• MacGregor Hall, Dawson Kidgell, Luke Perraton, Jack Morrissey, and Shapour Jaberzadeh.
• Department of Physiotherapy, Monash University,Frankston, VIC, Australia.
• Pain Med. 2021 Jun 4; 22 (6): 1399-1410.

BackgroundNeuroimaging studies show that nociceptive stimuli elicit responses in an extensive cortical network. Functional near-infrared spectroscopy (fNIRS) allows for functional assessment of changes in oxyhemoglobin (HbO), an indirect index for cortical activity. Unlike functional magnetic resonance imaging (fMRI), fNIRS is portable, relatively inexpensive, and allows subjects greater function. No systematic review or meta-analysis has drawn together the data from existing literature of fNIRS studies on the effects of experimental pain on oxyhemoglobin changes in the superficial areas of the brain.ObjectivesTo investigate the effects of experimental pain on brain fNIRS measures in the prefrontal-cortex and the sensory-motor-area; to determine whether there is a difference in oxyhemodynamics between the prefrontal-cortex and sensory-motor-area during pain processing; to determine if there are differences in HbO between patients with centralized persistent pain and healthy controls.MethodsStudies that used fNIRS to record changes in oxyhemodynamics in prefrontal-cortex or sensory-motor-cortex in noxious and innoxious conditions were included. In total, 13 studies were included in the meta-analysis.ResultsPain has a significantly greater effect on pre-frontal-cortex and sensory-motor areas than nonpainful stimulation on oxyhemodynamics. The effect of pain on sensory-motor areas was greater than the effect of pain on the prefrontal-cortex. There was an effect of centralized pain in the CPP group on oxyhemodynamics from a noxious stimulus compared to control's response to pain.ConclusionsPain affects the prefrontal and sensory-motor cortices of the brain and can be measured using fNIRS. Implications of this study may lead to a simple and readily accessible objective measure of pain.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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