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Attention to pain localization and unpleasantness discriminates the functions of the medial and lateral pain systems.
Abstract
Functional imaging studies have identified a matrix of structures in the brain that respond to noxious stimuli. Within this matrix, a division of function between sensory-discriminative and affective responses has so far been demonstrated by manipulating either pain intensity or unpleasantness under hypnosis in two different normal volunteer groups studied on separate occasions. Our study used positron emission tomography (PET) to demonstrate this division of function under more natural conditions in a healthy group of volunteers, using a CO(2) laser to provide nociceptive stimuli that selectively activate A-delta and C-fibres without contamination by touch sensations. We measured the differential cerebral responses to noxious and innocuous laser stimuli during conditions of selective attention to either the unpleasantness or location of the stimuli. Attention to location increased responses in the contralateral (right) primary somatosensory and inferior parietal cortices. This result implies that these components of the lateral pain system are concerned mainly with the localization of pain. In contrast, attention to unpleasantness increased responses in bilateral perigenual cingulate and orbitofrontal cortices, contralateral (right) amygdala, ipsilateral (left) hypothalamus, posterior insula, M1 and frontal pole. These areas comprise key components of the medial pain and neuroendocrine systems and the results suggest that they have a role in the affective response to pain. Our results indicate the importance of attentional effects on the pattern of nociceptive processing in the brain. They also provide the first clear demonstration, within a single experiment, of a major division of function within the neural pain matrix.
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“Thus, it seems that directing attention (a top-down influence rather than an automatic reaction) can increase the neural activity in somatosensory-discriminative component of pain processing.”
From What are you feeling? Using functional magnetic resonance imaging to assess the modulation of sensory and affective responses during empathy for pain (2007) · cites this paper as [19]
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Metadata
- Authors
- Kulkarni, B., Bentley, D. E., Elliott, R., Youell, P., Watson, A., Derbyshire, S. W. G., Frackowiak, R. S. J., Friston, K. J., & Jones, A. K. P.
- Affiliations
- Salford Royal Hospital (GB)
- University of Manchester (GB)
- University of Pittsburgh (US)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Kulkarni, B.
- Venue
- European Journal of Neuroscience
- Publisher
- Wiley
- Published
- 2005-06
- Volume
- 21
- Issue
- 11
- Pages
- 3133-3142
- ISSN
- 0953-816X (ISSN-L)
- 1460-9568
- OpenAlex
- W2016341768
- Cited by
- 337
- References
- 90
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 10 · 2023: 18 · 2022: 27 · 2021: 13 · 2020: 22 · 2019: 20 · 2018: 14 · 2017: 24 · 2016: 17 · 2015: 16 · 2014: 16 · 2013: 10 · 2012: 15
- FWCI
- 8.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- Wellcome Trust
- 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 localization, pain unpleasantness, attentional modulation of pain, nociceptive processing, primary somatosensory cortex, inferior parietal cortex, orbitofrontal cortex, amygdala, hypothalamus, posterior insula
- MeSH terms
- Adult, Afferent Pathways, Attention, Brain, Brain Mapping, Emotions, Humans, Functional Laterality, Limbic System, Male, Nerve Fibers, Myelinated, Neurosecretory Systems, Nociceptors, Pain, Physical Stimulation, Somatosensory Cortex, Nerve Fibers, Unmyelinated, Positron-Emission Tomography
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