Cerebellum is more concerned about visceral than somatic pain

Associative learning and extinction of conditioned threat predictors across sensory modalities

“…In addition to shared neural activation induced by US of different modalities, interoceptive US interestingly evoked greater neural activation within the anterior insula and dorsal anterior cingulate cortex as key regions of the salience network, with well-established roles in the central integration of interoceptive sensory signals with emotional and cognitive facets 55 – 57 . These findings, which appeared robust even when considering differences in US ratings as nuisance variables, reproduce and complement earlier efforts to elucidate the specificity of interoceptive visceral pain in shaping aversive anticipation and central pain processing, not only in direct comparison to an exteroceptive painful threat 4 , 26 , 58 , but also to a non-nociceptive, yet a priori equally aversive auditory threat. In line with a notable recent publication detailing a multivariate brain measure, the Neurologic Pain Signature (NPS), for visceral and somatic stimulation across different independent datasets 37 , our results from two independent studies support the unique salience of interoceptive pain as a US, above and beyond specific yet highly intertwined perceptual characteristics of intensity and unpleasantness, and underscore the suitability of this experimental model to elucidating the role of threat modality in associative learning and extinction processes in a clinically-relevant context.…”

Functional brain reconfiguration during sustained pain

“…The composition of Community 5 during the early period suggested that the brainstem regions were closely linked with the limbic brain regions, including the medial temporal lobe structures (e.g., hippocampus, amygdala, and parahippocampal gyrus) and the temporal pole, consistent with recent findings that showed the involvement of the spino-parabrachio-amygdaloid circuit in sustained pain ( Chiang et al, 2019 ; Huang et al, 2019 ; Rodriguez et al, 2017 ). In addition, the reconfiguration of Community 4 showed that the cerebellum-dominant community extended its connections to the brainstem and thalamus during the late period of sustained pain ( Figure 3C and Appendix 1—figure 8B ), suggesting an important, though less investigated, pain-modulatory role of the cerebellum in pain ( Claassen et al, 2020 ; Moulton et al, 2010 ).…”

Orofacial musculoskeletal pain: An evidence-based bio-psycho-social matrix model

“…It is worth noting that the cerebellum contains a variety of neural interconnections with different brain areas that are functionally involved in mediating stress-induced behavioral changes such as hypothalamus, amygdala, prefrontal and cingulate cortex, periaqueductal gray, nucleus raphe magnus, and others (Moreno-Rius, 2019). Thus, in addition to its involvement in controlling motor functions, the cerebellum has an intermediary role in cognitive and emotional processing, ANS activity, and pain (Adamaszek et al, 2017;Claassen et al, 2020;Moreno-Rius, 2019). Yet, although the cerebellum has frequently been shown to respond to painful stimuli including those from orofacial tissues, its specific contributions to pain processing remains elusive (Brügger et al, 2012).…”