It is widely understood that pain is a complex phenomenon, and a primary cause of distress and disability in many medical contexts. However, a precise understanding of the complex neural circuitry involved has not been available. In recent years, new methodological developments have enabled direct measurement and manipulation of the brain in pain, providing new insights into the origins of chronic pain. Moreover, recent longitudinal studies confirm earlier clinical observations that early life adversity greatly increases risk for chronic pain in adult life. These insights are changing the way we think about what pain is, how it is related to emotion, and how it can be successfully prevented and treated.
This research has yielded two emerging, and still controversial, insights: First, pain is more than a set of responses in nociceptive ‘pain sensory’ circuits. Pain arises from interactions between nociceptive circuits and a wider set of systems involved in emotion, thought, and motivation. Second, dysregulation of these systems in chronic pain may be a primary cause of disability and suffering. A major benefit of psychological and behavioral treatments may be in remodeling these systems, and understanding them at a mechanistic level is critical for refining existing treatments and developing new ones.
October 15, 2016
8:00 – 10:00am Session 1: Early adversity and chronic pain: State of the field
- Gary Macfarlane: The role of early life adversity in the aetiology of Chronic Widespread Pain
- Martin Teicher: Brain structural and functional sequelae of early life adversity
- Mary Meagher: Emotion-pain interactions in women with trauma history
10:00 – 11:30am Session 2: What is the role of the prefrontal cortex in acute and chronic pain?
- Maria Fitzgerald: Early life trauma and the development of nociceptive systems
- Frank Porreca: Role of anterior cingulate cortex and opioid systems in pain
- Jing Wang: Effects of prefrontal optogenetic stimulation on chronic pain
1:00 – 2:30pm Session 3: Linking prefrontal-striatal function, emotion, and pain
- Tor Wager: A neurobehavioral model of pain and pain avoidance systems
- Lauren Atlas: Effects of expectations (and placebo) on pain: A neural circuit perspective
- Vania Apkarian: Cerebral predictors of pain chronification
3:00 – 5:00pm Session 4: Implications for prevention, treatment, and self-regulation
- Lance McCracken: Contextual Cognitive Behavioral Approaches: Monistic, Pragmatic & Progressive
- Catherine Bushnell: Nonpharmacological modulation of chronic pain
- Frances Sommer Anderson: Growing Up Afraid: Early attachment disruption, emotional regulation, and somatic pain
- Richard Lane: An integrated model of emotion, brain, and risk for chronic pain