Moving Toward Conscious Pain Processing Detection in Chronic Disorders of Consciousness: Anterior Cingulate Cortex Neuromodulation

Abstract

Patients with DOC may not be able to respond to pain stimuli, although they may feel it. The possibility of detecting residual pain perceptions by means of a noninvasive neuromodulation paradigm, studying the correlation between the ACC and centroparietal γBO, may help clinicians to better assess pain in such individuals.

A Comprehensive Review of Dorsomedial Prefrontal Cortex rTMS Utilizing a Double Cone Coil

“…This result confirms the assumption that the medial prefrontal cortex is causally involved in perspective change and that its activity can be decreased by low frequency dmPFC‐DCC‐rTMS. The inhibitory effect of 1 Hz dmPFC‐DCC‐rTMS on ACC activity was confirmed by other studies in which single sessions of this protocol reduced electrophysiological and perceptual aspects of pain .…”

Pain Perception in Unresponsive Wakefulness Syndrome May Challenge the Interruption of Artificial Nutrition and Hydration: Neuroethics in Action

“…These empirical data corroborate the view that although patients with DoC may not be capable of exhibiting a detectable reaction to painful stimuli, they may nonetheless be capable of perceiving them (52). These data do not demonstrate that all patients with severe disorders of consciousness perceive and/or exhibit pain; yet, they demonstrate that several patients, deemed incapable of experiencing pain, showed a consistent response to noxious stimuli.…”

Animal Consciousness

“…In these patients, the brain responses to nociceptive stimuli involve the thalamus, the primary somatosensory cortex, the secondary somatosensory or insular cortex and the anterior cingulate cortex, although somewhat differently from healthy controls . Similar results were found using pain specific EEG responses to nociceptive stimuli (Naro et al, 2015). The authors concluded that minimally conscious patients might show an elaborate and integrated level of noxious processing associated with conscious pain perception Naro et al, 2015;Schnakers et al, 2008).…”

“…Similar results were found using pain specific EEG responses to nociceptive stimuli (Naro et al, 2015). The authors concluded that minimally conscious patients might show an elaborate and integrated level of noxious processing associated with conscious pain perception Naro et al, 2015;Schnakers et al, 2008).…”