Noxious stimuli often evoke very different pain experience across subjects, as documented both by verbal report and by the observation of pain behaviour. Moreover, the same stimulus or disease condition typically yields very different pain experience in the same individual over time. "Nonspecific" conditions such as distraction, stress, anticipation and placebo, for example, can radically alter pain experience.
Major advances have been made in recent years in the understanding of how brain mechanisms modulate pain experience. Generalities such as "it's psychological" have given way to the discovery of specific modulating brain circuits (e.g., descending inhibition from midbrain PAG) and mediators (e.g., amino acid neurotransmitters and their variety of modifiable receptors, endogenous opioids and cannabinoids, cytokines). Individual differences once referred to "high pain threshold" are being understood as due to genetic polymorphisms, changes in gene transcription or epigenetic regulation of neuronal networks. These insights open entirely new frontiers to advanced students and future young investigators. For example, while a few instances of pain suppression are known to be opioidergic, many are mediated by other, still unknown mechanisms. Discoveries that can be anticipated could change the face of pain therapeutics.
The European Pain School 2013 will explore the domain of brain modulation of individual pain experience. Disciplines that will be brought to bear on the problem range from psychology to molecular genetics, with a predictable cross-fertilization of ideas. Modulation subsumes multiple mechanisms that have become known by experimental research on animal and human subjects, as well as by clinical medical and psychological research on patients.
Contemporary pain science has attained high standards and is acknowledged as an academic discipline worldwide. Likewise, pain medicine is currently emerging as a medical subject with a great integrative potential against the centrifugal and often fragmented tendencies of much of contemporary practical medicine. The International Association for the Study of Pain (IASP) and its worldwide chapters provide impetus to this process, resulting in the advancement of interdisciplinary programs for the ultimate benefit of pain patients. The European Pain School is focused on advancing this new vision among junior investigators interested in basic and clinical research.
Topics
- Views into the brain: a pain matrix?
- Genetic and epigenetic sources of pain variability
- Glial-neuron interactions and neuro-immune mechanisms in pain
- Sex hormones and pain sensitivity
- Central pathways of pain modulation: inhibition and facilitation
- Situational, cognitive and emotional control of pain
- Placebo and verum analgesia - a useful combination to enhance therapeutic outcome?
- Opioids and cannabinoids: links between the control of pain and mood enhancement
- "Catastrophizing": thoughts that amplify pain
- Phantom pain, pain memory and mirror therapy
- Ontogeny of the pain system; is there "fetal programming"?
- Plasticity of ionic channels and inhibitory synaptic networks
- Transporter molecules in the neuropsychiatry of pain
- Pain and consciousness
Faculty
Anna Maria Aloisi, Siena, Italy
Fabrizio Benedetti, Turin, Italy
Giancarlo Carli, Siena, Italy
Geert Crombez, Gent, Belgium
Marshall Devor, Jerusalem, Israel
Giandomenico Iannetti, London, UK
Jon D. Levine, San Francisco, CA, USA
Deolinda Lima, Oporto, Portugal
Jordi Serra, Barcelona, Spain
Katarzyna Starowicz, Krakow, Poland
David Yarnitsky, Haifa, Israel
Manfred Zimmermann, Heidelberg, Germany
