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Pain Management 2015Pain is a significant national burden in terms of patient suffering, expenditure and lost productivity. Understanding pain is fundamental to improving evaluation,... (Review)
Review
Pain is a significant national burden in terms of patient suffering, expenditure and lost productivity. Understanding pain is fundamental to improving evaluation, treatment and innovation in the management of acute and persistent pain syndromes. Pain perception begins in the periphery, and then ascends in several tracts, relaying at different levels. Pain signals arrive in the thalamus and midbrain structures which form the pain neuromatrix, a constantly shifting set of networks and connections that determine conscious perception. Several cortical regions become active simultaneously during pain perception; activity in the cortical pain matrix evolves over time to produce a complex pain perception network. Dysfunction at any level has the potential to produce unregulated, persistent pain.
Topics: Analgesia; Brain; Chronic Pain; Humans; Nociception; Pain; Pain Perception; Pain Threshold; Peripheral Nervous System; Spinal Cord; Visceral Pain
PubMed: 26088531
DOI: 10.2217/pmt.15.27 -
Nature Neuroscience May 2023A painful episode can lead to a life-long increase in an individual's experience of pain. Fearful anticipation of imminent pain could play a role in this phenomenon, but...
A painful episode can lead to a life-long increase in an individual's experience of pain. Fearful anticipation of imminent pain could play a role in this phenomenon, but the neurobiological underpinnings are unclear because fear can both suppress and enhance pain. Here, we show in mice that long-term associative fear memory stored in neuronal engrams in the prefrontal cortex determines whether a painful episode shapes pain experience later in life. Furthermore, under conditions of inflammatory and neuropathic pain, prefrontal fear engrams expand to encompass neurons representing nociception and tactile sensation, leading to pronounced changes in prefrontal connectivity to fear-relevant brain areas. Conversely, silencing prefrontal fear engrams reverses chronically established hyperalgesia and allodynia. These results reveal that a discrete subset of prefrontal cortex neurons can account for the debilitating comorbidity of fear and chronic pain and show that attenuating the fear memory of pain can alleviate chronic pain itself.
Topics: Mice; Animals; Chronic Pain; Memory, Long-Term; Fear; Brain; Prefrontal Cortex; Hyperalgesia; Pain Perception
PubMed: 37024573
DOI: 10.1038/s41593-023-01291-x -
Journal of Neurophysiology Jan 2013Several theoretical frameworks have been proposed to explain the physiological basis of pain, although none yet completely accounts for all aspects of pain perception.... (Review)
Review
Several theoretical frameworks have been proposed to explain the physiological basis of pain, although none yet completely accounts for all aspects of pain perception. Here, we provide a historical overview of the major contributions, ideas, and competing theories of pain from ancient civilizations to Melzack and Wall's Gate Control Theory of Pain.
Topics: Animals; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; Humans; Pain; Pain Perception; Sensory Gating
PubMed: 23034364
DOI: 10.1152/jn.00457.2012 -
Neurological Sciences : Official... Jan 2022Language is one of the main tools with whom people describe their pain. The semantic value of words plays a fundamental role in the pain perception, intended as a... (Review)
Review
INTRODUCTION AND SCOPE
Language is one of the main tools with whom people describe their pain. The semantic value of words plays a fundamental role in the pain perception, intended as a complex process of modulation and processing in the brain. The priming effect is a cognitive process in which a certain stimulus can influence subsequent stimuli. It is therefore plausible that this effect plays a key role in the modulation and perception of pain. This study aimed to investigate the potential relationship between the semantic aspects of language, the priming effect, and the perception of pain.
METHODS AND RESULTS
A narrative review of the literature was conducted. Sixteen studies were included and categorized in four groups based on the effect of the verbal suggestion on the experimental acute pain and chronic pain and on the effect of pain-related words in free pain and post-surgical subjects.
CONCLUSIONS
There may be a link between language and pain, both at the behavioral and neural level. The processing of semantic information associated with pain influences the pain perception.
Topics: Brain; Brain Mapping; Humans; Pain; Pain Perception; Semantics
PubMed: 34462809
DOI: 10.1007/s10072-021-05577-5 -
Journal of Religion and Health Aug 2016Dhamma, which Lord Buddha has presented to people after his enlightenment, analyzes every phenomenon and objects into their ultimate elements. The explanation of sensory... (Review)
Review
Dhamma, which Lord Buddha has presented to people after his enlightenment, analyzes every phenomenon and objects into their ultimate elements. The explanation of sensory system is also found in a part of Dhamma named Abhidhammapitaka, the Book of the Higher Doctrine in Buddhism. To find out the relationship between explanation of pain in the present neuroscience and the explanation of pain in Abhidhamma, the study was carried out by the use of a comprehensive review. The comparisons were in terms of peripheral stimulation, signal transmission, modulation, perception, suffering, determination and decision making for the responding to pain. We found that details of the explanation on pain mechanism and perception in Abhidhamma could associate well with our present scientific knowledge. Furthermore, more refinement information about the process and its function in particular aspects of pain perception were provided in Abhidhammapitaka.
Topics: Buddhism; Humans; Pain Perception; Religion and Medicine
PubMed: 26112611
DOI: 10.1007/s10943-015-0080-z -
Nature Reviews. Neuroscience Jul 2013Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and... (Review)
Review
Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mind-body therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states - important components of mind-body therapies. It will also examine the accumulating evidence that chronic pain itself alters brain circuitry, including that involved in endogenous pain control, suggesting that controlling pain becomes increasingly difficult as pain becomes chronic.
Topics: Attention; Brain; Chronic Pain; Cognition; Emotions; Humans; Pain Management; Pain Perception
PubMed: 23719569
DOI: 10.1038/nrn3516 -
Pain Jun 2017Breathing techniques are commonly used to alleviate pain. Despite their frequent use, surprisingly little is known about their efficacy as well as their underlying... (Review)
Review
Breathing techniques are commonly used to alleviate pain. Despite their frequent use, surprisingly little is known about their efficacy as well as their underlying physiological mechanisms. The purpose of this systematic review is to summarize and critically appraise the results of existing studies on the association between respiration and pain, and to highlight a potential physiological mechanism underlying the respiration-pain connection. A total of 31 publications from between 1984 and 2015 were retrieved and analyzed. These articles were classified into 4 groups: experimental and clinical studies of the effect of pain on respiration, clinical studies of the effects of breathing techniques on pain, and experimental studies of the influence of various forms of respiration on laboratory-induced pain. The findings suggest that pain influences respiration by increasing its flow, frequency, and volume. Furthermore, paced slow breathing is associated with pain reduction in some of the studies, but evidence elucidating the underlying physiological mechanisms of this effect is lacking. Here, we focus on the potential role of the cardiovascular system on the respiratory modulation of pain. Further research is definitely warranted.
Topics: Animals; Breathing Exercises; Evidence-Based Medicine; Humans; Models, Biological; Pain Perception; Respiratory Mechanics; Treatment Outcome
PubMed: 28240995
DOI: 10.1097/j.pain.0000000000000865 -
Neuron Aug 2015Recent neuroimaging studies suggest that the brain adapts with pain, as well as imparts risk for developing chronic pain. Within this context, we revisit the concepts... (Review)
Review
Recent neuroimaging studies suggest that the brain adapts with pain, as well as imparts risk for developing chronic pain. Within this context, we revisit the concepts for nociception, acute and chronic pain, and negative moods relative to behavior selection. We redefine nociception as the mechanism protecting the organism from injury, while acute pain as failure of avoidant behavior, and a mesolimbic threshold process that gates the transformation of nociceptive activity to conscious pain. Adaptations in this threshold process are envisioned to be critical for development of chronic pain. We deconstruct chronic pain into four distinct phases, each with specific mechanisms, and outline current state of knowledge regarding these mechanisms: the limbic brain imparting risk, and the mesolimbic learning processes reorganizing the neocortex into a chronic pain state. Moreover, pain and negative moods are envisioned as a continuum of aversive behavioral learning, which enhance survival by protecting against threats.
Topics: Affect; Animals; Avoidance Learning; Brain; Humans; Nociception; Pain; Pain Perception
PubMed: 26247858
DOI: 10.1016/j.neuron.2015.06.005 -
Neuroscience Sep 2018An accumulating body of evidence suggests that the hypothalamic neuropeptide oxytocin (OT) has a modulatory effect on pain processing. Particularly strong evidence comes... (Review)
Review
An accumulating body of evidence suggests that the hypothalamic neuropeptide oxytocin (OT) has a modulatory effect on pain processing. Particularly strong evidence comes from animal models. Here, we review recent advances in animal research on the analgesic effects of OT and discuss possible target sites of OT within descending and ascending pain pathways in the brain. In addition to the spinal cord being a direct target of the neuropeptide, OT has also been shown to modulate the neuronal activity of limbic and cortical brain regions, which play a major role in the cognitive and emotional processing of pain. Human studies investigating the influence of OT on pain perception are less numerous and have revealed less consistent results. The human literature is therefore scanned thoroughly and different approaches to study the effects of OT on pain perception in humans are discussed. Moreover, we also address how OT might alleviate pain by influencing socio-emotional components in humans. We conclude that further investigating specific OT and OT-sensitive circuits, which modulate pain processing especially in primates, will improve our understanding of OT-analgesic effects. In human research, the increased use of neuroimaging and autonomic measures might help to bridge the gap to animal studies.
Topics: Analgesics; Animals; Brain; Humans; Models, Neurological; Oxytocin; Pain Perception; Spinal Cord
PubMed: 28965836
DOI: 10.1016/j.neuroscience.2017.09.041 -
Biological Psychology Jul 2015Suppression of spontaneous alpha oscillatory activities, interpreted as cortical excitability, was observed in response to both transient and tonic painful stimuli. The... (Review)
Review
Suppression of spontaneous alpha oscillatory activities, interpreted as cortical excitability, was observed in response to both transient and tonic painful stimuli. The changes of alpha rhythms induced by pain could be modulated by painful sensory inputs, experimental tasks, and top-down cognitive regulations such as attention. The temporal and spatial characteristics, as well as neural functions of pain induced alpha responses, depend much on how these factors contribute to the observed alpha event-related desynchronization/synchronization (ERD/ERS). How sensory-, task-, and cognitive-related changes of alpha oscillatory activities interact in pain perception process is reviewed in the current study, and the following conclusions are made: (1) the functional inhibition hypothesis that has been proposed in auditory and visual modalities could be applied also in pain modality; (2) the neural functions of pain induced alpha ERD/ERS were highly dependent on the cortical regions where it is observed, e.g., somatosensory cortex alpha ERD/ERS in pain perception for painful stimulus processing; (3) the attention modulation of pain perception, i.e., influences on the sensory and affective dimensions of pain experience, could be mediated by changes of alpha rhythms. Finally, we propose a model regarding the determinants of pain related alpha oscillatory activity, i.e., sensory-discriminative, affective-motivational, and cognitive-modulative aspects of pain experience, would affect and determine pain related alpha oscillatory activities in an integrated way within the distributed alpha system.
Topics: Alpha Rhythm; Attention; Electroencephalography Phase Synchronization; Humans; Pain Perception; Somatosensory Cortex
PubMed: 26026894
DOI: 10.1016/j.biopsycho.2015.05.004