Nociception, Pain, Negative Moods, and Behavior Selection

Marwan N. Baliki*, A. Vania Apkarian

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

218 Scopus citations

Abstract

Recent neuroimaging studies suggest that the brain adapts with pain, as well as imparts risk for developing chronic pain. Within this context, we revisit the concepts for nociception, acute and chronic pain, and negative moods relative to behavior selection. We redefine nociception as the mechanism protecting the organism from injury, while acute pain as failure of avoidant behavior, and a mesolimbic threshold process that gates the transformation of nociceptive activity to conscious pain. Adaptations in this threshold process are envisioned to be critical for development of chronic pain. We deconstruct chronic pain into four distinct phases, each with specific mechanisms, and outline current state of knowledge regarding these mechanisms: the limbic brain imparting risk, and the mesolimbic learning processes reorganizing the neocortex into a chronic pain state. Moreover, pain and negative moods are envisioned as a continuum of aversive behavioral learning, which enhance survival by protecting against threats.

Original languageEnglish (US)
Pages (from-to)474-491
Number of pages18
JournalNeuron
Volume87
Issue number3
DOIs
StatePublished - Aug 5 2015

ASJC Scopus subject areas

  • Neuroscience(all)

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