The commentary by Sean Mackey
3
makes several interesting points, many of which show strong agreement with the points
raised by all of the other articles. Within the early part of his article he agrees
that brain neuroimaging will not replace self-reporting of pain nor will it do so
in the future and that central neuroimaging findings alone do not define pain as a
disease. He then raises concerns that, based on our arguments forcefully presented
to readers,
6
they “may lose sight of the real value of central neuroimaging—a way to augment self-report
of pain and a potential, objective [italics ours] biomarker of pain and pain treatment.”
3
There are several points we wish to make about Mackey’s concerns that we think help
clarify our agreements and disagreements.To read this article in full you will need to make a payment
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References
- Pain and the brain: specificity and plasticity of the brain in clinical chronic pain.Pain. 2011; 152: S49-S64
- Is chronic pain a disease? Evaluating pain and nociception through self report and neuroimaging.J Pain. 2013; 14: 332-333
- Central neuroimaging of pain.J Pain. 2013; 14: 328-331
NIH: Biomarkers for chronic pain using functional brain connectivity. commonfundnihgov 2011
- Inner Experiences and Neuroscience. Merging the two perspectives.MIT Press, 2012
- Pain measurement and brain activity: Will neuroimages replace pain ratings?.J Pain. 2013; 14: 323-327
- What does it mean to call chronic pain a brain disease?.J Pain. 2013; 14: 317-322
- Understanding Consciousness.Routledge/London, Philadelphia, PA2009
- Structural brain changes in rheumatoid arthritis.Arthritis Rheum. 2012; 64: 371-379
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© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
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- Central Neuroimaging of PainThe Journal of PainVol. 14Issue 4
- PreviewCentral neuroimaging of pain has emerged as an effective way to assess central nervous system correlates and potentially also to characterize mechanisms of human pain perception, modulation, and plasticity. Central neuroimaging has allowed us to open windows into the brain to observe the roles of attention,18 anticipation,11 fear/anxiety,16 placebo,2 direct control,6 and other factors. We now better understand the changes in the brain associated with chronicity of pain,1,28 the effects of opioids,26,27 and effects of nonopioid therapies.
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