CHASING PAIN. THE SEARCH FOR A NEUROBIOLOGICAL MECHANISM

INTRODUCTION: WHY PAIN?
CHAPTER 1: A SAMPLE AT THE EXTREMES
CHAPTER 2: DRIVERS OF PAIN RESEARCH AND A MEETING IN ISSAQUAH
CHAPTER 3: Functional localization, the spinothalamic tract, and neurosurgery for pain
CHAPTER 4: Emotions, affect, and the limbic system
CHAPTER 5: EARLY EVIDENCE OF CNS CONTROL and A CONCEPTUAL MODEL REVISITED
CHAPTER 6: Psychophysics AND nociceptors
CHAPTER 7: Central sensitization AND PAIN GENES
CHAPTER 8: CNS MODULATION OF PAIN: NEUROPHYSIOLOGICAL AND CLINICAL EVIDENCE
CHAPTER 9: CNS GENERATION AND MODULATION OF PAIN; EARLY EVIDENCE FROM ANATOMICAL BRAIN IMAGING AND THE DEVELOPMENT OF FUNCTIONAL BRAIN IMAGING
CHAPTER 10: FUNCTIONAL IMAGING CONTRIBUTIONS TO CHASING PAIN
CHAPTER 11: UNFINISHED BUSINESS: A SAMPLE
CHAPTER 12: THE CHASE TODAY: SUMMARY AND IMPLICATIONS
Appendix

Conceptual models of how pain is created influence medical practice, neuroscientific research, and philosophical ideas about pain and other neurological functions. Given the broad scope of pain experiences, realistic models of pain neurobiology must consider the correlation between pain and tissue damage and how it is strongly affected by neurological disease, emotionally compelling circumstances, and by complex cognitive processes. Recent discoveries have made it clear that both sensory and affective systems are strongly modulated by activity in other sensory pathways and by affective and cognitive processes originating in the brain. As a result, pain should then be conceived as emerging from the conjoint activity of both sensory and affective neural systems, each becoming a target for pain treatment.

Historically, pain has been conceived as emerging either from an undefined pattern of neural activity or from anatomically and physiologically unique structures in the nervous system. Observations made during the early and mid- 20th century showed that pain and pain-like behaviors normally require not only sensory detectors of noxious events (called nociceptors) but also brain affective (hedonic) mechanisms that generate emotional experience and expression. In Chasing Pain, pain specialists and neuroscientists will find a thoughtful discussion of the neuroscientific and clinical evidence that has led to contemporary concepts of pain neurobiology and how pain might emerge from neuronal activity. Written in a concise and annotated format, Doctor Kenneth Casey reveals that while contemporary research has greatly enriched our model of pain neurobiology, several important and therapeutically challenging clinical conditions remain poorly understood.

Features
• Reviews the historical evolution of models of pain neurobiology
• Provides a balanced presentation of both scientific and clinical evidence that informs contemporary models of pain neurobiology
• Discusses the practical importance of implicit and explicit concepts of pain mechanisms
• Incorporates unique videos of major surgeries completed with acupuncture as the only analgesic method

Author
Kenneth L. Casey, MD is Professor Emeritus of Neurology and Molecular and Integrative Physiology at the University of Michigan in Ann Arbor, Michigan.