Is it possible to develop a valid biomarker for “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”? Yes, definitely. We already use such a biomarker daily in clinical practice. Patient report is the gold standard of pain assessment and by the definition in the IASP taxonomy and especially the accompanying explanatory note, pretty much the only valid measure of pain (http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions#Pain). However, inability to communicate verbally does not negate the possibility that an individual is experiencing pain.Other, more obvious biomarkers, such as a rise in the concentration of a neurotransmitter or a change in the plasma level of a hormone, activity of a certain neurone or a group of neurones (even a very large and opinionated group of neurones), or a behavioural pattern, such as withdrawal of limb from a noxious stimulus, all could be useful for research. But such changes should never be misunderstood as synonymous to pain.A certain activation pattern in fMRI imaging of brain areas known to be important for pain processing (including thalamus, the posterior and anterior insulae, the secondary somatosensory cortex, the anterior cingulate cortex, and the periaqueductal grey matter) has, in
Scandinavian Journal of Pain – de Gruyter
Published: Oct 1, 2013
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