Neuroscience - Psychological and neural mechanisms of the affective dimension of pain

The affective dimension of pain is made up of feelings of unpleasantness an d emotions associated with future implications, termed secondary affect. Ex perimental and clinical studies show serial interactions between pain sensa tion intensity, pain unpleasantness, and secondary affect. These pain dimen sions and their interactions relate to a central network of brain structure s that processes nociceptive information both in a parallel and in series. Spinal pathways to limbic structures and medial thalamic nuclei provide dir ect inputs to brain areas involved in affect. Another source is from spinal pathways to somatosensory thalamic and cortical areas and then through a c ortico-limbic pathway. The latter integrates nociceptive input with context ual information and memory to provide cognitive mediation of pain affect. B oth direct and cortical-limbic pathways converge on the same anterior cingu late cortical and subcortical structures whose function may be to establish emotional valence and response priorities.