Neuroimaging of Chronic Pain Mechanisms and Dynamics
Summary
Chronic pain arises from persistent nociceptive signalling and maladaptive neuroplastic changes across cortical and subcortical circuits. Neuroimaging modalities such as structural MRI, functional MRI, PET and EEG have elucidated morphological and functional aberrations in regions implicated in pain perception, modulation and affective processing. Structural analyses reveal region‐specific grey matter alterations in prefrontal, insular, cingulate and thalamic sites, while functional studies demonstrate disrupted resting‐state connectivity within the default mode, salience and descending modulatory networks. Molecular imaging has further quantified receptor binding and neurotransmitter dynamics, shedding light on the role of glutamatergic, dopaminergic and opioid systems in chronification processes. Advanced analytic approaches, including machine-learning and network modelling, allow for the characterisation of individual pain signatures and prognostic biomarkers, paving the way for precision interventions. Together, these findings underscore the dynamic interplay between central sensitisation, affective modulation and cognitive control in the maintenance of chronic pain and support the development of targeted neuromodulatory and pharmacological therapies.
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Neuroimaging of Chronic Pain Mechanisms and Dynamics publication trend
The graph below shows the total number of articles in neuroimaging of chronic pain mechanisms and dynamics across all publications each year (not limited to Nature Index journals).
Technical terms
Functional magnetic resonance imaging (fMRI): A technique that measures brain activity by detecting changes in blood oxygenation, used to infer neural function in pain studies.
Voxel-based morphometry (VBM): A neuroimaging analysis method that quantifies differences in local grey matter volume across subjects or conditions.
Deformation-based morphometry: An imaging technique that examines shape changes in brain structures by analysing the spatial transformations required to align individual scans.
Resting-state functional connectivity: Assessment of temporal correlations between spatially distinct brain regions during rest, revealing intrinsic network interactions.
Default mode network (DMN): A set of interconnected brain regions active during rest and internal mentation, often disrupted in chronic pain conditions.
Neuroplasticity: The capacity of the nervous system to reorganise structure and function in response to experience or injury, central to chronic pain chronification.
References
- Neuroimaging and artificial intelligence for assessment of chronic painful temporomandibular disorders—a comprehensive review. International Journal of Oral Science (2023).
- Alteration of the cortical morphology in classical trigeminal neuralgia: voxel-, deformation-, and surface-based analysis. The Journal of Headache and Pain (2023).
- Functional Reorganization of the Default Mode Network across Chronic Pain Conditions. PLOS ONE (2014).
- Gray matter alterations in chronic pain: A network-oriented meta-analytic approach. NeuroImage Clinical (2014).
- Disrupted functional connectivity of the periaqueductal gray in chronic low back pain. NeuroImage Clinical (2014).
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