Brain processing of pain in patients with unresponsive wakefulness syndrome
Article first published online: 28 JAN 2013
© 2013 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Brain and Behavior
Volume 3, Issue 2, pages 95–103, March 2013
How to Cite
Markl, A., Yu, T., Vogel, D., Müller, F., Kotchoubey, B. and Lang, S. (2013), Brain processing of pain in patients with unresponsive wakefulness syndrome. Brain and Behavior, 3: 95–103. doi: 10.1002/brb3.110
- Issue published online: 14 MAR 2013
- Article first published online: 28 JAN 2013
- Manuscript Accepted: 12 NOV 2012
- Manuscript Revised: 7 NOV 2012
- Manuscript Received: 14 AUG 2012
- German Research Society. Grant Number: Grant KO-1753/10-1
- European Commission Grant DECODER. Grant Number: Grant KO-1753/8
- Functional magnetic resonance imaging;
- unresponsive wakefulness syndrome
By definition, patients with unresponsive wakefulness syndrome (UWS) do not experience pain, but it is still not completely understood how far their brain can process noxious stimuli. The few positron emission tomography studies that have examined pain processing did not yield a clear and consistent result. We performed an functional magnetic resonance imaging scan in 30 UWS patients of nontraumatic etiology and 15 age- and sex-matched healthy control participants (HC). In a block design, noxious electrical stimuli were presented at the patients' left index finger, alternating with a resting baseline condition. Sixteen of the UWS patients (53%) showed neural activation in at least one subsystem of the pain-processing network. More specifically, 15 UWS patients (50%) showed responses in the sensory-discriminative pain network, 30% in the affective pain network. The data indicate that some patients completely fulfilling the clinical UWS criteria have the neural substrates of noxious stimulation processing, which resemble that in control individuals. We therefore suppose that at least some of these patients can experience pain.