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Published in: Current Pain and Headache Reports 2/2013

01-02-2013 | Anesthetic Techniques in Pain Management (KA Williams, Section editor)

Functional Imaging for Interpretation of Pain Pathways: Current Clinical Application/Relevance and Future Initiatives

Authors: Collin F. M. Clarke, Keith St. Lawrence

Published in: Current Pain and Headache Reports | Issue 2/2013

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Abstract

Functional imaging of the central nervous system has been utilized since the 1970s focusing on the concept that neural functioning is coupled to regional cerebral blood flow. This has allowed for extensive mapping of the neural pathways associated with pain, the “pain-matrix.” The study of the functional anatomy utilizes positron electron tomography and 2 magnetic resonance imaging techniques known as arterial spin labeling and blood oxygen dependent imaging. This area of study has greatly improved in recent years in being able to assist in the diagnosis of conditions and support in the creation of targeted therapies. The goal of this review is to educate the reader on the evolution of functional imaging and its application to the study of pain and furthermore to highlight the advances in this field that may allow for further clinical applications of this modality.
Literature
1.
go back to reference Toyama H, Lio M, Lisaka J, Chiba K, Yamada H, Matsui K, et al. Color functional images of the cerebral blood flow. J Nucl Med. 1976;17:953–8.PubMed Toyama H, Lio M, Lisaka J, Chiba K, Yamada H, Matsui K, et al. Color functional images of the cerebral blood flow. J Nucl Med. 1976;17:953–8.PubMed
2.
go back to reference Peyron R, Laurent B, Garcia-Larrea L. Functional imaging of brain responses to pain. A review and meta-analysis. Neurophysiol Clin. 2000;30:263–88.PubMed Peyron R, Laurent B, Garcia-Larrea L. Functional imaging of brain responses to pain. A review and meta-analysis. Neurophysiol Clin. 2000;30:263–88.PubMed
3.
go back to reference Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–84.PubMed Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–84.PubMed
4.
go back to reference Di Piero V, Jones AK, Iannotti F, Powell M, Perani D, Lenzi GL, et al. Chronic pain: a PET study of the central effects of percutaneous high cervical cordotomy. Pain. 1991;46:9–12.PubMed Di Piero V, Jones AK, Iannotti F, Powell M, Perani D, Lenzi GL, et al. Chronic pain: a PET study of the central effects of percutaneous high cervical cordotomy. Pain. 1991;46:9–12.PubMed
5.
go back to reference Hsieh JC, Belfrage M, Stone-Elander S, Hansson P, Ingvar M. Central representation of chronic ongoing neuropathic pain studied by positron emission tomography. Pain. 1995;63:225–36.PubMed Hsieh JC, Belfrage M, Stone-Elander S, Hansson P, Ingvar M. Central representation of chronic ongoing neuropathic pain studied by positron emission tomography. Pain. 1995;63:225–36.PubMed
6.
go back to reference Xu X, Fukuyama H, Yazawa S, Mima T, Hanakawa T, Magata Y, et al. Functional localization of pain perception in the human brain studied by PET. Neuroreport. 1997;8:555–9.PubMed Xu X, Fukuyama H, Yazawa S, Mima T, Hanakawa T, Magata Y, et al. Functional localization of pain perception in the human brain studied by PET. Neuroreport. 1997;8:555–9.PubMed
7.
go back to reference Davis KD, Kwan CL, Crawley AP, Mikulis DJ. Event-related fMRI of pain: entering a new era in imaging pain. Neuroreport. 1998;9:3019–23.PubMed Davis KD, Kwan CL, Crawley AP, Mikulis DJ. Event-related fMRI of pain: entering a new era in imaging pain. Neuroreport. 1998;9:3019–23.PubMed
8.
go back to reference Chen AC. New perspectives in EEG/MEG brain mapping and PET/fMRI neuroimaging of human pain. Int J Psychophysiol. 2001;42:147–59.PubMed Chen AC. New perspectives in EEG/MEG brain mapping and PET/fMRI neuroimaging of human pain. Int J Psychophysiol. 2001;42:147–59.PubMed
9.
go back to reference Bingel U, Tracey I. Imaging CNS modulation of pain in humans. Physiology. 2008;23:371–80.PubMed Bingel U, Tracey I. Imaging CNS modulation of pain in humans. Physiology. 2008;23:371–80.PubMed
10.
go back to reference Owen DG, Bureau Y, Thomas AW, Prato FS, St Lawrence KS. Quantification of pain-induced changes in cerebral blood flow by perfusion MRI. Pain. 2008;136:85–96.PubMed Owen DG, Bureau Y, Thomas AW, Prato FS, St Lawrence KS. Quantification of pain-induced changes in cerebral blood flow by perfusion MRI. Pain. 2008;136:85–96.PubMed
11.
go back to reference •• Owen DG, Clarke CF, Ganapathy S, Prato FS, St Lawrence KS. Using perfusion MRI to measure the dynamic changes in neural activation associated with tonic muscular pain. Pain. 2010;148:375–86. This study demonstrated that ASL can be applied to studies of prolonged pain since it becomes increasingly more sensitive than BOLD to changes in neural over time. It further supported that ASL can capture dynamic activation patterns during prolonged pain periods.PubMed •• Owen DG, Clarke CF, Ganapathy S, Prato FS, St Lawrence KS. Using perfusion MRI to measure the dynamic changes in neural activation associated with tonic muscular pain. Pain. 2010;148:375–86. This study demonstrated that ASL can be applied to studies of prolonged pain since it becomes increasingly more sensitive than BOLD to changes in neural over time. It further supported that ASL can capture dynamic activation patterns during prolonged pain periods.PubMed
12.
go back to reference Colombo B, Dalla Costa G, Dalla Libera D, Comi G. From neuroimaging to clinical setting: what have we learned from migraine pain? Neurol Sci. 2012;33 Suppl 1:S95–7.PubMed Colombo B, Dalla Costa G, Dalla Libera D, Comi G. From neuroimaging to clinical setting: what have we learned from migraine pain? Neurol Sci. 2012;33 Suppl 1:S95–7.PubMed
13.
go back to reference Tedeschi G, Russo A, Tessitore A. Functional neuroimaging in migraine: usefulness for the clinical neurologist. Neurol Sci. 2012;33 Suppl 1:S91–4.PubMed Tedeschi G, Russo A, Tessitore A. Functional neuroimaging in migraine: usefulness for the clinical neurologist. Neurol Sci. 2012;33 Suppl 1:S91–4.PubMed
14.
go back to reference • Gracely RH, Ambrose KR. Neuroimaging of fibromyalgia. Best Pract Res Clin Rheumatol. 2011;25:271–84. This paper reviews historical work performed in the investigation of fibromyalgia and how functional imaging has demonstrated that this disease is its own distinct, legitimate clinical entity.PubMed • Gracely RH, Ambrose KR. Neuroimaging of fibromyalgia. Best Pract Res Clin Rheumatol. 2011;25:271–84. This paper reviews historical work performed in the investigation of fibromyalgia and how functional imaging has demonstrated that this disease is its own distinct, legitimate clinical entity.PubMed
15.
go back to reference •• Borsook D, Upadhyay J, Klimas M, Schwarz AJ, Coimbra A, Baumgartner R, et al. Decision-making using fMRI in clinical drug development: revisiting NK-1 receptor antagonists for pain. Drug Discov Today. 2012;17:964–73. doi:10.1016/j.drudis.2012.05.004. This review highlights how functional imaging may be utilized as a cost effective tool to assist in the prediction of valid targets for drug design success in the therapeutic domain. •• Borsook D, Upadhyay J, Klimas M, Schwarz AJ, Coimbra A, Baumgartner R, et al. Decision-making using fMRI in clinical drug development: revisiting NK-1 receptor antagonists for pain. Drug Discov Today. 2012;17:964–73. doi:10.​1016/​j.​drudis.​2012.​05.​004. This review highlights how functional imaging may be utilized as a cost effective tool to assist in the prediction of valid targets for drug design success in the therapeutic domain.
16.
go back to reference Chapin H, Bagarinao E, Mackey S. Real-time fMRI applied to pain management. Neurosci Lett. 2012;520:174–81.PubMed Chapin H, Bagarinao E, Mackey S. Real-time fMRI applied to pain management. Neurosci Lett. 2012;520:174–81.PubMed
17.
go back to reference Oluigbo C, Abduljalil A, Yang X, Kalnin A, Knopp MV, Rezai AR. 156 Neuroimaging biomarkers of chronic neuropathic pain and its modulation: resting state fMRI signals during spinal cord stimulation. Neurosurgery. 2012;71:E562. Oluigbo C, Abduljalil A, Yang X, Kalnin A, Knopp MV, Rezai AR. 156 Neuroimaging biomarkers of chronic neuropathic pain and its modulation: resting state fMRI signals during spinal cord stimulation. Neurosurgery. 2012;71:E562.
18.
go back to reference • Borsook D, Becerra L. How close are we in utilizing functional neuroimaging in routine clinical diagnosis of neuropathic pain? Curr Pain Headache Rep. 2011;15:223–9. This paper serves as an excellent review of the socio-economic and clinical issues that surround the advancement of functional imaging into common place within the current medical environment.PubMed • Borsook D, Becerra L. How close are we in utilizing functional neuroimaging in routine clinical diagnosis of neuropathic pain? Curr Pain Headache Rep. 2011;15:223–9. This paper serves as an excellent review of the socio-economic and clinical issues that surround the advancement of functional imaging into common place within the current medical environment.PubMed
19.
go back to reference Takemura Y, Yamashita A, Horiuchi H, Furuya M, Yanase M, Niikura K, et al. Effects of gabapentin on brain hyperactivity related to pain and sleep disturbance under a neuropathic pain-like state using fMRI and brain wave analysis. Synapse. 2011;65:668–76.PubMed Takemura Y, Yamashita A, Horiuchi H, Furuya M, Yanase M, Niikura K, et al. Effects of gabapentin on brain hyperactivity related to pain and sleep disturbance under a neuropathic pain-like state using fMRI and brain wave analysis. Synapse. 2011;65:668–76.PubMed
20.
go back to reference Scrivani S, Wallin D, Moulton EA, Cole S, Wasan AD, Lockerman L, et al. A fMRI evaluation of lamotrigine for the treatment of trigeminal neuropathic pain: pilot study. Pain Med. 2010;11:920–41.PubMed Scrivani S, Wallin D, Moulton EA, Cole S, Wasan AD, Lockerman L, et al. A fMRI evaluation of lamotrigine for the treatment of trigeminal neuropathic pain: pilot study. Pain Med. 2010;11:920–41.PubMed
21.
go back to reference • Sharma HA, Gupta R, Olivero W. fMRI in patients with lumbar disc disease: a paradigm to study patients over time. J Pain Res. 2011;4:401–5. This study demonstrates the successful use of a clinical paradigm integrating the use of functional imaging and clinical exam to study patients with low back pain and leg pain including lumbar radiculopathy over time.PubMed • Sharma HA, Gupta R, Olivero W. fMRI in patients with lumbar disc disease: a paradigm to study patients over time. J Pain Res. 2011;4:401–5. This study demonstrates the successful use of a clinical paradigm integrating the use of functional imaging and clinical exam to study patients with low back pain and leg pain including lumbar radiculopathy over time.PubMed
22.
go back to reference Egloff N, Sabbioni ME, Salathe C, Wiest R, Juengling FD. Nondermatomal somatosensory deficits in patients with chronic pain disorder: clinical findings and hypometabolic pattern in FDG-PET. Pain. 2009;145:252–8.PubMed Egloff N, Sabbioni ME, Salathe C, Wiest R, Juengling FD. Nondermatomal somatosensory deficits in patients with chronic pain disorder: clinical findings and hypometabolic pattern in FDG-PET. Pain. 2009;145:252–8.PubMed
23.
go back to reference Davis KD. Neuroimaging of pain: what does it tell us? Curr Opin Support Palliat Care. 2011;5:116–21.PubMed Davis KD. Neuroimaging of pain: what does it tell us? Curr Opin Support Palliat Care. 2011;5:116–21.PubMed
24.
go back to reference Wang YT, Huang G. Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? From Chinese healthcare system perspective. Eur J Radiol. 2012;81:e903–9.PubMed Wang YT, Huang G. Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? From Chinese healthcare system perspective. Eur J Radiol. 2012;81:e903–9.PubMed
25.
go back to reference Mohr C, Leyendecker S, Mangels I, Machner B, Sander T, Helmchen C. Central representation of cold-evoked pain relief in capsaicin induced pain: an event-related fMRI study. Pain. 2008;139:416–30.PubMed Mohr C, Leyendecker S, Mangels I, Machner B, Sander T, Helmchen C. Central representation of cold-evoked pain relief in capsaicin induced pain: an event-related fMRI study. Pain. 2008;139:416–30.PubMed
26.
go back to reference Aguirre GK, Detre JA, Zarahn E, Alsop DC. Experimental design and the relative sensitivity of BOLD and perfusion fMRI. NeuroImage. 2002;15:488–500.PubMed Aguirre GK, Detre JA, Zarahn E, Alsop DC. Experimental design and the relative sensitivity of BOLD and perfusion fMRI. NeuroImage. 2002;15:488–500.PubMed
27.
go back to reference Kim SG. Quantification of relative cerebral blood flow change by flow-sensitive alternating inversion recovery (FAIR) technique: application to functional mapping. Magn Reson Med. 1995;34:293–301.PubMed Kim SG. Quantification of relative cerebral blood flow change by flow-sensitive alternating inversion recovery (FAIR) technique: application to functional mapping. Magn Reson Med. 1995;34:293–301.PubMed
28.
go back to reference Thunberg J, Lyskov E, Korotkov A, Ljubisavljevic M, Pakhomov S, Katayeva G, et al. Brain processing of tonic muscle pain induced by infusion of hypertonic saline. Eur J Pain. 2005;9:185–94.PubMed Thunberg J, Lyskov E, Korotkov A, Ljubisavljevic M, Pakhomov S, Katayeva G, et al. Brain processing of tonic muscle pain induced by infusion of hypertonic saline. Eur J Pain. 2005;9:185–94.PubMed
29.
go back to reference Wang J, Aguirre GK, Kimberg DY, Roc AC, Li L, Detre JA. Arterial spin labeling perfusion fMRI with very low task frequency. Magn Reson Med. 2003;49:796–802.PubMed Wang J, Aguirre GK, Kimberg DY, Roc AC, Li L, Detre JA. Arterial spin labeling perfusion fMRI with very low task frequency. Magn Reson Med. 2003;49:796–802.PubMed
30.
go back to reference Yongbi MN, Fera F, Yang Y, Frank JA, Duyn JH. Pulsed arterial spin labeling: comparison of multisection baseline and functional MR imaging perfusion signal at 1.5 and 3.0 T: initial results in six subjects. Radiology. 2002;222:569–75.PubMed Yongbi MN, Fera F, Yang Y, Frank JA, Duyn JH. Pulsed arterial spin labeling: comparison of multisection baseline and functional MR imaging perfusion signal at 1.5 and 3.0 T: initial results in six subjects. Radiology. 2002;222:569–75.PubMed
31.
go back to reference Bushnell MC, Duncan GH, Hofbauer RK, Ha B, Chen JI, Carrier B. Pain perception: is there a role for primary somatosensory cortex? Proc Natl Acad Sci U S A. 1999;96:7705–9.PubMed Bushnell MC, Duncan GH, Hofbauer RK, Ha B, Chen JI, Carrier B. Pain perception: is there a role for primary somatosensory cortex? Proc Natl Acad Sci U S A. 1999;96:7705–9.PubMed
32.
go back to reference Vogt BA, Berger GR, Derbyshire SW. Structural and functional dichotomy of human midcingulate cortex. Eur J Neurosci. 2003;18:3134–44.PubMed Vogt BA, Berger GR, Derbyshire SW. Structural and functional dichotomy of human midcingulate cortex. Eur J Neurosci. 2003;18:3134–44.PubMed
33.
go back to reference Peyron R, Frot M, Schneider F, Garcia-Larrea L, Mertens P, Barral FG, et al. Role of operculoinsular cortices in human pain processing: converging evidence from PET, fMRI, dipole modeling, and intracerebral recordings of evoked potentials. NeuroImage. 2002;17:1336–46.PubMed Peyron R, Frot M, Schneider F, Garcia-Larrea L, Mertens P, Barral FG, et al. Role of operculoinsular cortices in human pain processing: converging evidence from PET, fMRI, dipole modeling, and intracerebral recordings of evoked potentials. NeuroImage. 2002;17:1336–46.PubMed
34.
go back to reference Becerra LR, Breiter HC, Stojanovic M, Fishman S, Edwards A, Comite AR, et al. Human brain activation under controlled thermal stimulation and habituation to noxious heat: an fMRI study. Magn Reson Med. 1999;41:1044–57.PubMed Becerra LR, Breiter HC, Stojanovic M, Fishman S, Edwards A, Comite AR, et al. Human brain activation under controlled thermal stimulation and habituation to noxious heat: an fMRI study. Magn Reson Med. 1999;41:1044–57.PubMed
35.
go back to reference Casey KL, Minoshima S, Morrow TJ, Koeppe RA. Comparison of human cerebral activation pattern during cutaneous warmth, heat pain, and deep cold pain. J Neurophysiol. 1996;76:571–81.PubMed Casey KL, Minoshima S, Morrow TJ, Koeppe RA. Comparison of human cerebral activation pattern during cutaneous warmth, heat pain, and deep cold pain. J Neurophysiol. 1996;76:571–81.PubMed
36.
go back to reference Schreckenberger M, Siessmeier T, Viertmann A, Landvogt C, Buchholz HG, Rolke R, et al. The unpleasantness of tonic pain is encoded by the insular cortex. Neurology. 2005;64:1175–83.PubMed Schreckenberger M, Siessmeier T, Viertmann A, Landvogt C, Buchholz HG, Rolke R, et al. The unpleasantness of tonic pain is encoded by the insular cortex. Neurology. 2005;64:1175–83.PubMed
37.
go back to reference Teutsch S, Herken W, Bingel U, Schoell E, May A. Changes in brain gray matter due to repetitive painful stimulation. NeuroImage. 2008;42:845–9.PubMed Teutsch S, Herken W, Bingel U, Schoell E, May A. Changes in brain gray matter due to repetitive painful stimulation. NeuroImage. 2008;42:845–9.PubMed
38.
go back to reference Jenkins WM, Merzenich MM, Ochs MT, Allard T, Guic-Robles E. Functional reorganization of primary somatosensory cortex in adult owl monkeys after behaviorally controlled tactile stimulation. J Neurophysiol. 1990;63:82–104.PubMed Jenkins WM, Merzenich MM, Ochs MT, Allard T, Guic-Robles E. Functional reorganization of primary somatosensory cortex in adult owl monkeys after behaviorally controlled tactile stimulation. J Neurophysiol. 1990;63:82–104.PubMed
39.
go back to reference •• Wrigley PJ, Press SR, Gustin SM, Macefield VG, Gandevia SC, Cousins MJ, et al. Neuropathic pain and primary somatosensory cortex reorganization following spinal cord injury. Pain. 2009;141:52–9. This study demonstrates that, just as with phantom limb pain, the amount of S1 reorganization in subjects with spinal cord injury is correlates significantly with on-going pain intensity levels. Thus strategies aimed at reversing somatosensory cortical reorganization following spinal cord injury may have therapeutic potential.PubMed •• Wrigley PJ, Press SR, Gustin SM, Macefield VG, Gandevia SC, Cousins MJ, et al. Neuropathic pain and primary somatosensory cortex reorganization following spinal cord injury. Pain. 2009;141:52–9. This study demonstrates that, just as with phantom limb pain, the amount of S1 reorganization in subjects with spinal cord injury is correlates significantly with on-going pain intensity levels. Thus strategies aimed at reversing somatosensory cortical reorganization following spinal cord injury may have therapeutic potential.PubMed
40.
go back to reference Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Patterns of cortical reorganization in complex regional pain syndrome. Neurology. 2003;61:1707–15.PubMed Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Patterns of cortical reorganization in complex regional pain syndrome. Neurology. 2003;61:1707–15.PubMed
41.
go back to reference Fukumoto M, Ushida T, Zinchuk VS, Yamamoto H, Yoshida S. Contralateral thalamic perfusion in patients with reflex sympathetic dystrophy syndrome. Lancet. 1999;354:1790–1.PubMed Fukumoto M, Ushida T, Zinchuk VS, Yamamoto H, Yoshida S. Contralateral thalamic perfusion in patients with reflex sympathetic dystrophy syndrome. Lancet. 1999;354:1790–1.PubMed
42.
go back to reference Flor H, Denke C, Schaefer M, Grusser S. Effect of sensory discrimination training on cortical reorganisation and phantom limb pain. Lancet. 2001;357:1763–4.PubMed Flor H, Denke C, Schaefer M, Grusser S. Effect of sensory discrimination training on cortical reorganisation and phantom limb pain. Lancet. 2001;357:1763–4.PubMed
43.
go back to reference Flor H. Cortical reorganisation and chronic pain: implications for rehabilitation. J Rehabil Med. 2003;41(Suppl):66–72.PubMed Flor H. Cortical reorganisation and chronic pain: implications for rehabilitation. J Rehabil Med. 2003;41(Suppl):66–72.PubMed
44.
go back to reference Sprenger T, Boecker H, Tolle TR, Bussone G, May A, Leone M. Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology. 2004;62:516–7.PubMed Sprenger T, Boecker H, Tolle TR, Bussone G, May A, Leone M. Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology. 2004;62:516–7.PubMed
45.
go back to reference • Leone M, Franzini A, Cecchini AP, Bussone G. Efficacy of hypothalamic stimulation for chronic drug-resistant cluster headache. Cephalalgia. 2012;32:267–8. This study reviews work performed by this group on hypothalamic stimulation for headache. A theory originally proposed following discovery of hypothalamic activation changes noted during functional imaging in patients with chronic headache.PubMed • Leone M, Franzini A, Cecchini AP, Bussone G. Efficacy of hypothalamic stimulation for chronic drug-resistant cluster headache. Cephalalgia. 2012;32:267–8. This study reviews work performed by this group on hypothalamic stimulation for headache. A theory originally proposed following discovery of hypothalamic activation changes noted during functional imaging in patients with chronic headache.PubMed
46.
go back to reference Matharu MS, Cohen AS, Frackowiak RS, Goadsby PJ. Posterior hypothalamic activation in paroxysmal hemicrania. Ann Neurol. 2006;59:535–45.PubMed Matharu MS, Cohen AS, Frackowiak RS, Goadsby PJ. Posterior hypothalamic activation in paroxysmal hemicrania. Ann Neurol. 2006;59:535–45.PubMed
47.
go back to reference May A, Bahra A, Buchel C, Turner R, Goadsby PJ. Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol. 1999;46:791–4.PubMed May A, Bahra A, Buchel C, Turner R, Goadsby PJ. Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol. 1999;46:791–4.PubMed
48.
go back to reference Bartsch T, Falk D, Knudsen K, Reese R, Raethjen J, Mehdorn HM, et al. Deep brain stimulation of the posterior hypothalamic area in intractable short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT). Cephalalgia. 2011;31:1405–8.PubMed Bartsch T, Falk D, Knudsen K, Reese R, Raethjen J, Mehdorn HM, et al. Deep brain stimulation of the posterior hypothalamic area in intractable short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT). Cephalalgia. 2011;31:1405–8.PubMed
49.
go back to reference Walcott BP, Bamber NI, Anderson DE. Successful treatment of chronic paroxysmal hemicrania with posterior hypothalamic stimulation: technical case report. Neurosurgery. 2009;65:E997. discussion E997.PubMed Walcott BP, Bamber NI, Anderson DE. Successful treatment of chronic paroxysmal hemicrania with posterior hypothalamic stimulation: technical case report. Neurosurgery. 2009;65:E997. discussion E997.PubMed
50.
go back to reference Afridi SK, Matharu MS, Lee L, Kaube H, Friston KJ, Frackowiak RS, et al. A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate. Brain. 2005;128(Pt 4):932–9.PubMed Afridi SK, Matharu MS, Lee L, Kaube H, Friston KJ, Frackowiak RS, et al. A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate. Brain. 2005;128(Pt 4):932–9.PubMed
51.
go back to reference Afridi SK, Giffin NJ, Kaube H, Friston KJ, Ward NS, Frackowiak RS, et al. A positron emission tomographic study in spontaneous migraine. Arch Neurol. 2005;62:1270–5.PubMed Afridi SK, Giffin NJ, Kaube H, Friston KJ, Ward NS, Frackowiak RS, et al. A positron emission tomographic study in spontaneous migraine. Arch Neurol. 2005;62:1270–5.PubMed
52.
go back to reference Denuelle M, Fabre N, Payoux P, Chollet F, Geraud G. Posterior cerebral hypoperfusion in migraine without aura. Cephalalgia. 2008;28:856–62.PubMed Denuelle M, Fabre N, Payoux P, Chollet F, Geraud G. Posterior cerebral hypoperfusion in migraine without aura. Cephalalgia. 2008;28:856–62.PubMed
53.
go back to reference Mainero C, Boshyan J, Hadjikhani N. Altered functional magnetic resonance imaging resting-state connectivity in periaqueductal gray networks in migraine. Ann Neurol. 2011;70:838–45.PubMed Mainero C, Boshyan J, Hadjikhani N. Altered functional magnetic resonance imaging resting-state connectivity in periaqueductal gray networks in migraine. Ann Neurol. 2011;70:838–45.PubMed
54.
go back to reference Baliki MN, Geha PY, Jabakhanji R, Harden N, Schnitzer TJ, Apkarian AV. A preliminary fMRI study of analgesic treatment in chronic back pain and knee osteoarthritis. Mol Pain. 2008;4:47.PubMed Baliki MN, Geha PY, Jabakhanji R, Harden N, Schnitzer TJ, Apkarian AV. A preliminary fMRI study of analgesic treatment in chronic back pain and knee osteoarthritis. Mol Pain. 2008;4:47.PubMed
55.
go back to reference Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, et al. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum. 2004;50:613–23.PubMed Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, et al. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum. 2004;50:613–23.PubMed
56.
go back to reference Maihofner C, Neundorfer B, Birklein F, Handwerker HO. Mislocalization of tactile stimulation in patients with complex regional pain syndrome. J Neurol. 2006;253:772–9.PubMed Maihofner C, Neundorfer B, Birklein F, Handwerker HO. Mislocalization of tactile stimulation in patients with complex regional pain syndrome. J Neurol. 2006;253:772–9.PubMed
57.
go back to reference Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Cortical reorganization during recovery from complex regional pain syndrome. Neurology. 2004;63:693–701.PubMed Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Cortical reorganization during recovery from complex regional pain syndrome. Neurology. 2004;63:693–701.PubMed
58.
go back to reference Gustin SM, Schwarz A, Birbaumer N, Sines N, Schmidt AC, Veit R, et al. NMDA-receptor antagonist and morphine decrease CRPS-pain and cerebral pain representation. Pain. 2010;151:69–76.PubMed Gustin SM, Schwarz A, Birbaumer N, Sines N, Schmidt AC, Veit R, et al. NMDA-receptor antagonist and morphine decrease CRPS-pain and cerebral pain representation. Pain. 2010;151:69–76.PubMed
59.
go back to reference •• Schwenkreis P, Maier C, Tegenthoff M. Functional imaging of central nervous system involvement in complex regional pain syndrome. AJNR. 2009;30:1279–84. This paper utilized functional imaging to demonstrate reorganization in central somatosensory and motor networks in CRPS. Indicating that a significant amount of clinical findings of CRPS are related to central rather than peripheral changes. •• Schwenkreis P, Maier C, Tegenthoff M. Functional imaging of central nervous system involvement in complex regional pain syndrome. AJNR. 2009;30:1279–84. This paper utilized functional imaging to demonstrate reorganization in central somatosensory and motor networks in CRPS. Indicating that a significant amount of clinical findings of CRPS are related to central rather than peripheral changes.
60.
go back to reference Zambreanu L, Wise RG, Brooks JC, Iannetti GD, Tracey I. A role for the brainstem in central sensitisation in humans. Evidence from functional magnetic resonance imaging. Pain. 2005;114:397–407.PubMed Zambreanu L, Wise RG, Brooks JC, Iannetti GD, Tracey I. A role for the brainstem in central sensitisation in humans. Evidence from functional magnetic resonance imaging. Pain. 2005;114:397–407.PubMed
61.
go back to reference Seifert F, Bschorer K, De Col R, Filitz J, Peltz E, Koppert W, et al. Medial prefrontal cortex activity is predictive for hyperalgesia and pharmacological antihyperalgesia. J Neurosci. 2009;29:6167–75.PubMed Seifert F, Bschorer K, De Col R, Filitz J, Peltz E, Koppert W, et al. Medial prefrontal cortex activity is predictive for hyperalgesia and pharmacological antihyperalgesia. J Neurosci. 2009;29:6167–75.PubMed
62.
go back to reference Maihofner C, Handwerker HO, Birklein F. Functional imaging of allodynia in complex regional pain syndrome. Neurology. 2006;66:711–7.PubMed Maihofner C, Handwerker HO, Birklein F. Functional imaging of allodynia in complex regional pain syndrome. Neurology. 2006;66:711–7.PubMed
Metadata
Title
Functional Imaging for Interpretation of Pain Pathways: Current Clinical Application/Relevance and Future Initiatives
Authors
Collin F. M. Clarke
Keith St. Lawrence
Publication date
01-02-2013
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 2/2013
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-012-0311-x

Other articles of this Issue 2/2013

Current Pain and Headache Reports 2/2013 Go to the issue

Anesthetic Techniques in Pain Management (KA Williams, Section Editor)

Complementary and Alternative Treatments for Chronic Pelvic Pain

Anesthetic Techniques in Pain Management (KA Williams, Section editor)

Celiac Plexus Block and Neurolysis for Pancreatic Cancer

Trigeminal Autonomic Cephalalgias (MS Matharu, Section editor)

The Psychiatric Comorbidities of Cluster Headache

Anesthetic Techniques in Pain Management (KA Williams, Section editor)

Cervical Epidural Steroid Injections for the Treatment of Cervical Spinal (Neck) Pain