Central Integration of Pain, Center for Neuroscience of Lyon, Neurological Hospital, 59 Bd Pinel, 69003 Lyon, France.
Neurosci Lett. 2012 Jun 29;520(2):188-91. doi: 10.1016/j.neulet.2012.05.007. Epub 2012 May 10.
The recognition that dissociated sensory loss affecting selectively pain and temperature results from lesions of the operculo-insular cortex is due to Biemond in 1956. This contrasted with the prevailing view that the sensory aspects of pain did not imply regions above the thalamus. Anatomical data in non-human primates, as well as electrophysiology and functional imaging in humans have now abundantly demonstrated that the opercular-insular region is the main cortical target of the spinothalamic system, and a vast number of reports have confirmed the relation between lesions in this region and the development of dissociated sensory symptoms and central neuropathic pain. Operculo-insular pain (parasylvian pain) is a distinct entity that can be clinically suspected and objectively diagnosed with combined radiological and electrophysiological methods, in particular evoked potentials to spinothalamic (laser) input. The region comprising the posterior insula and medial operculum may deserve being considered as a third somatosensory cortex (S3) contributing to the spinothalamic attributes of somatic perception.
人们认识到，选择性影响疼痛和温度的分离性感觉丧失是由于 1956 年比蒙的病变所致。这与当时流行的观点形成了对比，即疼痛的感觉方面并不意味着丘脑以上的区域。现在，非人类灵长类动物的解剖学数据，以及人类的电生理学和功能影像学已经充分证明了脑岛盖区域是脊髓丘脑系统的主要皮质靶区，大量报告证实了该区域的病变与分离性感觉症状和中枢神经性疼痛的发展之间存在关系。脑岛盖疼痛（旁中央小叶疼痛）是一种明显的实体，可以通过联合放射学和电生理学方法，特别是对脊髓丘脑（激光）输入的诱发电位来进行临床怀疑和客观诊断。包括后岛和内侧脑岛盖的区域可能值得被认为是第三个躯体感觉皮层（S3），有助于躯体感觉的脊髓丘脑属性。
