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Ehmsen JF, Nikolova N, Christensen DE, Banellis L, Böhme RA, Brændholt M, Courtin AS, Krænge CE, Mitchell AG, Sardeto Deolindo C, Steenkjær CH, Vejlø M, Mathys C, Allen MG, Fardo F. Thermosensory predictive coding underpins an illusion of pain. SCIENCE ADVANCES 2025; 11:eadq0261. [PMID: 40073134 PMCID: PMC11900864 DOI: 10.1126/sciadv.adq0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 02/05/2025] [Indexed: 03/15/2025]
Abstract
The human brain has a remarkable ability to learn and update its beliefs about the world. Here, we investigate how thermosensory learning shapes our subjective experience of temperature and the misperception of pain in response to harmless thermal stimuli. Through computational modeling, we demonstrate that the brain uses a probabilistic predictive coding scheme to update beliefs about temperature changes based on their uncertainty. We find that these expectations directly modulate the perception of pain in the thermal grill illusion. Quantitative microstructural brain imaging further revealed that individual variability in computational parameters related to uncertainty-driven learning and decision-making is reflected in the microstructure of brain regions such as the precuneus, posterior cingulate gyrus, cerebellum, as well as basal ganglia and brainstem. These findings provide a framework to understand how the brain infers pain from innocuous thermal inputs, with important implications for the etiology of thermosensory symptoms under chronic pain conditions.
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Affiliation(s)
- Jesper Fischer Ehmsen
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niia Nikolova
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Daniel Elmstrøm Christensen
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Leah Banellis
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rebecca A. Böhme
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Malthe Brændholt
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- BioMedical Design, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Arthur S. Courtin
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Institute of Neuroscience (IoNS), Université catholique de Louvain, Brussels, Belgium
| | - Camilla E. Krænge
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Alexandra G. Mitchell
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Camila Sardeto Deolindo
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christian Holm Steenkjær
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Neurology, Aalborg University Hospital, Aalborg, Denmark
| | - Melina Vejlø
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christoph Mathys
- Interacting Minds Center (IMC), Aarhus University, Aarhus, Denmark
| | - Micah G. Allen
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Cambridge Psychiatry, University of Cambridge, Cambridge, UK
| | - Francesca Fardo
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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