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Open Access Highly Accessed Review

Neuroimaging revolutionizes therapeutic approaches to chronic pain

David Borsook123*, Eric A Moulton1, Karl F Schmidt12 and Lino R Becerra123

Author Affiliations

1 PAIN Group, Brain Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA

2 Imaging Consortium for Drug Development, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA

3 Program in Neuroscience Department of Psychiatry and Athinoula Martinos Center for Biomedical Engineering, Department of Radiology, Massachusetts Hospital, 149 13th Street, Charlestown, MA, 02129, USA

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Molecular Pain 2007, 3:25  doi:10.1186/1744-8069-3-25

Published: 11 September 2007

Abstract

An understanding of how the brain changes in chronic pain or responds to pharmacological or other therapeutic interventions has been significantly changed as a result of developments in neuroimaging of the CNS. These developments have occurred in 3 domains : (1) Anatomical Imaging which has demonstrated changes in brain volume in chronic pain; (2) Functional Imaging (fMRI) that has demonstrated an altered state in the brain in chronic pain conditions including back pain, neuropathic pain, and complex regional pain syndromes. In addition the response of the brain to drugs has provided new insights into how these may modify normal and abnormal circuits (phMRI or pharmacological MRI); (3) Chemical Imaging (Magnetic Resonance Spectroscopy or MRS) has helped our understanding of measures of chemical changes in chronic pain. Taken together these three domains have already changed the way in which we think of pain – it should now be considered an altered brain state in which there may be altered functional connections or systems and a state that has components of degenerative aspects of the CNS.