Insights gained into pain processing from patients with focal brain lesions

Neuroscience Letters
L Garcia-Larrea

Abstract

The recognition that dissociated sensory loss affecting selectively pain and temperature results from lesions of the operculo-insular cortex is due to Biemond in 1956. This contrasted with the prevailing view that the sensory aspects of pain did not imply regions above the thalamus. Anatomical data in non-human primates, as well as electrophysiology and functional imaging in humans have now abundantly demonstrated that the opercular-insular region is the main cortical target of the spinothalamic system, and a vast number of reports have confirmed the relation between lesions in this region and the development of dissociated sensory symptoms and central neuropathic pain. Operculo-insular pain (parasylvian pain) is a distinct entity that can be clinically suspected and objectively diagnosed with combined radiological and electrophysiological methods, in particular evoked potentials to spinothalamic (laser) input. The region comprising the posterior insula and medial operculum may deserve being considered as a third somatosensory cortex (S3) contributing to the spinothalamic attributes of somatic perception.

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Citations

Jun 12, 2013·Trends in Cognitive Sciences·A Vania Apkarian
Oct 9, 2012·Neurophysiologie clinique = Clinical neurophysiology·L Garcia-Larrea
Jun 19, 2012·Neuroscience Letters·Petra Schweinhardt, M Catherine Bushnell
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Jun 4, 2013·Pain·Jonathan H SmithEdythe A Strand
Feb 5, 2013·Pain·Nanna Brix Finnerup
Mar 7, 2017·The Anatomical Record : Advances in Integrative Anatomy and Evolutionary Biology·Pere Boadas-VaelloEnrique Verdú
Oct 5, 2017·European Journal of Pain : EJP·U CoffeenF Pellicer
Feb 18, 2016·Experimental Brain Research·Brianna BeckPatrick Haggard
Aug 30, 2017·Scandinavian Journal of Pain·Per Brodal
Nov 30, 2018·Revue neurologique·L Garcia-Larrea, K Hagiwara

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