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Can neuroimaging studies identify pain endophenotypes in humans?

Abstract

Pain is a complex, multidimensional experience that has defied our understanding for centuries. Through the advent of noninvasive neuroimaging techniques, we have been able to examine the human brain and its response to nociceptive inputs. As a result, our knowledge of which brain regions are critical for generating an acute pain experience has grown, as has our understanding of how cognitive, emotional, contextual and various physiological factors influence the pain experience. Furthermore, we have been able to identify key processes within the brain that underpin the transition to and maintenance of chronic pain states, as well as highlight the dramatic consequences of chronic pain on the brain's structure and neurochemistry. Building upon this knowledge, we are now in a position to consider whether any of these brain imaging 'phenotypes' of acute or chronic pain should be considered as useful endophenotypes; thereby enabling us to relate the complex genetics that underpin everyday pain sensitivity or chronic pain states to intermediate biomarkers. This endophenotypic approach—the focus of this Review—simplifies the connection between genes and behavior and is needed for complex disorders like chronic pain.

Key Points

  • Activity within multiple brain regions is required for the experience of pain

  • Neuroimaging studies have increased our understanding of how various brain regions generate and/or modulate the perception of pain

  • Genetic make-up influences many aspects of acute and chronic pain, but the relationship between genes and pain-related behavior is complex and remains to be fully resolved

  • Neuroimaging studies might identify functional, structural or biochemical endophenotypes for pain that can help us understand the relationship between genetics and pain conditions

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Figure 1: Factors involved in generating and influencing pain perception.

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Tracey, I. Can neuroimaging studies identify pain endophenotypes in humans?. Nat Rev Neurol 7, 173–181 (2011). https://doi.org/10.1038/nrneurol.2011.4

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