Central Neural Mechanisms that Interrelate Sensory and Affective Dimensions of Pain
Mol. Interv. 2002 2: 392-403.
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The perception of pain is highly complex, and requires neural integration from a variety of routes. Spinal pathways to the amygdala, hypothalamus, reticular formation, medial thalamic nuclei, and limbic cortical structures transmit information involved in arousal, bodily regulation, and emotional responses. Other, albeit indirect, pathways can carry signals to these same structures, for example, from spinal pathways to somatosensory thalamic and cortical areas, and from these areas to cortical limbic structures. Indirect cortico-limbic pathways integrate nociception with information about the status of the body and self to provide cognitive mediation of pain affect. Both direct and indirect routes must culminate in the prioritization of emotions and responses to pain.