The session will first present mechanisms of spatial filtering in experimental pain. We will then discuss mechanisms possibly underpinning intriguing spatial findings in the brain in chronic pain investigations, and present important experimental work into the encoding and discrimination of pain location.

Dr Coghill will begin with mechanistic work, presenting his research into multiple scales of spatial inhibition of nociceptive stimuli. He will discuss how conditioned pain modulation can be reconceptualised from a simple endogenous inhibitory process to a spatial filtering of afferent input as a critical component of nociceptive processing.

Dr Di Pietro will discuss inhibition mechanisms in clinical pain states, and how altered inhibition may explain the conjecture surrounding ‘cortical reorganisation’, the altered spatial representation of the painful limb in complex regional pain syndrome (CRPS). She will also discuss altered brain inhibition in orofacial pain.

Dr Mancini will discuss the spatial dimension in both experimental and clinical work. Her research indicates that the representation of pain intensity and location are at least partially independent: learning to distinguish pain intensity does not improve spatial discrimination, and vice versa. Dr Mancini will also question cortical reorganisation in pain, with neuroimaging evidence that functional spatial organisation is largely preserved in CRPS.

Learning Objectives:

• Gain an understanding of inhibitory mechanisms at several points in the central nervous system. They will appreciate the direct clinical implications, as these will be specifically considered and addressed.
• Gain deeper insight into, and conceptualise, the spatial representation of pain and touch. Delegates will be able to define central mechanisms supporting modulation of touch and pain perception.
• Be able to define the possible roles and implications of inhibitory mechanisms in chronic pain states.