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Controversy in pain research

Whether small fiber pathology accounts for pain in fibromyalgia, and whether brain imaging can be used as an objective marker of pain remain controversial and will be discussed during the next EAN congress in Oslo.


Several topics related to pain remain controversial. One topic concerns fibromyalgia, an often devastating chronic pain condition attributed mainly to central mechanisms and recently classified as « nociplastic » pain. This condition has recently been shown to be associated with small-fiber pathology and might thus be considered as neuropathic as well. However whether there is a causal link between small fiber pathology and pain in fibromyalgia remains controversial. A second controversial topic in pain research relates to brain imaging. Although pain is clearly subjective, the question is whether imaging tools in particular functional imaging can be used as an objective marker for pain including acute pain but also chronic pain.

These two controversial topics will oppose famous international speakers during a controversy session in Oslo organized by the panel Pain of the EAN. Pr Nurcan Üceyler (Würzburg, Germany) and Pr Andrea Truini (Rome, Italy) will discuss respectively the pros and cons of the first controversy, while Pr Ulrike Bingel (Hamburg, Germany) and Pr André Mouraux (Louvain, Belgium) will discuss respectively the pros and cons of the second controvers.

Key points:

  • fibromyalgia
  • small fiber neuropathy
  • neuroimaging
  • obvjective marker of pain


Üçeyler N, Zeller D, Kahn AK, Kewenig S, Kittel-Schneider S, Schmid A, Casanova-Molla J, Reiners K, Sommer C. Small fibre pathology in patients with fibromyalgia syndrome. Brain. 2013 Jun;136(Pt 6):1857-67.

Wager TD, Atlas LY, Lindquist MA, Roy M, Woo CW, Kross E. An fMRI-based neurologic signature of physical pain. N Engl J Med. 2013 Apr 11;368(15):1388-97.