Emotions have powerful effects on pain perception. However, the brain mechanisms underlying these effects remain largely unknown. In this study, we combined functional cerebral imaging with psychophysiological methods to explore the neural mechanisms implicated in the emotional modulation of spinal nociceptive responses (RIII-reflex) and pain perception in healthy participants. Emotions induced by pleasant or unpleasant pictures modulated the responses to painful electrical stimulations in the right insula, paracentral lobule, parahippocampal gyrii, thalamus and amygdala. Right insula activation covaried with the modulation of pain perception, consistent with a role of this structure in the integration of pain signals with the ongoing emotion. In contrast, activity in the thalamus and amygdala was associated with the modulation of spinal reflex responses. Connectivity analyses further supported a segregation of networks involved in cerebral and cerebro-spinal modulation, highlighting the multiplicity of emotion-related processes affecting pain.
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