlled fMRI Study. J Neural Transm. 2010; 117:123–131. PMID: 19937376.
Article
20. Gracely RH, Geisser ME, Giesecke T, Grant MA, Petzke F, Williams DA, et al. Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain. 2004; 127:835–843. PMID: 14960499.
Article
21. Burgmer M, Gaubitz M, Konrad C, Wrenger M, Hilgart S, Heuft G, et al. Decreased gray matter volumes in the cingulo-frontal cortex and the amygdala in patients with fibromyalgia. Psychosom Med. 2009; 71:566–573. PMID: 19414621.
Article
22. Pujol J, López-Solà M, Ortiz H, Vilanova JC, Harrison BJ, Yücel M, et al. Mapping brain response to pain in fibromyalgia patients using temporal analysis of FMRI. PLoS One. 2009; 4:e5224. PMID: 19381292.
Article
23. Andersson GB. Epidemiology of low back pain. Acta Orthop Scand Suppl. 1998; 281:28–31. PMID: 9771538.
Article
24. Baliki MN, Geha PY, Apkarian AV, Chialvo DR. Beyond feeling: chronic pain hurts the brain, disrupting the default-mode network dynamics. J Neurosci. 2008; 28:1398–1403. PMID: 18256259.
Article
25. Kobayashi Y, Kurata J, Sekiguchi M, Kokubun M, Akaishizawa T, Chiba Y, et al. Augmented cerebral activation by lumbar mechanical stimulus in chronic low back pain patients: an FMRI study. Spine. 2009; 34:2431–2436. PMID: 19789470.
Article
26. Maihöfner C, Forster C, Birklein F, Neundörfer B, Handwerker HO. Brain processing during mechanical hyperalgesia in complex regional pain syndrome: a functional MRI study. Pain. 2005; 114:93–103. PMID: 15733635.
Article
27. Ok SJ, Yang JY, Son JH, Jeong WJ, Lee YS, Kim WY, et al. Management of complex regional pain syndrome type 1 with total spinal block. Korean J Pain. 2010; 23:70–73. PMID: 20552078.
Article
28. Choi YS, Lee MG, Lee HM, Lee CJ, Jo JY, Jeon SY, et al. Epidemiology of complex regional pain syndrome: a retrospective chart review of 150 Korean patients. J Korean Med Sci. 2008; 23:772–775. PMID: 18955780.
Article
29. Lebel A, Becerra L, Wallin D, Moulton EA, Morris S, Pendse G, et al. fMRI reveals distinct CNS processing during symptomatic and recovered complex regional pain syndrome in children. Brain. 2008; 131:1854–1879. PMID: 18567621.
Article
30. Malinen S, Vartiainen N, Hlushchuk Y, Koskinen M, Ramkumar P, Forss N, et al. Aberrant temporal and spatial brain activity during rest in patients with chronic pain. Proc Natl Acad Sci USA. 2010; 107:6493–6497. PMID: 20308545.
Article
31. Cauda F, Sacco K, Duca S, Cocito D, D'Agata F, Geminiani GC, et al. Altered resting state in diabetic neuropathic pain. PLoS One. 2009; 4:e4542. PMID: 19229326.
Article
32. Berna C, Leknes S, Holmes EA, Edwards RR, Goodwin GM, Tracey I. Induction of depressed mood disrupts emotion regulation neurocircuitry and enhances pain unpleasantness. Biol Psychiatry. 2010; 67:1083–1090. PMID: 20303069.
Article
33. Harris RE, Sundgren PC, Craig AD, Kirshenbaum E, Sen A, Napadow V, et al. Elevated insular glutamate in fibromyalgia is associated with experimental pain. Arthritis Rheum. 2009; 60:3146–3152. PMID: 19790053.
Article
34. Prescot A, Becerra L, Pendse G, Tully S, Jensen E, Hargreaves R, et al. Excitatory neurotransmitters in brain regions in interictal migraine patients. Mol Pain. 2009; 5:34. PMID: 19566960.
Article
35. Grachev ID, Fredrickson BE, Apkarian AV. Abnormal brain chemistry in chronic back pain: an in vivo proton magnetic resonance spectroscopy study. Pain. 2000; 89:7–18. PMID: 11113288.
Article
36. Grachev ID, Fredrickson BE, Apkarian AV. Brain chemistry reflects dual states of pain and anxiety in chronic low back pain. J Neural Transm. 2002; 109:1309–1334. PMID: 12373563.
Article
37. Schmidt-Wilcke T, Leinisch E, Straube A, Kämpfe N, Draganski B, Diener HC, et al. Gray matter decrease in patients with chronic tension type headache. Neurology. 2005; 65:1483–1486. PMID: 16275843.
Article
38. Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci. 2004; 24:10410–10415. PMID: 15548656.
Article
39. Geha PY, Baliki MN, Harden RN, Bauer WR, Parrish TB, Apkarian AV. The brain in chronic CRPS pain: abnormal gray-white matter interactions in emotional and autonomic regions. Neuron. 2008; 60:570–581. PMID: 19038215.
Article
40. Lutz J, Jäger L, de Quervain D, Krauseneck T, Padberg F, Wichnalek M, et al. White and gray matter abnormalities in the brain of patients with fibromyalgia: a diffusion-tensor and volumetric imaging study. Arthritis Rheum. 2008; 58:3960–3969. PMID: 19035484.
Article
41. Burgmer M, Pogatzki-Zahn E, Gaubitz M, Wessoleck E, Heuft G, Pfleiderer B. Altered brain activity during pain processing in fibromyalgia. Neuroimage. 2009; 44:502–508. PMID: 18848998.
Article
42. Kuchinad A, Schweinhardt P, Seminowicz DA, Wood PB, Chizh BA, Bushnell MC. Accelerated brain gray matter loss in fibromyalgia patients: premature aging of the brain? J Neurosci. 2007; 27:4004–4007. PMID: 17428976.
Article
43. Kim JH, Suh SI, Seol HY, Oh K, Seo WK, Yu SW, et al. Regional grey matter changes in patients with migraine: a voxel-based morphometry study. Cephalalgia. 2008; 28:598–604. PMID: 18422725.
Article
44. Draganski B, Moser T, Lummel N, Gänssbauer S, Bogdahn U, Haas F, et al. Decrease of thalamic gray matter following limb amputation. Neuroimage. 2006; 31:951–957. PMID: 16520065.
Article
45. Schmidt-Wilcke T, Leinisch E, Gänssbauer S, Draganski B, Bogdahn U, Altmeppen J, et al. Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients. Pain. 2006; 125:89–97. PMID: 16750298.
Article
46. Schmidt-Wilcke T, Luerding R, Weigand T, Jürgens T, Schuierer G, Leinisch E, et al. Striatal grey matter increase in patients suffering from fibromyalgia--a voxel-based morphometry study. Pain. 2007; 132(Suppl 1):S109–S116. PMID: 17587497.
47. Teutsch S, Herken W, Bingel U, Schoell E, May A. Changes in brain gray matter due to repetitive painful stimulation. Neuroimage. 2008; 42:845–849. PMID: 18582579.
Article
48. Rovaris M, Agosta F, Pagani E, Filippi M. Diffusion tensor MR imaging. Neuroimaging Clin N Am. 2009; 19:37–43. PMID: 19064198.
Article
49. Rocca MA, Colombo B, Inglese M, Codella M, Comi G, Filippi M. A diffusion tensor magnetic resonance imaging study of brain tissue from patients with migraine. J Neurol Neurosurg Psychiatry. 2003; 74:501–503. PMID: 12640073.
Article
50. Rocca MA, Ceccarelli A, Falini A, Tortorella P, Colombo B, Pagani E, et al. Diffusion tensor magnetic resonance imaging at 3.0 tesla shows subtle cerebral grey matter abnormalities in patients with migraine. J Neurol Neurosurg Psychiatry. 2006; 77:686–689. PMID: 16614037.
Article
51. Rainville P, Duncan GH, Price DD, Carrier B, Bushnell MC. Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science. 1997; 277:968–971. PMID: 9252330.
Article
52. Sengupta S, Kumar D. Pain and emotion: relationship revisited. German J Psychiatry. 2005; 8:85–93.
53. Peyron R, Garcia-Larrea L, Grégoire MC, Costes N, Convers P, Lavenne F, et al. Haemodynamic brain responses to acute pain in humans: sensory and attentional networks. Brain. 1999; 122:1765–1780. PMID: 10468515.
54. Flor H, Braun C, Elbert T, Birbaumer N. Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neurosci Lett. 1997; 224:5–8. PMID: 9132689.
Article
55. López-Solà M, Pujol J, Hernández-Ribas R, Harrison BJ, Ortiz H, Soriano-Mas C, et al. Dynamic assessment of the right lateral frontal cortex response to painful stimulation. Neuroimage. 2010; 50:1177–1187. PMID: 20080188.
Article
56. Bantick SJ, Wise RG, Ploghaus A, Clare S, Smith SM, Tracey I. Imaging how attention modulates pain in humans using functional MRI. Brain. 2002; 125:310–319. PMID: 11844731.
Article
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