Pain Imaging: Progress in Pain Research and Management, Volume 18: Edited by Kenneth L. Casey and M. Catherine Bushnell Published by International Association for the Study of Pain, Seattle, Washington, USA, 2000 239 pages, $89.00 (Hardcover)

Abstract

The past few years have begun to see a convergence of discoveries in the neuroscience and clinical domains of pain. Four broad areas are providing significant incubators for this process: molecular and cellular biology, genetics, epidemiology and functional imaging. All of these areas are going to dramatically influence changes in how we evaluate and treat patients. Pain neuroimaging is perhaps the one arena that has significant translational abilities in pain clinico-neurobiology, because we can interrogate the “pain signal” in the brains of humans in acute and chronic pain conditions and evaluate the utility of human surrogate models of clinical pain. This volume in a series on pain by the IASP Press is important. It is the first book review of pain neuroimaging and provides a summary of developments and advances in the field of pain functional neuroimaging that only began some 10 years ago with the paper from the Montreal Group on “Multiple Representations of Pain” Science in 1991. The book covers both technical aspects of neuroimaging (single photon emission computer tomography, positron emission tomography and functional magnetic resonance imaging) and reviews of data obtained from a number of laboratories on imaging various pain states. Pain Imaging is divided into 8 chapters and cover a range of topics. Dr. Casey provides a beautiful overview in the introductory chapter on the rationale for pain neuroimaging. In subsequent chapters various modalities of imaging (optical, PET, fMRI) are discussed. Perhaps the book is a little too technical in parts for individuals not involved in the field (e.g., pain clinicians), but the chapters on technical aspects underpinning methodological aspects including correlation of synaptic activity and blood flow (on which these modalities are dependent) at a basic and applied level make important and useful contributions. The work on functional imaging of animal models (Chapter 8) in pain is really a prelude to in vivo neuroimaging of animals that will clearly, in the future, provide significant insights into neural systems in animal models of pain. Perhaps a little disappointing is that the book omits contributions from neuroimaging groups in the United Kingdom, France, Germany and Japan who have contributed important information on pain neuroimaging. The book provides the current state of the art and also describes, in the chapter by Karen Davis from the Toronto group, some of the potential of pain neuroimaging. Future developments will include how and when different regions of the brain are activated, how activation in one are is related to another, and so forth. The optimists' vision is that we will, in the very near future, have a method that can define the pain signature that determines the multidimensional aspects of pain: a sensation, an actual or perceived threat and an emotional experience that has subjective components such as unpleasantness. Thus, for any neuroscientist or pain clinician interested in keeping abreast of developments that will impact on their specific discipline within the field, this book is important and should be read.