title: Don't look now! Pain and attention.
abstract: Attention and pain are linked inexorably. The manipulation of attention, via either distraction or focused attention, has been used as a therapeutic initiative for generations. Imaging evidence and clinical observations demonstrate that attention can be altered with associated changes at the cortical level and this may have positive or negative effects on the individual. New theories suggest that cortical remapping and visual attention may play key roles in a cortical model of pain specifically involving the motor control system. Within this system, the relationship between allocentric (external) and egocentric (internal) stimuli are managed; where conflict occurs, somaesthetic disturbances may be generated. If an individual pays too much attention to such sensory disturbances, then they may report the disturbances as abnormal symptoms, which may explain the diverse symptomatology of fibromyalgia. The use of a therapeutic optokinetic device to correct existing imbalances in the motor control system is also discussed.
authors.affiliation: Royal National Hospital for Rheumatic Diseases, Bath. candy.mccabe@rnhrd-tr.swest.nhs.uk
authors.forename: Candida
authors.initials: C
authors.lastname: McCabe
authors.forename: Jenny
authors.initials: J
authors.lastname: Lewis
authors.forename: Nicholas
authors.initials: N
authors.lastname: Shenker
authors.forename: Jane
authors.initials: J
authors.lastname: Hall
authors.forename: Helen
authors.initials: H
authors.lastname: Cohen
authors.forename: David
authors.initials: D
authors.lastname: Blake
mesh_terms: D001288:Attention / Q000502:physiology*; D006801:Humans; D009044:Motor Cortex / Q000502:physiology*; D010146:Pain / Q000209:etiology; D059408:Pain Management