title: Brain activations during pain: a neuroimaging meta-analysis of patients with pain and healthy controls.
abstract: In response to recent publications from pain neuroimaging experiments, there has been a debate about the existence of a primary pain region in the brain. Yet, there are few meta-analyses providing assessments of the minimum cerebral denominators of pain. Here, we used a statistical meta-analysis method, called activation likelihood estimation, to define (1) core brain regions activated by pain per se, irrelevant of pain modality, paradigm, or participants and (2) activation likelihood estimation commonalities and differences between patients with chronic pain and healthy individuals. A subtraction analysis of 138 independent data sets revealed that the minimum denominator for activation across pain modalities and paradigms included the right insula, secondary sensory cortex, and right anterior cingulate cortex (ACC). Common activations for healthy subjects and patients with pain alike included the thalamus, ACC, insula, and cerebellum. A comparative analysis revealed that healthy individuals were more likely to activate the cingulum, thalamus, and insula. Our results point toward the central role of the insular cortex and ACC in pain processing, irrelevant of modality, body part, or clinical experience; thus, furthering the importance of ACC and insular activation as key regions for the human experience of pain.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden Clinic of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany Monell Chemical Senses Center, University of Pennsylvania, Philadelphia, PA, USA CogNAC, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada CÉAMS, Research Center, Sacré-Coeur Hospital, Montréal, QC, Canada Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Karin B
authors.initials: KB
authors.lastname: Jensen
authors.forename: Christina
authors.initials: C
authors.lastname: Regenbogen
authors.forename: Margarete C
authors.initials: MC
authors.lastname: Ohse
authors.forename: Johannes
authors.initials: J
authors.lastname: Frasnelli
authors.forename: Jessica
authors.initials: J
authors.lastname: Freiherr
authors.forename: Johan N
authors.initials: JN
authors.lastname: Lundström
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D059907:Functional Neuroimaging; D064368:Healthy Volunteers; D006801:Humans; D010146:Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology