Descending analgesia – When the spine echoes what the brain expects

  title={Descending analgesia – When the spine echoes what the brain expects},
  author={Philippe Goffaux and William John Redmond and Pierre Rainville and Serge Marchand},
Cortical influences on brainstem circuitry responsible for conditioned pain modulation in humans
These data suggest that during multiple or widespread painful stimuli, engagement of the prefrontal and cingulate cortices prevents the generation of CPM analgesia, raising the possibility altered responsiveness in these cortical regions underlie the reduced CPM observed in individuals with chronic pain.
Cerebral and Cerebrospinal Processes Underlying Counterirritation Analgesia
This fMRI study investigates brain responses to phasic painful electrical stimulation administered to the sural nerve to evoke a spinal nociceptive response (RIII reflex) before, during and after counterirritation induced by the immersion of the left contralateral foot in cold water to provide evidence for the implication of at least two partly separable neural mechanisms underlying the effects of counteririttation on pain and spinal nock in humans.
PLACEBO ANALGESIA 1 Placebo Analgesia
A more complete understanding of the placebo analgesic response could lead to new treatments that exploit psychological methods for activating pain-modulating circuitry and for ethically and optimally enhancing the placebo component of active treatments.
How expectations shape pain
A meta-analysis of brain mechanisms of placebo analgesia: consistent findings and unanswered questions.
Meta-analyses of neuroimaging studies of placebo analgesia revealed that placebo effects and expectations for reduced pain elicit reliable reductions in activation during noxious stimulation in regions often associated with pain processing, including the dorsal anterior cingulate, thalamus, and insula.
Intracortical modulation, and not spinal inhibition, mediates placebo analgesia
The selective suppression of late LEPs indicates that placebo analgesia is mediated by direct intracortical modulation rather than inhibition of the nociceptive input at spinal level, suggesting that higher order sensory processes are modulated during placebo analgesIA.


Pain-evoked anterior cingulate activity generating the negative difference potential may reflect response selection processes.
  • R. Dowman
  • Psychology, Biology
  • 2002
Differences in the cognitive demands of the control and cold pain conditions suggest that the pain-evoked 210-ms ACCcd activity reflects response selection processes, perhaps response competition monitoring.
Descending control of pain.
The periaqueductal grey, the raphe nuclei and the locus coeruleus are all key brainstem sites for the control of nociceptive transmission in the spinal cord and it is clear from more recent work that NA has an equally important part to play.
Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain
fMRI experiments found that placebo analgesia was related to decreased brain activity in pain-sensitive brain regions, including the thalamus, insula, and anterior cingulate cortex, and was associated with increased activity during anticipation of pain in the prefrontal cortex, providing evidence that placebos alter the experience of pain.
Imaging Attentional Modulation of Pain in the Periaqueductal Gray in Humans
High-resolution functional magnetic resonance imaging was used to define brain activation to painful heat stimulation applied to the hand of nine normal subjects within the periaqueductal gray region, providing direct evidence supporting the notion that the perianal gray is a site for higher cortical control of pain modulation in humans.
Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation.
It is proposed that the DLPFC exerts active control on pain perception by modulating corticosubcortical and corticocortical pathways.
Brain mechanisms of pain affect and pain modulation
  • P. Rainville
  • Psychology, Medicine
    Current Opinion in Neurobiology
  • 2002
Dissociating pain from its anticipation in the human brain.
Functional magnetic resonance imaging in healthy humans was applied to dissociate neural activation patterns associated with acute pain and its anticipation to find sites within the medial frontal lobe, insular cortex, and cerebellum distinct from, but close to, locations mediating pain experience itself.