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Cited by 2,171Pain Mechanisms and TreatmentsPain Management and Placebo EffectPain Management and Treatment

The DOI matches its Crossref record; 164 of the 164 references it cites were found in a registry or an index.

Functional imaging of brain responses to pain. A review and meta-analysis (2000)

Peyron, R., Laurent, B., García-Larrea, L.·2000·Neurophysiologie Clinique/Clinical Neurophysiology
DOI 10.1016/s0987-7053(00)00227-6
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Abstract

Brain responses to pain, assessed through positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are reviewed. Functional activation of brain regions are thought to be reflected by increases in the regional cerebral blood flow (rCBF) in PET studies, and in the blood oxygen level dependent (BOLD) signal in fMRI. rCBF increases to noxious stimuli are almost constantly observed in second somatic (SII) and insular regions, and in the anterior cingulate cortex (ACC), and with slightly less consistency in the contralateral thalamus and the primary somatic area (SI). Activation of the lateral thalamus, SI, SII and insula are thought to be related to the sensory-discriminative aspects of pain processing. SI is activated in roughly half of the studies, and the probability of obtaining SI activation appears related to the total amount of body surface stimulated (spatial summation) and probably also by temporal summation and attention to the stimulus. In a number of studies, the thalamic response was bilateral, probably reflecting generalised arousal in reaction to pain. ACC does not seem to be involved in coding stimulus intensity or location but appears to participate in both the affective and attentional concomitants of pain sensation, as well as in response selection. ACC subdivisions activated by painful stimuli partially overlap those activated in orienting and target detection tasks, but are distinct from those activated in tests involving sustained attention (Stroop, etc.). In addition to ACC, increased blood flow in the posterior parietal and prefrontal cortices is thought to reflect attentional and memory networks activated by noxious stimulation. Less noted but frequent activation concerns motor-related areas such as the striatum, cerebellum and supplementary motor area, as well as regions involved in pain control such as the periaqueductal grey. In patients, chronic spontaneous pain is associated with decreased resting rCBF in contralateral thalamus, which may be reverted by analgesic procedures. Abnormal pain evoked by innocuous stimuli (allodynia) has been associated with amplification of the thalamic, insular and SII responses, concomitant to a paradoxical CBF decrease in ACC. It is argued that imaging studies of allodynia should be encouraged in order to understand central reorganisations leading to abnormal cortical pain processing. A number of brain areas activated by acute pain, particularly the thalamus and anterior cingulate, also show increases in rCBF during analgesic procedures. Taken together, these data suggest that hemodynamic responses to pain reflect simultaneously the sensory, cognitive and affective dimensions of pain, and that the same structure may both respond to pain and participate in pain control. The precise biochemical nature of these mechanisms remains to be investigated.

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Citations

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Research works printed but not linked: 9

  1. Cabeza, 1997, Age-related changes in neural interactions during memory encoding and retrieval: a network analysis of PET data, Brain and Cognition, 35, 369
  2. Créac’h, 2000, Functional MRI analysis of pain-related brain activation following acute mechanical stimulation, Am J Neuroradiology, 21
  3. Fitzgerald, 1998, Attentional effects in somatosensory cortex during an orientation discrimination task, Proc Soc Neurosci [abstract], 24, 44410
  4. Frot, 2000, Effects of noxious stimulus intensity on signals from operculo-insular cortex: an intra-cerebral recordings study in humans, Clin Neurophysiol, 111 Suppl 1, 131
  5. García-Larrea, 1991, Mapping study of selective attentional effects on somatosensory evoked potentials, Electroencephal Clin Neurophysiol, 82, 101
  6. Kupers, 1998, PET activation study in a patient with neuropathic pain is successfully treated with thalamic stimulation, Soc Neurosci (LA), 547, 1387
  7. O’Leary, 1997, Auditory and visual attention assessed with PET, Hum Brain Map, 5, 422, 10.1002/(SICI)1097-0193(1997)5:6<422::AID-HBM3>3.0.CO;2-5 · DOI
  8. Peyron R, García-Larrea L, Mertens P, Costes N, Mauguière F, Michel D, et al. Temporal pattern of cerebral blood flow (CBF) in patients with electrical motor cortex stimulation (MCS) for pain control. Soc Neurosci (Miami) October 1999 [abstract] · DOI
  9. Svensson, 1997, A cerebral representation of graded painful phasic and tonic heat in humans: a positron emission tomography stimuli, Vol. 8, 867

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Metadata

Authors
Peyron, R., Laurent, B., & García-Larrea, L.
Affiliations
Centre d'Exploration et de Recherche Médicale par Emission de Positons (FR)
Corresponding author
Peyron, R.
ORCID
Venue
Neurophysiologie Clinique/Clinical Neurophysiology
Publisher
Elsevier BV
Published
2000-10
Volume
30
Issue
5
Pages
263-288
ISSN
0987-7053 (ISSN-L)
DOI
10.1016/s0987-7053(00)00227-6
OpenAlex
W2025577666
Cited by
2,171
References
164
Citations by year
2026: 27 · 2025: 43 · 2024: 34 · 2023: 50 · 2022: 60 · 2021: 76 · 2020: 95 · 2019: 77 · 2018: 82 · 2017: 94 · 2016: 91 · 2015: 114 · 2014: 84 · 2013: 132 · 2012: 105
FWCI
19.57
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Neurophysiologie Clinique (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
pain processing, brain activation, regional cerebral blood flow, anterior cingulate cortex, thalamus, insula, spatial summation, temporal summation, allodynia, chronic pain, analgesia, pain management, central sensitization
MeSH terms
Analgesia, Attention, Brain, Brain Mapping, Cerebral Cortex, Cerebrovascular Circulation, Cognition, Emotions, Gyrus Cinguli, Humans, Hyperesthesia, Magnetic Resonance Imaging, Oxygen, Pain, Pain Measurement, Parietal Lobe, Receptors, Opioid, Somatosensory Cortex, Subtraction Technique, Thalamus, Tomography, Emission-Computed, Prefrontal Cortex

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