NDLI: Preserved emotional awareness of pain in a patient with extensive bilateral damage to the insula, anterior cingulate, and amygdala

Content Provider	Springer Nature Link
Author	Feinstein, Justin S. Khalsa, Sahib S. Salomons, Tim V. Prkachin, Kenneth M. Frey Law, Laura A. Lee, Jennifer E. Tranel, Daniel Rudrauf, David
Copyright Year	2015
Abstract	Functional neuroimaging investigations of pain have discovered a reliable pattern of activation within limbic regions of a putative “pain matrix” that has been theorized to reflect the affective dimension of pain. To test this theory, we evaluated the experience of pain in a rare neurological patient with extensive bilateral lesions encompassing core limbic structures of the pain matrix, including the insula, anterior cingulate, and amygdala. Despite widespread damage to these regions, the patient’s expression and experience of pain was intact, and at times excessive in nature. This finding was consistent across multiple pain measures including self-report, facial expression, vocalization, withdrawal reaction, and autonomic response. These results challenge the notion of a “pain matrix” and provide direct evidence that the insula, anterior cingulate, and amygdala are not necessary for feeling the suffering inherent to pain. The patient’s heightened degree of pain affect further suggests that these regions may be more important for the regulation of pain rather than providing the decisive substrate for pain’s conscious experience.
Starting Page	1499
Ending Page	1511
Page Count	13
File Format	PDF
ISSN	18632653
Journal	Anatomy and Embryology
Volume Number	221
Issue Number	3
e-ISSN	18632661
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2015-01-11
Publisher Place	Berlin/Heidelberg
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Brain lesion Consciousness Emotion Feeling Limbic system Neurosciences Cell Biology Neurology
Content Type	Text
Resource Type	Article
Subject	Neuroscience Anatomy Histology

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