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Neuroimaging of Pain

  • S. Espinoza
  • C. Habas
Chapter
Part of the Contemporary Clinical Neuroscience book series (CCNE)

Abstract

Advanced neuroimaging techniques (fMRI, PET, and MEG) have led to the identification of a set of neural networks jointly and dynamically recruited during pain processing. These techniques allow also to better characterize cerebral anatomo-functional impairments underlying chronic pain. If a “pain matrix” (PM) was characterized as the first encephalic circuit processing location and intensity of nociceptive afferents, it turns out that several potentially collaborative networks underlie specific vegetative, motor, emotional, motivational, mnesic, and executive aspects of the integrated painful experience. In other words, all brain areas engaged in pain sensation do not belong to a unique, well-delineated pain-specific network but represent a “pain signature” across distinct networks (Tracey and Mantyh Neuron 55: 377–391, 2007). In this vein, if activation of the PM is always elicited either by nociceptive stimuli or by (pathological) endogenous mechanisms, placebo, hypnosis, or empathy can be accompanied by activity in PM and pain-recruited networks. Structural, functional, and metabolic neuroimaging has shed light on neuroplastic aberrant reshaping of large-scale circuits underlying chronic pain. Furthermore, specific areas of PM and associated pain modulatory networks, which are well-delineated by fMRI, can be targeted by several noninvasive brain stimulation methods, such as transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS), in order to alleviate pain symptoms, as well as real-time fMRI-based neurofeedback.

Keywords

Pain Chronic pain Pain matrix Analgesia Insula Anterior cingulate cortex Prefrontal cortex Canonical networks Salience network Default mode network fMRI ASL PET scan Spectroscopy Voxel-based morphometry Aversive learning Neurofeedback Neurostimulation 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Service de NeuroImagerieParisFrance

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