Supraspinal Mechanisms Underlying Ocular Pain

Abstract

Supraspinal mechanisms of pain are increasingly understood to underlie neuropathic ocular conditions previously thought to be exclusively peripheral in nature. Isolating individual causes of centralized chronic conditions and differentiating them is critical to understanding the mechanisms underlying neuropathic eye pain and ultimately its treatment. Though few functional imaging studies have focused on the eye as an end-organ for the transduction of noxious stimuli, the brain networks related to pain processing have been extensively studied with functional neuroimaging over the past 20 years. This article will review the supraspinal mechanisms that underlie pain as they relate to the eye.

Disentangling the neurological basis of chronic ocular pain using clinical, self-report, and brain imaging data: use of K-means clustering to explore patient phenotypes

“…The complex projections emanating from trigeminal nerve afferents through brainstem and sub-cortical regions support an investigation into the primary checkpoints of afferent sensory signaling in the brain. That is, prior work has established primary somatosensory and motor areas, as well as amygdala, lateral prefrontal cortex, presupplementary motor area, basal ganglia, cerebellum, and brainstem as core regions ( 17 ) (for review see ( 18 )). A direct connection between the periaqueductal gray (PAG) and the trigeminal brainstem nuclei ( 19 , 20 ) has been observed, linking PAG activity as a potential form of pain modulation to the trigeminal sensory complex.…”