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This paper reports the advances of a study concerning an instrumental technique used to assess pain. Pain is a debilitating condition affecting about 20% of adults in the world. It can be considered as a warning mechanism or the response of human body to alert about a harmful state. It involves complex neuronal processes and it is considered as a personal experience with a relevant subjective component. In specific conditions, pain can be so debilitating that it alters feelings and attitudes. So, pain has important physical, psychological and social consequences and it can affect the quality of life. In absence of suitable and prompt treatments, the immune system can be compromised and pain sensation can interfere with the person ability to eat, concentrate, sleep, or interact with others. Consequently, the prompt and accurate pain assessment is essential for expediting therapeutic administration. Algologists operate in absence of standard objective detection tools for pain assessment. The gold standard for its assessment is today the patients’ self-report. So it is clear the need to define new objective assessing tools.
The proposed FITI-PAIN technique aims to propose the Functional Infrared Thermal Imaging for investigating the role of microvascular perfusion in pain sensation as promising biosignal and biomarker for pain assessment. Sympathetic nervous system plays an important role in regulating microvascular perfusion during pain sensation. The authors propose the infrared thermal imaging to characterize the role of microvascular blood flow in pain mechanism. Skin temperature signal of the body part affected from pain is recorded by a thermal camera and processed to evaluate the heat exchange between the blood flowing in the microvessels and the skin surface.
Cold pressor test and painful stimuli by using a Wartenberg pinwheel have been used as pain triggering events to evoke pain in volunteers. Data related to the perfusion signal have allowed us to extract information on the sympathetic nervous system involvement in the pain mechanism. The study has shown clear alterations of microvascular perfusion during pain sensation. Such alterations are strictly related to physiological processes such as: the constriction or relaxation of vascular smooth cells; the involvement of the sympathetic nervous system; the shape changes of endothelial cells in the vessel wall as a response to haemodynamic cues; and the respiratory and cardiac activities. The strict relation between the pain mechanism and the above processes could provide significant information to measure pain in the next future.
