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The Journal of Neuroscience, April 1, 2002, 22(7):2748-2752
Imaging Attentional Modulation of Pain in the Periaqueductal Gray
in Humans
Irene
Tracey1,
Alexander
Ploghaus1,
Joseph
S.
Gati2,
Stuart
Clare1,
Steve
Smith1,
Ravi S.
Menon2, and
Paul M.
Matthews1
1 Centre for Functional Magnetic Resonance Imaging of
the Brain, Department of Clinical Neurology, University of Oxford,
Oxford OX3 9DU, United Kingdom, and 2 Laboratory for
Functional Magnetic Resonance Research, John P. Robarts Research
Institute, London, Ontario N6A 5K8, Canada
Pain is an unpleasant sensory and emotional experience usually
triggered by stimulation of peripheral nerves and often associated with
actual or potential tissue damage. It is well known that pain
perception for patients and normal subjects can be modulated by
psychological factors, such as attention, stress, and arousal. Our
understanding of how this modulation occurs at a neuroanatomical level
is poor. Here we neuroanatomically defined a key area in the network of
brain regions active in response to pain that is modulated by attention
to the painful stimulus. High-resolution functional magnetic resonance
imaging was used to define brain activation to painful heat stimulation
applied to the hand of nine normal subjects within the periaqueductal
gray region. Subjects were asked to either focus on or distract
themselves from the painful stimuli, which were cued using colored
lights. During the distraction condition, subjects rated the pain
intensity as significantly lower compared with when they attended to
the stimulus. Activation in the periaqueductal gray was significantly
increased during the distraction condition, and the total increase in
activation was predictive of changes in perceived intensity. This
provides direct evidence supporting the notion that the periaqueductal gray is a site for higher cortical control of pain modulation in humans.
Key words:
pain; fMRI; PAG; attention; modulation; brainstem
Copyright © 2002 Society for Neuroscience 0270-6474/02/2272748-05$05.00/0
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