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The “pain matrix” in pain-free individuals

Salomons, T. V., Iannetti, G. D., Liang, M. and Wood, J. N. (2016) The “pain matrix” in pain-free individuals. JAMA Neurology, 73 (6). pp. 755-756. ISSN 2168-6149

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To link to this item DOI: 10.1001/jamaneurol.2016.0653

Abstract/Summary

Human functional imaging provides a correlative picture of brain activity during pain. A particular set of central nervous system structures (eg, the anterior cingulate cortex, thalamus, and insula) consistently respond to transient nociceptive stimuli causing pain. Activation of this so-called pain matrix or pain signature has been related to perceived pain intensity, both within and between individuals,1,2 and is now considered a candidate biomarker for pain in medicolegal settings and a tool for drug discovery. The pain-specific interpretation of such functional magnetic resonance imaging (fMRI) responses, although logically flawed,3,4 remains pervasive. For example, a 2015 review states that “the most likely interpretation of activity in the pain matrix seems to be pain.”4 Demonstrating the nonspecificity of the pain matrix requires ruling out the presence of pain when highly salient sensory stimuli are presented. In this study, we administered noxious mechanical stimuli to individuals with congenital insensitivity to pain and sampled their brain activity with fMRI. Loss-of-function SCN9A mutations in these individuals abolishes sensory neuron sodium channel Nav1.7 activity, resulting in pain insensitivity through an impaired peripheral drive that leaves tactile percepts fully intact.5 This allows complete experimental disambiguation of sensory responses and painful sensations

Item Type:Article
Refereed:Yes
Divisions:Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
ID Code:64895
Additional Information:See also reply to Büchel, C.; Geuter, S. & Sprenger, C. JAMA Neurology 2016;73(10):1258-1259 doi:10.1001/jamaneurol.2016.2989 at JAMA Neurology 2016;73(10):1259-1260. doi:10.1001/jamaneurol.2016.2992
Publisher:American Medical Association

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