Neural substrates underlying evaluation of pain in actions depicted in words

Words hurt: common and distinct neural substrates underlying nociceptive and semantic pain

Introduction

Recent studies have shown that processing semantic pain, such as words associated with physical pain, modulates pain perception and enhances activity in regions of the pain matrix. A direct comparison between activations due to noxious stimulation and processing of words conveying physical pain may clarify whether and to what extent the neural substrates of nociceptive pain are shared by semantic pain. Pain is triggered also by experiences of social exclusion, rejection or loss of significant others (the so-called social pain), therefore words expressing social pain may modulate pain perception similarly to what happens with words associated with physical pain. This event-related fMRI study aims to compare the brain activity related to perceiving nociceptive pain and that emerging from processing semantic pain, i.e., words related to either physical or social pain, in order to identify common and distinct neural substrates.

Methods

Thirty-four healthy women underwent two fMRI sessions each. In the Semantic session, participants were presented with positive words, negative pain-unrelated words, physical pain-related words, and social pain-related words. In the Nociceptive session, participants received cutaneous mechanical stimulations that could be either painful or not. During both sessions, participants were asked to rate the unpleasantness of each stimulus. Linguistic stimuli were also rated in terms of valence, arousal, pain relatedness, and pain intensity, immediately after the Semantic session.

Results

In the Nociceptive session, the 'nociceptive stimuli' vs. 'non-nociceptive stimuli' contrast revealed extensive activations in SI, SII, insula, cingulate cortex, thalamus, and dorsolateral prefrontal cortex. In the Semantic session, words associated with social pain, compared to negative pain-unrelated words, showed increased activity in most of the same areas, whereas words associated with physical pain, compared to negative pain-unrelated words, only activated the left supramarginal gyrus and partly the postcentral gyrus.

Discussion

Our results confirm that semantic pain partly shares the neural substrates of nociceptive pain. Specifically, social pain-related words activate a wide network of regions, mostly overlapping with those pertaining to the affective-motivational aspects of nociception, whereas physical pain-related words overlap with a small cluster including regions related to the sensory-discriminative aspects of nociception. However, most regions of overlap are differentially activated in different conditions.

The Artery of Aphasia, A Uniquely Sensitive Posterior Temporal Middle Cerebral Artery Branch that Supplies Language Areas in the Brain: Anatomy and Report of Four Cases

BACKGROUND

Arterial disruption during brain surgery can cause devastating injuries to wide expanses of white and gray matter beyond the tumor resection cavity. Such damage may occur as a result of disrupting blood flow through en passage arteries. Identification of these arteries is critical to prevent unforeseen neurologic sequelae during brain tumor resection. In this study, we discuss one such artery, termed the artery of aphasia (AoA), which when disrupted can lead to receptive and expressive language deficits.

METHODS

We performed a retrospective review of all patients undergoing an awake craniotomy for resection of a glioma by the senior author from 2012 to 2018. Patients were included if they experienced language deficits secondary to postoperative infarction in the left posterior temporal lobe in the distribution of the AoA. The gross anatomy of the AoA was then compared with activation likelihood estimations of the auditory and semantic language networks using coordinate-based meta-analytic techniques.

RESULTS

We identified 4 patients with left-sided posterior temporal artery infarctions in the distribution of the AoA on diffusion-weighted magnetic resonance imaging. All 4 patients developed substantial expressive and receptive language deficits after surgery. Functional language improvement occurred in only 2/4 patients. Activation likelihood estimations localized parts of the auditory and semantic language networks in the distribution of the AoA.

CONCLUSIONS

The AoA is prone to blood flow disruption despite benign manipulation. Patients seem to have limited capacity for speech recovery after intraoperative ischemia in the distribution of this artery, which supplies parts of the auditory and semantic language networks.

Brain pathways of pain empathy activated by pained facial expressions: a meta-analysis of fMRI using the activation likelihood estimation method

OBJECTIVE:

The objective of this study is to summarize and analyze the brain signal patterns of empathy for pain caused by facial expressions of pain utilizing activation likelihood estimation, a meta-analysis method.

DATA SOURCES:

Studies concerning the brain mechanism were searched from the Science Citation Index, Science Direct, PubMed, DeepDyve, Cochrane Library, SinoMed, Wanfang, VIP, China National Knowledge Infrastructure, and other databases, such as SpringerLink, AMA, Science Online, Wiley Online, were collected. A time limitation of up to 13 December 2016 was applied to this study.

DATA SELECTION:

Studies presenting with all of the following criteria were considered for study inclusion: Use of functional magnetic resonance imaging, neutral and pained facial expression stimuli, involvement of adult healthy human participants over 18 years of age, whose empathy ability showed no difference from the healthy adult, a painless basic state, results presented in Talairach or Montreal Neurological Institute coordinates, multiple studies by the same team as long as they used different raw data.

OUTCOME MEASURES:

Activation likelihood estimation was used to calculate the combined main activated brain regions under the stimulation of pained facial expression.

RESULTS:

Eight studies were included, containing 178 subjects. Meta-analysis results suggested that the anterior cingulate cortex (BA32), anterior central gyrus (BA44), fusiform gyrus, and insula (BA13) were activated positively as major brain areas under the stimulation of pained facial expression.

CONCLUSION:

Our study shows that pained facial expression alone, without viewing of painful stimuli, activated brain regions related to pain empathy, further contributing to revealing the brain’s mechanisms of pain empathy.

The psycholinguistic and affective structure of words conveying pain

Despite the flourishing research on the relationships between affect and language, the characteristics of pain-related words, a specific type of negative words, have never been systematically investigated from a psycholinguistic and emotional perspective, despite their psychological relevance. This study offers psycholinguistic, affective, and pain-related norms for words expressing physical and social pain. This may provide a useful tool for the selection of stimulus materials in future studies on negative emotions and/or pain. We explored the relationships between psycholinguistic, affective, and pain-related properties of 512 Italian words (nouns, adjectives, and verbs) conveying physical and social pain by asking 1020 Italian participants to provide ratings of Familiarity, Age of Acquisition, Imageability, Concreteness, Context Availability, Valence, Arousal, Pain-Relatedness, Intensity, and Unpleasantness. We also collected data concerning Length, Written Frequency (Subtlex-IT), N-Size, Orthographic Levenshtein Distance 20, Neighbor Mean Frequency, and Neighbor Maximum Frequency of each word. Interestingly, the words expressing social pain were rated as more negative, arousing, pain-related, and conveying more intense and unpleasant experiences than the words conveying physical pain.

Long-Time Exposure to Violent Video Games Does Not Show Desensitization on Empathy for Pain: An fMRI Study

As a typical form of empathy, empathy for pain refers to the perception and appraisal of others’ pain, as well as the corresponding affective responses. Numerous studies investigated the factors affecting the empathy for pain, in which the exposure to violent video games (VVGs) could change players’ empathic responses to painful situations. However, it remains unclear whether exposure to VVG influences the empathy for pain. In the present study, in terms of the exposure experience to VVG, two groups of participants (18 in VVG group, VG; 17 in non-VVG group, NG) were screened from nearly 200 video game experience questionnaires. And then, the functional magnetic resonance imaging data were recorded when they were viewing painful and non-painful stimuli. The results showed that the perception of others’ pain were not significantly different in brain regions between groups, from which we could infer that the desensitization effect of VVGs was overrated.

Enhanced Brain Responses to Pain-Related Words in Chronic Back Pain Patients and Their Modulation by Current Pain

Previous functional magnetic resonance imaging (fMRI) studies in healthy controls (HC) and pain-free migraine patients found activations to pain-related words in brain regions known to be activated while subjects experience pain. The aim of the present study was to identify neural activations induced by pain-related words in a sample of chronic back pain (CBP) patients experiencing current chronic pain compared to HC. In particular, we were interested in how current pain influences brain activations induced by pain-related adjectives. Subjects viewed pain-related, negative, positive, and neutral words; subjects were asked to generate mental images related to these words during fMRI scanning. Brain activation was compared between CBP patients and HC in response to the different word categories and examined in relation to current pain in CBP patients. Pain-related words vs. neutral words activated a network of brain regions including cingulate cortex and insula in subjects and patients. There was stronger activation in medial and dorsolateral prefrontal cortex (DLPFC) and anterior midcingulate cortex in CPB patients than in HC. The magnitude of activation for pain-related vs. negative words showed a negative linear relationship to CBP patients’ current pain. Our findings confirm earlier observations showing that pain-related words activate brain networks similar to noxious stimulation. Importantly, CBP patients show even stronger activation of these structures while merely processing pain-related words. Current pain directly influences on this activation.

Spatiotemporal Brain Dynamics of Empathy for Pain and Happiness in Friendship

Background: Although a large number of functional magnetic resonance imaging (fMRI) studies have investigated the neural bases of empathy, little is known about its spatiotemporal dynamics or its modulation by the level of friendship between the observer and the agent who is being hurt. Moreover, most of the previous studies on empathy have focused on empathy for pain rather than empathy for positive emotions, such as happiness. In the present study, we addressed this question by investigating the spatiotemporal brain dynamics of two different kinds of empathy (empathy for pain, empathy for happiness) with a behavioral priming empathy task involving two different level of primes (a close friend, a stranger).

Method/Principal Findings: Electrical brain activity and behavioral data were analyzed from 30 subjects (12 males and 18 females). Half of the subjects performed a behavioral task on empathy for pain task (EPT), while the other half performed a behavioral task on empathy for happiness task (EHT). In each task, participants viewed prime photographs of either: (1) a stranger; or (2) a close friend (primes) followed by target photographs showing either a hand being hurt (or not; targets in the EPT), or a hand in happy circumstances (or not; targets in the EHT). In each task, participants were asked to judge the target situation and report whether they could feel the pain (in EPT) or the happiness (in the EHT), as a function of the primes i.e., either from the close friend’s or from the stranger’s perspective. Although our behavioral results didn’t reveal any explicit differences among the different types of primes within each task, our electrophysiological results showed variations as a function of the primes. First, a early smaller N110 amplitude for pain was observed in the anterior prefrontal cortex during the friend prime condition compared to the stranger prime condition. No similar early effects were found for happiness. On the other hand, both empathy for happiness (EHT) and empathy for pain (EPT) elicited later differences. In the EPT, the friend prime elicited a larger late positive potential (LPP) than the stranger prime. In the EHT, the friend prime elicited a larger N250, a smaller P300, and a smaller LPP than the stranger prime.

Conclusions: Taking the perspective of a close friend (as a prime stimulus) does have a dual-stage effect on empathy that is characterized by an early modulation for pain and later modulations for both pain and happiness. The early differences between friend and stranger primes for pain (but not for happiness) suggest that empathy for pain is an automatic process that has been socially learned and passed among friends. On the other hand, the later differences observed between stranger and friend prime suggest that additional cognitive appraisal take place for both pain and happiness. Our results suggest that it takes more cognitive attentional efforts to judge a stranger’s happiness than a friend’s happiness, whereas the opposite is true for pain. These findings open new avenues toward a better understanding of the empathic mind.

Neural responses to a modified Stroop paradigm in patients with complex chronic musculoskeletal pain compared to matched controls: an experimental functional magnetic resonance imaging study

Background

Chronic musculoskeletal pain (CMSKP) is attentionally demanding, complex and multi-factorial; neuroimaging research in the population seen in pain clinics is sparse. A better understanding of the neural activity underlying attentional processes to pain related information compared to healthy controls may help inform diagnosis and management in the future.

Methods

Blood oxygenation level dependent functional magnetic resonance imaging (BOLD fMRI) compared brain responses in patients with CMSKP (n = 15) and healthy controls (n = 14) while completing a modified Stroop task using pain-related, positive-emotional, and neutral control words.

Results

Response times in the Stroop task were no different for CMSKP patients compared with controls, but patients were less accurate in their responses to all word types. BOLD fMRI responses during presentation of pain-related words suggested increases in neural activation in patients compared to controls in regions previously reported as being involved in pain perception and emotion: the anterior cingulate cortex, insula and primary and secondary somatosensory cortex. No fMRI differences were seen between groups in response to positive or control words.

Conclusions

Using this modified Stroop tasks, specific differences were identified in brain activity between CMSKP patients and controls in response to pain-related information using fMRI. This provided evidence of differences in the way that pain-related information is processed in those with chronic complex musculoskeletal pain that were not detectable using the behavioural measures of speed and accuracy. The study may be helpful in gaining new insights into the impact of attention in those living with chronic pain.

Neural correlates of heat-evoked pain memory in humans

The neural processes underlying pain memory are not well understood. To explore these processes, contact heat-evoked potentials (CHEPs) were recorded in humans with electroencephalography (EEG) technique during a delayed matching-to-sample task, a working memory task involving presentations of two successive painful heat stimuli (S-1 and S-2) with different intensities separated by a 2-s interval (the memorization period). At the end of the task, the subject was required to discriminate the stimuli by indicating which (S-1 or S-2) induced more pain. A control task was used, in which no active discrimination was required between stimuli. All event-related potential (ERP) analysis was aligned to the onset of S-1. EEG activity exhibited two successive CHEPs: an N2-P2 complex (∼400 ms after onset of S-1) and an ultralate component (ULC, ∼900 ms). The amplitude of the N2-P2 at vertex, but not the ULC, was significantly correlated with stimulus intensity in these two tasks, suggesting that the N2-P2 represents neural coding of pain intensity. A late negative component (LNC) in the frontal recording region was observed only in the memory task during a 500-ms period before onset of S-2. LNC amplitude differed between stimulus intensities and exhibited significant correlations with the N2-P2 complex. These indicate that the frontal LNC is involved in maintenance of intensity of pain in working memory. Furthermore, alpha-band oscillations observed in parietal recording regions during the late delay displayed significant power differences between tasks. This study provides in the temporal domain previously unidentified neural evidence showing the neural processes involved in working memory of painful stimuli.

Double dissociation of neural responses supporting perceptual and cognitive components of social cognition: evidence from processing of others' pain

Models on how perceptual and cognitive information on others' mental states are treated by the cognitive architecture are often framed as duplex models considering two independent systems. In the context of the neuroscience of empathy analogous systems have been described. Using event-related potentials (i.e., ERPs) technique, we tested the hypothesis of temporal dissociation of two functional systems. We implemented a design in which perceptual (i.e., painful or neutral facial expressions) and contextual (i.e., painful or neutral related sentences) cues on others' mental states were orthogonally manipulated. Painful expressions selectively modulated the early activity at 110–360 ms over fronto-central and centro-parietal regions, whereas painful contexts selectively modulated the late activity at 400–840 ms over these same regions. Notably, the reactions to pain triggered by these cues added up when both were available, that is the joint reaction was characterized by additive effects. These findings favor a model assuming distinct neural paths of perceptual and cognitive processing, at least when the cognitive component is triggered by language.

Pain-related and negative semantic priming enhances perceived pain intensity

BACKGROUND

Negative affective and pain-related cues, such as pictures or words, have been shown to act as primes and enhance the perceived intensity of subsequent painful events. For pain-related semantic primes, it remains unclear whether this effect depends on negative valence itself or, specifically, on the pain-relatedness of the words.

OBJECTIVES

To investigate the effect of pain-related, negative affective (pain-unrelated) and neutral semantic primes on the perception of subsequent noxious target stimuli.

METHODS

Pain ratings in response to noxious electrical stimulation of light and moderate intensity were examined in 39 healthy subjects after subjects were exposed to semantic primes of different meaning and valence (pain-related, negative, positive and neutral adjectives) presented with different interstimulus intervals (0 ms, 500 ms and 1500 ms).

RESULTS

Increased pain ratings of noxious stimuli were observed following pain-related and negative compared with neutral primes.

DISCUSSION

The results support the motivational priming theory for semantic stimuli, indicating that affectively negative semantic primes increase subjective pain intensity. However, a specific pain-related priming effect was not reliably demonstrated. Additionally, it is shown that experimental parameters (ie, stimulus intensity and interstimulus interval) modify the extent of negative and pain-related semantic priming.

CONCLUSIONS

Verbal priming plays a role for the perception of noxious stimuli in a time-dependent manner.

Posterior P1 and early frontal negativity reflect developmental changes in attentional distraction during adolescence

Previous studies in adults have revealed that attentional distraction modulates the late positive potential (LPP) during emotion regulation. To determine whether early visual components reflect developmental changes in attentional distraction during adolescence, we collected event-related potentials from 20 young adolescents, 18 older adolescents, and 18 young adults as they performed a distraction task (counting) while viewing affective images. Consistent with previous findings obtained in distraction studies, the distraction task (counting) reduced emotional modulation of the LPP. At an early stage of processing, counting reduced emotional modulation of P1 and increased the negativity bias of early frontal negativity (eFN) for negatively valenced pictures compared to simple viewing with no distraction. sLORETA analyses further revealed eFN indexing of rostral prefrontal cortical activation, a cortical area that has been shown in recent fMRI studies to be activated by distraction. Moreover, P1 amplitudes in young and older adolescents did not differ but were both larger than the P1s in young adults. In addition, eFN amplitudes significantly decreased with age. The dissociable distraction patterns between the posterior P1 and eFN provide evidence not only for the timing hypothesis of emotion regulation but also for different developmental trajectories of visual processing areas and the prefrontal cortex during affective processing in adolescence.

Witnessing hateful people in pain modulates brain activity in regions associated with physical pain and reward

How does witnessing a hateful person in pain compare to witnessing a likable person in pain? The current study compared the brain bases for how we perceive likable people in pain with those of viewing hateful people in pain. While social bonds are built through sharing the plight and pain of others in the name of empathy, viewing a hateful person in pain also has many potential ramifications. In this functional Magnetic Resonance Imaging (fMRI) study, Caucasian Jewish male participants viewed videos of (1) disliked, hateful, anti-Semitic individuals, and (2) liked, non-hateful, tolerant individuals in pain. The results showed that, compared with viewing liked people, viewing hateful people in pain elicited increased responses in regions associated with observation of physical pain (the insular cortex, the anterior cingulate cortex (ACC), and the somatosensory cortex), reward processing (the striatum), and frontal regions associated with emotion regulation. Functional connectivity analyses revealed connections between seed regions in the left ACC and right insular cortex with reward regions, the amygdala, and frontal regions associated with emotion regulation. These data indicate that regions of the brain active while viewing someone in pain may be more active in response to the danger or threat posed by witnessing the pain of a hateful individual more so than the desire to empathize with a likable person's pain.

Anterior insular cortex and emotional awareness

This paper reviews the foundation for a role of the human anterior insular cortex (AIC) in emotional awareness, defined as the conscious experience of emotions. We first introduce the neuroanatomical features of AIC and existing findings on emotional awareness. Using empathy, the awareness and understanding of other people's emotional states, as a test case, we then present evidence to demonstrate: 1) AIC and anterior cingulate cortex (ACC) are commonly coactivated as revealed by a meta-analysis, 2) AIC is functionally dissociable from ACC, 3) AIC integrates stimulus-driven and top-down information, and 4) AIC is necessary for emotional awareness. We propose a model in which AIC serves two major functions: integrating bottom-up interoceptive signals with top-down predictions to generate a current awareness state and providing descending predictions to visceral systems that provide a point of reference for autonomic reflexes. We argue that AIC is critical and necessary for emotional awareness.

Distraction reduces theta synchronization in emotion regulation during adolescence

We sought to determine if attentional distraction in adolescents can modulate event-related desynchronization or synchronization (ERD or ERS) of the theta band during emotion regulation. Event-related theta oscillations were collected from 48 adolescents and young adults as they performed a distraction (counting) task while viewing affective pictures. Consistent with data from adult participants, positive and negative pictures elicited a larger theta ERS than did neutral pictures within a 100-400 ms window, indicating that early theta ERS is indicative of motivated attention to biologically salient stimuli. Counting as a distraction strategy attenuated early affective modulation of theta ERS. Moreover, theta ERS increased with age in the anterior regions of the brain regardless of valence; however, no age differences were found in the posterior regions. These results suggest that distraction depends on a top-down attentional mechanism that disrupts theta ERS for affective pictures at an early stage. Furthermore, adolescents undergo a developmental increase in oscillatory brain reorganization.

Cognitive and affective theory of mind share the same local patterns of activity in posterior temporal but not medial prefrontal cortex

Understanding emotions in others engages specific brain regions in temporal and medial prefrontal cortices. These activations are often attributed to more general cognitive 'mentalizing' functions, associated with theory of mind and also necessary to represent people's non-emotional mental states, such as beliefs or intentions. Here, we directly investigated whether understanding emotional feelings recruit similar or specific brain systems, relative to other non-emotional mental states. We used functional magnetic resonance imaging with multivoxel pattern analysis in 46 volunteers to compare activation patterns in theory-of-mind tasks for emotions, relative to beliefs or somatic states accompanied with pain. We found a striking dissociation between the temporoparietal cortex, that exhibited a remarkable voxel-by-voxel pattern overlap between emotions and beliefs (but not pain), and the dorsomedial prefrontal cortex, that exhibited distinct (and yet nearby) patterns of activity during the judgment of beliefs and emotions in others. Pain judgment was instead associated with activity in the supramarginal gyrus, middle cingulate cortex and middle insular cortex. Our data reveal for the first time a functional dissociation within brain networks sub-serving theory of mind for different mental contents, with a common recruitment for cognitive and affective states in temporal regions, and distinct recruitment in prefrontal areas.

Can contrast effects regulate emotions? A follow-up study of vital loss decisions

Although many studies focus on the how contrast effects can impact cognitive evaluations, the question of whether emotions are regulated by such contrast effects is still the subject of considerable debate, especially in the study of loss-related decisions. To address this gap in the literature, we designed three decision making loss conditions: (i) both losses are trivial (TT), (ii) one loss is trivial and the other loss is vital (TV), or (iii) one loss is trivial and the other loss is routine (TR). In study 1, which compared the difference between the negative emotion ratings in TT and TV, we found that negative emotions were affected by the contrast effects. In study 2, which compared the difference between the importance of trivial options in TT and TV, we found that the contrast effects differentially changed the importance of trivial options in the two conditions, which in turn down-regulated negative emotions. In study 3, the impact of decision difficulty was controlled by predetermining the items to be lost. In this study, we found that, when comparing the differences between the negative emotions of losing trivial options in TV and TR, the contrast effects still modulated the loss-related emotions. We concluded that the contrast effects could down-regulate emotions. To our knowledge, this is the first demonstration that contrast effects can alleviate negative affect in loss-related decision making. This study will enrich and extend the literature on emotion regulation theory, and it will provide a new cost-effective mitigation strategy for regulating negative emotions.

Cognition-emotion integration in the anterior insular cortex

Both cognitive and affective processes require mental resources. However, it remains unclear whether these 2 processes work in parallel or in an integrated fashion. In this functional magnetic resonance imaging study, we investigated their interaction using an empathy-for-pain paradigm, with simultaneous manipulation of cognitive demand of the tasks and emotional valence of the stimuli. Eighteen healthy adult participants viewed photographs showing other people's hands and feet in painful or nonpainful situations while performing tasks of low (body part judgment) and high (laterality judgment) cognitive demand. Behavioral data showed increased reaction times and error rates for painful compared with nonpainful stimuli under laterality judgment relative to body part judgment, indicating an interaction between cognitive demand and stimulus valence. Imaging analyses showed activity in bilateral anterior insula (AI) and primary somatosensory cortex (SI), but not posterior insula, for main effects of cognitive demand and stimulus valence. Importantly, cognitive demand and stimulus valence showed a significant interaction in AI, SI, and regions of the frontoparietal network. These results suggest that cognitive and emotional processes at least partially share common brain networks and that AI might serve as a key node in a brain network subserving cognition-emotion integration.

Distinct roles of the 'shared pain' and 'theory of mind' networks in processing others' emotional suffering

The brain mechanisms involved in processing another's physical pain have been extensively studied in recent years. The link between understanding others' physical pain and emotional suffering is less well understood. Using whole brain analysis and two separate functional localizers, we characterized the neural response profiles of narrative scenarios involving physical pain (PP), and scenarios involving emotional pain (EP) with functional magnetic resonance imaging (fMRI). Whole brain analyses revealed that PP narratives activated the Shared Pain network, and that the brain regions responsible for processing EP overlapped substantially with brain regions involved in Theory of Mind. Region of interest (ROI) analysis provided a finer-grained view. Some regions responded to stories involving physical states, regardless of painful content (secondary sensory regions), some selectively responded to both emotionally and physically painful events (bilateral anterior thalamus and anterior middle cingulate cortex), one brain region responded selectively to physical pain (left insula), and one brain region responded selectively to emotional pain (dorsomedial prefrontal cortex). These results replicated in two groups of participants given different explicit tasks. Together, these results clarify the distinct roles of multiple brain regions in responding to others who are in physical or emotional pain.

[Pain words activate pain-processing neural structures]

Previous studies suggested that areas of the neural"pain matrix" are activated by the processing of pain-related environmental cues such as pain-related pictures or descriptors of pain. However, it is still sketchy whether these activations are specific to the pain-relevant content of the stimuli or simply reflect a general effect of negative emotional valence or increased arousal. The present study addressed this question by investigating the neural mechanisms underlying the processing of pain-related, negative (non-pain-related), positive and neutral words. When subjects were instructed to image a situation associated with the word presented (imagination task), we found increased activation within the dorsolateral prefrontal cortex (DLPFC) and inferior parietal cortex (IPC) when processing pain-related words compared to other words. When attention was focused on a distracting task (distraction task), we found a decrease in activation within the dorsal anterior cingulum (dACC) and a relative increase in activation within the subgenual anterior cingulum (sACC) when processing pain-related words compared to other words. These results indicate that the differences in processing pain-related words compared to non-pain-related words are specific to the content of the words and cannot simply be explained by emotional valence or arousal. Additionally, we showed that the specific activations to pain-related words are substantially modulated by the attention demands of the task.

Can Sophie's choice be adequately captured by cold computation of minimizing losses? An fMRI study of vital loss decisions

The vast majority of decision-making research is performed under the assumption of the value maximizing principle. This principle implies that when making decisions, individuals try to optimize outcomes on the basis of cold mathematical equations. However, decisions are emotion-laden rather than cool and analytic when they tap into life-threatening considerations. Using functional magnetic resonance imaging (fMRI), this study investigated the neural mechanisms underlying vital loss decisions. Participants were asked to make a forced choice between two losses across three conditions: both losses are trivial (trivial-trivial), both losses are vital (vital-vital), or one loss is trivial and the other is vital (vital-trivial). Our results revealed that the amygdala was more active and correlated positively with self-reported negative emotion associated with choice during vital-vital loss decisions, when compared to trivial-trivial loss decisions. The rostral anterior cingulate cortex was also more active and correlated positively with self-reported difficulty of choice during vital-vital loss decisions. Compared to the activity observed during trivial-trivial loss decisions, the orbitofrontal cortex and ventral striatum were more active and correlated positively with self-reported positive emotion of choice during vital-trivial loss decisions. Our findings suggest that vital loss decisions involve emotions and cannot be adequately captured by cold computation of minimizing losses. This research will shed light on how people make vital loss decisions.

Affective brain regions are activated during the processing of pain-related words in migraine patients

Several brain areas that constitute the neural matrix of pain can be activated by noxious stimuli and by pain-relevant cues, such as pictures, facial expressions, and pain-related words. Although chronic pain patients are frequently exposed to pain-related words, it remains unclear whether their pain matrix is specifically activated during the processing of such stimuli in comparison to healthy subjects. To answer this question, we compared the neural activations induced by verbal pain descriptors in a sample of migraine patients with activations in healthy controls using functional magnetic resonance imaging. Participants viewed pain-related adjectives and negative, non-pain-related adjectives that were matched for valence and arousal and were instructed to either generate mental images (imagination condition) or to count the number of vowels (distraction condition). In migraine patients, pain-related adjectives as compared with negative adjectives elicited increased activations in the left orbitofrontal cortex and anterior insula during imagination and in the right secondary somatosensory cortex and posterior insula during distraction. More pronounced pain-related activation was observed in affective pain-related regions in the patient as compared with the control group during imagination. During distraction, no differential engagement of single brain structures in response to pain-related words could be observed between groups. Overall, our findings indicate that there is an involvement of brain regions associated with the affective and sensory-discriminative dimension of pain in the processing of pain-related words in migraine patients, and that the recruitment of those regions associated with pain-related affect is enhanced in patients with chronic pain experiences.

Empathic neural responses to others' pain are modulated by emotional contexts

Recent brain imaging studies indicate that empathy for pain relies upon both the affective and/or the sensorimotor nodes of the pain matrix, and empathic neural responses are modulated by stimulus reality, personal experience, and affective link with others. The current work investigated whether and how empathic neural responses are modulated by emotional contexts in which painful stimulations are perceived. Using functional magnetic resonance imaging (fMRI), we first showed that perceiving a painful stimulation (needle penetration) applied to a face with neutral expression induced activation in the anterior cingulate cortex (ACC) relative to nonpainful stimulation (Q-tip touch). However, when observation of the painful stimuli delivered to a neutral face was intermixed with observation of painful or happy faces, the ACC activity decreased while the activity in the face area of the secondary somatosensory cortex increased to the painful stimulation. Moreover, the secondary somatosensory activity associated with the painful stimulation decreased when the painful stimulation was applied to faces with happy and painful expressions. The findings suggest that observing painful stimuli in an emotional context weakens affective responses but increases sensory responses to perceived pain and implies possible interactions between the affective and sensory components of the pain matrix during empathy for pain.

The skin as a social organ

In general, social neuroscience research tends to focus on visual and auditory channels as routes for social information. However, because the skin is the site of events and processes crucial to the way we think about, feel about, and interact with one another, touch can mediate social perceptions in various ways. This review situates cutaneous perception within a social neuroscience framework by discussing evidence for considering touch (and to some extent pain) as a channel for social information. Social information conveys features of individuals or their interactions that have potential bearing on future interactions, and attendant mental and emotional states. Here, we discuss evidence for an affective dimension of touch and explore its wider implications for the exchange of social information. We consider three important roles for this affective dimension of the cutaneous senses in the transmission and processing of social information: first, through affiliative behavior and communication; second, via affective processing in skin-brain pathways; and third, as a basis for intersubjective representation.

Placebo conditioning and placebo analgesia modulate a common brain network during pain anticipation and perception

The neural mechanisms whereby placebo conditioning leads to placebo analgesia remain unclear. In this study we aimed to identify the brain structures activated during placebo conditioning and subsequent placebo analgesia. We induced placebo analgesia by associating a sham treatment with pain reduction and used fMRI to measure brain activity associated with three stages of the placebo response: before, during and after the sham treatment, while participants anticipated and experienced brief laser pain. In the control session participants were explicitly told that the treatment was inactive. The sham treatment group reported a significant reduction in pain rating (p=0.012). Anticipatory brain activity was modulated during placebo conditioning in a fronto-cingulate network involving the left dorsolateral prefrontal cortex (DLPFC), medial frontal cortex and the anterior mid-cingulate cortex (aMCC). Identical areas were modulated during anticipation in the placebo analgesia phase with the addition of the orbitofrontal cortex (OFC). However, during altered pain experience only aMCC, post-central gyrus and posterior cingulate demonstrated altered activity. The common frontal cortical areas modulated during anticipation in both the placebo conditioning and placebo analgesia phases have previously been implicated in placebo analgesia. Our results suggest that the main effect of placebo arises from the reduction of anticipation of pain during placebo conditioning that is subsequently maintained during placebo analgesia.

Alexithymic trait and voluntary control in healthy adults

BACKGROUND

Alexithymia is a personality trait characterized by deficiency in understanding, processing, or describing emotions. Recent studies have revealed that alexithymia is associated with less activation of the anterior cingulate cortex, a brain region shown to play a role in cognitive and emotional processing. However, few studies have directly investigated the cognitive domain in relation to alexithymia to examine whether alexithymic trait is related to less efficient voluntary control.

METHODOLOGY/PRINCIPAL FINDINGS

We examined the relationship between alexithymic trait and voluntary control in a group of healthy volunteers. We used the 20-item Toronto Alexithymia Scale (TAS-20) to measure alexithymic trait. Additionally, we examined state and trait voluntary control using the revised Attention Network Test (ANT-R) and the Adult Temperament Questionnaire (ATQ), respectively. Alexithymic trait was positively correlated with the overall reaction time of the ANT-R, and negatively correlated with the Effortful Control factor of the ATQ.

CONCLUSIONS/SIGNIFICANCE

Our results suggest that alexithymic trait is associated with less efficient voluntary control.