The cutaneous borders of interoception: active and social inference on pain and pleasure on the skin

Pain and pleasant touch have been recently classified as interoceptive modalities. This reclassification lies at the heart of long-standing debates questioning whether these modalities should be defined as sensations on their basis of neurophysiological specificity at the periphery or as homeostatic emotions on the basis of top-down convergence and modulation at the spinal and brain levels. Here, we outline the literature on the peripheral and central neurophysiology of pain and pleasant touch. We next recast this literature within a recent Bayesian predictive coding framework, namely active inference. This recasting puts forward a unifying model of bottom-up and top-down determinants of pain and pleasant touch and the role of social factors in modulating the salience of peripheral signals reaching the brain.