The Role and Treatment Implications of Peripheral and Central Processing of Pain, Pruritus, and Nausea in Heightened Somatic Awareness: A Review

This article reviews the acute neural transmission of pain, pruritus, and nausea symptoms, which can begin in the periphery and/or viscera. The subsequent multiple pathways in the central nervous system that become involved in the processing of these symptoms are also discussed. The authors describe human brain imaging studies that have revealed consistent cortical and subcortical networks  activated by these symptoms, including sensory, limbic, and associative regions. In particular, the authors discuss information revealed by the studies regarding the primary somatosensory cortex, secondary somatosensory cortex, anterior cingulate cortex, insula, prefrontal cortex and thalamus, are the brain areas most commonly activated by noxious stimuli.  Finally, the authors describe treatment options for chronic presentations of these symptoms, which are, in part, based on central nervous processing of these sensations. Introduction Heightened somatic awareness (HSA) refers to a greater than average awareness for a variety of physical sensations and symptoms. Individuals with HSA have a tendency to notice and report nonspecific symptoms, such as shortness of breath, presyncope, and a variety of chronic pain conditions, pruritus, and nausea.1 While each sensation has unique neural transmission pathways to the spinal cord, there appears to be a convergent processing of these sensations at the level of the brain itself. As opposed to acute sensory symptoms, the perpetuation of chronic s...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Neurologic Systems and Symptoms Neurology Pain Review central processing nausea pruritus Source Type: research