A pain memory 'trace': cumulative pain perception and damping during fight-or-flight response. In the realm of fight-or-flight response descriptions, the decision-making process often goes unaddressed, and its quantification remains elusive. However, recent research suggests that tissue damage level, signaled by pain perception, plays a pivotal role in this decision-making. The body's pain signaling systems, particularly nociceptors, transmit signals to the central nervous system when tissues are damaged or stressed, leading to pain perception. This paper proposes that the decision to fight or flee should consider both acute and cumulative damage measures. Cumulative pain, arising from repetitive or multiplicative pain stimuli, is distinct from acute pain, which is typically a response to immediate injury or threat. The body's pain signaling systems, especially nociceptors, influence how cumulative pain is perceived. Neuroplasticity, the brain's ability to adapt and reorganize neural connections, also contributes to cumulative pain perception. The paper illustrates how positive cumulation occurs, and ultimately, cumulative pain perception reflects the interaction between physiological responses, emotional and cognitive states, and the social environment. This multi-input interaction guides the decision to fight or flee in pain-generating situations. The authors propose that pain is an integral part of the fight-or-flight response and introduce the concept of a 'nocistat'. They also present a mathematical framework using Lotka-Volterra dynamics to model the interaction between ascending and descending pain pathways, emphasizing the need for a coupled feedback loop. The model demonstrates how pain perception and modulation change over time in response to consecutive or superimposed pain-inflicting events. The results suggest that the model can register, monitor, and discern individual consecutive pain signals, and that consecutive higher magnitude pain stimuli are registered as momentary spikes, while lower magnitude stimuli are registered as momentary dents in pain perception. The paper concludes by highlighting the importance of monitoring cumulative damage in addition to individual event damage for effective decision-making during fight-or-flight responses.
