title: Pain networks from the inside: Spatiotemporal analysis of brain responses leading from nociception to conscious perception.
abstract: Conscious perception of painful stimuli needs the contribution of an extensive cortico-subcortical network, and is completed in less than one second. While initial activities in operculo-insular and mid-cingulate cortices have been extensively assessed, the activation timing of most areas supporting conscious pain has barely been studied. Here we used intracranial EEG to investigate the dynamics of 16 brain regions (insular, parietal, prefrontal, cingulate, hippocampal and limbic) during the first second following nociceptive-specific laser pulses. Three waves of activation could be defined according to their temporal relation with conscious perception, ascertained by voluntary motor responses. Pre-conscious activities were recorded in the posterior insula, operculum, mid-cingulate and amygdala. Antero-insular, prefrontal and posterior parietal activities started later and developed during time-frames consistent with conscious voluntary reactions. Responses from hippocampus, perigenual and perisplenial cingulate developed latest and persisted well after conscious perception occurred. Nociceptive inputs reach simultaneously sensory and limbic networks, probably through parallel spino-thalamic and spino-parabrachial pathways, and the initial limbic activation precedes conscious perception of pain. Access of sensory information to consciousness develops concomitant to fronto-parietal activity, while late-occurring responses in the hippocampal region, perigenual and posterior cingulate cortices likely underlie processes linked to memory encoding, self-awareness and pain modulation. Hum Brain Mapp 37:4301-4315, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.|Unité D'Hypnologie, Service De Neurologie Fonctionnelle Et D'Épileptologie, Hôpital Neurologique, Hospices Civils De Lyon, Bron, F-69677, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Bastuji
authors.affiliation: Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Frot
authors.affiliation: Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Perchet
authors.affiliation: Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Magnin
authors.affiliation: Central Integration of Pain (NeuroPain) Lab - Lyon Neuroscience Research Center, INSERM U1028; CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.|Centre D'évaluation Et De Traitement De La Douleur, Hôpital Neurologique, Lyon, France.
authors.forename: Luis
authors.initials: L
authors.lastname: Garcia-Larrea
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001364:Awareness / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D000069279:Drug Resistant Epilepsy / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D000069280:Electrocorticography; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D059226:Nociceptive Pain / Q000503:physiopathology*; D058748:Pain Perception / Q000502:physiology*; D062211:Spatio-Temporal Analysis; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: consciousness; human; intracerebral EEG; nociceptive stimulus; pain matrix