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From the neuromatrix to the pain matrix (and back)

Abstract

Pain is a conscious experience, crucial for survival. To investigate the neural basis of pain perception in humans, a large number of investigators apply noxious stimuli to the body of volunteers while sampling brain activity using different functional neuroimaging techniques. These responses have been shown to originate from an extensive network of brain regions, which has been christened the Pain Matrix and is often considered to represent a unique cerebral signature for pain perception. As a consequence, the Pain Matrix is often used to understand the neural mechanisms of pain in health and disease. Because the interpretation of a great number of experimental studies relies on the assumption that the brain responses elicited by nociceptive stimuli reflect the activity of a cortical network that is at least partially specific for pain, it appears crucial to ascertain whether this notion is supported by unequivocal experimental evidence. Here, we will review the original concept of the “Neuromatrix” as it was initially proposed by Melzack and its subsequent transformation into a pain-specific matrix. Through a critical discussion of the evidence in favor and against this concept of pain specificity, we show that the fraction of the neuronal activity measured using currently available macroscopic functional neuroimaging techniques (e.g., EEG, MEG, fMRI, PET) in response to transient nociceptive stimulation is likely to be largely unspecific for nociception.

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Notes

  1. 1.

    Craig et al. (2000) proposed that the posterior insula may constitute a primary “thermosensory cortex”. However, this claim is based mainly on the finding that the magnitude of the responses elicited in this area correlates linearly with the intensity of the noxious stimulus. As shown in the next section, the observation of such a correlation could be satisfactorily explained by the fact that stimuli of greater intensity are also more salient.

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Acknowledgments

AM is supported by the Belgian National Fund for Scientific Research (FNRS) and has received funding from the EFIC Grünenthal grant. GDI is University Research Fellow of The Royal Society and acknowledges the support of the BBSRC. The authors are grateful to the members of the GAMFI Centre for useful discussions.

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Correspondence to G. D. Iannetti.

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Iannetti, G.D., Mouraux, A. From the neuromatrix to the pain matrix (and back). Exp Brain Res 205, 1–12 (2010). https://doi.org/10.1007/s00221-010-2340-1

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Keywords

  • Nociception
  • Pain matrix
  • Saliency
  • Multimodal
  • fMRI
  • EEG