Sensorimotor integration and pain perception: mechanisms integrating nociceptive processing

Chronic pain continues to be a prevalent condition in the U.S. costing the healthcare system billions of dollars annually with little success in treatment modalities. The goal of this study was to review nociceptive processing in the context of sensory and motor disorders where chronic pain often appears as a common symptom. An activation likelihood estimate (ALE) meta-analysis was performed on brain coordinates from articles containing sensory disorders (spinal cord injury and amputation) with or without pain performing a movement execution and movement imagery task and motor disorders (Parkinson’s disease and dystonia) performing a movement execution task. Aberrations found in the cortical activity of sensorimotor regions of both sensory and motor disorders suggests these disorders should be studied and treated as a dysfunction of sensorimotor integration instead of solely sensory or motor. Alterations of sensorimotor integration could be the necessary trigger for reorganization of cortical maps that alters nociceptive processing. Furthermore, abnormal activity found in the brain regions of both sensory and motor disorders involved in the cognitive and attentional modulation of pain suggests a once voluntary response has transitioned to a conditioned response that perpetuates the experience of pain