Cortical origin of pathological pain
Abstract
Pain without accompanying tissue pathology poses a classic puzzle, presented in extreme form by phantom pain in a non-existent amputated limb. A clue to the origin of such pain is given by the recent discovery of a region of cortex active in response to incongruence between motor intention, awareness of movement, and visual feedback. Phantom-limb sensation, and repetitive strain injuries or focal hand dystonias in writers, musicians, or keyboard operators, are accompanied by plastic changes in sensorimotor cortex and by pathological pain. Disorganised or inappropriate cortical representation of proprioception may falsely signal incongruence between motor intention and movement, which results in pathological pain in the same way that incongruence between vestibular and visual sensation results in motion sickness.
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The cortical model of pathological pain suggests that a disrupted cortical proprioceptive representation underpins pain arising from a mismatch between motor output and sensory feedback.
“This model suggests that a disrupted cortical proprioceptive representation underpins the pain which arises due to a mismatch between motor output and sensory feedback.”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [6]
Cites
Synaesthesia in phantom limbs induced with mirrors
(1996) · Proceedings of the Royal Society of London. Series B: Biological Sciences · doi:10.1098/rspb.1996.0058 · Cited by 1,246 · see citing works
The perception of phantom limbs. The D. O. Hebb lecture
Ramachandran, V. (1998) · Brain · doi:10.1093/brain/121.9.1603 · Cited by 1,065 · see citing works
Jenkins, W. M., Merzenich, M. M., Ochs, M. T., Allard, T., & Guic-Robles, E. (1990) · Journal of Neurophysiology · doi:10.1152/jn.1990.63.1.82 · Cited by 937 · see citing works
Multiple Representations of the Body Within the Primary Somatosensory Cortex of Primates
Kaas, J. H., Nelson, R. J., Sur, M., Lin, C.-S., & Merzenich, M. M. (1979) · Science · doi:10.1126/science.107591 · Cited by 710 · see citing works
Plasticity of the sensorimotor cortex representation of the reading finger in Braille readers
Pascual‐Leone, Á., & Torres, F. (1993) · Brain · doi:10.1093/brain/116.1.39 · Cited by 654 · see citing works
Effects of Constraint-Induced Movement Therapy on Patients With Chronic Motor Deficits After Stroke
Miltner, W. H. R., Bauder, H., Sommer, M., Dettmers, C., & Taub, E. (1999) · Stroke · doi:10.1161/01.str.30.3.586 · Cited by 591 · see citing works
A primate genesis model of focal dystonia and repetitive strain injury
Byl, N. N., Merzenich, M. M., & Jenkins, W. M. (1996) · Neurology · doi:10.1212/wnl.47.2.508 · Cited by 538 · see citing works
The neural consequences of conflict between intention and the senses
Fink, G. R., Marshall, J. C., Halligan, P. W., Frith, C., Driver, J., Frackowiak, R. S. J., & Dolan, R. J. (1999) · Brain · doi:10.1093/brain/122.3.497 · Cited by 445 · see citing works
Alteration of digital representations in somatosensory cortex in focal hand dystonia
Elbert, T. R., Candia, V., ALTENMÜLLER, E. O., Rau, H., Sterr, A., Rockstroh, B. S., Pantev, C., & Taub, E. (1998) · Neuroreport · doi:10.1097/00001756-199811160-00006 · Cited by 441 · see citing works
Abnormal somatosensory homunculus in dystonia of the hand
Bara‐Jimenez, W., Catalán, M. J., Hallett, M., & Gerloff, C. P. (1998) · Annals of Neurology · doi:10.1002/ana.410440520 · Cited by 399 · see citing works
Anosognosia in Parietal Lobe Syndrome
Ramachandran, V. S. (1995) · Consciousness and Cognition · doi:10.1006/ccog.1995.1002 · Cited by 306 · see citing works
Cortical reorganization and phantom phenomena in congenital and traumatic upper-extremity amputees
Flor, H., Elbert, T. R., Mühlnickel, W., Pantev, C., Wienbruch, C., & Taub, E. (1998) · Experimental Brain Research · doi:10.1007/s002210050334 · Cited by 300 · see citing works
Allard, T., Clark, S. A., Jenkins, W. M., & Merzenich, M. M. (1991) · Journal of Neurophysiology · doi:10.1152/jn.1991.66.3.1048 · Cited by 295 · see citing works
Sterr, A., Müller, M. M., Elbert, T. R., Rockstroh, B. S., Pantev, C., & Taub, E. (1998) · Journal of Neuroscience · doi:10.1523/jneurosci.18-11-04417.1998 · Cited by 276 · see citing works
Remission of somatoparaphrenic delusion through vestibular stimulation
Bisiach, E., Rusconi, M. L., & Vallar, G. (1991) · Neuropsychologia · doi:10.1016/0028-3932(91)90066-h · Cited by 242 · see citing works
Plasticity in the motor system related to therapy-induced improvement of movement after stroke
Kopp, B., Kunkel, A., Münickel, W., Villringer, K., Taub, E., & Flor, H. (1999) · Neuroreport · doi:10.1097/00001756-199903170-00026 · Cited by 238 · see citing works
Fatigue in patients with Parkinson's disease
Karlsen, K., Larsen, J. O., Tandberg, E., & J�rgensen, K. (1999) · Movement Disorders · doi:10.1002/1531-8257(199903)14:2 · Cited by 235 · see citing works
Acute plasticity in the human somatosensory cortex following amputation
Borsook, D., Becerra, L. R., Fishman, S. M., Edwards, A., Jennings, C. L., Stojanovic, M. P., Papinicolas, L., Ramachandran, V. S., González, R. G., & Breiter, H. (1998) · Neuroreport · doi:10.1097/00001756-199804200-00011 · Cited by 229 · see citing works
Noninvasive detection of cerebral plasticity in adult human somatosensory cortex
Yang, T. T., Gallen, C. C., Ramachandran, V. S., Cobb, S., Schwartz, B. J., & Bloom, F. E. (1994) · Neuroreport · doi:10.1097/00001756-199402000-00010 · Cited by 201 · see citing works
Knecht, S. (1998) · Brain · doi:10.1093/brain/121.4.717 · Cited by 147 · see citing works
Byl, N. N., Wilson, F., Merzenich, M. M., Melnick, M. E., Scott, P., Oakes, A. E., & McKenzie, A. L. (1996) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.1996.23.4.234 · Cited by 127 · see citing works
Central projections from the skin of the hand in squirrel monkeys
Florence, S. L., Wall, J. T., & Kaas, J. H. (1991) · The Journal of Comparative Neurology · doi:10.1002/cne.903110410 · Cited by 96 · see citing works
Hallett, M. (1998) · PubMed · Cited by 96 · see citing works
The neural consequences of repetition: Clinical implications of a learning hypothesis
Byl, N. N., & Melnick, M. E. (1997) · Journal of Hand Therapy · doi:10.1016/s0894-1130(97)80070-1 · Cited by 93 · see citing works
Vision for perception and vision for action in the primate brain.
Goodale, M. (2007) · Novartis Foundation symposium · doi:10.1002/9780470515563.ch3 · Cited by 38 · see citing works
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Cited by
Sorted by citations
Dumanian, G. A., Potter, B. K., Mioton, L. M., Ko, J. H., Cheesborough, J. E., Souza, J. M., Ertl, W. J., Tintle, S. M., Nanos, G. P., Valerio, I. L., et al. (2019) · Annals of Surgery · doi:10.1097/sla.0000000000003088 · Cited by 530 · see citing works
Soler, M. D., Kumru, H., Pelayo, R., Vidal, J., Tormos, J. M., Fregni, F., Navarro, X., & Pascual-Leone, A. (2010) · Brain · doi:10.1093/brain/awq184 · Cited by 308 · see citing works
Using visual illusion to reduce at-level neuropathic pain in paraplegia
Moseley, L. G. (2007) · Pain · doi:10.1016/j.pain.2007.01.007 · Cited by 156 · see citing works
Corporeal awareness and proprioceptive sense of the phantom
Giummarra, M. J., Georgiou‐Karistianis, N., Nicholls, M. E. R., Gibson, S. J., Chou, M., & Bradshaw, J. L. (2010) · British Journal of Psychology · doi:10.1348/000712610x492558 · Cited by 80 · see citing works
Space-based bias of covert visual attention in complex regional pain syndrome
Bultitude, J. H., Walker, I., & Spence, C. (2017) · Brain · doi:10.1093/brain/awx152 · Cited by 68 · see citing works
Presence-Inducing Media for Mental Health Applications
Riva, G., Botella, C., Baños, R., Mantovani, F., García-Palacios, A., Quero, S., Serino, S., Triberti, S., Repetto, C., Dakanalis, A., et al. (2015) · Immersed in Media · doi:10.1007/978-3-319-10190-3_12 · Cited by 55 · see citing works
Trost, Z., Anam, M., Seward, J., Shum, C., Rumble, D., Sturgeon, J., Mark, V., Chen, Y., Mitchell, L., Cowan, R., et al. (2022) · Pain · doi:10.1097/j.pain.0000000000002348 · Cited by 37 · see citing works
Application of Virtual Body Swapping to Patients with Complex Regional Pain Syndrome: A Pilot Study
Jeon, B., Cho, S., & Lee, J.-H. (2014) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2014.0046 · Cited by 32 · see citing works
Cortical Activation During Visual Illusory Walking in Persons With Spinal Cord Injury: A Pilot Study
Eick, J., & Richardson, E. J. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.10.020 · Cited by 18 · see citing works
Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study
Landmann, G., Aerni, M., Abächerli, R., Ernst, M., Ljutow, A., & Ottiger-Böttger, K. (2024) · Spinal Cord Series and Cases · doi:10.1038/s41394-024-00667-w · Cited by 6 · see citing works
“One model that may be relevant is the cortical model of pathological pain [6].”
Background
- Authors
- Harris, A. J.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Harris, A John
- ORCID
- Harris, A John
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1999-10
- Volume
- 354
- Issue
- 9188
- Pages
- 1464-1466
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2103226410
- Cited by
- 339
- References
- 25
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 10 · 2023: 12 · 2022: 15 · 2021: 18 · 2020: 16 · 2019: 10 · 2018: 14 · 2017: 13 · 2016: 21 · 2015: 15 · 2014: 26 · 2013: 17 · 2012: 22
- FWCI
- 5.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Keywords
- phantom limb pain, pathological pain, sensorimotor cortex, cortical plasticity, proprioception, motor intention, visual feedback, focal hand dystonia, repetitive strain injury, motion sickness
- MeSH terms
- Animals, Haplorhini, Brain Mapping, Humans, Models, Biological, Motion Perception, Motor Cortex, Pain, Phantom Limb, Proprioception, Cumulative Trauma Disorders, Somatosensory Cortex
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