Pain processing in the brain: What changes with chronic pain

Pain processing in the brain: What is different in chronic pain?
This film was developed to illustrate the extremely complex processes of pain transmission and pain processing in the brain. The film outlines what happens in the brain with acute pain and how this is different with chronic pain.
The film is aimed at children, adolescents and young adults with chronic pain, as well as their families, friends and practitioners from primary to tertiary care. Everything that we perceive from our environment and from our subjective experience is passed on to our brain as stimuli: for example, movement stimuli from the muscles, sensory stimuli such as hearing and pain stimuli.
The first part of the film explains how pain transmission works in acute pain, including which parts of our brain play a role in pain processing: the prefrontal cortex, the thalamus, the amygdala, the somatosensory cortex. A whole network is involved in pain processing. There is an exchange of information between the brain regions involved via neural connections. The prefrontal cortex draws attention to the most important stimuli currently and communicates this to the thalamus. The thalamus is connected to the amygdala, which is responsible for processing emotions. Emotional states have an impact on the intensity of the transmission of stimuli. The thalamus works like a filter, sorting through the incoming stimuli and forwarding the most important signals on so that we become aware of them. Finally, the incoming pain stimuli are assigned to a bodily pain location which is mapped in the somatosensory cortex.
The second part of the film shows what happens differently in the processing of pain in the brain in the case of chronic pain and how pain sensitization occurs. The prefrontal cortex repeatedly draws attention to potentially painful situations. Many stressful life situations and strong emotions lead to the amygdala increasing the transmission of pain stimuli through the thalamus. By paying attention to the pain, more already known pain stimuli arrive in the thalamus. Due to the abundance of incoming small and large pain and movement stimuli, and the lack of inhibition by the prefrontal cortex and the amygdala, more stimuli than before are passed on for conscious processing. Movement stimuli are also incorrectly perceived as pain stimuli. The thalamus has become more sensitive to pain stimuli. The increased number of incoming pain and movement stimuli reaches an increasingly activated somatosensory cortex via strongly developed nerve connections. Even small pain and movement stimuli are consciously perceived and can lead to increased pain sensitivity and thus an increased number of pain locations.
References:
Apkarian, A.V., Bushnell, M.C., Treede, R.D., & Zubieta, J.K. (2005). Human brain mechanisms of
pain perception and regulation in health and disease. European journal of pain, 9(4), 463-484.
Davis, D. A., Ghantous, M. E., Farmer, M. A., Baria, A. T., & Apkarian, A. V. (2016). Identifying brain
nociceptive information transmission in patients with chronic somatic pain. Pain reports, 1(4),
e575.
Fenton, B. W., Shih, E., & Zolton, J. (2015). The neurobiology of pain perception in normal and
persistent pain. Pain management, 5(4), 297-317.
Kuner, R., & Flor, H. (2017). Structural plasticity and reorganisation in chronic pain. Nature reviews.
Neuroscience, 18(2), 113.
McAlonan, K., Brown, V. J., Bowman, E. M. (2000). Thalamic Reticular Nucleus Activation Reflects
Attentional Gating during Classical Conditioning. Journal of Neuroscience, 20(23), 8897-8901.
Montero V. M. (2000). Attentional activation of the visual thalamic reticular nucleus depends on
'top-down' inputs from the primary visual cortex via corticogeniculate pathways. Brain research,
864(1), 95-104.
The film is based on scientific content. It was created by former Fix and Foxi chief draftsman Bone Buddrus and set to music by "Bows To Hymns".
This film was developed as part of the project “APPLAUS for young adults” (App-based therapy for long-term implementation of pain management strategies for young adults). This project is funded by the state of North Rhine-Westphalia using funds from the European Regional Development Fund (ERDF) as part of the ERDF NRW 2014-2020 (EFRE-0801059). You can find more information on funding at: www.leitmarktagentur.nrw.

[@ChiefEru]

Excellent video! Thank you!

[@loriwilliams4588]

Love this!! Thank you!!

[@danielaescobar694]

Really good animation !!!!

[@raymonde.tanneratomic-rc9370]

The print needs to be bigger, hard to read

[@jetpetty1613]

And now, doctors are not treating pain in children or adults because of DEA interference and opioid hysteria....lovely 😑