Cortical Midline Structures: "Self" and "Pain"

Abstract

Emerging evidence indicates that cortical midline structures (CMS) (which consist of the orbitomedial prefrontal cortex (OMPFC), dorsomedial prefrontal cortex (DMPFC), anterior cingulate cortex (ACC), and precuneus/posterior cingulate cortex (pC/PCC)) have a critical role in generating a model of the self. These regions also serve as hub regions for the default mode network (DMN) or salience network (SN). Furthermore, regions of the CMS overlap with pain-related regions such as the so-called "pain matrix," suggesting that pain has unique attributes compared to other sensations like vision. Previous studies have reported that disturbances of the CMS relate to chronic pain, as well as neurological and psychiatric diseases. The considerable overlap between regions involved in pain and those involved in self-cognition may provide important insights not only into the pathology of chronic pain and cognitive aspects of pain, but also for understanding self-representation in the brain.