Neural pathways of cognitive pain modulation. Cognitive modulations of pain are related to activation of prefrontal brain areas (shown in orange), which modulate activation in pain-associated regions in the cortex (ACC, SI, SII/insula and thalamus), brainstem and dorsal horn (shown in blue). Attention has been shown to mainly engage the DLPFC and ACC. The DLPFC is connected to the ACC, which, in turn, projects to thalamus and the PAG, a core component of the descending pain modulatory…