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EXPLORING PAIN

As far back as Hippocrates, it was understood that the brain was key to a person experiencing pain. Fortunately, these days we have many techniques available to explore the human central nervous system (CNS) noninvasivelyfrom a functional, structural and chemical perspective in both patients and healthy subjects. Identifying non-invasively where functional and structural plasticity, sensitisation and other amplification or attenuation processes occur along the pain neuraxis for an individual and relating these neural mechanisms to specific pain experiences, measures of pain relief, persistence of pain states, degree of injury and the subject's underlying genetics, has neuroscientific relevance and potential diagnostic value.

Such read-outs provide a ‘behind the scenes’ measure of the nociceptive processing that underpins the subjective ‘healthy’ acute pain experience as well as mechanisms relevant to the development and maintenance of chronic pain states. They can be powerfully used to aid explanation of a subject’s multidimensional pain experience or analgesia.

PAIN NEUROIMAGING

Importantly, these technologies have contributed to a better understanding of the consequences on the human CNS of patients left with poorly managed chronic pain. Current work focuses on identifying what aberrant CNS mechanisms might make an individual resilient or vulnerable to developing a chronic pain condition. It is our contention that 'pain neuroimaging' will play an increasing role in pain neuroscience, clinical decision-making and analgesic drug development in the coming decade. We are also interested in the neural mechanisms by which anaesthetics alter pain perception and awareness.