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Content:

Until the 1960s, pain was considered an inevitable sensory response to tissue damage. There was little room for the emotional dimension of this ubiquitous experience, and none whatsoever for the effects of genetic differences, past experience, anxiety, or expectation. In recent years, great advances have been made in our understanding of the mechanisms that underlie pain and in the treatment of people who complain of pain. This rapid progress is due in large part to the multidisciplinary approach simultaneously using systems neurobiology, behavioural analysis, genetics and cell and molecular techniques that has been taken. This module will cover all these aspects of modern neuroscience in the context of pain states, from both a pre-clinical and clinical point of view.

We will present an integrated approach to pain through a series of ten two-hour lectures covering the basic mechanisms of chronic pain and its clinical manifestations as well as current ideas about therapy and management. Research on pain will be related to broad ideas about the organisation of the nervous system, especially sensory systems.

This module is an option for students on the iBSc Anatomy, Cell and Developmental Biology and MSci Cell Biology programmes, and can be taken as an elective by students (including affiliate students) on other degree programmes. An understanding of neuroanatomy and neuroscience is essential.

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This module is an option for students on the iBSc Anatomy, Cell and Developmental Biology and MSci Cell Biology programmes, and can be taken as an elective by students (including affiliate students) on other degree programmes. An understanding of neuroanatomy and neuroscience is essential.

Teaching delivery:

The module is taught in 10 weekly two-hour lecture slots.

Indicative lecture topics (based on a typical year's syllabus):

• The Primary Afferent: Molecular Biology and Growth Factors.
• The Primary Afferent: TRP and Sodium Channels and disease.
• Dorsal horn and Pain Pathways to the Brain.
• Central sensitization.
• Descending controls and cortical pathways.
• Developmental aspects of Pain Systems. Pain in Early Life.
• Neuropathic Pain.
• Central representation of Pain.
• Pharmacology of Chronic Pain States.
• Spinal Cord Circuits for touch, itch and pain.

Module Aims:

The overall aim of this module is for students to acquire a comprehensive understanding of pain encompassing its biological underpinnings, clinical manifestations, and therapeutic implications.

Module Objectives:

Level 6 and Level 7:

• Understand the organization of the sensory nervous system and its relevance to pain processing.
• Acknowledge the emotional and multifaceted nature of pain and how this is driven by the complexity of pain pathways.
• Identify the basic mechanisms underlying chronic pain, including neurobiological processes and molecular pathways.
• Evaluate current therapeutic approaches and management strategies for chronic pain, considering both pharmacological and non-pharmacological interventions.
• Develop critical thinking skills by integrating pre-clinical and clinical perspectives on pain research and treatment.
• Apply knowledge of neuroanatomy and neuroscience to comprehend the complexities of pain states and their management.
• Synthesize information from lectures, readings, and discussions to formulate informed perspectives on modern neuroscience approaches to pain.

Level 7 only:

• Demonstrate originality in designing novel approaches for the investigation and management chronic pain
• Demonstrate the ability to develop hypotheses based on current understanding of the field.

Recommended readings:

On the relation of injury to pain.

Pain . 1979 Jun;6(3):253-264. doi: 10.1016/0304-3959(79)90047-2.

The John J. Bonica lecture; Patrick D Wall

A new view of pain as a homeostatic emotion

Trends Neurosci . 2003 Jun;26(6):303-7. doi: 10.1016/s0166-2236(03)00123-1.

A D Craig

Contacts: Dr Sandrine Géranton (sandrine.geranton@ucl.ac.uk) and Professor Stephen Hunt (hunt@ucl.ac.uk).