Psychological and neural mechanisms of the affective dimension of pain

Science. 2000 Jun 9;288(5472):1769-72. doi: 10.1126/science.288.5472.1769.


The affective dimension of pain is made up of feelings of unpleasantness and emotions associated with future implications, termed secondary affect. Experimental and clinical studies show serial interactions between pain sensation intensity, pain unpleasantness, and secondary affect. These pain dimensions and their interactions relate to a central network of brain structures that processes nociceptive information both in parallel and in series. Spinal pathways to limbic structures and medial thalamic nuclei provide direct inputs to brain areas involved in affect. Another source is from spinal pathways to somatosensory thalamic and cortical areas and then through a cortico-limbic pathway. The latter integrates nociceptive input with contextual information and memory to provide cognitive mediation of pain affect. Both direct and cortico-limbic pathways converge on the same anterior cingulate cortical and subcortical structures whose function may be to establish emotional valence and response priorities.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Affect / physiology*
  • Afferent Pathways
  • Animals
  • Brain Mapping
  • Cerebral Cortex / physiology*
  • Humans
  • Limbic System / physiology*
  • Pain / physiopathology*
  • Pain / psychology*
  • Parietal Lobe / physiology
  • Somatosensory Cortex / physiology*
  • Spinal Cord / physiology
  • Thalamic Nuclei / physiology
  • Tomography, Emission-Computed