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Brain regions associated with psychological pain: implications for a neural network and its relationship to physical pain

Brain Imaging and Behavior volume 7, pages 1–14 (2013)Cite this article

Abstract

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.

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Affiliations

  1. Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, USA

    Esther L. Meerwijk & Sandra J. Weiss

  2. Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA

    Judith M. Ford

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  1. Esther L. Meerwijk
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Correspondence to Esther L. Meerwijk.

Appendix

Appendix

The following tables show areas of changed brain activity during the experience of psychological pain (PP), as implicated by 18 studies included in this review. Results for each study are shown for the study condition in which higher intensity of psychological pain was expected (e.g. higher vs. lower psychological pain, complicated grief vs. noncomplicated grief, sadness vs. neutral mood). The brain areas are non-overlapping and organized under the left and right hemispheres and subcortical medial areas. Green cells in the table indicate increased activity and red cells indicate decreased activity. Dotted cells indicate that a study reported a global brain area, whereas other studies may have distinguished subdivisions.

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Meerwijk, E.L., Ford, J.M. & Weiss, S.J. Brain regions associated with psychological pain: implications for a neural network and its relationship to physical pain. Brain Imaging and Behavior 7, 1–14 (2013). https://doi.org/10.1007/s11682-012-9179-y

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Keywords

  • Psychological pain
  • Emotional pain
  • Emotion
  • Pain
  • Brain