Interrelations between pain, stress and executive functioning

Liviu Feller, Gal Feller, Theona Ballyram, Rakesh Chandran, Johan Lemmer, Razia Abdool Gafaar Khammissa*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Aim: The purpose of this narrative review is to discuss the interrelations between pain, stress and executive functions. Implications for practice: Self-regulation, through executive functioning, exerts control over cognition, emotion and behaviour. The reciprocal neural functional connectivity between the prefrontal cortex and the limbic system allows for the integration of cognitive and emotional neural pathways and then for higher-order psychological processes (reasoning, judgement etc.) to generate goal-directed adaptive behaviours and to regulate responses to psychosocial stressors and pain signals. Impairment in cognitive executive functioning may result in poor regulation of stress-, pain- and emotion-related processing of information. Conversely, adverse emotion, pain and stress impair executive functioning. The characteristic of the feedback and feedforward neural connections (quantity and quality) between the prefrontal cortex and the limbic system determine adaptive behaviour, stress response and pain experience.

Original languageEnglish
Pages (from-to)188-194
Number of pages7
JournalBritish Journal of Pain
Issue number3
Publication statusPublished - 1 Aug 2020


  • Chronic pain
  • executive functioning
  • neural connections
  • pain experience
  • psychosocial stressors
  • stress response


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