# 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.

## Key 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.