ReviewFrontiers in psychiatry2018
Threat Response System: Parallel Brain Processes in Pain vis-à-vis Fear and Anxiety.
Review in Frontiers in psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Virtual reality for reducing pain, anxiety, and distress in children, adolescents, and young adults with cancer: a systematic review and meta-analysis of randomized controlled trials.Frontiers in psychiatry · 2026Pooled it
- Common and specific large-scale brain changes in major depressive disorder, anxiety disorders, and chronic pain: a transdiagnostic multimodal meta-analysis of structural and functional MRI studies.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Pooled it
- Trial
- Effect of Citrus Aurantium L. on pain and blood pressure in patients undergoing hand reconstructive surgery.Pain management · 2025Trial
- Preoperative Anxiety's Impact on the Median Effective Dose of Esketamine for Alleviating Propofol Injection Pain in Patients Undergoing Painless abortion: A Randomized, Double-Blind, Controlled Trial.Drug design, development and therapy · 2024Trial
- Dynamic reconfiguration of directed effective connectivity between attention networks and the default mode network in knee osteoarthritis: a combined resting-state and non-noxious thermal stimulation functional magnetic resonance imaging study.The Korean journal of pain · 2026Article
- The Link Between Exposure to Traumatic Stress and Chronic Pain: The Mediation Effect of Hyperarousal Is Moderated by Sensitivity to Pain Traumatization.European journal of pain (London, England) · 2026Article
- Characterising Pain in Post-COVID-19 Syndrome: An Observational Study of Intensity and Sensitivity.Diagnostics (Basel, Switzerland) · 2026Article
- Distinct effects of fibromyalgia pain, depression and anxiety on perception of affective touch and pain.The Journal of physiology · 2026Article
- MASSAG model: Towards an integrative neuroscience framework linking emotional trauma, pain, and mechanisms of force-based manipulations.Neuroscience and biobehavioral reviews · 2026Review
- The Handgrip Endurance Task as a Simple Clinical Indicator of Mental Fatigue in Patients with Chronic Low Back Pain.Journal of pain research · 2026Article
- A valuation based theory of learning's origin and development.Frontiers in systems neuroscience · 2025Article
- The impact of thermal and auditory unpleasant stimulus on explicit motor imagery in healthy individuals: An experimental study.PloS one · 2025Article
- Article
- Validity of mental and physical stress models.Neuroscience and biobehavioral reviews · 2024Review
- Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain.Canadian journal of pain = Revue canadienne de la douleur · 2024Article
- Pain, Fear, Anxiety, and Stress: Relations to the Endogenous Opioid System.Advances in neurobiology · 2024Article
- 2023 AAFP/IAAHPC feline hospice and palliative care guidelines.Journal of feline medicine and surgery · 2023Review
- Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes.Children (Basel, Switzerland) · 2023Review
- Fear memory engram is the mind-killer.Nature neuroscience · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pain is essential for avoidance of tissue damage and for promotion of healing. Notwithstanding the survival value, pain brings about emotional suffering reflected in fear and anxiety, which in turn augment pain thus giving rise to a self-sustaining feedforward loop. Given such reciprocal relationships, the present article uses neuroscientific conceptualizations of fear and anxiety as a theoretical framework for hitherto insufficiently understood pathophysiological mechanisms underlying chronic pain. To that end, searches of PubMed-indexed journals were performed using the following Medical Subject Headings' terms: pain and nociception plus amygdala, anxiety, cognitive, fear, sensory, and unconscious. Recursive sets of scientific and clinical evidence extracted from this literature review were summarized within the following key areas: (1) parallelism between acute pain and fear and between chronic pain and anxiety; (2) all are related to the evasion of sensory-perceived threats and are subserved by subcortical circuits mediating automatic threat-induced physiologic responses and defensive actions in conjunction with higher order corticolimbic networks (e.g., thalamocortical, thalamo-striato-cortical and amygdalo-cortical) generating conscious representations and valuation-based adaptive behaviors; (3) some instances of chronic pain and anxiety conditions are driven by the failure to diminish or block respective nociceptive information or unconscious treats from reaching conscious awareness; and (4) the neural correlates of pain-related conscious states and cognitions may become autonomous (i.e., dissociated) from the subcortical activity/function leading to the eventual chronicity. Identifying relative contributions of the diverse neuroanatomical sources, thus, offers prospects for the development of novel preventive, diagnostic, and therapeutic strategies in chronic pain patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.