title: Functional reorganisation in chronic pain and neural correlates of pain sensitisation: A coordinate based meta-analysis of 266 cutaneous pain fMRI studies.
abstract: Maladaptive mechanisms of pain processing in chronic pain conditions (CP) are poorly understood. We used coordinate based meta-analysis of 266 fMRI pain studies to study functional brain reorganisation in CP and experimental models of hyperalgesia. The pattern of nociceptive brain activation was similar in CP, hyperalgesia and normalgesia in controls. However, elevated likelihood of activation was detected in the left putamen, left frontal gyrus and right insula in CP comparing stimuli of the most painful vs. other site. Meta-analysis of contrast maps showed no difference between CP, controls, mood conditions. In contrast, experimental hyperalgesia induced stronger activation in the bilateral insula, left cingulate and right frontal gyrus. Activation likelihood maps support a shared neural pain signature of cutaneous nociception in CP and controls. We also present a double dissociation between neural correlates of transient and persistent pain sensitisation with general increased activation intensity but unchanged pattern in experimental hyperalgesia and, by contrast, focally increased activation likelihood, but unchanged intensity, in CP when stimulated at the most painful body part.
authors.affiliation: Clinical Neurology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK; Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK.
authors.forename: Radu
authors.initials: R
authors.lastname: Tanasescu
authors.affiliation: Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK; Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK.
authors.forename: William J
authors.initials: WJ
authors.lastname: Cottam
authors.affiliation: Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK; Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Condon
authors.affiliation: Clinical Neurology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Tench
authors.affiliation: Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK; Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK. Electronic address: dorothee.auer@nottingham.ac.uk.
authors.forename: Dorothee P
authors.initials: DP
authors.lastname: Auer
mesh_terms: D001921:Brain; D001931:Brain Mapping; D059350:Chronic Pain; D006801:Humans; D006930:Hyperalgesia; D008279:Magnetic Resonance Imaging
keywords: Chronic pain; Coordinate based meta-analysis; Hyperalgesia; Neural pain signature; fMRI