The genesis of pain

  • Mike Hudspith
    Mike Hudspith PhD FFPMRCA is a Consultant in Pain Medicine and Honorary Associate Professor (MED) UEA, Norfolk and Norwich University Hospital, Norwich, UK. Conflict of Interest: non declared
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      This article explores mechanisms that may generate pain as a multidimensional and embodied construct rather than a simple sensory state. Existing models of pain will be reviewed alongside dynamic functional imaging data and contemporary cognitive neuroscience principles, including Bayesian predictive processing, to provide a potential explanation of chronic pain states. The focus is upon an exploration of integrated cortico-limbic processing as opposed to peripheral and central sensitization.


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      Further reading

        • Baroso J.
        • Branco P.
        • Apkarian A.V.
        Brain mechanisms of chronic pain: critical role of translational approach.
        Transl Res. 2021; 238: 76-89
        • Barrett L.F.
        The theory of constructed emotion: an active inference account of interoception and categorization.
        Soc Cogn Affective Neurosci. 2017; 12: 1-23
        • Clark A.
        Surfing uncertainty.
        Oxford University Press, 2016
      1. Corns J. The Routledge handbook of philosophy of pain. Taylor & Francis, 2017
        • Craig A.
        How do you feel? Interoception: the sense of the physiological condition of the body.
        Nat Rev Neurosci. 2002; 3: 655-666
        • Hudspith M.
        Anatomy, physiology and pharmacology of pain.
        Anaesth Intensive Care Med. 2019; 20: 419-425
        • Navratilova E.
        • Porreca F.
        Reward and motivation in pain and pain relief.
        Nat Neurosci. 2014; 17: 1304-1312
        • Nicholas M.
        • Vlaeyen J.
        • Rief W.
        • et al.
        The IASP classification of chronic pain for ICD-11: chronic primary pain.
        Pain. 2019; 160: 28-37
        • Solms M.
        • Friston K.
        How and why consciousness arises.
        J Conscious Stud. 2018; 25: 202-238
        • Tabor A.
        • Thacker M.
        • Moseley G.L.
        • et al.
        Pain: a statistical account.
        PLoS Comput Biol. 2017; 13: e1005142
        • Wager T.
        • Atlas L.
        • Lindquist M.
        • et al.
        An fMRI-based neurophysiologic signature of physical pain.
        NEJM. 2013; 368: 1388-1397