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The rostral ventromedial medulla is a critical structure in modulating descending control of nociception. It is distinct from the rostral ventrolateral medulla, which plays different roles in the control of autonomic functions and blood pressure regulation. The RVM has a critical role in both inhibition and facilitation of pain through interactions with the spinal cord, and RVM plasticity may be important for the transition to chronic pain. It also likely plays a role in behavioral responses to painful events, including conditioned place preferences and immobilization responses.

Image and Location

Example image: Example: Kong et al. 2010

Region of Interest image (ROI): ROI

Neurosynth connectivity image: Connectivity

Neurosynth structure image: None available

Links to electronic ROI-definition files: ROI clusters .mat file


Searches so far:

fMRI [all] and RVM [all]

Most important references

(classic papers, best papers)

Eippert, F., Bingel, U., Schoell, E. D., Yacubian, J., Klinger, R., Lorenz, J., et al. (2009). Activation of the opioidergic descending pain control system underlies placebo analgesia. Neuron, 63(4), 533-543.

Fields, H. L. (2000). Pain modulation: expectation, opioid analgesia and virtual pain.Progress in brain research, 122, 245-253.

Fields, H. L., Malick, A., & Burstein, R. (1995). Dorsal horn projection targets of ON and OFF cells in the rostral ventromedial medulla. Journal of neurophysiology, 74(4), 1742-1759.





* laminae I, II, and V of the dorsal horn * laminae VII and VIII of the intermediate and ventral horns * the intermediolateral column (sympathetic ganglia in spinal cord) * lamina X


Summary list

In the RVM, electrical stimulation, as well as the injection of excitatory amino acids or opioids, inhibits behavioral responses to noxious stimuli (Jensen and Yaksh 1984; McGowan and Hammond 1993).

Nociceptive modulation

Effects of stimulation/microinjection

  • Electrical stimulation, as well as the injection of excitatory amino acids or opioids, inhibits behavioral responses to noxious stimuli (Jensen and Yaksh 1984; McGowan and Hammond 1993).
  • Stimulation of OFF cells reduces nociception
  • Stimulation of ON cells can increase nociception

Effects of lesions/inactivation

  • Block or reduce antinociception due to footshock stress
  • Block or reduce antinociception due to classical conditioning (Watkins and Mayer 1982),
  • Block or reduce antinociception due to opioid administration (Urban and Smith 1994; Young et al. 1984).

Effects of microinjection

  • List with references.
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  • List with references.
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Function Area 2 [Name]

Effects of stimulation

  • List with references.
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Effects of lesions/inactivation

  • List with references.
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Effects of microinjection

  • List with references.
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Studies activating


Coordinates (x, y, z): [0 -36 -40]

(Average of all but Derbyshire, adjusted to midline based on anatomy)

Specific study coordinates (if not too many)

Study Description x y z
Kong 2010 RVM seed 4 -34 -40
Eippert 2009 Placebo > Control late pain 8 -38 -40
Eippert 2009 Placebo > Control early pain -6 -35 -39
Derbyshire 2009 Offset analgesia 18 -30 -30

List of Studies

Kong 2010 Eippert 2009 Derbyshire 2009

Specific, key studies

Study list: Coordinate based

Neurosynth results for coordinate(s)

A bilateral cortico-bulbar network associated with breath holding in humans, determined by functional magnetic resonance imaging McKay LC; Adams L; Frackowiak RS; Corfield DR NeuroImage 2008 18343687 A cerebellar thalamic cortical circuit for error-related cognitive control Ide JS; Li CS NeuroImage 2011 20656038 A Distributed Left Hemisphere Network Active During Planning of Everyday Tool Use Skills Johnson-Frey SH; Newman-Norlund R; Grafton ST Cerebral Cortex 2005 15342430 A meta-analysis of instructed fear studies: implications for conscious appraisal of threat Mechias ML; Etkin A; Kalisch R NeuroImage 2010 19786103 Abnormal hemodynamics in schizophrenia during an auditory oddball task Kiehl KA; Stevens MC; Celone K; Kurtz M; Krystal JH Biological Psychiatry 2005 15860344 Altered resting state in diabetic neuropathic pain Cauda F; Sacco K; Duca S; Cocito D; D'Agata F; Geminiani GC; Canavero S PLoS ONE 2009 19229326 Amygdala and orbitofrontal reactivity to social threat in individuals with impulsive aggression Coccaro EF; McCloskey MS; Fitzgerald DA; Phan KL Biological Psychiatry 2007 17210136 An adaptive reflexive processing model of neurocognitive function: supporting evidence from a large scale (n = 100) fMRI study of an auditory oddball task Kiehl KA; Stevens MC; Laurens KR; Pearlson G; Calhoun VD; Liddle PF NeuroImage 2005 15808990 An fMRI case report of photophobia: activation of the trigeminal nociceptive pathway Moulton EA; Becerra L; Borsook D Pain 2009 19674842 An fMRI study on the interaction and dissociation between expectation of pain relief and acupuncture treatment Kong J; Kaptchuk TJ; Polich G; Kirsch I; Vangel M; Zyloney C; Rosen B; Gollub RL NeuroImage 2009 19501656 Anterior cingulate activity during error and autonomic response Critchley HD; Tang J; Glaser D; Butterworth B; Dolan RJ NeuroImage 2005 15996878 Anticipatory brainstem activity predicts neural processing of pain in humans Fairhurst M; Wiech K; Dunckley P; Tracey I Pain 2007 17070996 Bilateral brain regions associated with naming in older adults Obler LK; Rykhlevskaia E; Schnyer D; Clark-Cotton MR; Spiro A 3rd; Hyun J; Kim DS; Goral M; Albert ML Brain and Language 2010 20399492 Brain activity associated with dual-task management differs depending on the combinations of response modalities Mochizuki H; Tashiro M; Gyoba J; Suzuki M; Okamura N; Itoh M; Yanai K Brain Research 2007 17825803 Brain Activity Associated with Expectancy-Enhanced Placebo Analgesia as Measured by Functional Magnetic Resonance Imaging Kong J; Gollub RL; Rosman IS; Webb JM; Vangel MG; Kirsch I; Kaptchuk TJ Journal of Neuroscience 2006 16407533 Brain structure and function related to cognitive reserve variables in normal aging, mild cognitive impairment and Alzheimer's disease Sole-Padulles C; Bartres-Faz D; Junque C; Vendrell P; Rami L; Clemente IC; Bosch B; Villar A; Bargallo N; Jurado MA; Barrios M; Molinuevo JL Neurobiology of Aging 2009 18053618 Cerebral control of the lower urinary tract: how age-related changes might predispose to urge incontinence Griffiths DJ; Tadic SD; Schaefer W; Resnick NM NeuroImage 2009 19427909 Changes in brain activation associated with use of a memory strategy: a functional MRI study Kondo Y; Suzuki M; Mugikura S; Abe N; Takahashi S; Iijima T; Fujii T NeuroImage 2005 15670693 Changes in resting neural connectivity during propofol sedation Stamatakis EA; Adapa RM; Absalom AR; Menon DK PLoS ONE 2010 21151992 Common neural systems for contact heat and laser pain stimulation reveal higher-level pain processing Helmchen C; Mohr C; Roehl M; Bingel U; Lorenz J; Buchel C Human Brain Mapping 2008 17924552 Compensatory cortical activation observed by fMRI during a cognitive task at the earliest stage of multiple sclerosis Audoin B; Ibarrola D; Ranjeva JP; Confort-Gouny S; Malikova I; Ali-Cherif A; Pelletier J; Cozzone P Human Brain Mapping 2003 14505331 Contagious yawning and the frontal lobe: An fMRI study Nahab FB; Hattori N; Saad ZS; Hallett M Human Brain Mapping 2009 18937281 Correlates of movement initiation and velocity in Parkinson's disease: A longitudinal PET study Carbon M; Felice Ghilardi M; Dhawan V; Eidelberg D NeuroImage 2007 17064939 Differential activation of the human trigeminal nuclear complex by noxious and non-noxious orofacial stimulation Nash PG; Macefield VG; Klineberg IJ; Murray GM; Henderson LA Human Brain Mapping 2009 19492300 Dynamic EEG-informed fMRI modeling of the pain matrix using 20-ms root mean square segments Brinkmeyer J; Mobascher A; Warbrick T; Musso F; Wittsack HJ; Saleh A; Schnitzler A; Winterer G Human Brain Mapping 2010 20162596 Empathy and Judging Other's Pain: An fMRI Study of Alexithymia Moriguchi Y; Decety J; Ohnishi T; Maeda M; Mori T; Nemoto K; Matsuda H; Komaki G Cerebral Cortex 2007 17150987 Enhanced visual processing contributes to matrix reasoning in autism Soulieres I; Dawson M; Samson F; Barbeau EB; Sahyoun CP; Strangman GE; Zeffiro TA; Mottron L Human Brain Mapping 2009 19530215 Exaggerated and disconnected insular-amygdalar blood oxygenation level-dependent response to threat-related emotional faces in women with intimate-partner violence posttraumatic stress disorder Fonzo GA; Simmons AN; Thorp SR; Norman SB; Paulus MP; Stein MB Biological Psychiatry 2010 20573339 Exploring the brain in pain: activations, deactivations and their relation Kong J; Loggia ML; Zyloney C; Tu P; Laviolette P; Gollub RL Pain 2010 20005043 Eyeblink-related areas in human cerebellum as shown by fMRI Dimitrova A; Weber J; Maschke M; Elles HG; Kolb FP; Forsting M; Diener HC; Timmann D Human Brain Mapping 2002 12353244 Fluctuations in electrodermal activity reveal variations in single trial brain responses to painful laser stimuli–a fMRI/EEG study Mobascher A; Brinkmeyer J; Warbrick T; Musso F; Wittsack HJ; Stoermer R; Saleh A; Schnitzler A; Winterer G NeuroImage 2009 18848631 FMRI evidence of a functional network setting the criteria for withholding a response Vallesi A; McIntosh AR; Alexander MP; Stuss DT NeuroImage 2009 19162201 Functional magnetic resonance imaging response to experimental pain in drug-free patients with schizophrenia de la Fuente-Sandoval C; Favila R; Gomez-Martin D; Pellicer F; Graff-Guerrero A Psychiatry Research: Neuroimaging 2010 20609569 Functional MRI of galvanic vestibular stimulation with alternating currents at different frequencies Stephan T; Deutschlander A; Nolte A; Schneider E; Wiesmann M; Brandt T; Dieterich M NeuroImage 2005 15955481 Glucocorticoid-induced impairment of declarative memory retrieval is associated with reduced blood flow in the medial temporal lobe European Journal of Neuroscience 2003 Hypercapnic Exposure in Congenital Central Hypoventilation Syndrome Reveals CNS Respiratory Control Mechanisms Harper RM; Macey PM; Woo MA; Macey KE; Keens TG; Gozal D; Alger JR Journal of Neurophysiology 2005 15525806 Individual sensitivity to pain expectancy is related to differential activation of the hippocampus and amygdala Ziv M; Tomer R; Defrin R; Hendler T Human Brain Mapping 2010 19790170 Learning to appreciate others: neural development of cognitive perspective taking Dosch M; Loenneker T; Bucher K; Martin E; Klaver P NeuroImage 2010 20025981 Learning to Like: A Role for Human Orbitofrontal Cortex in Conditioned Reward Cox SM; Andrade A; Johnsrude IS Journal of Neuroscience 2005 15758183 Mapping the spinal and supraspinal pathways of dynamic mechanical allodynia in the human trigeminal system using cardiac-gated fMRI Mainero C; Zhang WT; Kumar A; Rosen BR; Sorensen AG NeuroImage 2007 17336547 Mental rotation and object categorization share a common network of prefrontal and dorsal and ventral regions of posterior cortex Schendan HE; Stern CE NeuroImage 2007 17346989 Microstructural status of ipsilesional and contralesional corticospinal tract correlates with motor skill in chronic stroke patients Schaechter JD; Fricker ZP; Perdue KL; Helmer KG; Vangel MG; Greve DN; Makris N Human Brain Mapping 2009 19370766 Modulation of spontaneous breathing via limbic/paralimbic-bulbar circuitry: an event-related fMRI study Evans KC; Dougherty DD; Schmid AM; Scannell E; McCallister A; Benson H; Dusek JA; Lazar SW NeuroImage 2009 19450692 Neural correlates of a mystical experience in Carmelite nuns Beauregard M; Paquette V Neuroscience Letters 2006 16872743 Neural Signatures of Body Ownership: A Sensory Network for Bodily Self-Consciousness Tsakiris M; Hesse MD; Boy C; Haggard P; Fink GR Cerebral Cortex 2007 17138596 Neurobehavioral mechanisms of human fear generalization Dunsmoor JE; Prince SE; Murty VP; Kragel PA; Labar KS NeuroImage 2011 21256233 Neuronal modulation of auditory attention by informative and uninformative spatial cues Mayer AR; Franco AR; Harrington DL Human Brain Mapping 2009 18661505 Premotor cortex mediates perceptual performance Callan D; Callan A; Gamez M; Sato MA; Kawato M NeuroImage 2010 20184959 Regional networks underlying interhemispheric connectivity: An EEG and DTI study in healthy ageing and amnestic mild cognitive impairment Teipel SJ; Pogarell O; Meindl T; Dietrich O; Sydykova D; Hunklinger U; Georgii B; Mulert C; Reiser MF; Moller HJ; Hampel H Human Brain Mapping 2009 18781594 Relation between muscle and brain activity during isometric contractions of the first dorsal interosseus muscle van Duinen H; Renken R; Maurits NM; Zijdewind I Human Brain Mapping 2008 17394210 Retention of identity versus expression of emotional faces differs in the recruitment of limbic areas Roder CH; Mohr H; Linden DE Neuropsychologia 2011 21134387 Sensitivity of the Action Observation Network to Physical and Observational Learning Cross ES; Kraemer DJ; Hamilton AF; Kelley WM; Grafton ST Cerebral Cortex 2009 18515297 Solving future problems: Default network and executive activity associated with goal-directed mental simulations Gerlach KD; Spreng RN; Gilmore AW; Schacter DL NeuroImage 2011 21256228 Stabilities of negative correlations between blood oxygen level-dependent signals associated with sensory and motor cortices Tian L; Jiang T; Liang M; Li X; He Y; Wang K; Cao B; Jiang T Human Brain Mapping 2007 17266102 SUNCT: bilateral hypothalamic activation during headache attacks and resolving of symptoms after trigeminal decompression Sprenger T; Valet M; Platzer S; Pfaffenrath V; Steude U; Tolle TR Pain 2005 15661452 The basal ganglia are hyperactive during the discrimination of tactile stimuli in writer's cramp Peller M; Zeuner KE; Munchau A; Quartarone A; Weiss M; Knutzen A; Hallett M; Deuschl G; Siebner HR Brain 2006 16854945 The development of performance-monitoring function in the posterior medial frontal cortex Fitzgerald KD; Perkins SC; Angstadt M; Johnson T; Stern ER; Welsh RC; Taylor SF NeuroImage 2010 19913101 The functional neuroanatomy of coordinated orofacial movements: sparse sampling fMRI of whistling Dresel C; Castrop F; Haslinger B; Wohlschlaeger AM; Hennenlotter A; Ceballos-Baumann AO NeuroImage 2005 16084116 The neural basis of the egocentric and allocentric spatial frame of reference Zaehle T; Jordan K; Wustenberg T; Baudewig J; Dechent P; Mast FW Brain Research 2007 17258693 The relations between white matter and declarative memory in older children and adolescents Mabbott DJ; Rovet J; Noseworthy MD; Smith ML; Rockel C Brain Research 2009 19632208 The supraspinal neural correlate of bladder cold sensation-An fMRI study Mehnert U; Michels L; Zempleni MZ; Schurch B; Kollias S Human Brain Mapping 2010 20661957 Thoughts, behaviour, and brain dynamics during navigation in the real world Spiers HJ; Maguire EA NeuroImage 2006 16584892 Time-varied characteristics of acupuncture effects in fMRI studies Bai L; Qin W; Tian J; Liu P; Li L; Chen P; Dai J; Craggs JG; von Deneen KM; Liu Y Human Brain Mapping 2009 19350547

Last modified: 2017/09/27 22:54