You too can become a feedback junkie -- check out "Quantified Self"

For the past 3 years, I have been studying the role of feedback in pain as well as many other conditions (such as social anxiety) and working on the development of feedback-targeted treatments. Over this same period of time there has been an explosion in the availability of software and devices that enable people to track so many different aspects of their lives and then receive feedback in various forms.

The Quantified Self is a website devoted to the endeavor of self-tracking and it's worth a gander.

Research center developing sensor technologies relevant to in vivo research

The popularity of in vivo studies (where data about people's activities and health status are captured while people go about their daily lives -- that is, while in vivo) will flourish as inexpensive devices are systems are made available to automate data capture as much as possible. You don't want to ask people to stop what they're doing to take their pulse and blood pressure. The best systems will be those that unobtrusively just record these data, with minimal intervention. Technologies and apps are increasingly appearing to take advantage of the sophisticated capabilities and sensors (camera, accelerometer, gyro, etc.) already built into the most popular smartphones!

The Center for Embedded Networked Sensing (CENS) is a research center at UCLA working on all sorts of different sensor technologies. They're not all health-related (many are environmental sensors) but I don't see any reason why the technologies they're developing can't be applied for in vivo research.

Imagined movements in spinal cord injury pain patients improves pain and restores cortical activation patterns to normal

A recent study (reported at IASP 2010 in Montreal) enrolled 13 patients with pain below the level of spinal cord injury into a 6-week training program employing 30 mins of imagined movements and sensation in painful limbs every day. Participants kept daily pain diaries and functional MRI (fMRI) scanning was performed both before and after the training program. Healthy controls were also scanned at baseline for comparison purposes.

The fMRI scan below shows activity in normal subjects in response to executed movement of the right hand. Activity is primarily in the primary motor and somatosensory cortices and supplementary motor area.

This next image shows brain activity in response to the same movement in spinal cord injury patients before imagery training. Notice that activity in motor circuits is considerably lower compared to normals.

This final image shows brain activity in the same spinal cord injury patients after the 6-wk mental imagery program. The activation maps look very similar to the healthy controls, with activity in the motor pathways.

Imagining pain can make it so

Perhaps one of the ways in which chronic pain reinforces itself is because people are exposed to the pain either constantly or repeatedly (in the case of recurring pain conditions) and so become exceedingly familiar with how it feels. This familiarity can fuel more complete and vivid imagining of the pain experience, which may very well exacerbate the pain. Indeed, it may very well that it is not fear per se that is the problem when people anticipate pain, but rather than they are imagining what the pain will feel like and it is the mental “picture” of the pain in advance of any actual pain, which evokes fear.

Evidence now exists that simply imagining pain can actually activate much of the same pain circuits in the brain that are typically involved during the experiencing of painful stimuli.

Allodynia is a condition in which normally innocuous or even pleasurable tactile sensations are perceived as painful. Kramer et al (2008) showed that by imagining touch as painful (imagined allodynia) activates the same neural structures as actual allodynia. They divided healthy participants into two groups. The first group had previously been exposed to experimentally induced allodynia within the past 6 months. The second group had no experience with allodynia and so did not know what touch-evoked pain is like. Both groups received tactile stimulation on hand and then the other, but they were asked to imagine that the sensation on the right hand was painful. Non-painful tactile stimulation activated contralateral S1 and S2 (see top panel of figure below). During imagination of allodynic pain in the right hand, there was activation in the ACC and Insula and medial frontal cortex in addition to contralateral S1 and bilateral S2 (see lower panel of figure below).

Thus, people who have had prior experience with allodynia are able to conjure up the experience in their imaginations and when they do, the brain regions normally associated with painful touch sensations become activated. Those with more allodynia experience showed more pronounced activation in the contralateral S1, mid insula, inferior frontal cortices, ACC and ipsilateral amygdala (see figure below):