• Friedrich E Lersch, Fabienne C S Frickmann, Richard D Urman, Gabriel Burgermeister, Kaya Siercks, Markus M Luedi, and Sven Straumann.
• Department of Anaesthesiology and Pain Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland. friedrich.lersch@insel.ch.
• Curr Pain Headache Rep. 2023 Nov 1; 27 (11): 631638631-638.

Purpose Of ReviewIn order to better treat pain, we must understand its architecture and pathways. Many modulatory approaches of pain management strategies are only poorly understood. This review aims to provide a theoretical framework of pain perception and modulation in order to assist in clinical understanding and research of analgesia and anesthesia.Recent FindingsLimitations of traditional models for pain have driven the application of new data analysis models. The Bayesian principle of predictive coding has found increasing application in neuroscientific research, providing a promising theoretical background for the principles of consciousness and perception. It can be applied to the subjective perception of pain. Pain perception can be viewed as a continuous hierarchical process of bottom-up sensory inputs colliding with top-down modulations and prior experiences, involving multiple cortical and subcortical hubs of the pain matrix. Predictive coding provides a mathematical model for this interplay.© 2023. The Author(s).

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