Theory article

Psychotherapy in pain management: New viewpoints and treatment targets based on a brain theory

  • Received: 21 April 2020 Accepted: 30 June 2020 Published: 14 July 2020
  • The current paper provides an explanation of neurophysiological pain processing based the Dimensional Systems Model (DSM), a theory of higher cortical functions in which the cortical column is considered the binary digit for all cortical functions. Within the discussion, novel views on the roles of the basal ganglia, cerebellum, and cingulate cortex are presented. Additionally, an applied Clinical Biopsychological Model (CBM) based on the DSM will be discussed as related to psychological treatment with chronic pain patients. Three specific areas that have not been adequately addressed in the psychological treatment of chronic pain patients will be discussed based on the CBM. The treatment approaches have been effectively used in a clinical setting. Conclusions focus on a call for researchers and clinicians to fully evaluate the value of both the DSM and CBM.

    Citation: Robert A. Moss. Psychotherapy in pain management: New viewpoints and treatment targets based on a brain theory[J]. AIMS Neuroscience, 2020, 7(3): 194-207. doi: 10.3934/Neuroscience.2020013

    Related Papers:

  • The current paper provides an explanation of neurophysiological pain processing based the Dimensional Systems Model (DSM), a theory of higher cortical functions in which the cortical column is considered the binary digit for all cortical functions. Within the discussion, novel views on the roles of the basal ganglia, cerebellum, and cingulate cortex are presented. Additionally, an applied Clinical Biopsychological Model (CBM) based on the DSM will be discussed as related to psychological treatment with chronic pain patients. Three specific areas that have not been adequately addressed in the psychological treatment of chronic pain patients will be discussed based on the CBM. The treatment approaches have been effectively used in a clinical setting. Conclusions focus on a call for researchers and clinicians to fully evaluate the value of both the DSM and CBM.


    Abbreviation ACC: Anterior cingulate cortex; aIns: Anterior insula; aMCC: Anterior MCC; BLA: Basolateral amygdala; BNST: Bed nucleus of the stria terminalis; CeA: Central nucleus of the amygdala; BOLD: Blood oxygen level dependent; CBM: Clinical Biopsychological Model; DMN: Default mode network; DG: Dentate gyrus; DSM: Dimensional Systems Model; DAT: Dopamine active transporter; dACC: Dorsal ACC; dlPFC: Dorsolateral prefrontal cortex; dmPFC: Dorsomedial PFC; dpIns: Dorsal posterior insula; FPC: Frontopolar cortex; GP: Globus pallidus; ILN: Intralaminar nuclei; HG: Heschel's gyrus; lPBN: Lateral PBN; POm: Medial nucleus of the posterior group; MSN: Medium spiny neuron; MACM: Meta-analytic connectivity modeling; MCC: Middle cingulate cortex; mIns: Middle insula; NAc: Nucleus accumbens; NCC: Neural correlates of consciousness; NPS: Neurologic Pain Signature; OFC: Orbitofrontal cortex; PBN: Parabrachial nucleus; PHC: Parahippocampal cortex; PAG: Periaqueductal gray; VMpo: Posterior part of the ventral medial nucleus; PCC: Posterior cingulate cortex; pACC: Posterior ACC; pMCC: Posterior MCC; pPCC: Posterior PCC; PFC: Prefrontal cortex; RSC: Retrosplenial cortex; rACC: Rostral ACC; SN: Substantia nigra pars reticulata; STN: Subthalamic nucleus; SF: Superficial amygdala; CT: Tactile C fibers; TPJ: Temporoparietal junction; UCT: Universal Cerebellar Transform; vPCC: Ventral PCC; Mdvc: Ventrocaudal mediodorsal nucleus; vlPFC: Ventrolateral PFC; vmPFC: Ventromedial PFC; VPC: Ventral posterior complex; VPI: Ventroposterior inferior; VPL: Ventral posterolateral; VPM: Ventral posteromedial;

    Conflict of interest

    The author declares no conflict of interests in this paper.

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