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Pain and the Brain 

Pain and the Brain
Chapter:
Pain and the Brain
Source:
Pain: Dynamics and Complexities
Author(s):

Daniel M. Doleys

DOI:
10.1093/med/9780199331536.003.0004

The basic theory and mechanism involved in neuroimaging including the relative advantages and disadvantages of fMRI, SPECT, PET, EEG, DTI, MEG, and OIS is described. Caution is expressed regarding the interpretation of these findings as they relate to pain, especially chronic pain. There is no evidence that examining the brain’s response to noxious experimental stimuli to be predictive of the brain’s response in the chronic pain condition. Neuroplastic changes (plasticity) relate to alterations in functional, neurochemical, and structural nature of the peripheral and central nervous system which may be responsible for acute pain becoming chronic (chronification). The nature a of asymbolia for pain, congenital insensitivity to pain (CIP), the default Mode Network (DMN), and the nature of Diffuse Noxious Inhibitory Control (DNIC) are summarized. Coherence, oscillation, avalanches, and synchronicity are defined as is their potential role in understanding pain. The concept of thalamocortical dysrhythmia (TCD) as a possible mechanism to explain neurogenic pain is reviewed. The application of a ‘fork-in-the-road’ vs. going-over-a-precipice’ to the systems theory notion of bifurcation and a phase-transition is made.

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