Pain perception and its genesis in the human brain

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Andrew CN CHEN(Key Laboratory of Mental Health,Instiute of Psychology,Chinese Academy of Sciences.Beijing 100101,China)
Journal Title:
Volume 60, Issue 05, 2008
Key Word:
human pain perception;brain measures;nociceptive pain;pathological pain;anatomy-physiology;genesis

Abstract: In the past two decades, pain perception in the human brain has been studied with EEG/MEG brain topography and PET/ fMRI neuroimaging techniques. A host of cortical and subeortical loci can be activated by various nociceptive conditions. The activation in pain perception can be induced by physical (electrical, thermal, mechanical), chemical (capsacin, ascoric acid), psychological (anxiety, stress, nocebo) means, and pathological (e.g. migraine, neuropathic) diseases. This article deals mainly on the activation, but not modulation, of human pain in the brain. The brain areas identified are named pain representation, matrix, neuraxis, or signature. The sites are not uniformly isolated across various studies, but largely include a set of cores sites: thalamus and primary somatic area (SI), second somatic area (SII), insular cortex (IC), prefrontal cortex (PFC), cingnlate, and parietal cortices. Other areas less reported and considered important in pain perception include brainstem, hippocampus, amygdala and supplementary motor area (SMA). The issues of pain perception basically encompass both the site and the mode of brain function. Although the site issue is delineared to a large degree, the mode issue has been much less explored. From the temporal dynamics, IC can be considered as the initial stage in genesis of pain perception as conscious suffering, the unique aversion in the human brain.

  • [1]Chen AC.Human brain measures of clinical pain:a review.I.Topographic mappings.Pain 1993; 54 (2):115-132.
  • [2]Chen AC.Human brain measures of clinical pain:a review.Ⅱ.Tomographic imagings.Pain 1993; 54 (2):133-144.
  • [3]Casey KL.Match and mismatch:identifying the neuronal determinants of pain.Ann Intern Med 1996 124 (11):995-998.
  • [4]Jones AK,Derbyshire SW.Cerebral mechanisms operating in the presence and absence of inflammatory pain.Ann Rheum Dis 1996; 55 (7):411-420.
  • [5]Kramer U,Nevo Y,Harel S.Electroencephalography in the evaluation of headache patients:a review.Isr J Med Sci 1997; 33(12):816-820.
  • [6]Frishberg BM.Neuroimaging in presumed primary headache disorders.Semin Neurol 1997; 17 (4):373-382.
  • [7]Bromm B,Lorenz J.Neurophysiological evaluation of pain.Electroencephaiogr Clin Neurophysiol 1998; 107 (4):227-253.
  • [8]Ingvar M.Pain and functional imaging.Philos Trans R Soc Lond B Biol Sci 1999; 354 (1387):1347-1358.
  • [9]Casey KL.Forebrain mechanisms ofnociception and pain:analysis through imaging.Proc Nail Acad Sci USA 1999; 96 (14):668-674.
  • [10]Treede RD,Vogel H,Rios M,Krauss G,Lesser RP,Lenz FA.Pain-related evoked potentials from parasylvian cortex in humans.Electroencephalogr Clin Neurophysiol Supp11999; 49:250-254.
  • [11]Treede RD,Kenshalo DR,Gracely RH,Jones AK.The cortical representation of pain.Pain 1999; 79 (2-3):105-111.
  • [12]Schnitzler A,Ploner M.Neurophysiology and functional neuroanatomy of pain perception.J Clin Neurophysiol 2000; 17(6):592-603.
  • [13]Treede RD,Apkarian AV,Bromm B,Greenspan JD,Lenz FA.Cortical representation of pain:functional characterization of nociceptive areas near the lateral sulcus.Pain 2000; 87 (2):113-119.
  • [14]Kakigi R,Watanabe S,Yamasaki H.Pain-related somatosensory evoked potentials.J Clin Neurophysiol 2000; 17 (3):295-308.
  • [15]Derbyshire SW.Exploring the pain "neuromatrix".Curt Rev Pain 2000; 4 (6):467-477.
  • [16]Casey KL.Concepts of pain mechanisms:the contribution of functional imaging of the human brain.Prog Brain Res 2000; 129:277-287.
  • [17]Wiech K PH,Birbaumer N.Neuroimaging of chronic pain:phantom limb and musculoskeletal pain.Scand J Rheumatol Suppl2000; 113:13-18.
  • [18]Aziz Q,Schnitzler A,Enck P.Functional neuroimaging of vis ceral sensation.J Clin Neurophysiol 2000; 17 (6):604-612.
  • [19]Cutrer FM,O'Donnell A,Sanchez Del Rio M.Functional neuroimaging:enhanced understanding of migraine pathophysiology.Neurology 2000; 55 (9 Suppl 2):S36-S45.
  • [20]Bradley LA,McKendree-Smith NL,Alherts KR,Alarc6n GS,Mountz JM,Deutsch G.Use of neuroimaging to understand abnormal pain sensitivity in fibromyalgia.Curr Rheumatol Rep2000; 2(2):141-148.
  • [21]Chen AC.New perspectives in EEG/MEG brain mapping and PET/fMRI neuroimaging of human pain.Int J Psychophysiol2001; 42(2):147-159.
  • [22]Bromm B.Brain images of pain.News Physiol Sci 2001; 16:244-249.
  • [23]Goadsby PJ.Nearoimaging in head,he.Microsc Res Tech 2001;53 (3):179-187.
  • [24]RainviUe P,Bushnell MC,Duncan GH.Representation of acute and persistent pain in the human CNS:potential implications for chemical intolerance.Ann NY Acad Sci 2001; 933:130-141.
  • [25]Price DD,Barrell JJ,Rainville P.Integrating experientialphenomenological methods and neuroscience to study neuralmechanisms of pain and consciousness.Conscious Cogn 2002; 11(4):593-608.
  • [26]Rainville P.Brain mechanisms of pain affect and pain modulation.Curt Opin Neurobiol 2002; 12 (2):195-204.
  • [27]Kakigi R,Tran TD,Qiu Y,Wang X,Nguyen TB,Inui K,Watanabe S,Hoshiyama M.Cerebral responses following stimulation ofunmyelinated C-fibers in humans:electro-and magnetoencephalographic study.Neurosci Res 2003; 45 (3):255-275.
  • [28]Garcia-Larrea L,Frot M,Vaieriani M.Brain generators of laserevoked potentials:from dipoles to functional significance.Neurophysiol Clin 2003; 33 (6):279-292.
  • [29]Lorenz J,Garcia-Larrea L.Contribution of attentional and cognitive factors to laser evoked brain potentials.Neurophysiol Chn 2003; 33 (6):293-301.
  • [30]May A.Headache:lessons learned from functional imaging.Br Med Bull 2003; 65:223-234.
  • [31]Derbyshire SW.Visceral afferent pathways and functional brain imaging.ScientificWorldJoumal2003; 3:1065-1080.
  • [32]Mackey SC,Maeda F.Functional imaging and the neural systems of chronic pain.Neurosurg Clin N Am 2004; 15 (3):269-288.
  • [33]Mechtler L.Role of neuroimaging in our understanding of the pathogenesis of primary headaches.Curr Pain Headache Rep 2004; 8 (5):404-409.
  • [34]Sánchez del Rio M,Alvarez Linera J.Functional neuroimaging of headaches.Lancet Neuro12004; 3 (11):645-651.
  • [35]Chiapparini L,Ciceri E,Nappini S,Castellani MR,Mea E,Bnssone G,Leone M,Savoiardo M.Headache and intracranial hypotension:neuroradiologieal findings.Neurol Sci 2004; 25Suppl 3:S138-S141.
  • [36]May A.The contribution of functional neuroimaging to primary headaches.Neural Sci 2004; 25 Suppl 3:S85-S88.
  • [37]Davis KD.Neuroimaging of pain.Suppl Clin Neorophysio12004;57:72-77.
  • [38]Kakigi R,Inui K,Tamura Y.Electrophysiological studies on human pain perception.Clin Neurophysio12005; 116 (4):743-763.
  • [39]Lorenz J,Casey KL.Imaging of acute versus pathological pain in humans.EurJ Pain 2005; 9 (2):163-165.
  • [40]Apkarian AV,Bushnell MC,Treede RD,Zubieta JK.Human brain mechanisms of pain perception and regulation in health and disease.EurJ Pain 2005; 9 (4):463-484.
  • [41]Cohen AS,Goadsby PJ.Functional neuroimaging of primary headache disorders.Curr Pain Headache Rep 2005; 9 (2):141-146.
  • [42]May A.The role of imaging in the pathophysioiogy and diagnosis of headache.Curr Opin Neurol 2005; 18 (3):293-297.
  • [43]Tracey I.Nociceptive processing in the human brain.Curr Opin Neurobio12005; 15 (4):478-487.
  • [44]de Leeuw R,Albuquerque R,Okeson J,Carlson C.The contribution of neuroimaging techniques to the understanding of supraspinal pain circuits:implications for orofacial pain.Oral Stag Oral Med Oral Pathol Oral Radiol Endod 2005; 100 (3):308-314.
  • [45]Favier L Haan J,Ferrari MD..Chronic cluster headache:a review.J Headache Pain 2005; 6 (1):3-9.
  • [46]Rossi P,Serrao M,Perrotta A,Pierelli F,Sandrini G,Nappi G.Neurophysiological approach to central pain modulation in primary headaches.J Headache Pain 2005; 6 (4):191-194.
  • [47]Treede RD,Lenz FA.Passing lanes and slow lanes into the nociceptive network of the human brain.Pain 2006; 123 (3):223-225.
  • [48]Aurora SK,Bowyer SM.New insights into brain dysfunction in migraine.Expert Rev Neurother 2006; 6 (3):307-312.
  • [49]May A.A review of diagnostic and functional imaging in headache.J Headache Pain 2006; 7 (4):174-184.
  • [50]Mee S,Bunney BG,Reist C,Potkin SG,Bunney WE.Psychological pain:a review of evidence.J Psychiatr Res 2006; 40 (8):680-690.
  • [51]Cohen AS,Goadsby PJ.Functional neuroimaging of primary headache disorders.Expert Rev Neurother 2006; 6 (8):1159-1171.
  • [52]Derbyshire SW.Burning questions about the brain in pain.Pain 2006; 1226 (3):217-218.
  • [53]Anderson WS,O'Hara S,Lawson HC,Treede RD,Lenz FA.Plasticity of pain-related neuronal activity in the human thalamus.Prog Brain Res 2006; 157:353-364.
  • [54]Schweinhardt P,Lee M,Tracey I.Imaging pain in patients:is it meaningful? Curr Opin Neurol 2006; 19 (4):392-400.
  • [55]Borsook D,Burstein R,Moulton E,Becerra L.Functional imaging of the trigeminal system:applications to migraine pathophysiology.Headache 2006; 46 Suppl 1:S32-S38.
  • [56]Detsky ME,McDonald DR,Baerlocher MO,Tomlinson GA,McCrory DC,Booth CM.Does this patient with headache have a migraine or need neuroimaging? JAMA 2006; 296 (10):1274-1283.
  • [57]Williams DA,Gracely RH.Biology and therapy of fibromyalgia.Functional magnetic resonance imaging findings in fibromyalgia.Arthritis Res Ther 2006; 8 (6):224.
  • [58]Jackson PL,Rainville P,Decety J.To what extent do we share the pain of others? Insight from the neural bases of pain empathy.Pain 2006; 125 (1-2):5-9.
  • [59]Mayer EA,Naiiboff BD,Craig AD.Neuroimaging of the braingut axis:from basic understanding to treatment of functional GI disorders.Gastroenteroiogy 2006; 131 (6):1925-1942.
  • [60]Duquette M,Roy M,Leporé F,Peretz I,RainviUe P.Cerebral mechanisms involved in the interaction between pain and emotion.Rev Neurol (Paris) 2007; 163 (2):169-179.
  • [61]DaSilva AF,Goadsby PJ,Borsook D.Cluster headache:a review of neuroimaging findings.Curt Pain Headache Rep 2007; 11(2):131-136.
  • [62]ay A,Matharu M.New insights into migraine:application of functional and structural imaging.Curt Opin Neuro12007; 20 (3):306-309.
  • [63]Cook DB,Stegner AJ,McLoughlin MJ.Imaging pain of fibromyalgia.Curt Pain Headache Rep 2007; 11 (3):190-200.
  • [64]ay A.Neuroimaging:visualising the brain in pain.Neurol Sci 2007; 28 Suppl 2:S101-107.
  • [65]eone M,Proietti Cecchini A,Mea E,Curone M,Tullo V,Casucci G,Bonavita V,Bussone G.Functional neuroimaging and headache pathophysiology:new findings and new prospects.Neurol Sci 2007,28 Suppl 2:S108-S113.
  • [66]oisset X,Bouhassira D.Brain imaging of neuropathic pain.Neuroimage 2007; 37 Suppl 1:S80-S88.
  • [67]Tracey I,Mantyh PW.The cerebral signature for pain perception and its modulation.Neuron 2007;55 (3):377-391.
  • [68]Linder SL.Post-traumatic headache.Curr Pain Headache Rep 2007; 11 (5):396-400.
  • [69]Veldhuijzen DS,Greenspan JD,Kim JH,Coghill RC,Treede RD,Ohara S,Lenz FA.Imaging central pain syndromes.Curt Pain Headache Rep 2007; 11 (3):183-189.
  • [70]Derbyshire SW,Osbom J.Modeling pain circuits:how imaging may modify perception.Neuroimaging Clin N Am 2007; 17 (4):485-493.
  • [71]Derbyshire SW.Imaging visceral pain.Curt Pain Headache Rep 2007; 11 (3):178-182.
  • [72]Wood PB.Role of central dopamine in pain and analgesia.Expert Rev Neurother 2008;8 (5):781-797.
  • [73]Tracey I.Imaging pain.BrJ Anaesth 2008; 101(1):32-39.
  • [74]Peyron R,Laurent B,García-Larrea L.Functional imaging of brain responses to pain.A review and meta-analysis.Neurophysiol Clin 2000; 30 (5):263-288.
  • [75]Price DD.Psychological and neural mechanisms of the affective dimension of pain.Science 2000; 288:1769-1772.
  • [76]Porro CA,Cettolo V,Francescato MP,Baraldi P.Temporal and intensity coding of pain in human cortex.J Neurophysiol 1998;80 (6):3312-3320.
  • [77]Porro CA,Baraldi P,Pagnoni G,Serafini M,Facchin P,Maieron M,Nichelli P.Does anticipation of pain affect cortical nociceplive systems? J Neurosci 2002; 22 (8):3206-3214.
  • [78]Derbyshire SW,WhaUey MG,Stenger VA,Oakley DA.Cerebral activation during hypnotically induced and imagined pain.Neuroimage 2004; 23 (1):392-401.
  • [79]Benedetti F,Lanotte M,Lopiano L,Colloca L.When words are painful:unraveling the mechanisms of the nocebo effect.Neuroscience 2007;147 (2):260-271.
  • [80]Colloca L,Sigaudo M,Benedetti F.The role of learning in noceho and placebo effects.Pain 2008; 136 (1-2):211-218.
  • [81]Raichle ME,Snyder AZ.A default mode of brain function:a brief history of an evolving idea.Neuroimage 2007;37 (4):1083-1090.
  • [82]Baiiki MN,Geha PY,Apkarian AV,Chialvo DR.Beyond feeling:chronic pain hurts the brain,disrupting the default-mode network dynamics.J Neurosci 2008; 28 (6):1398-1403.
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