Pain vulnerability: a neurobiological perspective
Open accessAbstract
There are many known risk factors for chronic pain conditions, yet the biological underpinnings that link these factors to abnormal processing of painful signals are only just beginning to be explored. This Review will discuss the potential mechanisms that have been proposed to underlie vulnerability and resilience toward developing chronic pain. Particular focus will be given to genetic and epigenetic processes, priming effects on a cellular level, and alterations in brain networks concerned with reward, motivation/learning and descending modulatory control. Although research in this area is still in its infancy, a better understanding of how pain vulnerability emerges has the potential to help identify individuals at risk and may open up new therapeutic avenues.
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A meta-analysis of 23 studies found that more than half of people diagnosed with TBI report chronic pain complaints, likely because of associated physical injuries at the time of TBI.
“According to a metaanalysis of 23 studies, more than 50% of people diagnosed with TBI report chronic pain complaints 80, likely due to the associated physical injuries at the time of the TBI81.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [80]
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- Authors
- Denk, F., McMahon, S. B., & Tracey, I.
- Affiliations
- King's College London (GB)
- University of Oxford (GB)
- Corresponding author
- McMahon, Stephen B
- Venue
- Nature Neuroscience
- Published
- 2014-01-28
- Volume
- 17
- Issue
- 2
- Pages
- 192-200
- ISSN
- 1097-6256 (ISSN-L)
- 1546-1726
- OpenAlex
- W2009740794
- Cited by
- 363
- References
- 103
- Citations by year
- 2026: 18 · 2025: 24 · 2024: 26 · 2023: 22 · 2022: 31 · 2021: 29 · 2020: 28 · 2019: 38 · 2018: 37 · 2017: 36 · 2016: 32 · 2015: 28 · 2014: 14
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Nature Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (102645, 102645/Z/13/Z, 097903, 83259)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- pain vulnerability, chronic pain, pain resilience, genetic risk factors, epigenetics, brain networks, descending pain modulation, reward and motivation, pain learning
- MeSH terms
- Animals, Humans, Neural Pathways, Neurobiology, Pain, Risk Factors, Epigenomics
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