abstract Marina de Tommaso

Marina de Tommaso (Neurophysiopathology of pain unit, Department of Neurology, University of Bari, Italy)

Affective, cognitive and aesthetic distractors. Main findings in healthy subjects and migraine patients.

Pain processing is a complex function of the brain, subjected by a complex modulation under different conditions. Painful punctual stimuli activate selectively nociceptive a-delta and C afferents, and are able to evoke a cortical response which is maximally expressed at the vertex and explains the relevance of the painful inputs. Normal subjects show reduced pain-related cortical activation when performing different tasks or looking at images, which may be considered potential non pharmacological "pain killers". The modality of pain stimulus modulation changes in patients affected by chronic syndromes as migraine or chronic pain. Visual stimuli are able to modulate pain , depending upon the content of the visual stimuli. Pictures considered beautiful and/or pleasant, are perceived as salient in normal subjects and compete with cortical recruitment induced by painful stimuli. Migraine patients are charecterized by a less predictable modality of pain modulation, being sensitive to images suggesting suffrance and illness, which do not influence pain perception in normal subjects. The study of nociceptive inputs modulation by concurring laser and multimodality stimulations may help to understand some factors conditioning clinical outcome in chronic pain patients.