Dissociating pain from its anticipation in the human brain

The experience of pain is subjectively different from the fear and anxiety caused by threats of pain. Functional magnetic resonance imaging in healthy humans was applied to dissociate neural activation patterns associated wit h acute pain and its anticipation. Expectation of pain activated sites with in the medial frontal lobe, insular cortex, and cerebellum distinct from, b ut close to, locations mediating pain experience itself. Anticipation of pa in can in its own right cause mood changes and behavioral adaptations that exacerbate the suffering experienced by chronic pain patients. Selective ma nipulations of activity at these sites may offer therapeutic possibilities for treating chronic pain.