Brain regions associated with psychological pain: implications for a neural network and its relationship to physical pain
Research on brain areas involved in experiencing emotion and physical pain is abundant; however, psychological pain has received little attention in studies of the brain. The purpose of this systematic review was to provide an overview of studies on brain function related to psychological pain. The review was limited to studies in which participants experienced actual psychological pain or recalled a significant autobiographical event that may be assumed to have involved psychological pain. Based on results of the studies (N = 18), a tentative neural network for psychological pain is proposed that includes the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. Results indicated that grief may be a more accurate exemplar of psychological pain than recalled sadness, with indications of greater arousal during psychological pain. The proposed neural network for psychological pain overlaps to some extent with brain regions involved in physical pain, but results suggest a markedly reduced role for the insula, caudate, and putamen during psychological pain. Psychological pain is well known for its association with depression and as a precursor of suicidal behavior. Thus, identification of brain areas involved in psychological pain may help guide development of interventions to decrease mortality and morbidity.
KeywordsPsychological pain Emotional pain Emotion Pain Brain
Conflict of interest
The authors declare that they have no conflict of interest.
- Biro, D. (2010). Is there such a thing as psychological pain? and why It matters. Culture, Medicine and Psychiatry. doi: 10.1007/s11013-010-9190-y.
- Drevets, W. C., & Raichle, M. E. (1998). Reciprocal suppression of regional cerebral blood flow during emotional versus higher cognitive processes: implications for interactions between emotion and cognition. Cognition and Emotion. Special Issue: Neuropsychological perspectives on affective and anxiety disorders, 12(3), 353–385.Google Scholar
- Eickhoff, S. B., Laird, A. R., Grefkes, C., Wang, L. E., Zilles, K., & Fox, P. T. (2009). Coordinate-based activation likelihood estimation meta-analysis of neuroimaging data: a random-effects approach based on empirical estimates of spatial uncertainty. Human Brain Mapping, 30(9), 2907–2926. doi: 10.1002/hbm.20718.PubMedCrossRefGoogle Scholar
- Gerber, A. J., Posner, J., Gorman, D., Colibazzi, T., Yu, S., Wang, Z., et al. (2008). An affective circumplex model of neural systems subserving valence, arousal, and cognitive overlay during the appraisal of emotional faces. Neuropsychologia, 46(8), 2129–2139. doi: 10.1016/j.neuropsychologia.2008.02.032.PubMedCrossRefGoogle Scholar
- Keedwell, P. A., Andrew, C., Williams, S. C., Brammer, M. J., & Phillips, M. L. (2005). A double dissociation of ventromedial prefrontal cortical responses to sad and happy stimuli in depressed and healthy individuals. Biological Psychiatry, 58(6), 495–503. doi: 10.1016/j.biopsych.2005.04.035.PubMedCrossRefGoogle Scholar
- Lancaster, J. L., Rainey, L. H., Summerlin, J. L., Freitas, C. S., Fox, P. T., Evans, A. C., et al. (1997). Automated labeling of the human brain: a preliminary report on the development and evaluation of a forward-transform method. Human Brain Mapping, 5(4), 238–242. doi: 10.1002/(SICI)1097-0193(1997)5:4<238::AID-HBM6>3.0.CO;2-4.PubMedCrossRefGoogle Scholar
- Lancaster, J. L., Woldorff, M. G., Parsons, L. M., Liotti, M., Freitas, C. S., Rainey, L., et al. (2000). Automated Talairach atlas labels for functional brain mapping. Human Brain Mapping, 10(3), 120–131. doi: 10.1002/1097-0193(200007)10:3<120::AID-HBM30>3.0.CO;2-8.PubMedCrossRefGoogle Scholar
- Munro, B. H. (2005). Statistical methods for health care research (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.Google Scholar
- Murray, H. A. (2008). Explorations in personality (70th ed.). New York, NY: Oxford University Press.Google Scholar
- Olié, E., Guillaume, S., Jaussent, I., Courtet, P., & Jollant, F. (2010). Higher psychological pain during a major depressive episode may be a factor of vulnerability to suicidal ideation and act. Journal of Affective Disorders, 120(1–3), 226–230. doi: 10.1016/j.jad.2009.03.013.PubMedCrossRefGoogle Scholar
- Pelletier, M., Bouthillier, A., Levesque, J., Carrier, S., Breault, C., Paquette, V., et al. (2003). Separate neural circuits for primary emotions? Brain activity during self-induced sadness and happiness in professional actors. Neuroreport, 14(8), 1111–1116. doi: 10.1097/01.wnr.0000075421.59944.69.PubMedCrossRefGoogle Scholar
- Reisch, T., Seifritz, E., Esposito, F., Wiest, R., Valach, L., & Michel, K. (2010). An fMRI study on mental pain and suicidal behavior. Journal of Affective Disorders. doi: 10.1016/j.jad.2010.03.005.
- Sherwood, L. (2010). Human physiology: from cells to systems (7th ed.). Belmont, CA: Cengage Learning.Google Scholar
- Shneidman, E. S. (1998). Perspectives on suicidology: further reflections on suicide and psychache. Suicide & Life-Threatening Behavior, 28(3), 245–250.Google Scholar
- Talairach, J., & Tournoux, P. (1988). Co-planar stereotaxic atlas of the human brain. 3-dimensional proportional system: an approach to cerebral imaging. New York: Thieme. Thieme Classics.Google Scholar
- Tanida, M., Sakatani, K., Takano, R., & Tagai, K. (2004). Relation between asymmetry of prefrontal cortex activities and the autonomic nervous system during a mental arithmetic task: near infrared spectroscopy study. Neuroscience Letters, 369(1), 69–74. doi: 10.1016/j.neulet.2004.07.076.PubMedCrossRefGoogle Scholar
- van Heeringen, K., Van den Abbeele, D., Vervaet, M., Soenen, L., & Audenaert, K. (2010). The functional neuroanatomy of mental pain in depression. Psychiatry Research. doi: 10.1016/j.pscychresns.2009.07.011.
- Zubieta, J. K., Ketter, T. A., Bueller, J. A., Xu, Y., Kilbourn, M. R., Young, E. A., et al. (2003). Regulation of human affective responses by anterior cingulate and limbic mu-opioid neurotransmission. Archives of General Psychiatry, 60(11), 1145–1153. doi: 10.1001/archpsyc.60.11.1145.PubMedCrossRefGoogle Scholar