Neuroinflammation and Neuroplasticity in Pain

2017 ◽  
Author(s):  
Jürgen Sandkühler
Keyword(s):  
Chronic Pain ◽  
Neuronal Cells ◽  
The Body ◽  
Membrane Excitability ◽  
Nociceptive System ◽  
Nociceptive Pathways ◽  
New Concepts ◽  
System P ◽  
Long Term Changes

Much progress has been made in unraveling the mechanisms that underlie the transition from acute to chronic pain. Traditional beliefs are being replaced by novel, more powerful concepts that consider the mutual interplay of neuronal and non-neuronal cells in the nervous system during the pathogenesis of chronic pain. The new focus is on the role of neuroinflammation for neuroplasticity in nociceptive pathways and for the generation, amplification, and mislocation of pain. The latest insights are reviewed here and provide a basis for understanding the interdependence of chronic pain and its comorbidities. The new concepts will guide the search for future therapies to prevent and reverse chronic pain. Long-term changes in the properties and functions of nerve cells, including changes in synaptic strength, membrane excitability, and the effects of inhibitory neurotransmitters, can result from a wide variety of conditions. In the nociceptive system, painful stimuli, peripheral inflammation, nerve injuries, the use of or withdrawal from opioids—all can lead to enhanced pain sensitivity, to the generation of pain, and/or to the spread of pain to unaffected sites of the body. Non-neuronal cells, especially microglia and astrocytes, contribute to changes in nociceptive processing. Recent studies revealed not only that glial cells support neuroplasticity but also that their activation can trigger long-term changes in the nociceptive system.

scholarly journals MEG Can Map Short and Long-Term Changes in Brain Activity following Deep Brain Stimulation for Chronic Pain

PLoS ONE ◽  
2012 ◽  
Vol 7 (6) ◽  
pp. e37993 ◽  
Author(s):  
Hamid R. Mohseni ◽  
Penny P. Smith ◽  
Christine E. Parsons ◽  
Katherine S. Young ◽  
Jonathan A. Hyam ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Brain Activity ◽  
Long Term Changes ◽  
Short And Long Term ◽  
Deep Brain

scholarly journals Pharmacology of Opioids in the Treatment of Chronic Pain Syndromes

2011 ◽  
Vol 4;14 (4;7) ◽  
pp. E343-E360
Author(s):  
Ricardo Vallejo
Keyword(s):  
Chronic Pain ◽  
The Body ◽  
Intractable Pain ◽  
Human History ◽  
Oral Ingestion ◽  
Pain Syndromes ◽  
Current Therapies ◽  
Pros And Cons ◽  
Chronic Pain Syndromes

The perpetual pursuit of pain elimination has been constant throughout human history and pervades human cultures. In some ways it is as old as medicine itself. Cultures throughout history have practiced the art of pain management through remedies such as oral ingestion of herbs or techniques believed to have special properties. In fact, even Hippocrates wrote about the practice of trepanation, the cutting of holes in the body to release pain. Current therapies for management of pain include the pervasive utilization of opioids, which have an extensive history, spanning centuries. There is general agreement about the appropriateness of opioids for the treatment of acute and cancer pain, but the long-term use of these drugs for treatment of chronic non-malignant pain remains controversial. The pros and cons regarding these issues are beyond the scope of this review. Instead, the purpose of this review will be directed towards the pharmacology of commonly prescribed opioids in the treatment of various chronic pain syndromes. Opium, derived from the Greek word for “juice,” is extracted from the latex sap of the opium poppy (Papaverum somniferum). The juice of the poppy is the source of some 20 different alkaloids of opium. These alkaloids of opioids can be divided into 2 chemical classes: phenanthrenes (morphine, codeine, and thebaine) and benzylisoquinolines (agents that do not interact with opioid receptors). Key words: Opioid metabolism, opioid interactions, morphine, codeine, hydrocodone, oxycodone, hydromorphone, methadone, intractable pain, endorphins, enkephalins, dynorphins, narcotics, pharmacology, propoxyphene, fentanyl, oxymorphone, tramadol

Plasticity and Cortical Reorganization Associated With Pain

2016 ◽  
Vol 224 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Thomas Weiss
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Cortical Reorganization ◽  
Noxious Stimulation ◽  
Large Network ◽  
Short Term ◽  
New Concepts ◽  
Plastic Changes

Abstract. This review focuses on plasticity and reorganization associated with pain. It is well established that noxious stimulation activates a large network of neural structures in the human brain, which is often denominated as the neuromatrix of pain. Repeated stimulation is able to induce plasticity in nearly all structures of this neuromatrix. While the plasticity to short-term stimulation is usually transient, long-term stimulation might induce persistent changes within the neuromatrix network and reorganize its functions and structures. Interestingly, a large longitudinal study on patients with subacute back pain found predictors for the persistence of pain versus remission in mesolimbic structures not usually included in the neuromatrix of pain. From these results, new concepts of nociception, pain, and transition from acute to chronic pain emerged. Overall, this review outlines a number of plastic changes in response to pain. However, the role of plasticity for chronic pain has still to be established.

scholarly journals Acupuncture and its Effects on Chronic Pain

2020 ◽  
pp. 84-97
Author(s):  
Pavan Patel ◽  
Michael Sabia ◽  
Jashen Patheja ◽  
Rohan Kapoor ◽  
Tiffany Mathias ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Sleep Disturbances ◽  
The Body ◽  
Acupuncture Points ◽  
Energy Flows ◽  
History Of

Acupuncture is an complementary form of medicine that has relatively recently become a component of traditional Chinese medicine (TCM). It involves the application of thin needles at specific points throughout the body, although initially, general areas instead of points were used. There are estimated to be about 395 different points that can be utilized, and the technique behind using these points can vary widely between practitioners. In addition to acupuncture points, TCM is said to use meridians or pathways along with qi, or energy flows. In terms of acupunctures’ utility, it has been known to treat a variety of ailments ranging from pain and headaches to sleep disturbances, but it's true benefits continue to be questioned. To date, thousands of studies have been performed in regards to its efficacy with varying conclusions. Once considered to be “pseudomedicine”, this ancient technique has been found to provide long-term benefits for patients with chronic pain. This manuscript aims at providing a brief history of acupuncture and examines studies in favor of its relief of chronic pain.

Coping with chronic pain, illness and incarceration: what patients and prisoners have to teach each other (and all of us)

2018 ◽  
Vol 44 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Drew Leder
Keyword(s):  
Chronic Pain ◽  
Emotional Responses ◽  
Phenomenological Approach ◽  
The Body ◽  
Mutual Benefit ◽  
Social Contacts ◽  
Prison Life ◽  
Lived Space ◽  
Lived Time

This article proposes the benefits to be had from an unusual conversation: that between those suffering from chronic pain/illness and from long-term incarceration. Taking a phenomenological approach, a series of experiential commonalities are outlined: pain and illness, like incarceration, can cause (1) a constriction of lived space and the range of possible action; (2) a disruption of lived time, such that one is trapped in an aversive ‘now’, or ever trying to escape it; (3) isolation, as meaningful social contacts diminish or are ripped away; and (4) disempowerment and depersonalisation, especially when the ill person feels caught within a medical system that can be dehumanising in ways that echo prison life. Drawing on pathographies, and my published conversations from teaching philosophy classes in prison, I outline some of the strategies whereby creative individuals help relieve these modes of disruption. These include (1) adaptability, as individuals learn to live differently, but well, within the limits imposed by pain/illness or incarceration; (2) appreciative presence, the ability to find joy in, and richly utilise, the ‘now’; (3) mental freedom, which includes the capacity to choose emotional responses, and to expand the intellect and spirit even when the body is confined; and (4) community, surmounting isolation through empathic relation with others. I suggest a conversation between these groups can bring mutual benefit, and teach us all how to live well in extreme circumstances, which we may encounter some time in our life.

Emotion System

2017 ◽  
pp. 349-374
Author(s):  
Eduardo E. Benarroch ◽  
Jeremy K. Cutsforth-Gregory ◽  
Kelly D. Flemming
Keyword(s):  
Metabolic Syndrome ◽  
Chronic Pain ◽  
Drug Addiction ◽  
The Body ◽  
Brain State ◽  
System P ◽  
Wide Range ◽  
Sensory Motor ◽  
Anxiety Depression ◽  
Physical Reaction

Chapter Abstract (Approx 50-100 words): The emotion system includes several interacting circuits that also form part of the sensory, motor, and autonomic systems. Emotion is an ancestral brain state that is critical for survival. Emotion is both a psychological and physical reaction, experienced as a strong feeling associated with physiologic changes that prepare the body for immediate action. Disorders of the emotion system underlie a wide range of neurologic, psychiatric, and medical conditions. These include chronic pain disorders, drug addiction, anxiety, depression, and metabolic syndrome.

Defining the Competence of Psychologists with a View to Public Accountability *

1997 ◽  
Vol 2 (4) ◽  
pp. 293-300 ◽  
Author(s):  
Ype H. Poortinga ◽  
Ingrid Lunt
Keyword(s):  
Scientific Knowledge ◽  
Professional Training ◽  
Professional Competence ◽  
Codes Of Ethics ◽  
The Body ◽  
The European Union ◽  
Rigorous Evaluation ◽  
Judicial Proceedings ◽  
Psychological Knowledge

In national codes of ethics the practice of psychology is presented as rooted in scientific knowledge, professional skills, and experience. However, it is not self-evident that the body of scientific knowledge in psychology provides an adequate basis for current professional practice. Professional training and experience are seen as necessary for the application of psychological knowledge, but they appear insufficient to defend the soundness of one's practices when challenged in judicial proceedings of a kind that may be faced by psychologists in the European Union in the not too distant future. In seeking to define the basis for the professional competence of psychologists, this article recommends taking a position of modesty concerning the scope and effectiveness of psychological interventions. In many circumstances, psychologists can only provide partial advice, narrowing down the range of possible courses of action more by eliminating unpromising ones than by pointing out the most correct or most favorable one. By emphasizing rigorous evaluation, the profession should gain in accountability and, in the long term, in respectability.

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