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Placebos and Nocebos in Headaches pp 27–41Cite as

Mechanisms of Pain and Headache

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Part of the book series: Headache ((HEAD))

Abstract

Recent years have witnessed great advances in the neuroimaging field that permitted the elaborated evaluation of the brain structure and, most importantly, the complex central activity that takes place in humans at rest and during different types of functional challenges or cognitive activities. Such functional and structural studies provided fundamental information that when correlated with clinical symptoms brought better understanding for the cortical and subcortical mechanisms related to chronic pain syndromes. With regard to primary headaches, most of the MRI-based neuroimaging studies explored the pathophysiology of migraine and its related signs and symptoms such as pain severity, nausea, phonophobia, photophobia, and allodynia. Considering the unique cyclic characteristic of the disease, migraine research offers additional opportunities and logistic challenges including the study of patients during and outside their attacks (ictal and interictal phases, respectively), the increased sensitive to stimuli from the environment, and response to treatment. More recent studies using positron-emission tomography (PET) have provided novel clues at molecular level of major endogenous modulatory systems that could play an important role in the development and maintenance of migraine and other chronic pain states. For instance, molecular neuroimaging has showed in vivo that there is a significant dysfunction in endogenous mu-opioidergic and dopaminergic mechanisms during migraine attacks and allodynia, as well as neuropathic pain. In this chapter, we discuss novel discoveries using neuroimaging, including the role of central molecular mechanisms in migraine/pain suffering and treatment.

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Authors and Affiliations

  1. Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences, School of Dentistry, The Molecular and Behavioral Neuroscience Institute (MBNI), University of Michigan, Ann Arbor, MI, USA

    Alexandre F. M. DaSilva & Marcos Fabio DosSantos

  2. Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA

    Alexandre F. M. DaSilva

  3. Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

    Marcos Fabio DosSantos

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  1. Alexandre F. M. DaSilva
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Correspondence to Alexandre F. M. DaSilva .

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  1. Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Dimos D. Mitsikostas

  2. Neuroscience Department, University of Turin Medical School, Torino, Italy

    Fabrizio Benedetti

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DaSilva, A.F.M., DosSantos, M.F. (2019). Mechanisms of Pain and Headache. In: Mitsikostas, D., Benedetti, F. (eds) Placebos and Nocebos in Headaches. Headache. Springer, Cham. https://doi.org/10.1007/978-3-030-02976-0_3

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