Cited by 339Pain Management and TreatmentPain Mechanisms and TreatmentsMotor Control and Adaptation

Cortical origin of pathological pain

Harris, A John·1999·The Lancet

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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Crossref · 10.1016/s0140-6736(99)05003-5

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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.”

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Authors
Harris, A. J.
Affiliations
University of Otago (NZ)
Corresponding author
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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