A review of descending pain modulation in humans
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By
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Christopher D’Souza
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Eden Brander-Whittingham
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Shima Hassanpour
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Brieana Keast
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Jessica Merletti
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Matthew Kong
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Hannan Algitami
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Patrick Stroman
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June 4, 2026
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Clinical Scorecard: An Examination of Descending Pain Modulation Mechanisms in Humans
At a Glance
| Category | Detail |
|---|
| Condition | Descending Pain Modulation |
| Key Mechanisms | Involves periaqueductal grey and rostral medulla as central hubs, with contributions from cortical regions. |
| Target Population | Human populations experiencing pain modulation. |
| Care Setting | Clinical and research settings focusing on pain management. |
Key Highlights
- Descending pain modulation involves both inhibitory and facilitatory pathways.
- Cognitive and emotional factors influence pain modulation through altered connectivity.
- Therapeutic applications include transcranial direct current stimulation and spinal cord stimulation.
Guideline-Based Recommendations
Diagnosis
- Utilize neuroimaging and neuropsychological assessments to evaluate descending pain pathways.
Management
- Consider cognitive and emotional interventions to enhance pain modulation.
Monitoring & Follow-up
- Assess functional connectivity in descending pain networks during treatment.
Risks
- Monitor for variability in pain modulation responses due to psychological factors.
Patient & Prescribing Data
Individuals with pain modulation issues.
Opioid agonist treatment can enhance functional connectivity in pain modulation pathways.
Clinical Best Practices
- Incorporate psychological assessments in pain management strategies.
- Utilize multimodal approaches to address both physiological and psychological aspects of pain.
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