Attentional and emotional states alter the way we perceive pain. Recent findings suggest that the mechanisms underlying these two forms of pain modulation are at least partially separable. This concept is supported by the observation that attention and emotions differentially alter the sensory and affective dimensions of pain perception and apparently implicate different brain circuits. In this review, we will examine those recent findings within the broader cognitive neuroscience conceptualization of human attention and emotion and the corresponding functional neuroanatomy.
Baliki M., Al-Amin HA, Atweh SF, Jaber M., Hawwa N., Jabbur SJ, and others. 2003. Attenuation of neuropathic manifestations by local block of the activities of the ventrolateral orbito-frontal area in the rat. Neuroscience120:1093-104.
2.
Bantick SJ, Wise RG, Ploghaus A., Clare S., Smith SM, Tracey I.2002. Imaging how attention modulates pain in humans using functional MRI. Brain125:310-9.
3.
Behrmann M., Geng JJ, Shomstein S.2004. Parietal cortex and attention. Curr Opin Neurobiol14:212-7.
4.
Blood AJ, Zatorre RJ2001. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Natl Acad Sci U S A98:11818-23.
5.
Brooks JC, Nurmikko TJ, Bimson WE, Singh KD, Roberts N.2002. fMRI of thermal pain: effects of stimulus laterality and attention. Neuroimage15:293-301.
6.
Buffington AL, Hanlon CA, McKeown MJ2005. Acute and persistent pain modulation of attention-related anterior cingulate fMRI activations. Pain113:172-84.
7.
Burton H., Sinclair RJ2000. Attending to and remembering tactile stimuli: a review of brain imaging data and single-neuron responses. J Clin Neurophysiol17:575-91.
8.
Bushnell MC, Duncan GH, Hofbauer RK, Ha B., Chen JI, Carrier B.1999. Pain perception: is there a role for primary somatosensory cortex? Proc Natl Acad Sci U S A96:7705-9.
9.
Carlson JD, Maire JJ, Martenson ME, Heinricher MM2007. Sensitization of pain-modulating neurons in the rostral ventromedial medulla after peripheral nerve injury. J Neurosci27:13222-31.
10.
Cavada C., Company T., Tejedor J., Cruz-Rizzolo RJ, Reinoso-Suarez F.2000. The anatomical connections of the macaque monkey orbitofrontal cortex. A review. Cereb Cortex10:220-42.
11.
Coghill RC, Sang CN, Maisog JM, Iadarola MJ1999. Pain intensity processing within the human brain: a bilateral, distributed mechanism. J Neurophysiol82:1934-43.
12.
Corbetta M., Shulman GL2002. Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci3:201-15.
13.
Craig AD, Chen K., Bandy D., Reiman EM2000. Thermosensory activation of insular cortex. Nat Neurosci3:184-90.
14.
Duncan GH, Albanese MC2003. Is there a role for the parietal lobes in the perception of pain? Adv Neurol93:69-86.
15.
Dunckley P., Aziz Q., Wise RG, Brooks J., Tracey I., Chang L.2007. Attentional modulation of visceral and somatic pain. Neurogastroenterol Motil19:569-77.
16.
Dunckley P., Wise RG, Fairhurst M., Hobden P., Aziz Q., Chang L., and others. 2005. A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging. J Neurosci25:7333-41.
17.
Ehrlichman H., Kuhl SB, Zhu J., Warrenburg S.1997. Startle reflex modulation by pleasant and unpleasant odors in a between-subjects design. Psychophysiology34:726-9.
18.
Fan J., McCandliss BD, Fossella J., Flombaum JI, Posner MI2005. The activation of attentional networks. Neuroimage26:471-9.
19.
Farrell MJ, Egan GF, Zamarripa F., Shade R., Blair-West J., Fox P., and others. 2006. Unique, common, and interacting cortical correlates of thirst and pain. Proc Natl Acad Sci U S A103:2416-21.
20.
Fields H.2004. State-dependent opioid control of pain. Nat Rev Neurosci5:565-575.
Frankenstein UN, Richter W., McIntyre MC, Remy F.2001. Distraction modulates anterior cingulate gyrus activations during the cold pressor test. Neuroimage14:827-36.
23.
Gebhart GF2004. Descending modulation of pain. Neurosci Biobehav Rev27:729-37.
24.
Hahn B., Ross TJ, Stein EA2006. Neuroanatomical dissociation between bottom-up and top-down processes of visuospatial selective attention. Neuroimage32:842-53.
25.
Hoffman HG, Richards TL, Coda B., Bills AR, Blough D., Richards AL, Sharar SR2004. Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI. Neuroreport15:1245-8.
26.
Hutchison WD, Harfa L., Dostrovsky JO1996. Ventrolateral orbital cortex and periaqueductal gray stimulation-induced effects on on- and off-cells in the rostral ventromedial medulla in the rat . Neuroscience70:391-407.
27.
Kenntner-Mabiala R., Weyers P., Pauli P.2007. Independent effects of emotion and attention on sensory and affective pain perception. Cogn Emot21:1615-29.
28.
Keogh E., Ellery D., Hunt C., Hannent I.2001. Selective attentional bias for pain-related stimuli amongst pain fearful individuals. Pain91:91-100.
29.
Kringelbach ML2005. The human orbitofrontal cortex: linking reward to hedonic experience. Nat Rev Neurosci6:691-702.
30.
Lang PJ, Bradley MM, Cuthbert BN1992. A motivational analysis of emotion-reflex cortex connections . Psychol Sci3:44-9.
31.
Lepsien J., Nobre AC2006. Cognitive control of attention in the human brain: insights from orienting attention to mental representations. Brain Res1105:20-31.
Longe SE, Wise R., Bantick S., Lloyd D., Johansen-Berg H., McGlone F., and others. 2001. Counter-stimulatory effects on pain perception and processing are significantly altered by attention: an fMRI study. Neuroreport12:2021-5.
34.
McLemore S., Crown ED, Meagher MW, Grau JW1999. Shock-induced hyperalgesia: II. Role of the dorsolateral periaqueductal gray. Behav Neurosci113:539-49.
35.
Mesulam MM1998. From sensation to cognition. Brain121 (Pt 6):1013-52.
36.
Millan MJ1999. The induction of pain: an integrative review. Prog Neurobiol57:1-164.
37.
Morin C., Duncan GH, Lavigne G., Boily JG, Bushnell MC1999. Differential effects of morphine on pain and temperature perception in human volunteers. Eur J Pain3:193-204.
38.
Murphy FC, Nimmo-Smith I., Lawrence AD2003. Functional neuroanatomy of emotions: a meta-analysis. Cogn Affect Behav Neurosci3:207-33.
39.
Nebel K., Wiese H., Stude P., de Grieff A., Diener HC, Keidel M.2005. On the neural basis of focused and divided attention. Brain Res Cogn Brain Res25:760-76.
40.
Ohara PT, Vit JP, Jasmin L.2005. Cortical modulation of pain. Cell Mol Life Sci62:44-52.
41.
Olausson H., Charron J., Marchand S., Villemure C., Strigo IA, Bushnell MC2005. Feelings of warmth correlate with neural activity in right anterior insular cortex. Neurosci Lett389:1-5.
42.
Pardo JV, Fox PT, Raichle ME1991. Localization of a human system for sustained attention by positron emission tomography. Nature349:61-4.
43.
Petersen SE, Corbetta M., Miezin FM, Shulman GL1994. PET studies of parietal involvement in spatial attention: comparison of different task types. Can J Exp Psychol48:319-38.
Phillips ML, Gregory LJ, Cullen S., Coen S., Ng V., Andrew C., and others. 2003. The effect of negative emotional context on neural and behavioural responses to oesophageal stimulation. Brain126:669-84.
46.
Ploghaus A., Narain C., Beckmann CF, Clare S., Bantick S., Wise R., and others. 2001. Exacerbation of pain by anxiety is associated with activity in a hippocampal network. J Neurosci21:9896-903.
47.
Posner MI, Petersen SE1990. The attention system of the human brain. Annu Rev Neurosci13:25-42.
48.
Price DD2002. Central neural mechanisms that interrelate sensory and affective dimensions of pain. Mol Interv2: 392-403, 339.
49.
Rainville P., Bao QV, Chretien P.2005. Pain-related emotions modulate experimental pain perception and autonomic responses. Pain118:306-18.
50.
Rhudy JL, Meagher MW2001. The role of emotion in pain modulation. Curr Opin Psychiatry14:241-5.
51.
Seminowicz DA, Mikulis DJ, Davis KD2004. Cognitive modulation of pain-related brain responses depends on behavioral strategy. Pain112:48-58.
52.
Shomstein S., Yantis S.2004. Control of attention shifts between vision and audition in human cortex. J Neurosci24:10702-6.
53.
Shomstein S., Yantis S.2006. Parietal cortex mediates voluntary control of spatial and nonspatial auditory attention. J Neurosci26:435-9.
54.
Tracey I., Ploghaus A., Gati JS, Clare S., Smith S., Menon RS, and others. 2002. Imaging attentional modulation of pain in the periaqueductal gray in humans. J Neurosci22: 2748-52.
55.
Valet M., Sprenger T., Boecker H., Willoch F., Rummeny E., Conrad B., and others. 2004. Distraction modulates connectivity of the cingulo-frontal cortex and the midbrain during pain-an fMRI analysis. Pain109:399-408.
56.
Villemure C., Bushnell MC2002. Cognitive modulation of pain: how do attention and emotion influence pain processing? Pain95:195-9.
Villemure C., Slotnick BM, Bushnell MC2003. Effects of odors on pain perception: deciphering the roles of emotion and attention. Pain106:101-8.
59.
Wiech K., Ploner M., Tracey I.2008. Neurocognitive aspects of pain perception. Trends Cogn Sci12:306-13.
60.
Wiech K., Seymour B., Kalisch R., Stephan KE, Koltzenburg M., Driver J., and others. 2005. Modulation of pain processing in hyperalgesia by cognitive demand. Neuroimage27:59-69.
61.
Wiech K., Tracey I.2009. The influence of negative emotions on pain: behavioral effects and neural mechanisms. Neuroimage47:987-94.
62.
Wu CT, Weissman DH, Roberts KC, Woldorff MG2007. The neural circuitry underlying the executive control of auditory spatial attention. Brain Res1134:187-98.
63.
Yantis S., Serences JT2003. Cortical mechanisms of space-based and object-based attentional control. Curr Opin Neurobiol13:187-93.
64.
Zelman DC, Howland EW, Nichols SN, Cleeland CS1991. The effects of induced mood on laboratory pain. Pain46:105-11.
