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8: Documentation

8: In adults, stimulation or ablation of the cerebral cortex does not alter pain perception, while stimulation or ablation of the thalamus does.

DOCUMENTATION:

1. Brusseau, 2008, p.16, para.3, “In keeping with the critical insights of Penfield and Jasper, clinical evidence suggests that either ablation or stimulation of the primary somatosensory cortex does not alter pain perception in adults (demonstrated by Penfield and Jasper themselves), whereas both thalamic ablation and stimulation have been shown to interrupt pain perception.”

p.17, para.1 “In keeping with this evidence, we should consider that if cortical activity is not a prerequisite for pain perception in adults, then by analogy neither would it be a necessary criterion for fetuses.”

Note: Brusseau is ultimately agnostic regarding the ability of unborn children to feel pain before 28 weeks.

Brusseau R. Developmental Perpectives: is the Fetus Conscious? International Anesthesiology Clinics.  46:3 (2008) 11-23.

Penfield W, Jasper HH.  Epilepsy and the Functional Anatomy of the Human Brain.  Boston: Little, Brown & Co; 1954.

2. Van Scheltema, 2008, p.313, para.1, “Others however, argue that thalamocortical connections are not a necessary criterion for (fetal) pain perception as clinical data show that ablation or stimulation of the thalamus alone is sufficient to alter pain perception in adults.11-14

Van Scheltema PNA, Bakker S, Vandenbussche FPHA, Oepkes, D. Fetal Pain. Fetal and Maternal Medicine Review. 19:4  (2008) 311-324.

11Brooks JK, Zambreanu L, Godinez A, Craig AD, Tracey I. Somatotopic organization of the human insula to painful heat studied with high resolution functional imaging. Neuroimage.  27 (2005) 201-209.

12Craig AD. Interoception: the sense of the physiological condition of the body. Current Opinion in Neurobiology. 13 (2003) 500-505.

13Nandi D, Aziz T, Carter H, Stein J. Thalamic field potentials in chronic central pain treated by periventricular gray stimulation – a series of eight cases. Pain. 101 (2003) 97-107.

14Nandi D, Liu X, Joint C, Stein J, Aziz T. Thalamic field potentiasls during deep brain stimulation of periventricular gray in chronic pain.  Pain.  97 (2002) 47-51.

3. Merker, 2007, p.65, col.1, para.3, “Penfield and Jasper note that cortical removal even as radical as hemispherectomy does not deprive a patient of consciousness, but rather of certain forms of information, discrimination capacities, or abilities, but not of consciousness itself… What impressed Penfield and Jasper was the extent to which the cerebral cortex could be subjected to acute insult without producing so much as an interruption in the continuity of consciousness.  Their opinion in this regard bears some weight, in that their magnum opus of 1954 – Epilepsy and the Functional Anatomy of the Human Brain – summarizes and evaluates experience with 750 such operations.”

Merker B. Consciousness without a cerebral cortex: A challenge for neuroscience and medicine. Behavioral and Brain Sciences. 30 (2007) 63-81. 

Penfield W, Jasper HH.  Epilepsy and the Functional Anatomy of the Human Brain.  Boston: Little, Brown & Co; 1954.

4. Morsella, 2010, p.15, col.1, para.3, “It seems that consciousness can persist even when great quantities of the cortex are absent.”

Morsella E, Krieger SC, Bargh JA. Minimal neuroanatomy for a conscious brain: Homing in on the networks constituting consciousness. Neural Networks.  23 (2010) 14-15.

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