Image 1 shows cerebral regions involved in pain processing: the brainstem’s medulla oblongata, pons, and midbrain; the amygdala and the cingulate, insular and somatosensory cortices; and the thalamus and hypothalamus. Image 2 shows ascending nociception (red) as well as brainstem (violet) and affective cerebral modulation (yellow), and their overlap with the rostroventral medulla oblongata’s nucleus raphe magnus and the midbrain’s periaqueductal grey matter. Image 3 shows the dorsal (green) and ventral (violet) visual streams activating the cortex via vision and perception (blue), substituted by imagery in Image 4, highlighting the many areas of cerebral modulation: the reverse ventral stream, the parieto- and temporo-occipital regions, the frontal and temporal lobes, and the left precuneus.

Figure 25: Descending modulation

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