Current pain and headache reports
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Curr Pain Headache Rep · Apr 2010
ReviewUnravelling the mystery of pain, suffering, and relief with brain imaging.
In humans, the experience of pain and suffering is conveyed specifically by language. Noninvasive neuroimaging techniques now provide an account of neural activity in the human brain when pain is experienced. Knowledge gleaned from neuroimaging experiments has shaped contemporaneous accounts of pain. ⋯ In the brains of patients with chronic pain, neuroimaging has revealed subtle but significant structural, functional, and neurochemical abnormalities. Converging evidence suggests that the chronic pain state may arise from dysfunction of the frontal-limbic system. Further research in the clinical pain population will continue to identify neural mechanisms that contribute to the experience and consequence of pain, which may then be targeted therapeutically.
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Torture is widely practiced throughout the world. Recent studies indicate that 50% of all countries, including 79% of the G-20 countries, continue to practice systematic torture despite a universal ban. ⋯ This review highlights the epidemiology, classification, pain sequelae, and clinical treatment guidelines of torture victims. In addition, the role of pharmacologic and psychologic interventions is explored in the context of rehabilitation.
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Cluster headache (CH) is a rare, excruciating primary headache disorder. A genetic basis has been suggested by family and twin studies, but the mode of transmission seems to vary and the amount of heritability is unclear. The number of genetic association studies investigating variants implicated in the pathophysiology of CH is limited. ⋯ However, it only appears to account for a part of the genetic susceptibility for CH, and additional genetic and environmental factors are likely implicated. Pharmacogenetic studies have suggested that the GNB3 825C > T polymorphism may modify treatment response to triptans among CH patients by altering the signal transduction cascade via G protein-coupled receptors. Genetic studies in CH are notoriously difficult due to the complex nature of the disorder and the low prevalence of CH.
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Curr Pain Headache Rep · Apr 2010
ReviewRole of sphenopalatine ganglion neuroablation in the management of cluster headache.
Cluster headache is a primary neurovascular headache. It is a strictly unilateral head pain that is associated with cranial autonomic symptoms and usually follows circadian and circannual patterns. ⋯ The sphenopalatine ganglion (SPG), located in the pterygopalatine fossa, is involved in the pathophysiology of cluster headache and has been a target for blocks and other surgical approaches. Percutaneous radiofrequency ablation of the SPG was shown to have encouraging results in those patients with intractable cluster headaches.
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Chronic pain is an affliction that affects a large proportion of the general population and is often accompanied by a myriad of negative emotional, cognitive, and physical effects. However, current pain adaptation paradigms do not account for the many chronic pain patients who demonstrate little or no noticeable impairment due to the effects of chronic pain. This paper offers resilience as an integrative perspective that can illuminate the traits and mechanisms underlying the sustainability of a good life and recovery from distress for individuals with chronic pain.