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A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging

Dunckley, Paul, Wisel, Richard G., Fairhurst, Merle, Hobden, Peter, Aziz, Qasim, Chang, Lin and Tracey, Irene 2005. A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging. Journal of Neuroscience 25 (32) , pp. 7333-7341. 10.1523/JNEUROSCI.1100-05.2005

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Evidence from both human and animal studies has demonstrated a key role for brainstem centers in the control of ascending nociceptive input. Nuclei such as the rostral ventromedial medulla and periaqueductal gray (PAG) are able to both inhibit and facilitate the nociceptive response. It has been proposed that altered descending modulation may underlie many of the chronic pain syndromes (both somatic and visceral). We used functional magnetic resonance imaging to image the neural correlates of visceral and somatic pain within the brainstem. Ten healthy subjects were scanned twice at 3 tesla, during which they received matched, moderately painful, electrical stimuli to either the midline lower abdomen or rectum. Significant activation was observed in regions consistent with the PAG, nucleus cuneiformis (NCF), ventral tegmental area/substantia nigra, parabrachial nuclei/nucleus ceruleus, and red nucleus bilaterally to both stimuli. Marked spatial similarities in activation were observed for visceral and somatic pain, although significantly greater activation of the NCF (left NCF, p = 0.02; right NCF, p = 0.01; Student's paired t test, two-tailed) was observed in the visceral pain group compared with the somatic group. Right PAG activity correlated with anxiety during visceral stimulation (r = 0.74; p < 0.05, Pearson's r, two-tailed) but not somatic stimulation. We propose that the differences in NCF and right PAG activation observed may represent a greater nocifensive response and greater emotive salience of visceral over somatic pain.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Uncontrolled Keywords: visceral; somatic; fMRI; rectum; pain; brainstem;
Additional Information: Pdf uploaded in accordance with publisher's policy at (accessed 27/02/2014).
Publisher: Society for Neuroscience
ISSN: 0270-6474
Date of First Compliant Deposit: 30 March 2016
Last Modified: 04 Jun 2017 04:05

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