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An examination of blood oxygen level dependent functional magnetic resonance imaging methods in analysing chronic non-malignant pain patients' responses to non -painful pain stimuli

Taylor, Ann 2012. An examination of blood oxygen level dependent functional magnetic resonance imaging methods in analysing chronic non-malignant pain patients' responses to non -painful pain stimuli. PhD Thesis, Cardiff University.
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Abstract

The main focus of this thesis is chronic musculoskeletal pain (CMSKP) as this equates to the largest proportion of patients with chronic non malignant pain and results in the huge burden on the individual, society and health system. Pain interrupts, demands attention, and is difficult to disengage from and fear, anxiety and catastrophising are seen as major factors moderating the attentional demands of pain. Early work with clinical populations indicates considerable promise for fMRI methods to be used in pain diagnosis and therapy which may improve the categorisation of pain conditions in an objective manner based on a better understanding of central mechanisms. Given that treatment for CMSKP has not advanced for many years and behavioural research has not achieved consistent results, fMRI methods may help to provide further understanding of how pain-related attention, fear and catastrophising affect patients. The aim of the thesis was to explore Blood Oxygen Level Dependent (BOLD) signal changes in response to viewing non-painful pain-relevant stimuli. Three neuroimaging studies were undertaken. Two studies involved a population of CMSKP patients where an emotional counting pain and positive Stroop task was used and the other a modified visual task using pictures of activities of daily living (PHODA). One study recruited a population of chronic low back pain patients (CLBP) using a modified picture task and this also include voxel based morphometry and resting BOLD analyses. The main findings were that patients attended to the pain-related stimuli and BOLD region differences in patients compared to controls showed that anxiety, fear and catastrophising were implicated in the large number of regions traditionally involved in the sensory and emotional processing of pain. BOLD differences were greater with the picture stimuli than with a word stimulus. No differences in brain structure was seen in the CLBP group and resting BOLD results are discussed. Implications, limitations and future research directions are presented.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Funders: National Institute of Academic Anaesthesia (NIAA), Welsh Institute of Cognitive Neuroscience (WICN)
Date of First Compliant Deposit: 30 March 2016
Last Modified: 04 Jun 2017 04:42
URI: http://orca-mwe.cf.ac.uk/id/eprint/43177

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