A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging

Research output: Contribution to journalResearch articleContributedpeer-review


  • Paul Dunckley - , University of Oxford (Author)
  • Richard G. Wise - , University of Oxford (Author)
  • Merle Fairhurst - , University of Oxford (Author)
  • Peter Hobden - , University of Oxford (Author)
  • Qasim Aziz - , University of Manchester (Author)
  • Lin Chang - , University of California at Los Angeles (Author)
  • Irene Tracey - , University of Oxford (Author)


Evidence from both human and animal studies has demonstrated a key role for brainstem centers in the control of ascending nociceptive input. Nuclei such as the rostral ventromedial medulla and periaqueductal gray (PAG) are able to both inhibit and facilitate the nociceptive response. It has been proposed that altered descending modulation may underlie many of the chronic pain syndromes (both somatic and visceral). We used functional magnetic resonance imaging to image the neural correlates of visceral and somatic pain within the brainstem. Ten healthy subjects were scanned twice at 3 tesla, during which they received matched, moderately painful, electrical stimuli to either the midline lower abdomen or rectum. Significant activation was observed in regions consistent with the PAG, nucleus cuneiformis (NCF), ventral tegmental area/substantia nigra, parabrachial nuclei/nucleus ceruleus, and red nucleus bilaterally to both stimuli. Marked spatial similarities in activation were observed for visceral and somatic pain, although significantly greater activation of the NCF (left NCF, p = 0.02; right NCF, p = 0.01; Student's paired t test, two-tailed) was observed in the visceral pain group compared with the somatic group. Right PAG activity correlated with anxiety during visceral stimulation (r = 0.74; p < 0.05, Pearson's r, two-tailed) but not somatic stimulation. We propose that the differences in NCF and right PAG activation observed may represent a greater nocifensive response and greater emotive salience of visceral over somatic pain.


Original languageEnglish
Pages (from-to)7333-7341
Number of pages9
JournalJournal of Neuroscience
Issue number32
Publication statusPublished - 10 Aug 2005
Externally publishedYes

External IDs

PubMed 16093383
ORCID /0000-0001-6540-5891/work/150883502


Sustainable Development Goals

ASJC Scopus subject areas


  • Brainstem, fMRI, Pain, Rectum, Somatic, Visceral