Is finding a pukka neurosignature for pain on the top of our discovery list?

Earlier this month, Nature Reviews Neurology published a Consensus Statement from a presidential taskforce of the International Association for the Study of Pain (IASP), on the use of brain imaging tests for chronic pain. The statement answers the question of whether chronic pain can be identified ‘objectively’. Whether or not brain imaging can … [Read more...]

Chronic Pain: Lost Inhibition?

While working with chronic neuropathic pain sufferers over the last few years, quite often I was asked if there is a “pain center” within our body, particularly in the brain, where pain is generated. One of my chronic pain patients actually quipped: “If you tell me where the pain hub is I will go to a surgeon and let them cut it out”. … [Read more...]

Just how much can the coloured blobs tell us

When it comes to treating someone in pain we have one way of knowing if our treatment has effected pain relief, and that is the patient’s verbal report.   Perhaps another way of knowing whether pain has changed is to look at what’s happening in the brain.  Well, this review is addressing precisely this question.  Presented here[1] are the findings … [Read more...]

Vania Apkarian and the holy grail

I love hearing Vania Apkarian speak. He is always so positive about his data and so forthright in his views that you have no doubt what he thinks and no doubt that he loves going to work.  This workshop I went to today was no exception – it was Apkarian at his best. And, quite possibly, he has good reason to be excited. His group at NorthWestern in … [Read more...]

Timing is everything

Human brain mapping doesn’t go back as far as one might think.  The first brain activation studies used positron emission tomography (PET) back in the late 1980s.   Functional magnetic resonance imaging, or fMRI, followed in the early 90s and went on to radically change neuroimaging [1]. Given that it’s such early days for brain mapping, it … [Read more...]

Regret, empathy, espresso

I’ve got news for those of us who thought that Italians just sat around wearing designer sunglasses and drinking fine coffee; it turns out we were wrong.  This fMRI study by a group in Milan is a pearler, and I urge anyone who’s interested to have a look at it.[1] First was a look into empathy: these investigators wanted to know whether the same … [Read more...]

Someone else’s pain—Are you in or out?

One of the bits of the brain I find the toughest to understand is the insula.  We hear about it when the “pain matrix” is discussed.  The insula is part of what is currently understood as the medial pain system— involved in assigning meaning, emotion and affect to the pain experience[1].  Various neuroimaging studies have found activity in the … [Read more...]

rTMS and chronic pain: Our two penny’s worth

Some of you might have heard of repetitive transcranial magnetic stimulation (rTMS) and its use in chronic pain. Basically rTMS uses magnetic fields to generate electrical currents within the brain. This is a direct way of altering neuronal firing or excitability in the brain and a number of research groups have been investigating whether it might … [Read more...]

Introducing DAMIEN – the brain’s default mode network

Numerous studies involving functional magnetic resonance imaging (fMRI) of the brain, tell us that chronic back pain (CBP) alters brain function well beyond the feeling of pain and can cause impairments like depression, impaired decision-making and sleep disturbance [1,2]. It was Baliki’s group in 2008 which confirmed for the first time that CBP … [Read more...]