Intégration centrale de la douleur chronique et apport de l'imagerie fonctionnelle

Progress in brain imaging of pain has been made possible by developments in anatomic and functional magnetic resonance imaging and positron emission tomography with automatic mapping of anatomic zones. Knowledge of the pain receptor matrix in the normal subject was a prerequisite for studying control systems and their visualization by labeling opiate receptors. The possibility of activating a pain matrix by simple visualization of an algogenic stimulus enabled the demonstration that perceived pain and imaged pain share certain regions of cortical reception. A complete field of research has arisen with the knowledge of mirror neurons and the automatic phenomenon of empathy. Brain imaging has enabled a study of the basis of organic or somatoform chronic pain and the effect of medications, but most importantly, the impact of non-pharmacological approaches such as hypnosis, acupuncture or the placebo effect.