***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objects in our environment tend to be grouped in typical context s. How does the human brain analyze such associations between visual objects and their specific context ? We addressed this question in four functional neuroimaging experiments and revealed the cortical mechanisms that are uniquely activated when people recognize highly context ual objects ( e.g. , a traffic light ) . Our findings indicate that a region in the parahippocampal cortex and a region in the retrosplenial cortex together comprise a system that mediates both spatial and nonspatial context ual processing . Interestingly , each of these regions has been identified in the past with two functions : the processing of spatial information and episodic memory . Attributing context ual analysis to these two areas , instead , provides a framework for bridging between previous reports Emotions have powerful effects on pain perception . However , the brain mechanisms underlying these effects remain largely unknown . In this study , we combined functional cerebral imaging with psychophysiological methods to explore the neural mechanisms involved in the emotional modulation of spinal nociceptive responses ( RIII-reflex ) and pain perception in healthy participants . Emotions induced by pleasant or unpleasant pictures modulated the responses to painful electrical stimulations in the right insula , para central lobule , parahippocampal gyrus , thalamus , and amygdala . Right insula activation covaried with the modulation of pain perception , consistent with a key role of this structure in the integration of pain signals with the ongoing emotion . In contrast , activity in the thalamus , amygdala , and several prefrontal areas was associated with the modulation of spinal reflex responses . Last , connectivity analyses suggested an involvement of prefrontal , parahippocampal , and brainstem structures in the cerebral and cerebrospinal modulation of pain by emotions . This multiplicity of mechanisms underlying the emotional modulation of pain is reflective of the strong interrelations between pain and emotions , and emphasizes the powerful effects that emotions can have on pain The experience of pain is subjectively different from the fear and anxiety caused by threats of pain . Functional magnetic resonance imaging in healthy humans was applied to dissociate neural activation patterns associated with acute pain and its anticipation . Expectation of pain activated sites within the medial frontal lobe , insular cortex , and cerebellum distinct from , but close to , locations mediating pain experience itself . Anticipation of pain can in its own right cause mood changes and behavioral adaptations that exacerbate the suffering experienced by chronic pain patients . Selective manipulations of activity at these sites may offer therapeutic possibilities for treating chronic pain For many hospital patients , the experience brings pain and anxiety . Unfamiliar surroundings , various diagnostic and therapeutic procedures , and the sight and sounds of medical procedures exacerbate pain and anxiety . To block off the anxiety-inducing sights and sounds of hospital surroundings and create a pleasing environment , the therapeutic potential of visual stimulation as a nursing intervention was investigated . In a r and omized , controlled , cross-over study , pain was produced by a modified tourniquet technique in 46 healthy volunteers . Subjects were r and omly allocated to two groups ( Group V and Group B ) with subsequent cross-over . Those in Group V watched a soundless video display of natural scenery during tourniquet inflation , whereas in Group B subjects watched a static blank screen .  Pain threshold was defined as the time when subjects reported the first detectable pain , whereas pain tolerance was the time the pain was reported to be intolerable and deflation of the tourniquet was requested . With the use of visual stimuli , there was a significant increase in pain threshold ( P < 0.05 ) and pain tolerance ( P < 0.01 ) . Gender and the sequence of visual stimuli did not have any significant effect on pain threshold and pain tolerance . Further studies specifically addressing level of anxiety and physiological data correlated with pain scores and visual stimuli are needed . The findings have implication s for nurses and other healthcare professionals to use various visual stimuli as positive adjuncts to other methods of pain relief and for different pain conditions in clinical areas STUDY OBJECTIVES To determine whether distraction therapy with nature sights and sounds during flexible bronchoscopy ( FB ) reduces pain and anxiety . DESIGN R and omized controlled trial . SETTING Teaching hospital in Baltimore , MD . PATIENTS Consecutive adult patients ( n = 80 ) undergoing FB with conscious sedation . INTERVENTION Nature scene murals were placed at the bedside , and patients were provided a tape of nature sounds to listen to before , during , and after the procedure . Patients assigned to the control group were not offered either the nature scene or the sounds . MEASUREMENTS AND RESULTS The primary outcomes were patient ratings of pain control ( a 5-point scale ranging from poor to excellent ) and anxiety . In a multivariate ordinal logistic regression model , the odds of better pain control were greater in the intervention patients than in the control patients ( odds ratio [ OR ] , 4.76 ; 95 % confidence interval [ CI ] , 1.35 to 16.7 ) , after adjustment for age , gender , race , education , health status , and dose of narcotic medication . Older patients and patients with better health status reported significantly less pain . There was no difference in patient-reported anxiety between the two groups ( OR , 0.87 ; 95 % CI , 0.39 to 1.96 ) . CONCLUSIONS Distraction therapy with nature sights and sounds significantly reduces pain in patients undergoing FB . Although the precise mechanism of this beneficial effect requires further investigation , clinicians should consider this nonintrusive strategy in addition to st and ard analgesic medications in patients undergoing painful , invasive procedures Underst and ing another person 's experience draws on " mirroring systems , " brain circuitries shared by the subject 's own actions/feelings and by similar states observed in others . Lately , also the experience of pain has been shown to activate partly the same brain areas in the subjects ' own and in the observer 's brain . Recent studies show remarkable overlap between brain areas activated when a subject undergoes painful sensory stimulation and when he/she observes others suffering from pain . Using functional magnetic resonance imaging , we show that not only the presence of pain but also the intensity of the observed pain is encoded in the observer 's brain-as occurs during the observer 's own pain experience . When subjects observed  pain  from the  faces of chronic pain patients , activations in bilateral anterior insula ( AI ) , left anterior cingulate cortex , and left inferior parietal lobe in the observer 's brain correlated with their estimates of the intensity of observed pain . Furthermore , the strengths of activation in the left AI and left inferior frontal gyrus during observation of intensified pain correlated with subjects ' self-rated empathy . These findings imply that the intersubjective representation of pain in the human brain is more detailed than has been previously thought The amygdala is known to play an important role in conscious and unconscious processing of emotional and highly arousing stimuli . Neuroanatomical evidence suggests that the amygdala participates in the control of autonomic responses , such as skin conductance responses ( SCRs ) , elicited by emotionally salient stimuli , but little is known regarding its functional role in such control . We investigated this issue by showing emotional visual stimuli of varying arousal to patients with left ( n = 12 ) , right ( n = 8) , and bilateral ( n = 3 ) amygdala damage and compared their results with those from 38 normal controls .  Stimuli were presented both subliminally ( using backward masking ) and supraliminally under lateralized presentation to one visual hemifield . We collected SCRs as a physiological index of emotional responses . Subjects subsequently rated each stimulus on valence and arousal under free viewing conditions . There were two key findings : ( 1 ) impaired overall SCR after right amygdala damage ; and ( 2 ) impaired correlation of SCR with the rated arousal of the stimuli after left amygdala damage . The second finding was strengthened further by finding a positive correlation between the evoked SCR magnitude and postsurgery amygdala volume , indicating impaired autonomic responses with larger tissue damage . Bilateral amygdala damage result ed in severe impairments on both of the above measures . Our results provide support for the hypothesis that the left and right amygdalae subserve different functions in emotion processing : the left may decode the arousal signaled by the specific stimulus , whereas the right may provide a global level of autonomic activation triggered automatically by any arousing stimulus The capacity to anticipate aversive circumstances is central not only to successful adaptation but also to underst and ing the abnormalities that contribute to excessive worry and anxiety disorders . Forecasting and reacting to aversive events mobilize a host of affective and cognitive capacities and corresponding brain processes . Rapid event-related functional magnetic resonance imaging ( fMRI ) in 21 healthy volunteers assessed the overlap and divergence in the neural instantiation of anticipating and being exposed to aversive pictures . Brain areas jointly activated by the anticipation of and exposure to aversive pictures included the dorsal amygdala , anterior insula , dorsal anterior cingulate cortex ( ACC ) , right dorsolateral prefrontal cortex ( DLPFC ) , and right posterior orbitofrontal cortex ( OFC ) . Anticipatory processes were uniquely associated with activations in rostral ACC , a more superior sector of the right DLPFC , and more medial sectors of the bilateral OFC . Activation of the right DLPFC in anticipation of aversion was associated with self-reports of increased negative affect , whereas OFC activation was associated with increases in both positive and negative affect . These results show that anticipation of aversion recruits key brain regions that respond to aversion , thereby potentially enhancing adaptive responses to aversive events 
    Output:
    
Conclusions : The amygdala was identified as one of the key regions of the brain involved in the processing of fear , anxiety , and pain ( induced by visual images ) .
Other key areas included the thalamus , insula , and hippocampus .
Characteristics of visual images such as the emotional dimension ( valence/arousal ) , subject matter ( familiarity , ambiguity , novelty , realism , and facial expressions ) , and form ( sharp and curved contours ) were identified as key factors influencing emotional processing .
The broad structural properties of an image and overall content were found to have a more pivotal role in the emotional response than the specific details of an image .