Abstract
The relationship between consciousness and brain imaging is discussed from the vantage point of pain perception. It is argued that taking into consideration the temporal variations in perceived pain can pinpoint the brain circuitry specifically related to conscious, subjective perception of pain. Moreover, that this procedure is general enough to be used in examining clinical pain conditions. Brain regions activated with painful stimuli have now been described by a variety of laboratories using either positron emission tomography (PET) or functional magnetic resonance imaging (fMRI). These studies have identified a large cortical network with many components. Pinpointing the functional roles of the different components of this network is a major focus of our current fMRI studies. To this end we examine the cortical circuitry of pain along the stimulus-perception dimension, and also demonstrate that small changes in painful stimulus parameters result in dramatic reorganization of the cortical network underlying pain perception. We also examine this cortical network underlying pain in different pain patient groups: one patient with large fiber polyneuropathy over the whole body below the neck, chronic reflex sympathetic dystrophy (RSD or CRPS I) patients, chronic back pain patients, and patients with syringomyelia. Cortical activations with painful stimuli or following the exacerbation of the pain that the patients suffer from results in giving us different insights to the spatio-temporal dynamics of the cortical network underlying pain and its re-organization in time.
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Apkarian, A.V. (2000). In Search of Pain Consciousness or Pain and the Metaphysics of a Porsche 911. In: Saadé, N.E., Apkarian, A.V., Jabbur, S.J. (eds) Pain and Neuroimmune Interactions. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4225-4_15
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DOI: https://doi.org/10.1007/978-1-4615-4225-4_15
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