By Helen Shen
A thermometer is great for measuring a fever, but when it comes to pain, doctors must rely on the age-old question, "How bad is it?" Scientists have long struggled to find physiological signs that can reliably tell "ouch" from "@#%!" and everything in between. Now, a brain scanning study suggests that painful heat excites a specific pattern of neural activity that could hold the key to better diagnosis and treatment of all kinds of pain in the future.
Functional magnetic resonance imaging (fMRI) studies have shown that certain areas of the brain-including the anterior cingulate cortex, somatosensory cortex, and thalamus-activate when people experience pain. But those same regions also light up in response to other experiences, such as painful thoughts or social rejection. In recent years, scientists have looked for a particular pattern of activity across these areas that single out the experience of physical pain. "What we're evolving towards is trying to predict quantitatively from patterns of brain activity how much an individual is feeling," says Tor Wager, a neuroscientist at the University of Colorado, Boulder.
In the new study, Wager's group performed fMRI brain scans on a total of 114 healthy participants while delivering different amounts of heat to the volunteers' arms with a computer-controlled hot plate. In an initial experiment, the scientists used data from 20 people to find a brain-wide pattern of excitation and inhibition-a neural "signature"-that changed reliably as people experienced varying degrees of heat, ranging from painless to scalding. In the remainder of the study, Wager and his colleagues were able use the signature derived from the first group to predict pain responses in a completely different set of subjects-a promising sign for one day using such a model on patients suffering from unknown conditions, he says.