Event-related fMRI of pain: entering a new era in imaging pain.

Previous imaging studies of pain used a block design of prolonged (up to 1 min) noxious stimulation that are not well tolerated and subject to temporal interactions. We describe an adaptation of event-related fMRI to study pain with short duration stimuli. Functional images were acquired with a spiral sequence on a 1.5T GE echospeed MRI system of the thalamus, anterior cingulate, insula and second somatosensory cortex during brief (1-3 s) noxious thermal stimulation of the hand of normal volunteers. An MRI-compatible computerized rating system continuously monitored subjects' pain. Brief pain-related activations were clearly identified in the cortex and thalamus with a hemodynamic delay of 3-6 s. These findings demonstrate that brief stimuli combined with on-line pain ratings can be used to study pain with fMRI.