Abstract Details

Title The Role of Neural Plasticity in Cancer Pain Management: A Comprehensive Review of Neuroimaging Studies and Cognitive Interventions

Topic Pain

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-011

Objective To comprehensively evaluate how neural plasticity contributes to cancer-related pain and to determine the effects of cognitive and neuromodulatory interventions such as MBCT, CBT, tDCS, and rTMS on pain modulation as evidenced by neuroimaging and validated clinical outcomes.

Background Pain related to cancer has a considerable impact on the quality of life due to maladaptive neural phenomena and neuroinflammation. Cognitive therapies such as MBCT and CBT might be the avenues through which pain perception can be altered via neuroplasticity, yet systematic studies are scarce.

Design/Methods Adult cancer patients with pain conditions were searched in PubMed, Embase, and Scopus. Included studies investigated cognitive interventions (MBCT, CBT) that were assessed via neuroimaging (fMRI, PET, EEG) or validated outcomes. The risk of bias was assessed using Cochrane and Newcastle-Ottawa, and the certainty of evidence was assessed using GRADE.

Results 18 studies of 9 RCTs, 3 longitudinal, 4 pilot, and 4 protocol papers revealed maladaptive plasticity, which includes prefrontal cortex atrophy and anterior cingulate hyperactivity associated with chronic pain. Cognitive training and MBCT reduced pain intensity with the enhanced dorsolateral prefrontal activation, while neuromodulation through tDCS and rTMS and melatonin down-regulated descending inhibition. Pain neuroscience education showed stiff UOR. Findings were limited due to small samples and sample heterogeneity.

Conclusions Interventions for the treatment of cancer pain may be cognitive and neuromodulatory therapies to target neural plasticity; however, their full potential can be realized only in biomarker-guided longitudinal trials. From these findings, one can make a strong case for multimodal, mechanism-based interventions that carry hope for increasing pain relief and, subsequently, quality of life in cancer patients.

Authors/Disclosures
Nimrah Fatima IV, MBBS PRESENTER	Dr. Fatima has nothing to disclose.
GAURAV KANSAL IV, MBBS	Mr. KANSAL has nothing to disclose.
Ashvath A. Pillai, Student	Mr. Pillai has nothing to disclose.
Sai Kumar Reddy Pasya, MD, MBBS	Dr. Pasya has nothing to disclose.
Naveen Goyal, MBBS	Mr. Goyal has nothing to disclose.
Lasyapriya Cherukupalli, MBBS	Dr. Cherukupalli has nothing to disclose.
Vrinda Prabhu	Dr. Prabhu has nothing to disclose.
Haindavi Bandari, MBBS	Dr. Bandari has nothing to disclose.

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