Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25297
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dc.contributor.authorPistoia, Francescaen_UK
dc.contributor.authorSacco, Simonaen_UK
dc.contributor.authorStewart, Janeten_UK
dc.contributor.authorSara, Marcoen_UK
dc.contributor.authorCarolei, Antonioen_UK
dc.date.accessioned2017-11-09T23:35:46Z-
dc.date.available2017-11-09T23:35:46Z-
dc.date.issued2016-10en_UK
dc.identifier.other47en_UK
dc.identifier.urihttp://hdl.handle.net/1893/25297-
dc.description.abstractThe experience of pain in disorders of consciousness is still debated. Neuroimaging studies, using functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), multichannel electroencephalography (EEG) and laser-evoked potentials, suggest that the perception of pain increases with the level of consciousness. Brain activation in response to noxious stimuli has been observed in patients with unresponsive wakefulness syndrome (UWS), which is also referred to as a vegetative state (VS), as well as those in a minimally conscious state (MCS). However, all of these techniques suggest that pain-related brain activation patterns of patients in MCS more closely resemble those of healthy subjects. This is further supported by fMRI findings showing a much greater functional connectivity within the structures of the so-called pain matrix in MCS as compared to UWS/VS patients. Nonetheless, when interpreting the results, a distinction is necessary between autonomic responses to potentially harmful stimuli and conscious experience of the unpleasantness of pain. Even more so if we consider that the degree of residual functioning and cortical connectivity necessary for the somatosensory, affective and cognitive-evaluative components of pain processing are not yet clear. Although procedurally challenging, the particular value of the aforementioned techniques in the assessment of pain in disorders of consciousness has been clearly demonstrated. The study of pain-related brain activation and functioning can contribute to a better understanding of the networks underlying pain perception while addressing clinical and ethical questions concerning patient care. Further development of technology and methods should aim to increase the availability of neuroimaging, objective assessment of functional connectivity and analysis at the level of individual cases as well as group comparisons. This will enable neuroimaging to truly become a clinical tool to reliably investigate pain in severely brain-injured patients as well as an asset for research.en_UK
dc.language.isoenen_UK
dc.publisherMDPIen_UK
dc.relationPistoia F, Sacco S, Stewart J, Sara M & Carolei A (2016) Disorders of consciousness: Painless or painful conditions?-evidence from neuroimaging studies. Brain Sciences, 6 (4), Art. No.: 47. https://doi.org/10.3390/brainsci6040047en_UK
dc.rights© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectconsciousnessen_UK
dc.subjectneuroimagingen_UK
dc.subjectpainen_UK
dc.subjectvegetative stateen_UK
dc.subjectunresponsive wakefulness syndromeen_UK
dc.subjectminimally conscious stateen_UK
dc.titleDisorders of consciousness: Painless or painful conditions?-evidence from neuroimaging studiesen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.3390/brainsci6040047en_UK
dc.identifier.pmid27740600en_UK
dc.citation.jtitleBrain Sciencesen_UK
dc.citation.issn2076-3425en_UK
dc.citation.volume6en_UK
dc.citation.issue4en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.citation.date08/10/2016en_UK
dc.contributor.affiliationUniversity of L'Aquilaen_UK
dc.contributor.affiliationUniversity of L'Aquilaen_UK
dc.contributor.affiliationSan Raffaele Scientific Instituteen_UK
dc.contributor.affiliationUniversity of L'Aquilaen_UK
dc.identifier.isiWOS:000391699800007en_UK
dc.identifier.scopusid2-s2.0-85010908078en_UK
dc.identifier.wtid534577en_UK
dc.date.accepted2016-09-28en_UK
dcterms.dateAccepted2016-09-28en_UK
dc.date.filedepositdate2017-05-02en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorPistoia, Francesca|en_UK
local.rioxx.authorSacco, Simona|en_UK
local.rioxx.authorStewart, Janet|en_UK
local.rioxx.authorSara, Marco|en_UK
local.rioxx.authorCarolei, Antonio|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2017-05-02en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by/4.0/|2017-05-02|en_UK
local.rioxx.filenamebrainsci-06-00047.pdfen_UK
local.rioxx.filecount1en_UK
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