Pain Anticipation in the Cingulate Gyrus

Throughout this chapter, we focus mainly on theinvolvement of the cingulate cortex in the anticipationof somatosensory input and specifi cally of pain. Thisissue has important theoretical and clinical implications,given the role of the cingulate cortex in themechanisms of pain and analgesia (see Chapters 14and 15). A specifi c question is that whether anticipationis able to affect the activity of pain-related populationsin the cingulate cortex and in the pain matrix in general.Indeed, it has long been hypothesized (James 1892)that essentially the same brain regions were implicatedboth in the anticipation and in the perception of astimulus; this hypothesis has now been directly testedby electrophysiological and functional imaging studiesin humans and non-human primates. Also, whenappropriate, we will briefl y compare the activity ofthe cingulate cortex during anticipation of painand during anticipation of other aversive or rewardevents. The specifi c goals of this chapter include thefollowing:1 Assess electrophysiological evidence of neurons activeduring pain anticipation in the cingulate cortex.2 Evaluate evidence from functional imaging studiesof activity changes related to somatosensory anticipationin different portions of the cingulate gyrus inhealthy volunteers and in pain patients.3 Appraise the modulation of basal- and stimulusevokedactivity of pain-related populations in thecingulate cortex and in other pain-related areas.4 Consider anticipation of pain and analgesia in termsof the potential underlying mechanisms and cingulatecircuits.