Opioids and brain imaging

Shyam Balasubramanian, MBBS, MD, FRCA; Patricia Morley-Forster, MD, FRCPC; Yves Bureau, PhD

doi:10.5055/jom.2006.0024

Authors

Shyam Balasubramanian, MBBS, MD, FRCA
Patricia Morley-Forster, MD, FRCPC
Yves Bureau, PhD

DOI:

https://doi.org/10.5055/jom.2006.0024

Keywords:

brain imaging, fMRI, PET, central opioid pathways, central pain processing

Abstract

Since the introduction of the gate-control theory, a plethora of evidence to support the spinal processing of pain signals has come to light. Cognitive and affective aspects of the pain experience indicate the importance of supraspinal structures, but the biological mechanisms have remained inadequately explored. Within the past decade, imaging techniques have emerged that enable in vivo assessment of the central opioidergic system and the central processing of pain. The two most important imaging modalities to this end are functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). This article will describe the underlying principles of these techniques and explain their importance in determining the loci of opioidergic pathways and their neuromodulatory influence on acute and chronic pain conditions, role in placebo effects, implication in drug dependence, and potential role in studying the analgesic efficacy of new drugs.

Author Biographies

Shyam Balasubramanian, MBBS, MD, FRCA

Clinical Fellow, Interdisciplinary Pain Program, Schulich School of Medicine, St. Joseph’s Health Care London, London, Ontario, Canada.

Patricia Morley-Forster, MD, FRCPC

Medical Director, Interdisciplinary Pain Program, Schulich School of Medicine, St. Joseph’s Health Care London, London, Ontario, Canada.

Yves Bureau, PhD

Research Scientist, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada.

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