Pain imaging in health and disease — how far have we come?
Petra Schweinhardt, M. Catherine Bushnell
Petra Schweinhardt, M. Catherine Bushnell
Published November 1, 2010
Citation Information: J Clin Invest. 2010;120(11):3788-3797. https://doi.org/10.1172/JCI43498.
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Pain imaging in health and disease — how far have we come?

Abstract

Since modern brain imaging of pain began 20 years ago, networks in the brain related to pain processing and those related to different types of pain modulation, including placebo, have been identified. Functional and anatomical connectivity of these circuits has begun to be analyzed. Imaging in patients suggests that chronic pain is associated with altered function and structural abnormalities in pain modulatory circuits. Moreover, biochemical alterations associated with chronic pain are being identified that provide information on cellular correlates as well as potential mechanisms of structural changes. Data from these brain imaging studies reinforce the idea that chronic pain leads to brain changes that could have functional significance.

Authors

Petra Schweinhardt, M. Catherine Bushnell

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Figure 3

Clinical pain is shifted in the insula.

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Clinical pain is shifted in the insula. (A) Localization of rostral (gre...
(A) Localization of rostral (green) and caudal (blue) anterior insula, as defined in ref. 64, in the human brain. (B) Peak activations found in imaging studies investigating acute experimental pain in healthy subjects (purple spheres) and clinical pain in patients (black spheres). Clinical pain studies investigated ongoing neuropathic pain, provoked mechanical allodynia in neuropathic pain patients, angina pectoris, cluster headache, or punctate hyperalgesia in CRPS. Clinical pain is located significantly more anterior than acute pain (Mann-Whitney-Wilcoxon test, P < 0.001). (C) The mean localization of anterior insular activation in studies investigating clinical pain (black), acute experimental pain in healthy subjects (purple), interoception (yellow), and anxiety or non-painful stimuli with highly aversive content (red). In addition, cognitive or emotional modulation of acute experimental pain in healthy subjects is depicted (blue). Clinical pain is located as anterior as aversive stimuli or interoception (Mann-Whitney-Wilcoxon tests, P = 0.9 and P = 0.4, respectively). Ellipsoids are relative in size to the standard deviation in the y direction. Coordinates are in MNI standard stereotaxic space. y refers to anterior-posterior (nose to back of the head); z refers to superior-inferior (head to feet). Reproduced with permission from NeuroImage (64). Refer to ref. 64 for a complete list of references.