The human amygdala and pain: evidence from neuroimaging
One page on PainSci cites Simons 2014: Chronic Pain as a Conditioned Response
PainSci notes on Simons 2014:
This is a review of studies of role of the amygdala in processing pain. The amygdala is a brain region associated with memory, emotion (most notably fear and anxiety), and decision-making. And it “lights up” (the inevitable metaphor) differently in pain patients than healthy people, and there are even distinctive differences between types of pain. For instance, the authors report that clinical pain (as opposed to experimentally induced pain) results in activation of the laterobasal region, which is “suggestive of the cognitive-affective overlay present among individuals suffering from chronic pain.”
The most prosaic interpretation of this is not that the amygdala is actually modulating pain (which cannot be shown by this data), but just that people have thoughts and feelings about it. Imagine!
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
The amygdala, a small deep brain structure involved in behavioral processing through interactions with other brain regions, has garnered increased attention in recent years in relation to pain processing. As pain is a multidimensional experience that encompasses physical sensation, affect, and cognition, the amygdala is well suited to play a part in this process. Multiple neuroimaging studies of pain in humans have reported activation in the amygdala. Here, we summarize these studies by performing a coordinate-based meta-analysis within experimentally induced and clinical pain studies using an activation likelihood estimate analysis. The results are presented in relation to locations of peak activation within and outside of amygdala subregions. The majority of studies identified coordinates consistent with human amygdala cytoarchitecture indicating reproducibility in neuroanatomical labeling across labs, analysis methods, and imaging modalities. Differences were noted between healthy and clinical pain studies: in clinical pain studies, peak activation was located in the laterobasal region, suggestive of the cognitive-affective overlay present among individuals suffering from chronic pain; while the less understood superficial region of the amygdala was prominent among experimental pain studies. Taken together, these findings suggest several important directions for further research exploring the amygdala's role in pain processing.
related content
- “New developments in the understanding and management of persistent pain,” Flor, Curr Opin Psychiatry, 2012.
- “Conditioned Pain Modulation in Patients With Acute and Chronic Low Back Pain,” Mlekusch et al, The Clinical Journal of Pain, 2016.
- “In search of conditioned pain: an experimental analysis,” Kang et al, Pain, 2023.
- “Do clinicians think that pain can be a classically conditioned response to a non-noxious stimulus?,” Madden et al, Manual Therapy, 2016.
- “Can Pain or Hyperalgesia Be a Classically Conditioned Response in Humans? A Systematic Review and Meta-Analysis,” Madden et al, Pain Med, 2016.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Restoring trust in menopause management: menopause hormone therapy is not a panacea, and physical activity remains a critical intervention. Tulloh 2025 Br J Sports Med.
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.