Understanding cortical pain perception in humans

Abstract

AbstractPain is a conscious experience and a highly subjective sensation with a complex and often non‐linear relationship between nociceptive input and pain perception. Our understanding of the neural correlates of pain perception in humans has increased significantly since the advent of neuroimaging. Relating neural activity changes to the varied pain experiences has led to the concept that cognition, emotion, context, and injury can separately influence pain perception. In this mini review, the current concept of the central pain mechanism (CPM) is described. First, the concept of the “pain matrix” is stated: Nociceptive stimuli elicit responses in an extensive cortical network including somatosensory, insular, and cingulate areas, as well as frontal and parietal areas. Then, electrophysiological assessments of the CPM are reviewed based on the literature and our recent studies. In particular, supraspinal (cortical) mechanisms for pain perception and pain relief are outlined. The insular cortex has key roles in sensory‐associated as well as cognitive‐associated processing for pain perception.