New Trend of Pain Study by Brain Imaging Devices

Sun Joon Bai; Zang-Hee Cho; Bae Hwan Lee

doi:10.5124/jkma.2009.52.2.182

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Bai, Cho, and Lee: New Trend of Pain Study by Brain Imaging Devices

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2009; 52(2): 182-188.

Published online: 28 February 2009

DOI: https://doi.org/10.5124/jkma.2009.52.2.182

New Trend of Pain Study by Brain Imaging Devices

Sun Joon Bai, MD¹, Zang-Hee Cho, Ph.D², Bae Hwan Lee, MD³

¹Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Korea.

²Neuroscience Research Institute, Gachon University of Medicine and Science, Korea.

³Department of Physiology, Yonsei University College of Medicine, Korea. bhlee@yuhs.ac

Abstract

The study of pain has recently received much attention, especially in understanding its neurophysiology by using new brain imaging techniques, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), both of which allow us to visualize brain function in vivo. Also the new brain imaging devices allow us to evaluate the patient's pain status and plan to treat patients objectively. Functional activation of brain regions are thought to be reflected by increases in the regional cerebral blood flow in the brain imaging studies. Regional cerebral blood flow increases to noxious stimuli are observed in second somatic (SII) and insular regions and in the anterior cingulate cortex and with slightly less consistency in the first somatic area (S1), motor area, supplementary motor area, prefrontal area, amygdala and contralateral thalamus. These data suggest that pain has multidimensions such as sensory-discrimitive, motivational-affective and cognitive-evaluative.

Keywords: Pain, Brain imaging devices, Positron emission tomography, Functiolnal magnetic resonance imaging

Figures and Tables

Figure 1

Putative mechanisms involved in neurometabolic and neurovascular coupling during neuronal activation.

Figure 2

Glucose utilization and fluoride deoxyglucose (FDG) in FDG PET.

Figure 3

Positron annihilation coincidence photon detection.

Figure 4

Glutamatergic synapse and blood flow increase.

EET: epoxy-eicosa-trienoic acids

Figure 5

The signal pattern of fMRI.

Figure 6

Putative pain pathway in the brain.

PFC: Prefrontal cortex, AMG: Amygdala, rACC: rostral Anterior cyngulate gyrus, dACC: dorsal Anterior cingulate gyrus, cACC: caudal Anterior cingulate gyrus, S1: Sensory area 1, S2: Sensory area 2, SMA: Supplementary motor area, HT: Hypothalamus, STT: Spinothalamic tract, SRT: Spinoreticular tract, SMT: Spinomesencephalic tract.

Notes

This work was supported by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MEST)(R11-2005-014).

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