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Cited by 1,077Pain Mechanisms and TreatmentsPain Management and TreatmentPain Management and Placebo Effect

The cortical representation of pain

Treede, Rolf-Detlef, Kenshalo, Daniel R, Gracely, Richard H, Jones, Anthony K.P·1999·Pain
DOI 10.1016/s0304-3959(98)00184-5
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Abstract

Anatomical and physiological studies in animals, as well as functional imaging studies in humans have shown that multiple cortical areas are activated by painful stimuli. The view that pain is perceived only as a result of thalamic processing has, therefore, been abandoned, and has been replaced by the question of what functions can be assigned to individual cortical areas. The following cortical areas have been shown to be involved in the processing of painful stimuli: primary somatosensory cortex, secondary somatosensory cortex and its vicinity in the parietal operculum, insula, anterior cingulate cortex and prefrontal cortex. These areas probably process different aspects of pain in parallel. Previous psychophysical research has emphasized the importance of separating pain experience into sensory-discriminative and affective-motivational components. The sensory-discriminative component of pain can be considered a sensory modality similar to vision or olfaction; it becomes more and more evident that it is subserved by its own apparatus up to the cortical level. The affective-motivational component is close to what may be considered 'suffering from pain'; it is clearly related to aspects of emotion, arousal and the programming of behaviour. This dichotomy, however, has turned out to be too simple to explain the functional significance of nociceptive cortical networks. Recent progress in imaging technology has, therefore, provided a new impetus to study the multiple dimensions of pain.

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  • Neuroimaging studies consistently show that AIC activation is associated with a broad range of bodily, emotional, and cognitive functions.

    “Neuroimaging studies consistently show that AIC activation is associated with cardiovascular functions (King et al., 1999; Henderson et al., 2002), respiration (Banzett et al., 2000; Henderson et al., 2002), pain (Treede et al., 1999; Wager et al., 2004), touch (Keysers et al., 2004; Lindgren et al., 2012), thermosensory awareness (Craig et al., 2000), disgust (Phillips et al., 1997; Wicker et al.”

    From Anterior insular cortex and emotional awareness (2013) · cites this paper as Treede et al., 1999

  • The NPS is defined by meso-scale patterns within both medial and lateral pain systems that are consistent across individuals.

    “It is defined by meso-scale patterns within both medial (e.g., “affective”; anterior cingulate cortex) and lateral (e.g., “sensory”; somatosensory cortices) “pain systems” [66] that are consistent across individuals.”

    From Distinct Brain Systems Mediate the Effects of Nociceptive Input and Self-Regulation on Pain (2015) · cites this paper as [66]

  • In humans, intranasal oxytocin has been shown to increase rCBF, and hence neuronal activity, in cortical areas directly implicated in the processing of nociceptive input and the experience of pain, as well as in the descending modulation of nociceptive input, such as the frontoparietal opercula, the insula and the anterior cingulate cortex.

    “In humans, intranasal oxytocin has been shown to increase rCBF, and hence neuronal activity, in cortical areas directly implicated in the processing of nociceptive input and the experience of pain, as well as in the descending modulation of nociceptive input, such as the frontoparietal opercula, the insula and the anterior cingulate cortex 58, 66, 67.”

    From The Analgesic Effect of Oxytocin in Humans: A Double‐Blind, Placebo‐Controlled Cross‐Over Study Using Laser‐Evoked Potentials (2016) · cites this paper as [67]

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Authors
Treede, R.-D., Kenshalo, D. R., Gracely, R. H., & Jones, A. K. P.
Affiliations
  • Johannes Gutenberg University Mainz (DE)
  • National Institutes of Health (US)
  • Salford Royal Hospital (GB)
Corresponding author
Treede, Rolf-Detlef
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1999-02-01
Volume
79
Issue
2
Pages
105-111
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/s0304-3959(98)00184-5
OpenAlex
W2023718219
Cited by
1,077
References
52
Citations by year
2026: 10 · 2025: 20 · 2024: 31 · 2023: 19 · 2022: 24 · 2021: 35 · 2020: 37 · 2019: 34 · 2018: 24 · 2017: 41 · 2016: 43 · 2015: 49 · 2014: 31 · 2013: 55 · 2012: 43
FWCI
21.33
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
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
pain processing, primary somatosensory cortex, secondary somatosensory cortex, parietal operculum, insula, anterior cingulate cortex, prefrontal cortex, sensory-discriminative pain, thalamus, pain perception
MeSH terms
Animals, Cerebral Cortex, Humans, Neural Pathways, Pain

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