Central modulation of pain

J Clin Invest. 2010 Nov;120(11):3779-87. doi: 10.1172/JCI43766. Epub 2010 Nov 1.


It has long been appreciated that the experience of pain is highly variable between individuals. Pain results from activation of sensory receptors specialized to detect actual or impending tissue damage (i.e., nociceptors). However, a direct correlation between activation of nociceptors and the sensory experience of pain is not always apparent. Even in cases in which the severity of injury appears similar, individual pain experiences may vary dramatically. Emotional state, degree of anxiety, attention and distraction, past experiences, memories, and many other factors can either enhance or diminish the pain experience. Here, we review evidence for "top-down" modulatory circuits that profoundly change the sensory experience of pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Brain / anatomy & histology
  • Brain / physiology*
  • Chronic Disease
  • Emotions / physiology
  • Humans
  • Neural Pathways / anatomy & histology
  • Neural Pathways / physiology
  • Nociceptors / physiology*
  • Norepinephrine / metabolism
  • Pain / drug therapy
  • Pain / physiopathology*
  • Pain / psychology*
  • Serotonin / metabolism
  • Stress, Physiological
  • Stress, Psychological


  • Analgesics
  • Serotonin
  • Norepinephrine