We intuitively understand what is meant by the term “disease.” Surprisingly though,
there is no agreement as to the precise definition of a “disease.”
10
Definitions and classifications are important clinically and scientifically and should
be based on science and medical facts. However, there are societal, political, and
economic implications to classifying a condition as a disease, and this can impact
the resources and effort to understand, treat, and cure. The article in this issue
by Sullivan et al
11
asks whether chronic pain should be considered a “disease” and whether neuroimaging
can provide evidence for such a designation.To read this article in full you will need to make a payment
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References
- On the normal and the pathological.D. Reidel Publishing Company, Boston, MA1978
- Recent advances and future prospects in neuroimaging of acute and chronic pain.Future Neurol. 2006; 1: 203-213
- Neuroethical issues related to the use of brain imaging: Can we and should we use brain imaging as a biomarker to diagnose chronic pain?.Pain. 2012; 153: 1555-1559
- Central mechanisms of pain revealed through functional and structural MRI.J Neuroimmune Pharmacol. July 24, 2012; ([Epub ahead of print] DOI)
- Neuroimaging of pain: What does it tell us?.Curr Opin Support Palliat Care. 2011; 5: 116-121
International Association for the Study of Pain Taxonomy updated from H. Merskey and N. Bogduk (eds): Classification of Chronic Pain, 2nd Edition, IASP Task Force on Taxonomy, 1994. http://www.iasp-pain.org/Content/NavigationMenu/GeneralResourceLinks/PainDefinitions/default.htm
Merriam-Webster Online Dictionary. Based on the print version of Merriam-Webster's Collegiate® Dictionary, Eleventh Edition. http://www.merriam-webster.com/medical/disease
- The necessity of animal models in pain research.Pain. 2010; 151: 12-17
- Pain measurement and brain activity: Will neuroimages replace pain ratings?.J Pain. 2013; 14: 323-327
- What is a disease?.EMBO Rep. 2004; 5: 650-653
- What does it mean to call chronic pain a brain disease?.J Pain. 2013; 14: 317-322
Article info
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© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
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- What Does It Mean to Call Chronic Pain a Brain Disease?The Journal of PainVol. 14Issue 4
- PreviewMultiple investigators have recently asked whether neuroimaging has shown that chronic pain is a brain disease. We review the clinical implications of seeing chronic pain as a brain disease. Abnormalities noted on imaging of peripheral structures have previously misled the clinical care of patients with chronic pain. We also cannot assume that the changes associated with chronic pain on neuroimaging are causal. When considering the significance of neuroimaging results, it is important to remember that “disease” is a concept that arises out of clinical medicine, not laboratory science.
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- Pain Measurement and Brain Activity: Will Neuroimages Replace Pain Ratings?The Journal of PainVol. 14Issue 4
- PreviewArguments made for the advantages of replacing pain ratings with brain-imaging data include assumptions that pain ratings are less reliable and objective and that brain image data would greatly benefit the measurement of treatment efficacy. None of these assumptions are supported by available evidence. Self-report of pain is predictable and does not necessarily reflect unreliability or error. Because pain is defined as an experience, magnitudes of its dimensions can be estimated by well-established methods, including those used to validate brain imaging of pain.
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