Neuroimaging of paediatric pain

Abstract

Pain during childhood can have a major impact on a child's quality of life and development. However, given the changes in neurobiology, pharmacodynamics and pain assessment across this wide age range, from preverbal premature infants to adolescents, the question of how to effectively assess and manage pain in this population is complex. Recent research using neuroimaging techniques has advanced our understanding of paediatric pain. In this chapter, we discuss this research, including studies examining infant pain, pain in older children and the long-term effects of early life pain exposure. While there is a relative lack of neuroimaging research in paediatric pain compared with studies investigating adult pain, the early research in this field demonstrates the wealth of information that can be gained from the use of these techniques. As cortical activity is a prerequisite for pain perception, measuring pain-related brain activity may be particularly useful in children who cannot describe their pain experience. Neuroimaging studies in older children have highlighted both the vulnerability and plasticity of the developing nervous system. Understanding this plasticity may improve the treatment of chronic pain in children. Furthermore, neuroimaging studies provide an opportunity to examine how analgesics modulate neuronal activity and how this changes as the nervous system develops. In summary, neuroimaging provides a significant new direction in the complex field of paediatric pain.