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Hess et al. (1) recently reported that nociceptive stimuli-activated brain areas, revealed by functional MRI (fMRI), were significantly reduced within 24 h after an infusion of a monoclonal antibody to TNF-α in their patients with rheumatoid arthritis (RA). Together with evidence from accompanying animal experiments, the authors concluded that neutralization of TNF-α could rapidly inhibit pain responses in the CNS. Although the investigation represented an important attempt to understand fully the fast therapeutical effect …

Does functional MRI convincingly explain the fast effect of TNF-α blockade?