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Neuron. 2016 Jan 6;89(1):11-36. doi: 10.1016/j.neuron.2015.11.027.

Common Brain Mechanisms of Chronic Pain and Addiction.

Author information

1
Boonshoft School of Medicine, Wright State University and Dayton VA Medical Center, East Medical Plaza, 627 South Edwin C. Moses Boulevard, Dayton, OH 45417, USA. Electronic address: igor.elman@wright.edu.
2
Harvard Medical School, Center for Pain and the Brain, Boston Children's Hospital, Massachusetts General Hospital and McLean Hospital, 9 Hope Avenue, Waltham, MA 02453, USA.

Abstract

While chronic pain is considered by some to be a CNS disease, little is understood about underlying neurobiological mechanisms. Addiction models have heuristic value in this regard, because both pain and addictive disorders are characterized by impaired hedonic capacity, compulsive drug seeking, and high stress. In drug addiction such symptomatology has been attributed to reward deficiency, impaired inhibitory control, incentive sensitization, aberrant learning, and anti-reward allostatic neuroadaptations. Here we propose that similar neuroadaptations exist in chronic pain patients.

KEYWORDS:

amygdala; analgesia; catastrophizing; corticotropin-releasing factor; deficient or excessive reward dysfunction; delay discounting; dopamine; dynorphin; effectors; habenula; hedonostat; homeostasis; nucleus accumbens; opioid; opponent; prediction error; regulators; therapeutic dependence

PMID:
26748087
DOI:
10.1016/j.neuron.2015.11.027
[Indexed for MEDLINE]
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