Nociception, pain, negative moods, and behavior selection
Open accessAbstract
Recent neuroimaging studies suggest that the brain adapts with pain, as well as imparts risk for developing chronic pain. Within this context, we revisit the concepts for nociception, acute and chronic pain, and negative moods relative to behavior selection. We redefine nociception as the mechanism protecting the organism from injury, while acute pain as failure of avoidant behavior, and a mesolimbic threshold process that gates the transformation of nociceptive activity to conscious pain. Adaptations in this threshold process are envisioned to be critical for development of chronic pain. We deconstruct chronic pain into four distinct phases, each with specific mechanisms, and outline current state of knowledge regarding these mechanisms: the limbic brain imparting risk, and the mesolimbic learning processes reorganizing the neocortex into a chronic pain state. Moreover, pain and negative moods are envisioned as a continuum of aversive behavioral learning, which enhance survival by protecting against threats.
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Behavioral interventions based on the biopsychosocial theory of pain and targeting psychosocial factors may be especially suitable for reducing persistent post-surgical pain in breast cancer survivors.
“Behavioral intervention strategies that are grounded in the biopsychosocial theory of pain7, and target psychosocial factors thought to contribute to persistent pain in interaction with underlying central neurobiological processing and peripheral afferent inputs6, 8–11, may be especially well suited to ameliorate PSP among breast cancer suvivors6, 8.”
From Improving well-being for individuals with persistent pain after surgery for breast cancer, lobular carcinoma in situ, or ductal carcinoma in situ: A randomized clinical trial (2022) · cites this paper as [9]
In “The human brain in chronic pain – a general model” (page unavailable), the paper describes chronic pain as involving interplay between brain processes and injury-related sensory input. It does not assess behavioral interventions or establish that they are especially suitable for persistent post-surgical pain in breast cancer survivors. (LLM, conf=0.84)
Experimental — accuracy not yet measuredNeuroimaging studies showed that the activated brain areas by nociceptive stimuli are the same ones involved in emotional and behavioral states.
“neuroimaging studies showed that the activated brain areas by nociceptive stimuli are the same ones involved in emotional and behavioral states [22].”
From The Risk Factors of Chronic Pain in Victims of Violence: A Scoping Review (2023) · cites this paper as [22]
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- Authors
- Baliki, M. N., & Apkarian, A. V.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Baliki, Marwan N.
- Apkarian, A. Vania
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 87
- Issue
- 3
- Pages
- 474-491
- ISSN
- 0896-6273 (ISSN-L)
- PMC
- PMC4529956
- OpenAlex
- W1664843084
- Cited by
- 731
- References
- 196
- Citations by year
- 2026: 64 · 2025: 91 · 2024: 73 · 2023: 75 · 2022: 86 · 2021: 86 · 2020: 52 · 2019: 59 · 2018: 53 · 2017: 53 · 2016: 34 · 2015: 4
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuron (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P30CA060553)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100924)
- National Institute of Neurological Disorders and Stroke (R01NS057704, R01NS035115)
- National Institute of Dental and Craniofacial Research (R01DE022746)
- National Center for Complementary and Integrative Health (R01AT007987)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- nociception, acute pain, chronic pain, negative mood, behavior selection, mesolimbic system, pain threshold, limbic system, aversive learning, pain adaptation
- MeSH terms
- Affect, Animals, Avoidance Learning, Brain, Humans, Pain, Pain Perception, Nociception
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