1IntroductionArguably one of the great continuing controversies in visceral pain research is whether the pathology that leads to chronic symptoms is largely concentrated in the periphery or in central structures. In this issue of the Scandinavian Journal of Pain, Frøkjær and coworkers  report their findings of a case-control study where they sought to delineate the presence or absence of microstructural changes in the central pain neuromatrix of patients with functional chest pain of presumed oesophageal origin (FCP). Using diffusion tensor imaging, they demonstrated that, in a well-defined cohort of functional chest pain patients in the absence of psychological comorbidity, that there were no differences in white matter microstructure. This suggests that the pathophysiology of FCP, in a select group of patients, lies outside these structures. FCP is characterized by recurrent unexplained midline chest pain. The Rome III diagnostic criteria include at least 3 months of symptoms, with onset at least 6 months prior to diagnosis, in the absence of another cause such as oesophageal dysmotility or gastro-oesophageal reflux disease . Despite this criteria, it remains unclear as to whether disorders with similar symptoms, albeit with contrasting nomenclature such as non-cardiac chest pain (NCCP) or syndrome X, represent identical
Scandinavian Journal of Pain – de Gruyter
Published: Apr 1, 2014
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