Central Pain or Central Pains? Vistas for a Classification

Structural and functional imaging and neurophysiological evidence point to a wide range of alterations taking place in the central nervous system (CNS) in a large range of chronic pains. Central changes seem to mediate the effects of chronic pain on mood, cognition, and sleep, and may play a role in its persistence. While central alterations have been reported in many pain conditions, central changes are particularly prominent when pain is caused by neurological diseases affecting the central nervous system, even when the somatosensory system is not primarily affected. Importantly, the presence of central abnormalities does not grant these pains are "neuropathic", in as much as central neuropathic pain needs evidence of lesion or disease of the central somatosensory transmission system, and specific pain characteristics in relation to the lesion location. Distinguishing which clinical, imaging, and neurophysiological findings are specific to central neuropathic pain and can differentiate it from (i) non-neuropathic pain due to CNS diseases, and (ii) other chronic "centralized" pains is key for a clear diagnosis and treatment. Three speakers provide fundamental and new evidence from the clinic, neurophysiology and imaging to allow attendees detangle central neuropathic pain from central abnormalities seen in chronic pain in general.

Faculty:

• Daniel Ciampi de Andrade
• Luis Daniel Ciampi de Andrade
• Ruth Defrin