The Neuroanatomical Correlates of Visceral Pain: An Activation Likelihood Estimation Meta-Analysis

TL;DR

This study identifies brain regions involved in processing visceral pain using a meta-analysis of neuroimaging data.

Contribution

The study provides a meta-analysis revealing distinct brain pathways for sensory and emotional aspects of visceral pain.

Findings

Bihemispheric activation of the insula and thalamus was observed in visceral pain processing.

Clusters in the right inferior parietal lobe and left postcentral gyrus were consistently activated.

The findings support two distinct neuroanatomical pathways for visceral pain dimensions.

Abstract

Background: Acute visceral pain is among the most common symptoms of patients seeking in-hospital treatment and is related to various thoracic, abdominal, and pelvic diseases. It is characterized by distinguishable sensory qualities and can be described on a sensory-discriminative and affective-motivational level. These sensory qualities correlate with the activation of cerebral areas involved in the neuronal processing of visceral pain and can be visualized using functional neuroimaging. Methods: An ALE (activation likelihood estimation) meta-analysis of a total of 21 studies investigating different balloon distention paradigms during either PET or fMRI was performed to demonstrate the neuroanatomical correlates of visceral pain. The ALE meta-analysis was performed using the GingerAle software version 3.0.2 and was displayed with the Mango software 4.1 on an anatomical MNI template. Results: Summarizing studies investigating the functional neuroanatomy of visceral pain, bihemispheric activation of the insula, the thalamus, and clusters involving the right inferior parietal lobe/postcentral gyrus as well as the left postcentral gyrus/parietal inferior lobe were observed. Conclusions: This ALE meta-analysis substantiates the concept of two distinguishable neuroanatomical pathways of visceral pain which are related to either the sensory-discriminative or the affective-motivational dimension of pain processing.

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