Pain Processing and Modulation in the Cingulate Gyrus

Cingulate cortex occupies a large part of the medial surface of the brain and has become an important region of interest in acute and chronic pain studies. Although it is among the most frequently activated regions in human functional imaging research, no part of the cingulate gyrus can be referred to as a “pain center” because none has been shown to have mainly pain processing functions. For example, the midcingulate region, which is usually activated during acute noxious stimulation, has primarily skeletomotor functions through the two cingulate motor areas and has been activated in numerous tasks that do not involve noxious stimuli. These include the Stroop and Flanker interference, complex movement, and word generation tasks. The logic of studying pain processing in this context requires a clear statement of the functions of each cingulate region in general brain function followed by an assessment of how these functions are redirected to resolve problems of anticipated or actual pain experiences. Here we consider the structural, connection and functional organization of the cingulate gyrus, its top-down role in anticipation of pain and the application of hypnosis to engage cingulate mediated processing for hypnosedation.