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World J Gastrointest Pathophysiol. Feb 15, 2014; 5(1): 33-39
Published online Feb 15, 2014. doi: 10.4291/wjgp.v5.i1.33
Electrophysiology as a tool to unravel the origin of pancreatic pain
Dina Lelic, Søren Schou Olesen, Carina Graversen, Christina Brock, Massimiliano Valeriani, Asbjørn Mohr Drewes
Dina Lelic, Søren Schou Olesen, Carina Graversen, Christina Brock, Asbjørn Mohr Drewes, Mech-Sense, Department of Gastroenterology and Hepatology, Mølleparkvej 4, Aalborg University Hospital, 9000 Aalborg, Denmark
Massimiliano Valeriani, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, 00165 Rome, Italy
Massimiliano Valeriani, Asbjørn Mohr Drewes, Department of Health Science and Technology, Center for Sensory-Motor Interactions, Aalborg University, 9000 Aalborg, Denmark
Author contributions: Lelic D, Olesen SS, Graversen C, Brock C, Valeriani M and Drewes AM contributed equally to this work.
Correspondence to: Dina Lelic, MSc, PhD, Mech-Sense, Department of Gastroenterology and Hepatology, Mølleparkvej 4, Aalborg University Hospital, 9000 Aalborg, Denmark. dl@mech-sense.com
Telephone: +45-99-326247 Fax: +45-99-326507
Received: August 27, 2013
Revised: October 14, 2013
Accepted: November 15, 2013
Published online: February 15, 2014
Processing time: 175 Days and 20.9 Hours
Abstract

Intense abdominal pain is the most common symptom in chronic pancreatitis, but the underlying mechanisms are not completely understood and pain management remains a significant clinical challenge. The focus of pain origin in chronic pancreatitis traditionally has been on the pancreatic gland, assuming pain to originate in the pancreas or its surrounding organs. However, research in the last decade points to abnormal central nervous system pain processing. For this reason, electroencephalography has been receiving increasing attention. In contrast to imaging methods such as functional magnetic resonance imaging and positron emission tomography, electroencephalogram has excellent temporal resolution making it possible to investigate central processing of pain on a millisecond time scale. Moreover, continuously advancing methodology made it possible to explore brain sources responsible for generation of evoked potentials and hence to study brain reorganization due to pain in chronic pancreatitis. The aim of this review is to give an overview of the current methods and findings in electroencephalography as a tool to unravel the origin of pancreatic pain.

Keywords: Chronic pancreatitis, Electrophysiology, Evoked potentials, Brain source localization, Electroencephalography frequency analysis, Visceral pain, Chronic pain, Pancreatic pain

Core tip: Chronic pancreatitis (CP) is a disease with progressive destruction of the pancreatic gland and intense abdominal pain is one of its main characteristics. The understanding of pain in CP has conventionally focused on the diseased pancreas itself, assuming pain to be due to increased parenchymal or ductal pressure. However, recent research points to possible involvement of abnormal central nervous system pain processing. This review gives an insight into electrophysiology as a tool to unravel brain abnormalities underlying pancreatic pain and provides up to date electrophysiological results in this patient group.