Gary B. Rollman,
Emeritus Professor of Psychology,
University of Western Ontario,
London, ON N6A 5C2
(in addition to links below, see weekly archives in the right column)
Wednesday, February 06, 2013
European Pain School 2013, Siena, Italy
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.
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
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