Davis Karen Deborah, de Oliveira Monica, Besik Ariana, Buchman Daniel Z
Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Can J Pain. 2025 Jan 17;8(2):2425596. doi: 10.1080/24740527.2024.2425596. eCollection 2024.
Pain is an individual and subjective experience that places a burden on individuals to convince others they have pain. Brain imaging technologies can potentially inform pain management but raise neuroethical questions.
We examined the degree of endorsement and concerns of adults in Canada with chronic pain regarding the use of brain imaging to detect and treat chronic pain in six areas: new brain imaging technologies, brain data privacy, stigma, treatment, objective representations of pain, and dismissing pain self-reports.
An online survey was completed by 349 Canadian adults living with chronic pain. Most respondents were open to using brain imaging for diagnostics, prediction, and therapeutic decision making (>90%). More than half of respondents felt that a brain scan would give them more confidence in their diagnosis and treatment plans and that health care providers would be more likely to believe they had chronic pain. However, they worried that brain scans could be used to dismiss their pain self-report. Most respondents felt there were policies to protect their brain data, but 40% were concerned about privacy and brain scan use against them by their employers/insurers. Although most respondents felt that a brain scan could represent their pain and suffering, 80% disagreed that their pain is only real if seen in a brain scan.
People with chronic pain recognize the potential benefits of brain imaging but are concerned about data security and dismissal of their self-reported pain. Our data align with previous recommendations to use brain imaging as an adjunct to pain self-reports but not as a replacement for the same.
疼痛是一种个体主观体验,个体需努力让他人相信自己确实疼痛,这给他们带来了负担。脑成像技术有可能为疼痛管理提供信息,但也引发了神经伦理问题。
我们调查了加拿大慢性疼痛成年人对使用脑成像检测和治疗慢性疼痛在六个方面的认可程度和担忧:新的脑成像技术、脑数据隐私、污名化、治疗、疼痛的客观表征以及忽视疼痛自我报告。
349名患有慢性疼痛的加拿大成年人完成了一项在线调查。大多数受访者对使用脑成像进行诊断、预测和治疗决策持开放态度(>90%)。超过一半的受访者认为脑部扫描会让他们对自己的诊断和治疗计划更有信心,并且医疗保健提供者会更有可能相信他们患有慢性疼痛。然而,他们担心脑部扫描可能会被用来忽视他们的疼痛自我报告。大多数受访者认为有保护他们脑数据的政策,但40%的人担心隐私问题以及雇主/保险公司利用脑部扫描来对付他们。尽管大多数受访者认为脑部扫描可以体现他们的疼痛和痛苦,但80%的人不同意只有在脑部扫描中看到的疼痛才是真实的。
慢性疼痛患者认识到脑成像的潜在益处,但担心数据安全以及自己的疼痛自我报告被忽视。我们的数据与之前将脑成像用作疼痛自我报告的辅助手段而非替代手段的建议一致。