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Today it seems clear that the experimental manipulation used to induce placebo analgesia plays a fundamental role in the magnitude of the response. Among the different manipulations that have been performed, both the type of verbal suggestions and the individual’s previous experience have been found to be important. Verbal suggestions that induce certain expectations of …
The lateral and medial pain systems are affected differently in Alzheimer’s disease. Both the primary somatosensory cortex and some thalamic nuclei, which belong to the lateral pain system, are relatively unaffected by the histological changes that characterize Alzheimer’s disease, thus indicating that a preserved sensory-discriminative function should be expected. By contrast, the intralaminar thalamic nuclei, …
Continue reading "The Lateral and Medial Pain Systems in Alzheimer’s Disease"
Today we know that there is not a pain center in which the final pain experience emerges, but rather there is a distributed system that is made up of an intricate network of cortical and subcortical areas, each with some specific functions. This network is often referred to as the “pain matrix.” The organization of …
Placebo effects can be very effective in certain pain conditions, but their use is still highly controversial. Several studies show that patients would accept a placebo treatment under certain circumstances, particularly when they are informed prior to the treatment or when there are no effective treatment alternatives. This study examines the question, which factors influence the degree of acceptability of a hypothetical placebo application.
Let's say that you stub your toe. Nerves in the toe known as nociceptors, tasked with sensing pain, go into action. They send messages to the spinal cord that pain has occurred; the worse the stub, the more rapidly and powerfully they fire. The spinal cord then releases neurotransmitters to the brain's thalamus, communicating with the …
This article provides an overview of the physiological mechanisms of pain and the important pain pathways. We will discuss pain receptors, transmission of pain signals to the spinal cord and pain pathways within the spinal cord. We will also look at how pain can be modulated at different levels along the pathway. Finally we discuss different types of pain including visceral and neuropathic pain.
There are two main classifications of pain: the commonsensical sort that arises from damaged tissue (nociceptive pain), and the more exotic kind that comes from damage to the system that reports and interprets damage, the nervous system (neuropathic pain). This is the difference between engine trouble and trouble with that light on your dashboard that claims there’s engine trouble. Oddly, there is still no official …
The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of pre-amputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain.
Persistent or chronic pain is the primary reason people seek medical care, yet current therapies are either inadequate for certain types of pain or cause intolerable side effects. Recently, pain neurobiologists have identified a number of cellular and molecular processes that lead to the initiation and maintenance of pain. Understanding these underlying mechanisms has given significant promise for the development of more effective, more specific pain therapies in the near future.
Placebo effects illustrate the power of the human brain; simply expecting an improvement can alter pain processing and produce analgesia. We induced placebo improvement of both negative and positive feelings (painful and pleasant touch) in healthy humans, and compared the brain processing using functional MRI. Pain reduction dampened sensory processing in the brain, whereas increased touch pleasantness increased sensory processing. Neurocircuitry associated with emotion and reward underpinned improvement of both pain and pleasant touch. Our findings suggest that expectation of improvement can recruit common neurocircuitry, which up- or down-regulates sensory processing, depending on whether the starting point is painful or pleasant. These results promote widening the scope of medical research to improvement of positive experiences and pleasure.