Emotional and Motivational Pain Processing: Current State of Knowledge and Perspectives in Translational Research

Abstract

Pain elicits fear and anxiety and promotes escape, avoidance, and adaptive behaviors that are essential for survival. When pain persists, motivational priority and attention shift to pain-related information. Such a shift often results in impaired functionality, leading to maladaptive pain-related fear and anxiety and escape and avoidance behaviors. Neuroimaging studies in chronic pain patients have established that brain activity, especially in cortical and mesolimbic regions, is different from activity observed during acute pain in control subjects. In this review, we discuss the psychophysiological and neuronal factors that may be associated with the transition to chronic pain. We review information from human studies on neural circuits involved in emotional and motivational pain processing and how these circuits are altered in chronic pain conditions. We then highlight findings from animal research that can increase our understanding of the molecular and cellular mechanisms underlying emotional-motivational pain processing in the brain. Finally, we discuss how translational approaches incorporating results from both human and animal investigations may aid in accelerating the discovery of therapies.

The association between daily physical exercise and pain among women with fibromyalgia: the moderating role of pain catastrophizing

“…A primary challenge to effective self-management of chronic pain is limited adherence to physical activity and lifestyles that are most likely to reduce the physical and emotional “triggers” that worsen symptoms in chronic pain. 2 , 9 , 44 We now have abundant evidence that negative affective and cognitive states contribute to reduced activity levels in patients with chronic pain. 15 Although we do not have data on the mechanisms by which these associations unfold, it is possible that high catastrophizing may magnify the perception of pain when physical activity levels are higher, promoting a feeling of reduced motivation and increased physical symptoms.…”

Behavioral, Biochemical and Electrophysiological Changes in Spared Nerve Injury Model of Neuropathic Pain

“…Similar to rodents, in humans there is also a close correlation between neuropathic pain and cognitive/affective disorders [79,80]. This is due to the fact that chronic pain causes anatomical and functional alterations in the main neural circuits that control both, pain and cognition/affect [79].…”

“…Similar to rodents, in humans there is also a close correlation between neuropathic pain and cognitive/affective disorders [79,80]. This is due to the fact that chronic pain causes anatomical and functional alterations in the main neural circuits that control both, pain and cognition/affect [79]. This overlap also explains why reciprocally psychological procedures such as distraction, yoga and meditation can be effective in some individuals and pain conditions and how the expectation of pain-relief is associated with placebo-induced analgesia in humans [80].…”

Selected pathobiological features and principles of pharmacological pain management

“…33 The hippocampus, hypothalamus, amygdala, nucleus accumbens, medial prefrontal cortex, and periaqueductal gray matter are brain regions commonly involved in the modulation of both emotion and the experience of pain; these aspects affect an individual’s state of mind (Figure 2). 25,34,35…”