Neuroimaging Correlates for Psychological and Chronic Pain Experiences

Psychological factors play a key role in the pain experience. Clinical and experimental research has highlighted altered behavioral, cognitive, and emotional responses as endemic in chronic pain populations, which contribute to physical dysfunction and to depression, anxiety, and other psychiatric disorders. Neuroimaging research has complemented the knowledge in this domain by identifying how neural structure and function are altered in chronic pain. Brain processes related to mental illness, emotion, memory, and cognition are distributed throughout the brain and modulate pain processing in both the acute and chronic states. These processes can be targeted both behaviorally and neurophysiologically through noninvasive and nonpharmacological psychological therapies, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based stress reduction. Psychological therapies are further supported by emerging neuroimaging research that demonstrates changes in brain structure and function associated with positive changes in patients’ responses to pain and overall improved quality of life.