Tim Salomons

• Ph.D.
• Professor at University of Reading

Introduction Fibromyalgia is associated with chronic widespread pain and disturbed sleep. Multidisciplinary, multimodal management often includes pharmacotherapy; however, current drugs used to treat fibromyalgia provide meaningful benefit to only 30–60% of treated individuals. Combining two or more different drugs is common in clinical practice wi...

Introduction Pain management in patients with chronic pain and comorbid depression is challenging and understudied. There is interest in intermittent theta-burst stimulation (iTBS), a new modality of repetitive transcranial magnetic stimulation (rTMS). This retrospective review describes changes in pain, anxiety and depression throughout iTBS treat...

Acute pain serves to warn an organism of potential damage. When nociceptive stimulation persists, two possible responses emerge: If no risk of harm is anticipated, habituation may occur. If harm is considered possible, pain sensitization is likely. An individuals adaptation to prolonged pain may provide insight into their ability to manage resource...

Knee osteoarthritis (OA) is the most common form of OA and is not currently considered to be a curable disease. Specifically, mild-to-moderate knee OA that is resistant to conservative treatment, but does not warrant joint replacement, poses a significant clinical problem. Genicular arterial embolisation (GAE) is an interventional radiological tech...

Background Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder with current psychotherapeutic treatments, while somewhat effective, yielding low accessibility and scalability. A lack of knowledge regarding the neural pathology of OCD may be hindering the development of innovative treatments. Previous research has observed b...

Central sensitization (CS) is defined as an increased nociceptive responsiveness due to sensitization of neurons in the central nervous system, usually the result of prolonged nociceptive input or a disease state associated with noxious inputs (e.g., polyarthritis). The concept of CS has recently been adopted in clinical assessments of chronic pain...

Background: Due to the inherent subjectivity of pain, it is difficult to make accurate judgments of pain in others. Research has found discrepancies between the ways in which perceived "objective" (e.g., medical evidence of injury) and "subjective" information (e.g., self-report) influence judgments of pain. This study aims to explore which potent...

Introduction: Conditioned pain modulation (CPM) is a psychophysical assessment used to estimate the efficiency of an individual's endogenous modulatory mechanisms. Conditioned pain modulation has been used as a predictive assessment for the development of chronic pain and responses to pain interventions. Although much is known about the spinal cor...

Escitalopram may have pain-alleviating effects for patients with comorbid pain and depression. This study aimed to quantify improvements in pain for patients on escitalopram and adjunctive aripiprazole. A secondary analysis of the CAN-BIND-1 trial was conducted which only included participants with a current depressive episode and pain. Participant...

Introduction: Central sensitization (CS) was first defined in animal studies to be increased nociceptive responsiveness due to sensitization of neurons in the central nervous system, usually the result of prolonged nociceptive input or a disease state. Recently, the concept of CS has been adopted in clinical assessments of chronic pain, but its di...

According to standard philosophical and clinical understandings, pain is essentially a mental phenomenon (typically, a kind of conscious experience). In a challenge to this standard conception, a recent burst of empirical work in experimental philosophy (e.g. by Sytsma and Reuter [1-3]) purports to show that people ordinarily conceive of pain as an...

Introduction: Evidence suggests that attention to pain is a product of both incoming sensory signals and cognitive evaluation of a stimulus. Intrinsic attention to pain (IAP) is a measure that captures an individual's natural tendency to attend to a painful stimulus and may be important in understanding why pain disrupts cognitive functioning in s...

BACKGROUND Obsessive-compulsive disorder (OCD) is a debilitating and prevalent anxiety disorder. While the basal ganglia and frontal cortex are the most hypothesized brain regions involved, the exact pathophysiology is unknown. By observing the effects of proven treatments on brain activation levels, the cause of OCD can be better understood. Curre...

Background: Obsessive-compulsive disorder (OCD) is a debilitating and prevalent anxiety disorder. While the basal ganglia and frontal cortex are the most hypothesized brain regions involved, the exact pathophysiology is unknown. By observing the effects of proven treatments on brain activation levels, the cause of OCD can be better understood. Cur...

How we perceive our bodies is fundamental to our self-consciousness and our experience in the world. There are two types of interrelated internal body representations-a subjective experience of the position of a limb in space (body schema) and the subjective experience of the shape and size of the limb (body image). Body schema has been extensively...

By definition, pain is a sensory and emotional experience that is felt in a particular part of the body. The precise relationship between somatic events at the site where pain is experienced, and central processing giving rise to the mental experience of pain remains the subject of debate, but there is little disagreement in scholarly circles that...

Pain disorders and psychiatric illness are strongly comorbid, particularly in the context of Major Depressive Disorder (MDD). While these disorders account for a significant amount of global disability, the mechanisms of their overlap remain unclear. Understanding these mechanisms is of vital importance to developing prevention strategies and inter...

Background & Aims Much is known about the impact of pain in terms of medical costs and missed work. Less is known about its associations when individuals are present for work. This study examines “presenteeism” by analysing the psychosocial costs of pain in the workplace, using the 2015 European Working Conditions Survey (EWCS). Methods We conduct...

According to standard philosophical and clinical understandings, pain is essentially a mental phenomenon (typically, a kind of conscious experience). In a challenge to this standard conception, a recent burst of empirical work in experimental philosophy (e.g. by Sytsma and Reuter [1-3]) purports to show that people ordinarily conceive of pain as an...

Most patients with chronic pain do not find adequate pain relief with a single treatment, and accumulating evidence points to the added benefits of rational combinations of different treatments. Given that psychological therapies, such as mindfulness-based interventions (MBIs), are often delivered in conjunction with concomitant analgesic drug ther...

How we perceive our bodies is fundamental to our self-consciousness and our experience in the world. There are two types interrelated internal body representations; a subjective experience of the position of a limb in space (body schema) and the subjective experience of the shape and size of the limb (body image). Body schema has been extensively s...

Introduction: Most current chronic pain treatment strategies have limitations in effectiveness and tolerability, and accumulating evidence points to the added benefits of rational combinations of different therapies. However, most published clinical trials of treatment combinations have involved combinations of 2 drugs, whereas very little researc...

The amygdala is central to emotional processing of sensory stimuli, including pain. Because recent findings suggest that individual differences in emotional processes play a part in the development of chronic pain, a better understanding of the individual patterns of functional connectivity that make individuals susceptible to emotionally modulated...

Both patients and clinicians frequently report problems around communicating and assessing pain. Patients express dissatisfaction with their doctors and doctors often find exchanges with chronic pain patients difficult and frustrating. This chapter thus asks how we could improve pain communication and thereby enhance outcomes for chronic pain patie...

Examining how individual differences in natural mindfulness propensity can influence pain, and how this relates to attentional mechanisms in the brain at rest

Philosophers often assume that folk hold pain to be a mental state. However, folk also assign pains bodily locations: unlike most other mental states, pains are held to exist in arms, feet, etc. This has led some to talk of the “paradox of pain,” whereby the folk notion of pain is inherently conflicted. Recently, several authors have rejected the p...

Mindfulness-based training reduces pain in clinical and experimental settings. Evidence suggests that these beneficial effects are facilitated via an increased focus on the present moment and a reduced emotional enhancement of pain. Most of the existing literature has focused on mindfulness as a learned skill and on the neural mechanisms that under...

Inter-individual differences in pain sensitivity vary as a function of interactions between sensory, cognitive-affective and dispositional factors. Trait mindfulness, characterized as the innate capacity to non-reactively sustain attention to the present moment, is a psychological construct that is associated with lower clinical pain outcomes. Yet,...

Human pain neuroimaging has exploded in the past 2 decades. During this time, the broader neuroimaging community has continued to investigate and refine methods. Another key to progress is exchange with clinicians and pain scientists working with other model systems and approaches. These collaborative efforts require that non-imagers be able to eva...

Background: Flashbacks are a form of multisensory memory that are experienced with a ‘happening in the present’ quality. Pain flashbacks are a re-experiencing of pain felt at the time of a traumatic event. It is unclear how common pain flashbacks are. Aims: The current study was designed primarily to assess the prevalence of pain flashbacks in a sa...

Perspective: To examine whether sex and gender affect willingness to participate in pain studies, we assessed gender identification in male and female participants, then attempted to recruit them to participate in a pain study. Males who agree to participate in pain studies are significantly higher in masculine gender identification than males who...

In Reply We thank Büchel and colleagues for their letter, and we are pleased to see that their considerations are based on a viewpoint almost entirely in agreement with our own. Their statement that pain matrix responses generated using traditional analysis methods and experimental designs are “confounded by unspecific effects” is a concise summary...

This study administered noxious mechanical stimuli to individuals with congenital insensitivity to pain and sampled their brain activity with functional magnetic resonance imaging.Human functional imaging provides a correlative picture of brain activity during pain. A particular set of central nervous system structures (eg, the anterior cingulate c...

Background: Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers ("biomarkers") of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of bioma...

Repeated sensory exposures shape the brain's function and its responses to environmental stimuli. An important clinical and scientific question is how exposure to pain affects brain network activity and whether that activity is modifiable with training. We sought to determine whether repeated pain exposure would impact brain-network activity and wh...

Early debate on pain processing focused on whether pain was the product of specific receptors in the periphery. The discovery of nociceptors and the variety of modalities of dangerous stimuli they can process have largely convinced the pain community that specificity exists at least at the level of primary afferents. Nevertheless, nociception does...

Functional neuroimaging investigations of pain have discovered a reliable pattern of activation within limbic regions of a putative "pain matrix" that has been theorized to reflect the affective dimension of pain. To test this theory, we evaluated the experience of pain in a rare neurological patient with extensive bilateral lesions encompassing co...

Anxiolytic effects of perceived control have been observed across species. In humans, neuroimaging studies have suggested that perceived control and cognitive reappraisal reduce negative affect through similar mechanisms. An important limitation of extant neuroimaging studies of perceived control in terms of directly testing this hypothesis, howeve...

The frontal pole corresponds to Brodmann area (BA) 10, the largest single architectonic area in the human frontal lobe. Generally, BA10 is thought to contain two or three subregions that subserve broad functions such as multitasking, social cognition, attention, and episodic memory. However, there is a substantial debate about the functional and st...

Repeated exposure to pain can result in sensitization of the central nervous system enhancing subsequent pain and potentially leading to chronicity. The ability to reverse this sensitization in a top-down manner would be of tremendous clinical benefit but the degree that this can be accomplished volitionally remains unknown. Here we investigated wh...

rTMS is currently being explored as a potential adjunctive treatment for anorexia and bulimia nervosa. Previous studies have found, at best, modest efficacy for rTMS in this setting using the conventional target in the dorsolateral prefrontal cortex (DLPFC). However, neuroimaging studies suggest that the dorsomedial prefrontal cortex (DMPFC) may be...

rTMS is an emerging treatment for major depressive disorder (MDD) refractory to medications and psychotherapy. The conventional target for rTMS in MDD is the dorsolateral prefrontal cortex (DLPFC). However, convergent evidence from lesion, stimulation, and neuroimaging studies suggests that the dorsomedial prefrontal cortex (DMPFC) may play a more...

Patients with Obsessive-Compulsive Disorder (OCD) often show minimal response to either pharmacotherapy or psychotherapy. Repetitive transcranial magnetic stimulation (rTMS) is being explored as a new treatment for OCD. rTMS targeting the dorsolateral prefrontal cortex (DLPFC) has not shown robust efficacy; however, neuroimaging studies of OCD have...

Depression is a heterogeneous mental illness. Neurostimulation treatments, by targeting specific nodes within the brain's emotion-regulation network, may be useful both as therapies and as probes for identifying clinically relevant depression subtypes. Here, we applied 20 sessions of magnetic resonance imaging-guided repetitive transcranial magneti...

Significance The mind easily wanders away from mundane tasks, but pain is presumed to automatically capture attention. We demonstrate that individuals differ in how often their minds spontaneously wander away from pain and that these differences are associated with the disruptive effect of pain on cognitive performance. Brain–behavior relationships...

Despite its high toll on society, there has been little recent improvement in treatment efficacy for major depressive disorder (MDD). The identification of biological markers of successful treatment response may allow for more personalized and effective treatment. Here we investigate whether resting-state functional connectivity predicted response...

Physical pain can be clearly distinguished from other states of distress. In recent years, however, the notion that social distress is experienced as physically painful has permeated the scientific literature and popular media. This conclusion is based on the overlap of brain regions that respond to nociceptive input and sociocultural distress. Her...

Background / Purpose: Repetitive transcranial magnetic stimulation (rTMS) for major depression conventionally targets the dorsolateral prefrontal cortex (DLPFC). However, converging evidence from lesion, stimulation, and imaging studies suggests the dorsomedial prefrontal cortex (DMPFC) may be as, or more, central to mood regulation. We studied t...

Temporomandibular disorder (TMD) is a prevalent chronic pain disorder that remains poorly understood. Recent imaging studies reported functional and gray matter abnormalities in brain areas implicated in sensorimotor, modulatory, and cognitive function in TMD, but it is not known whether there are white matter (WM) abnormalities along the trigemina...

Widespread brain gray matter (GM) atrophy is a normal part of the aging process. However, recent studies indicate that age-related GM changes are not uniform across the brain and may vary according to health status. Therefore the aims of this study were to determine whether chronic pain in temporomandibular disorder (TMD) is associated with abnorma...

Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulnes...

The experience of pain occurs when the level of a stimulus is sufficient to elicit a marked affective response, putatively to warn the organism of potential danger and motivate appropriate behavioral responses. Understanding the biological mechanisms of the transition from innocuous to painful levels of sensation is essential to understanding pain...

Although the co-occurrence of negative affect and pain is well recognized, the mechanism underlying their association is unclear. To examine whether a common self-regulatory ability impacts the experience of both emotion and pain, we integrated neuroimaging, behavioral, and physiological measures obtained from three assessments separated by substan...

It has been argued that emotion, pain and cognitive control are functionally segregated in distinct subdivisions of the cingulate cortex. However, recent observations encourage a fundamentally different view. Imaging studies demonstrate that negative affect, pain and cognitive control activate an overlapping region of the dorsal cingulate--the ante...

Pain is an unpleasant sensory and emotional experience that can be regulated by many different cognitive mechanisms. We compared the regulatory qualities of two different meditation practices during noxious thermal stimuli: Focused Attention, directed at a fixation cross away from the stimulation, which could regulate negative affect through a sens...

Unlabelled: Facial expressions of pain are an important part of the pain response, signaling distress to others and eliciting social support. To evaluate how voluntary modulation of this response contributes to the pain experience, 29 subjects were exposed to thermal stimulation while making standardized pain, control, or relaxed faces. Dependent...

The degree to which perceived controllability alters the way a stressor is experienced varies greatly among individuals. We used functional magnetic resonance imaging to examine the neural activation associated with individual differences in the impact of perceived controllability on self-reported pain perception. Subjects with greater activation i...

Facial expressions of pain are an important part of the pain response, signaling distress to others and eliciting social support. To evaluate how voluntary modulation of this response contributes to the pain experience, 29 subjects were exposed to thermal stimulation while making standardized pain, control, or relaxed faces. Dependent measures were...

The response to painful stimulation depends not only on peripheral nociceptive input but also on the cognitive and affective context in which pain occurs. One contextual variable that affects the neural and behavioral response to nociceptive stimulation is the degree to which pain is perceived to be controllable. Previous studies indicate that perc...

Surgical patients who regain consciousness while under general anesthesia may develop symptoms of Posttraumatic Stress Disorder (PTSD). One common PTSD symptom is the experiencing of abnormal perceptions during which the patient feels as if the trauma is recurring. The objective of this report is to document the re-occurrence of pain as part of the...

To compare patients who participate in a clinical trial for pain management involving epidural anesthesia to those who refuse and document their reasons for refusing. Demographic and health history information was collected from 621 female patients who were screened for inclusion in a pain management trial involving epidural anesthesia. Patients wh...