Pain-related disorders cause an incalculable toll in human suffering and present a significant economic problem. The development of new treatments for these disorders is being hindered by a lack of information about the basic brain mechanisms that support sensory aspects of pain experience. Functional imaging studies using functional magnetic resonance imaging (fMRI) provide powerful tools for addressing such issues in human subjects. Using such techniques, a highly distributed network of brain regions that may contribute to sensory discriminative pain processes has been identified. However, the involvement of specific components in supporting conscious awareness of discrete dimensions of pain, such as intensity and location, remains poorly understood. These perceived sensory aspects of pain can be dramatically modulated by cognitive interpretation and expectations about the nature of the stimulus. Yet, the brain mechanisms underlying this modulation remain unknown. A series of combined psychophysical and functional imaging studies will systematically test the hypotheses that 1) distinct parieto-frontal mechanisms are engaged in processes supporting conscious awareness of the location and intensity of painful stimuli, and 2) that activation within these areas can be modulated by dynamic temporal aspects of painful stimuli. These studies will significantly enhance our knowledge of basic brain mechanisms underlying the pain experience, while simultaneously providing new directions for behavioral strategies of pain management.
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