From Cue to Meaning

Sensory cues in our environment continuously guide processing in the brain. A simple touch, tone or a flash of light shapes our thought process countless numbers of times per day. In pain, cues leading to expectations of higher upcoming pain not only increase subjective pain ratings, but also increase the degree of activity in brain areas engaged … [Read more...]

Stability of conditioned pain modulation in patients with chronic pain: Implications for pain assessment & treatment

Over the past few decades, considerable evidence has accumulated indicating that pain may be modulated by a variety of endogenous pain-inhibitory processes. These operate at various levels of the central nervous system (CNS), and play a role in shaping the subjective experience of pain. Importantly, several lines of research suggest that … [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...]

Altered brain function and structure in chronic low back pain

Many studies trying to unravel the chronic pain picture suggest that differences in central pain-transmitting systems may explain chronic pain. Our body disposes of several internal mechanisms to regulate the pain, which are deficient in patients with whiplash associated disorders, fibromyalgia, etc. We reviewed the central pain processing in … [Read more...]

It is the instrument that shapes your brain and not only the time you spend with it

We know that repetitive training changes functional circuits and even the structure of the brain.  These structural changes are especially prominent in people who train for many years several hours a day, for example musicians who are highly motivated to play their instrument and often have extensive training periods. It has been demonstrated … [Read more...]

Structural changes in chronic pain. The innocent bystander?

Most BiM readers will be familiar with a body of research indicating that chronic pain is associated with apparent structural changes in the brain. We’ve discussed this issue here at length (see here and here). These findings, principally of reductions in grey matter density across a smattering of brain regions, have led researchers, myself … [Read more...]

VBM – voxel-based morphometry or very bad measurement?

Brain imaging technology has become a big player in the world of pain research in the last 2 decades. In more recent years voxel based morphometry (VBM), which allows us to look at structural changes in the brain (specifically neuronal matter density) has produced some eyebrow raising research in chronic pain. It is this technology that produced … [Read more...]

A big hole in the control? Transcranial direct current stimulation blinding on trial

You may or may not have heard of transcranial direct current stimulation (tDCS), but it is non-invasive method for stimulating the brain with low intensity electrical currents. Over the last decade or so there has been plenty of basic physiology research demonstrating that tDCS directly modulates cortical excitability. Neatly, anodal stimulation … [Read more...]

The search for the ‘hurt’… the brain?

It was quite the line up at the recent IASP conference: Tracey, Apkarian, Flor, Crombez, Iannetti, Moseley …the groupies were gathering around a melting pot of pain-full ideas. One such thought provoking notion was the search for “the ‘hurt’ in the brain”, in association with a staunch refuting of the use of the ‘pain signature’ label- a … [Read more...]

Not a dry eye in my house. Paralympics, pain and plasticity.

I LOVE the Olympics. And didn't London put on a stellar show - I have really enjoyed watching you Brits hold up the mirror and get rather surprised at how good you really are at stuff - the Olympic medal haul from Team GB was truly magnificent of course. I remember how Uber-Australian we all became during and for a while after the Sydney 2000 … [Read more...]