Pain and the emotional brain: pain-related cortical processes are better reflected by affective evaluation than by cognitive evaluation

Abstract

The experience of pain has been dissociated into two interwoven aspects: a sensory-discriminative aspect and an affective-motivational aspect. We aimed to explore which of the pain descriptors is more deeply rooted in the human brain. Participants were asked to evaluate applied cold pain. The majority of the trials showed distinct ratings: some were rated higher for unpleasantness and others for intensity. We compared the relationship between functional data recorded from 7 T MRI with unpleasantness and intensity ratings and revealed a stronger relationship between cortical data and unpleasantness ratings. The present study underlines the importance of the emotional-affective aspects of pain-related cortical processes in the brain. The findings corroborate previous studies showing a higher sensitivity to pain unpleasantness compared to ratings of pain intensity. For the processing of pain in healthy subjects, this effect may reflect the more direct and intuitive evaluation of emotional aspects of the pain system, which is to prevent harm and to preserve the physical integrity of the body.

The impact of an immersive digital therapeutic tool on experimental pain: a pilot randomized within-subject experiment with an active control condition

“…This finding is coherent with the evidence pointing to significant differences between these two pain components. First, there reliable is evidence that these two components are processed by different brain regions ( 50 ). Moreover, there is evidence demonstrating that pain intensity and unpleasantness may exhibit divergent responses to certain analgesic procedures such as transcutaneous electric nerve stimulation, hypnosis and opioids ( 51 – 55 ).…”