Journal
HUMAN BRAIN MAPPING
Volume 27, Issue 9, Pages 715-721Publisher
WILEY-LISS
DOI: 10.1002/hbm.20213
Keywords
cognitive; pain; fMRI; anterior insula; cingulate cortex
Funding
- NCCIH NIH HHS [P01 AT002048, R21 AT000949, R21AT00949, P01-AT002048-A-01] Funding Source: Medline
- NIDA NIH HHS [R21 DA11229] Funding Source: Medline
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Neuroimaging studies of painful stimuli in humans have identified a network of brain regions that is more extensive than identified previously in electrophysiological and anatomical studies of nociceptive pathways. This extensive network has been described as a pain matrix of brain regions that mediate the many interrelated aspects of conscious processing of nociceptive input such as perception, evaluation, affective response, and emotional memory. We used functional magnetic resonance imaging in healthy human subjects to distinguish brain regions required for pain sensory encoding from those required for cognitive evaluation of pain intensity. The results suggest that conscious cognitive evaluation of pain intensity in the absence of any sensory stimulation activates a network that includes bilateral anterior insular cortex/frontal operculum, dorsal lateral prefrontal cortex, bilateral medial prefrontal cortex/anterior cingulate cortex, right superior parietal cortex, inferior parietal lobule, orbital prefrontal cortex, and left occipital cortex. Increased activity common to both encoding and evaluation was observed in bilateral anterior insula/frontal operculum and medial prefrontal cortex/anterior cingulate cortex. We hypothesize that these two regions play a crucial role in bridging the encoding of pain sensation and the cognitive processing of sensory input.
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