Feeling
pain is in the same time a sensory and an affective experience.
Pain asymbolia and prefrontal
lobotomy, two distinct neurological pictures, help to better understand the cerebral basis of the emotional dimension of
pain. In
pain asymbolia, the selective alteration of the affective dimension of
pain is associated with a loss of the sense of threat and danger. Following prefrontal
lobotomy, the emotional impact of
chronic pain is dramatically reduced, while affective responses to
acute pain are paradoxically increased. Such clinical observations allow to make a clear distinction between immediate
pain unpleasantness on the one hand, and secondary
pain affect, linked to the significance of the
pain experience in terms of the self and of the future, on the other hand. Moreover, recent functional neuroimaging data allow to better define the neural substrates of the affective dimension of
pain and to highlight the shared neuro-anatomical networks between physical and psychic suffering.