Reply to Commentary

      The commentary by Sean Mackey
      • Mackey S.
      Central neuroimaging of pain.
      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,
      • Robinson M.E.
      • Staud R.
      • Price D.D.
      Pain measurement and brain activity: Will neuroimages replace pain ratings?.
      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.”
      • Mackey S.
      Central neuroimaging of pain.
      There are several points we wish to make about Mackey’s concerns that we think help clarify our agreements and disagreements.
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      Linked Article

      • Central Neuroimaging of Pain
        The Journal of PainVol. 14Issue 4
        • Preview
          Central 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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