Current concepts of pain pathways: a brief review of anatomy, physiology, and medical imaging

Curr Med Imaging. 2023 May 19. doi: 10.2174/1573405620666230519144112. Online ahead of print.

Abstract

Background: Although the essential components of pain pathways have been identified, a thorough comprehension of the interactions necessary for creating focused treatments is still lacking. Such include more standardised methods for measuring pain in clinical and preclinical studies and more representative study populations.

Objective: This review describes the essential neuroanatomy and neurophysiology of pain nociception and its relation with currently available neuroimaging methods focused on health professionals responsible for treating pain.

Methods: Conduct a PubMed search of pain pathways using pain-related search terms, selecting the most relevant and updated information.

Results: Current reviews of pain highlight the importance of their study in different areas from the cellular level, pain types, neuronal plasticity, ascending, descending, and integration pathways to their clinical evaluation and neuroimaging. Advanced neuroimaging techniques such as fMRI, PET, and MEG are used to better understand the neural mechanisms underlying pain processing and identify potential targets for pain therapy.

Conclusions: The study of pain pathways and neuroimaging methods allows physicians to evaluate and facilitate decision-making related to the pathologies that cause chronic pain. Some identifiable issues include a better understanding of the relationship between pain and mental health, developing more effective interventions for chronic pain's psychological and emotional aspects, and better integrating data from different neuroimaging modalities for the clinical efficacy of new pain therapies.

Keywords: Nociceptive pathways; magnetic resonance imaging.; pain central nervous system anatomy; pain surgical approaches.