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The Representation of Nociception and Pain in the Developing Brain

Lorenzo Fabrizi1, Maria Fitzgerald1

  • 1Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom; email: l.fabrizi@ucl.ac.uk, m.fitzgerald@ucl.ac.uk.

Annual Review of Physiology
|November 21, 2025
PubMed

Insights

Newborn pain processing involves subcortical and cortical brain activity. This review examines how tissue injury pain is represented in the infant brain, considering neural development and influencing factors.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Pain Research

Background:

  • Pain is a complex experience requiring higher cortical processing, even in newborns.
  • Noxious stimuli trigger responses in infants, indicating early neural engagement.
  • Understanding pain representation in the newborn brain is crucial for infant care.

Purpose of the Study:

  • To review current knowledge on newborn brain pain representation following tissue injury.
  • To explore nociceptive input, immature cortical networks, and influencing factors.
  • To propose a model for the evolution of pain representation with neural development.

Main Methods:

  • Review of existing literature on infant pain processing.
  • Analysis of methods for recording infant brain activity during painful procedures.
  • Synthesis of data on differential maturation of sensory, emotional, and cognitive systems.

Main Results:

  • Newborn pain perception involves both subcortical and cortical pathways.
  • Immature cortical networks play a role in interpreting nociceptive input.
  • Biological and external factors modulate pain mechanisms in infants.

Conclusions:

  • Pain representation in the newborn brain is dynamic and evolves with neural maturation.
  • Addressing misconceptions about infant pain is important.
  • A proposed model illustrates the developmental trajectory of pain representation.

Keywords:
cortical pain activitymicrostatesnERPneonatal painnociceptive-specific event-related potentialpain connectome

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