Pain-related changes in the brain: diagnostic and therapeutic potentials

Emerging evidence suggests that chronic pain is a disease that can alter brain function. Imaging studies have demonstrated structural remapping and functional reorganization of brain circuits under various pain conditions. In parallel, preclinical models have demonstrated that chronic pain causes long-term neuroplasticity. For example, thalamo-cortical oscillations are dysregulated and neurons in the sensory thalamus undergo ectopic firing linked to misexpression of membrane ion channels. In theory, physiological changes at the single-unit, multi-unit, and circuitry levels can be used as predictors of pain, and possibly to guide targeted neuromodulation of specific brain regions for therapeutic purposes. Therefore, multidisciplinary research into the mechanisms of pain-related phenomena in the brain may offer insights into novel approaches for the diagnosis, monitoring, and management of persistent pain.