Cerebral cortex modulation of pain

Yu-feng XIE^1,2,*, Fu-quan HUO¹, Jing-shi TANG¹

¹Department of Physiology and Pathophysiology, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an Jiao-tong University, Xi’an 710061, China;
²Department of Pharmacology, Health Science Centre, University of Tennessee, USA

Pain is a complex experience encompassing sensory-discriminative, affective-motivational and cognitiv e-emotional components mediated by different mechanisms.  Contrary to the traditional view that the cerebral cortex is not involved in pain perception, an extensive cortical network associated with pain processing has been revealed using multiple methods over the past decades.  This network consistently includes, at least, the anterior cingulate cortex, the agranular insular cortex, the primary (SΙ) and secondary somatosensory (SΠ) cortices, the ventrolateral orbital cortex and the motor cortex.  These cortical structures constitute the medial and lateral pain systems, the nucleus submedius-ventrolateral orbital cortex-periaqueductal gray system and motor cortex system, respectively.  Multiple neurotransmitters, including opioid, glutamate, GABA and dopamine, are involved in the modulation of pain by these cortical structures.  In addition, glial cells may also be involved in cortical modulation of pain and serve as one target for pain management research.  This review discusses recent studies of pain modulation by these cerebral cortical structures in animals and human.

Keywords:anterior cingulate cortex; agranular insular cortex; ventrolateral orbital cortex; periaqueductal gray; primary and secondary somatosensory cortices; motor cortex; nociception