Kong Jian, White Nathan S, Kwong Kenneth K, Vangel Mark G, Rosman Ilana S, Gracely Richard H, Gollub Randy L
Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts, USA.
Hum Brain Mapp. 2006 Sep;27(9):715-21. doi: 10.1002/hbm.20213.
Neuroimaging studies of painful stimuli in humans have identified a network of brain regions that is more extensive than identified previously in electrophysiological and anatomical studies of nociceptive pathways. This extensive network has been described as a pain matrix of brain regions that mediate the many interrelated aspects of conscious processing of nociceptive input such as perception, evaluation, affective response, and emotional memory. We used functional magnetic resonance imaging in healthy human subjects to distinguish brain regions required for pain sensory encoding from those required for cognitive evaluation of pain intensity. The results suggest that conscious cognitive evaluation of pain intensity in the absence of any sensory stimulation activates a network that includes bilateral anterior insular cortex/frontal operculum, dorsal lateral prefrontal cortex, bilateral medial prefrontal cortex/anterior cingulate cortex, right superior parietal cortex, inferior parietal lobule, orbital prefrontal cortex, and left occipital cortex. Increased activity common to both encoding and evaluation was observed in bilateral anterior insula/frontal operculum and medial prefrontal cortex/anterior cingulate cortex. We hypothesize that these two regions play a crucial role in bridging the encoding of pain sensation and the cognitive processing of sensory input.
对人类疼痛刺激的神经影像学研究已经确定了一个脑区网络,该网络比之前在伤害性感受通路的电生理和解剖学研究中所确定的更为广泛。这个广泛的网络被描述为一个脑区疼痛矩阵,它介导了伤害性感受输入的意识处理的许多相互关联的方面,如感知、评估、情感反应和情绪记忆。我们在健康人类受试者中使用功能磁共振成像来区分疼痛感觉编码所需的脑区和疼痛强度认知评估所需的脑区。结果表明,在没有任何感觉刺激的情况下,对疼痛强度的有意识认知评估会激活一个网络,该网络包括双侧前岛叶皮质/额盖、背外侧前额叶皮质、双侧内侧前额叶皮质/前扣带回皮质、右侧顶上叶皮质、顶下小叶、眶前额叶皮质和左侧枕叶皮质。在双侧前岛叶/额盖以及内侧前额叶皮质/前扣带回皮质中观察到编码和评估过程中共同的活动增加。我们假设这两个区域在连接疼痛感觉的编码和感觉输入的认知处理方面起着关键作用。