“…While the authors did not suggest that this region alone encodes ongoing pain, as other areas were also reported as periodically active and recent animal work highlights a dominant role for the amygdala in pain unpleasantness, for example, reminding us of pain's complexity and requirement to activate many brain regions (Corder et al, 2019), several results, including the neurochemistry findings discussed above, propose that this region provides potential as a possible biomarker of nociceptive drive and pain intensity. This is perhaps supported by the failure to activate it, unlike most other pain-related brain regions, by empathy, hypnosis, or recalled pain (Fairhurst et al, 2012;Raij et al, 2005;Wager et al, 2013); it is part of the NPS and Pain-Analgesic network; predictive coding identifies its role encoding stimulus intensity (Geuter et al, 2017); it is not encoding saliency (Horing et al, 2018); and there is alteration of pain upon posterior insula modulation (acute and tonic) in animals and humans (Dimov et al, 2018;Garcia-Larrea and Mauguiè re, 2018;Han et al, 2015;Lin et al, 2017). A composite signature reflecting ongoing activity, neurochemical and network coupling changes from various brain regions, such as the dorsal posterior insula combined with other regions, would be interesting to explore in the context of a potential biomarker.…”