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The cortical rhythms of chronic back pain

It seems increasingly unlikely that we are going to understand chronic pain as the isolated overactivity of a single brain region, and much more likely that it relates to the abnormal dynamic activity and connectivity between a network that spans cortical, subcortical and spinal regions. But finding out the nature of this abnormal connectivity is not an easy task. This study focuses on one such method: resting frequency analysis of the functional magnetic resonance imaging (fMRI) blood-oxygen-level-dependent (BOLD) signal. Not only do the authors show clear excess of high-frequency oscillatory activity in patients, centred on medial prefrontal cortical activity, but they also show that this abnormal activity correlates with spontaneous fluctuations of pain, providing the first convincing evidence of a functional relationship between dynamic cortical activity and chronic pain.

This is likely to stimulate research into sophisticated spatiotemporal decoding methods for fMRI activity, as well as parallel studies using other methodologies (such as magnetoencephalography [MEG]), and marks an important direction for chronic pain research.

Baliki MN, Baria AT, Apkarian AV. The cortical rhythms of chronic back pain. J Neurosci. 2011 Sep 28; 31(39): 13981-90

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