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Corradi‐Dell'Acqua C, Hofstetter C, Sharvit G, Hugli O, Vuilleumier P. Healthcare experience affects pain-specific responses to others' suffering in the anterior insula. Hum Brain Mapp 2023; 44:5655-5671. [PMID: 37608624 PMCID: PMC10619377 DOI: 10.1002/hbm.26468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 07/22/2023] [Indexed: 08/24/2023] Open
Abstract
Medical students and professional healthcare providers often underestimate patients' pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self-pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other's pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self-pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others' suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain that is shared with that of first-hand nociception, and related more to AI than to other pain-responsive regions. Taken together, our study suggests a decreased propensity to appraise others' suffering as one's own, associated with a reduced recruitment of pain-specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings.
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Affiliation(s)
- Corrado Corradi‐Dell'Acqua
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE)University of GenevaGenevaSwitzerland
- Geneva Neuroscience CenterUniversity of GenevaGenevaSwitzerland
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
| | - Christoph Hofstetter
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
| | - Gil Sharvit
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
- Swiss Center for Affective Sciences, University of GenevaGenevaSwitzerland
- Balgrist University Hospital and University of ZurichZurichSwitzerland
| | - Olivier Hugli
- Emergency Department, University Hospital of Lausanne (UHL)LausanneSwitzerland
| | - Patrik Vuilleumier
- Geneva Neuroscience CenterUniversity of GenevaGenevaSwitzerland
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
- Swiss Center for Affective Sciences, University of GenevaGenevaSwitzerland
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2
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Forkmann K, Wiech K, Schmidt K, Schmid-Köhler J, Bingel U. Neural underpinnings of preferential pain learning and the modulatory role of fear. Cereb Cortex 2023; 33:9664-9676. [PMID: 37408110 DOI: 10.1093/cercor/bhad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023] Open
Abstract
Due to its unique biological relevance, pain-related learning might differ from learning from other aversive experiences. This functional magnetic resonance imaging study compared neural mechanisms underlying the acquisition and extinction of different threats in healthy humans. We investigated whether cue-pain associations are acquired faster and extinguished slower than cue associations with an equally unpleasant tone. Additionally, we studied the modulatory role of stimulus-related fear. Therefore, we used a differential conditioning paradigm, in which somatic heat pain stimuli and unpleasantness-matched auditory stimuli served as US. Our results show stronger acquisition learning for pain- than tone-predicting cues, which was augmented in participants with relatively higher levels of fear of pain. These behavioral findings were paralleled by activation of brain regions implicated in threat processing (insula, amygdala) and personal significance (ventromedial prefrontal cortex). By contrast, extinction learning seemed to be less dependent on the threat value of the US, both on the behavioral and neural levels. Amygdala activity, however, scaled with pain-related fear during extinction learning. Our findings on faster and stronger (i.e. "preferential") pain learning and the role of fear of pain are consistent with the biological relevance of pain and may be relevant to the development or maintenance of chronic pain.
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Affiliation(s)
- Katarina Forkmann
- Department of Neurology, Center for Translational Neuro- and Behavioural Sciences, University Hospital Essen, University Duisburg Essen, Hufelandstraße 55, Essen 45147, Germany
| | - Katja Wiech
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom
| | - Katharina Schmidt
- Department of Neurology, Center for Translational Neuro- and Behavioural Sciences, University Hospital Essen, University Duisburg Essen, Hufelandstraße 55, Essen 45147, Germany
| | - Julia Schmid-Köhler
- Department of Neurology, Center for Translational Neuro- and Behavioural Sciences, University Hospital Essen, University Duisburg Essen, Hufelandstraße 55, Essen 45147, Germany
| | - Ulrike Bingel
- Department of Neurology, Center for Translational Neuro- and Behavioural Sciences, University Hospital Essen, University Duisburg Essen, Hufelandstraße 55, Essen 45147, Germany
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3
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Sharvit G, Schweinhardt P. The influence of social signals on the self-experience of pain: A neuroimaging review. Front Neurol 2022; 13:856874. [PMID: 36090868 PMCID: PMC9459049 DOI: 10.3389/fneur.2022.856874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Researchers in cognitive neuroscience have investigated extensively how psychological factors shape the processing and perception of pain using behavioral, physiological, and neuroimaging methods. However, social influences of pain, an essential part of biopsychosocial pain models, have received relatively little attention. This is particularly true for the neurobiological mechanisms underlying social modulations on pain. Therefore, this review discusses the findings of recent neuroimaging studies measuring the effects of social manipulations on pain perception (e.g., verbal and non-verbal social signals, social interaction style, conformity, social support, and sociocultural mediators). Finally, a schematic summary of the different social modulatory themes is presented.
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Affiliation(s)
- Gil Sharvit
- Department of Chiropractic Medicine, Integrative Spinal Research, Balgrist University Hospital, University of Zurich (UZH), Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich (UZH), Zurich, Switzerland
- *Correspondence: Gil Sharvit
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Integrative Spinal Research, Balgrist University Hospital, University of Zurich (UZH), Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich (UZH), Zurich, Switzerland
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4
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Chae Y, Park HJ, Lee IS. Pain modalities in the body and brain: Current knowledge and future perspectives. Neurosci Biobehav Rev 2022; 139:104744. [PMID: 35716877 DOI: 10.1016/j.neubiorev.2022.104744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/29/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022]
Abstract
Development and validation of pain biomarkers has become a major issue in pain research. Recent advances in multimodal data acquisition have allowed researchers to gather multivariate and multilevel whole-body measurements in patients with pain conditions, and data analysis techniques such as machine learning have led to novel findings in neural biomarkers for pain. Most studies have focused on the development of a biomarker to predict the severity of pain with high precision and high specificity, however, a similar approach to discriminate different modalities of pain is lacking. Identification of more accurate and specific pain biomarkers will require an in-depth understanding of the modality specificity of pain. In this review, we summarize early and recent findings on the modality specificity of pain in the brain, with a focus on distinct neural activity patterns between chronic clinical and acute experimental pain, direct, social, and vicarious pain, and somatic and visceral pain. We also suggest future directions to improve our current strategy of pain management using our knowledge of modality-specific aspects of pain.
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Affiliation(s)
- Younbyoung Chae
- College of Korean Medicine, Kyung Hee University, Seoul, the Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, the Republic of Korea
| | - Hi-Joon Park
- College of Korean Medicine, Kyung Hee University, Seoul, the Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, the Republic of Korea
| | - In-Seon Lee
- College of Korean Medicine, Kyung Hee University, Seoul, the Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, the Republic of Korea.
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5
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Fermin ASR, Friston K, Yamawaki S. An insula hierarchical network architecture for active interoceptive inference. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220226. [PMID: 35774133 PMCID: PMC9240682 DOI: 10.1098/rsos.220226] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/09/2022] [Indexed: 05/05/2023]
Abstract
In the brain, the insular cortex receives a vast amount of interoceptive information, ascending through deep brain structures, from multiple visceral organs. The unique hierarchical and modular architecture of the insula suggests specialization for processing interoceptive afferents. Yet, the biological significance of the insula's neuroanatomical architecture, in relation to deep brain structures, remains obscure. In this opinion piece, we propose the Insula Hierarchical Modular Adaptive Interoception Control (IMAC) model to suggest that insula modules (granular, dysgranular and agranular), forming parallel networks with the prefrontal cortex and striatum, are specialized to form higher order interoceptive representations. These interoceptive representations are recruited in a context-dependent manner to support habitual, model-based and exploratory control of visceral organs and physiological processes. We discuss how insula interoceptive representations may give rise to conscious feelings that best explain lower order deep brain interoceptive representations, and how the insula may serve to defend the body and mind against pathological depression.
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Affiliation(s)
- Alan S. R. Fermin
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Karl Friston
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, England
| | - Shigeto Yamawaki
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, Hiroshima, Japan
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6
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Horing B, Büchel C. The human insula processes both modality-independent and pain-selective learning signals. PLoS Biol 2022; 20:e3001540. [PMID: 35522696 PMCID: PMC9116652 DOI: 10.1371/journal.pbio.3001540] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/18/2022] [Accepted: 04/15/2022] [Indexed: 12/02/2022] Open
Abstract
Prediction errors (PEs) are generated when there are differences between an expected and an actual event or sensory input. The insula is a key brain region involved in pain processing, and studies have shown that the insula encodes the magnitude of an unexpected outcome (unsigned PEs). In addition to signaling this general magnitude information, PEs can give specific information on the direction of this deviation-i.e., whether an event is better or worse than expected. It is unclear whether the unsigned PE responses in the insula are selective for pain or reflective of a more general processing of aversive events irrespective of modality. It is also unknown whether the insula can process signed PEs at all. Understanding these specific mechanisms has implications for understanding how pain is processed in the brain in both health and in chronic pain conditions. In this study, 47 participants learned associations between 2 conditioned stimuli (CS) with 4 unconditioned stimuli (US; painful heat or loud sound, of one low and one high intensity each) while undergoing functional magnetic resonance imaging (fMRI) and skin conductance response (SCR) measurements. We demonstrate that activation in the anterior insula correlated with unsigned intensity PEs, irrespective of modality, indicating an unspecific aversive surprise signal. Conversely, signed intensity PE signals were modality specific, with signed PEs following pain but not sound located in the dorsal posterior insula, an area implicated in pain intensity processing. Previous studies have identified abnormal insula function and abnormal learning as potential causes of pain chronification. Our findings link these results and suggest that a misrepresentation of learning relevant PEs in the insular cortex may serve as an underlying factor in chronic pain.
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Affiliation(s)
- Björn Horing
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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7
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Resting-state functional heterogeneity of the right insula contributes to pain sensitivity. Sci Rep 2021; 11:22945. [PMID: 34824347 PMCID: PMC8617295 DOI: 10.1038/s41598-021-02474-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022] Open
Abstract
Previous studies have described the structure and function of the insular cortex in terms of spatially continuous gradients. Here we assess how spatial features of insular resting state functional organization correspond to individual pain sensitivity. From a previous multicenter study, we included 107 healthy participants, who underwent resting state functional MRI scans, T1-weighted scans and quantitative sensory testing on the left forearm. Thermal and mechanical pain thresholds were determined. Connectopic mapping, a technique using non-linear representations of functional organization was employed to describe functional connectivity gradients in both insulae. Partial coefficients of determination were calculated between trend surface model parameters summarizing spatial features of gradients, modal and modality-independent pain sensitivity. The dominant connectopy captured the previously reported posteroanterior shift in connectivity profiles. Spatial features of dominant connectopies in the right insula explained significant amounts of variance in thermal (R2 = 0.076; p < 0.001 and R2 = 0.031; p < 0.029) and composite pain sensitivity (R2 = 0.072; p < 0.002). The left insular gradient was not significantly associated with pain thresholds. Our results highlight the functional relevance of gradient-like insular organization in pain processing. Considering individual variations in insular connectopy might contribute to understanding neural mechanisms behind pain and improve objective brain-based characterization of individual pain sensitivity.
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Atlas LY. A social affective neuroscience lens on placebo analgesia. Trends Cogn Sci 2021; 25:992-1005. [PMID: 34538720 PMCID: PMC8516707 DOI: 10.1016/j.tics.2021.07.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/26/2022]
Abstract
Pain is a fundamental experience that promotes survival. In humans, pain stands at the intersection of multiple health crises: chronic pain, the opioid epidemic, and health disparities. The study of placebo analgesia highlights how social, cognitive, and affective processes can directly shape pain, and identifies potential paths for mitigating these crises. This review examines recent progress in the study of placebo analgesia through affective science. It focuses on how placebo effects are shaped by expectations, affect, and the social context surrounding treatment, and discusses neurobiological mechanisms of placebo, highlighting unanswered questions and implications for health. Collaborations between clinicians and social and affective scientists can address outstanding questions and leverage placebo to reduce pain and improve human health.
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Affiliation(s)
- Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA; National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA; National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.
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9
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Koenen LR, Pawlik RJ, Icenhour A, Petrakova L, Forkmann K, Theysohn N, Engler H, Elsenbruch S. Associative learning and extinction of conditioned threat predictors across sensory modalities. Commun Biol 2021; 4:553. [PMID: 33976383 PMCID: PMC8113515 DOI: 10.1038/s42003-021-02008-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/18/2021] [Indexed: 12/19/2022] Open
Abstract
The formation and persistence of negative pain-related expectations by classical conditioning remain incompletely understood. We elucidated behavioural and neural correlates involved in the acquisition and extinction of negative expectations towards different threats across sensory modalities. In two complementary functional magnetic resonance imaging studies in healthy humans, differential conditioning paradigms combined interoceptive visceral pain with somatic pain (study 1) and aversive tone (study 2) as exteroceptive threats. Conditioned responses to interoceptive threat predictors were enhanced in both studies, consistently involving the insula and cingulate cortex. Interoceptive threats had a greater impact on extinction efficacy, resulting in disruption of ongoing extinction (study 1), and selective resurgence of interoceptive CS-US associations after complete extinction (study 2). In the face of multiple threats, we preferentially learn, store, and remember interoceptive danger signals. As key mediators of nocebo effects, conditioned responses may be particularly relevant to clinical conditions involving disturbed interoception and chronic visceral pain.
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Affiliation(s)
- Laura R Koenen
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Robert J Pawlik
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Adriane Icenhour
- Translational Pain Research Unit, Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Liubov Petrakova
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Katarina Forkmann
- Translational Pain Research Unit, Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nina Theysohn
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany.
- Translational Pain Research Unit, Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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10
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Ushio K, Nakanishi K, Mikami Y, Yoshino A, Takamura M, Hirata K, Akiyama Y, Kimura H, Okamoto Y, Adachi N. Altered Resting-State Connectivity with Pain-Related Expectation Regions in Female Patients with Severe Knee Osteoarthritis. J Pain Res 2020; 13:3227-3234. [PMID: 33299346 PMCID: PMC7719440 DOI: 10.2147/jpr.s268529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose Expectation affects pain experience in humans. Numerous studies have reported that pre-stimulus activity in the anterior insular cortex (aIC), together with prefrontal and limbic regions, integrated pain intensity and expectations. However, it is unclear whether the resting-state functional connectivity (rs-FC) between the aIC and other brain regions affects chronic pain. The purpose of this study was to examine the rs-FC between the aIC and the whole brain regions in female patients with severe knee osteoarthritis (OA). Patients and Methods Nineteen female patients with chronic severe knee OA and 15 matched controls underwent resting-state functional magnetic resonance imaging. We compared the rs-FC from the aIC seed region between the two groups. A disease-specific measurement of knee OA was performed. Results The aIC showed stronger rs-FC with the right orbitofrontal cortex (OFC), subcallosal area, and bilateral frontal pole compared with controls. The strength of rs-FC between the left aIC and the right OFC was positively correlated with the knee OA pain score (r = 0.49, p = 0.03). The strength of rs-FC between the right aIC and right OFC was positively correlated with the knee OA total score (r = 0.48, p = 0.036) and pain score (r = 0.46, p = 0.049). The OFC, subcallosal area, and frontal pole, together with the aIC, were activated during anticipation of pain stimulus. These areas have been reported as representative pain-related expectation regions. Conclusion This was the first study to show the stronger rs-FCs between the aIC and other pain-related expectation regions in female patients with severe knee OA. Female sex and preoperative pain intensity are risk factors of persistent postoperative pain after total knee arthroplasty. It is suggested that the functional relationship between pain-related expectation regions affects the formation of severe knee OA and persistent postoperative pain following total knee arthroplasty.
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Affiliation(s)
- Kai Ushio
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.,Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Orthopedic Surgery, Nihon University School of Medicine, Nihon University, Tokyo, Japan
| | - Yukio Mikami
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.,Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Brain, Mind and KANSEI Sciences Research Center, Hiroshima University, Hiroshima, Japan
| | - Kazuhiko Hirata
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuji Akiyama
- Department of Clinical Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.,Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan.,Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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11
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Wang D, Merkle SL, Lee JE, Sluka KA, Rakel B, Graven-Nielsen T, Frey-Law LA. Multisensory Sensitivity is Related to Deep-Tissue but Not Cutaneous Pain Sensitivity in Healthy Individuals. J Pain Res 2020; 13:2493-2508. [PMID: 33116791 PMCID: PMC7548328 DOI: 10.2147/jpr.s267972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/29/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Some individuals with chronic pain find daily life sensations (eg, noise, light, or touch) aversive. This amplification of multisensory sensations has been associated with centrally mediated plasticity; for example, greater multisensory sensitivity (MSS) occurs in patients with fibromyalgia than rheumatoid arthritis. However, whether MSS preferentially relates to pain measures which reflect central influences (eg, dynamic quantitative sensory testing (QST) or referred pain), or whether the MSS-pain relationship requires priming from chronic pain, is unknown. Thus, this cross-sectional study investigated the relationships between MSS assessed in a pain-free state and evoked pain sensitivity. METHODS Experimental intramuscular infusion pain and multiple static and dynamic QST were assessed in 465 healthy, pain-free adults: pain thresholds using pressure (PPTs) and heat (HPTs), temporal summation of pain (TSP) using pressure, heat or punctate stimuli, and conditioned pain modulation (CPM) using pressure or heat test stimuli. MSS was assessed using 7 items from Barsky's Somatosensory Amplification Scale. Differences in pain and QST between sex-specific MSS quartiles were assessed, adjusting for multiple comparisons. All participants completed at least one intramuscular infusion condition, but not all were asked to complete each QST (n=166-465). RESULTS Both static and dynamic QST differed between highest and lowest MSS quartiles using pressure stimuli: lower PPTs (adjusted-p<0.01); increased pressure TSP (adjusted-p=0.02); lower pressure CPM (adjusted-p=0.01). However, none of the heat or punctate QST measures (HPTs, TSP, or CPM) differed between MSS quartiles (adjusted-p>0.05). Odds of experiencing TSP or referred pain was not greater, whereas CPM was 8-fold less likely, in those with highest MSS. CONCLUSION Normal variation in non-noxious MSS is related to both static and dynamic pain sensitivity, without sensitization associated with chronic pain, but is dependent on the QST stimulus. Thus, common influences on MSS and pain sensitivity may involve central mechanisms but are likely more complex than previously recognized.
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Affiliation(s)
- Dan Wang
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Shannon L Merkle
- United States Army Research Institute of Environmental Medicine (USARIEM), Natick, MA, USA
| | - Jennifer E Lee
- Department of Psychology, Mount Mercy University, Cedar Rapids, IA, USA
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Barbara Rakel
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Aalborg University, Aalborg, Denmark
| | - Laura A Frey-Law
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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12
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Sharvit G, Lin E, Vuilleumier P, Corradi-Dell'Acqua C. Does inappropriate behavior hurt or stink? The interplay between neural representations of somatic experiences and moral decisions. SCIENCE ADVANCES 2020; 6:6/42/eaat4390. [PMID: 33067240 PMCID: PMC7567598 DOI: 10.1126/sciadv.aat4390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
Embodied models suggest that moral judgments are strongly intertwined with first-hand somatic experiences, with some pointing to disgust, and others arguing for a role of pain/harm. Both disgust and pain are unpleasant, arousing experiences, with strong relevance for survival, but with distinctive sensory qualities and neural channels. Hence, it is unclear whether moral cognition interacts with sensory-specific properties of one somatic experience or with supramodal dimensions common to both. Across two experiments, participants evaluated ethical dilemmas and subsequently were exposed to disgusting (olfactory) or painful (thermal) stimulations of matched unpleasantness. We found that moral scenarios enhanced physiological and neural activity to subsequent disgust (but not pain), as further supported by an independently validated whole-brain signature of olfaction. This effect was mediated by activity in the posterior cingulate cortex triggered by dilemma judgments. Our results thus speak in favor of an association between moral cognition and sensory-specific properties of disgust.
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Affiliation(s)
- G Sharvit
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Haas School of Business, University of California, Berkeley, Berkeley, CA, USA
| | - E Lin
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
- Department of Management, Technology, and Economics, ETH, 8006, Zurich, Switzerland
| | - P Vuilleumier
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
| | - C Corradi-Dell'Acqua
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland.
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland
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Zarei SP, Briscese L, Capitani S, Rossi B, Carboncini MC, Santarcangelo EL, Motie Nasrabadi A. Hypnotizability-Related Effects of Pain Expectation on the Later Modulation of Cortical Connectivity. Int J Clin Exp Hypn 2020; 68:306-326. [PMID: 32510271 DOI: 10.1080/00207144.2020.1762196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined hypnotizability-related modulation of the cortical network following expected and nonexpected nociceptive stimulation. The electroencephalogram (EEG) was recorded in 9 high (highs) and 8 low (lows) hypnotizable participants receiving nociceptive stimulation with (W1) and without (noW) a visual warning preceding the stimulation by 1 second. W1 and noW were compared to baseline conditions to assess the presence of any later effect and between each other to assess the effects of expectation. The studied EEG variables measured local and global features of the cortical connectivity. With respect to lows, highs exhibited scarce differences between experimental conditions. The hypnotizability-related differences in the later processing of nociceptive information could be relevant to the development of pain-related individual traits. Present findings suggest a lower impact of nociceptive stimulation in highs than in lows.
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Affiliation(s)
| | - Lucia Briscese
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Simone Capitani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Bruno Rossi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Maria C Carboncini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
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14
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Helversen B, Coppin G, Scheibehenne B. Money does not stink: Using unpleasant odors as stimulus material changes risky decision making. JOURNAL OF BEHAVIORAL DECISION MAKING 2020. [DOI: 10.1002/bdm.2178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bettina Helversen
- Department of Psychology University of Bremen Bremen Germany
- Department of Psychology University of Zurich Zürich Switzerland
| | - Géraldine Coppin
- Department of Psychology University of Geneva Geneva Switzerland
- Swiss Center for Affective Sciences University of Geneva Geneva Switzerland
- Department of Psychology Distance Learning University, Switzerland (UniDistance) Sierre Switzerland
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15
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Liang M, Su Q, Mouraux A, Iannetti GD. Spatial Patterns of Brain Activity Preferentially Reflecting Transient Pain and Stimulus Intensity. Cereb Cortex 2019; 29:2211-2227. [PMID: 30844052 PMCID: PMC6458907 DOI: 10.1093/cercor/bhz026] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/29/2019] [Indexed: 01/19/2023] Open
Abstract
How pain emerges in the human brain remains an unresolved question. Neuroimaging studies have suggested that several brain areas subserve pain perception because their activation correlates with perceived pain intensity. However, painful stimuli are often intense and highly salient; therefore, using both intensity- and saliency-matched control stimuli is crucial to isolate pain-selective brain responses. Here, we used these intensity/saliency-matched painful and non-painful stimuli to test whether pain-selective information can be isolated in the functional magnetic resonance imaging responses elicited by painful stimuli. Using two independent datasets, multivariate pattern analysis was able to isolate features distinguishing the responses triggered by (1) intensity/saliency-matched painful versus non-painful stimuli, and (2) high versus low-intensity/saliency stimuli regardless of whether they elicit pain. This indicates that neural activity in the so-called "pain matrix" is functionally heterogeneous, and part of it carries information related to both painfulness and intensity/saliency. The response features distinguishing these aspects are spatially distributed and cannot be ascribed to specific brain structures.
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Affiliation(s)
- M Liang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Q Su
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - A Mouraux
- Institute of Neuroscience (IoNS), Université catholique de Louvain, Brussels, Belgium
| | - G D Iannetti
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
- Neuroscience and Behaviour Laboratory, Istituto Italiano di Tecnologia, Rome, Italy
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16
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Cortisol affects pain sensitivity and pain-related emotional learning in experimental visceral but not somatic pain: a randomized controlled study in healthy men and women. Pain 2019; 160:1719-1728. [DOI: 10.1097/j.pain.0000000000001579] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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17
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Antico L, Cataldo E, Corradi-Dell'Acqua C. Does my pain affect your disgust? Cross-modal influence of first-hand aversive experiences in the appraisal of others' facial expressions. Eur J Pain 2019; 23:1283-1296. [PMID: 30848050 DOI: 10.1002/ejp.1390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/14/2019] [Accepted: 03/03/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Embodied models of social cognition argue that others' affective states are processed by re-enacting a sensory-specific representation of the same state in the observer. However, neuroimaging studies suggest that a reliable part of the representation shared between self and others is supramodal and relates to dimensions such as Unpleasantness or arousal, common to qualitatively different experiences. Here we investigated whether representations of first-hand pain and disgust influenced the subsequent evaluation of facial expressions in Modality-specific fashion, or in terms of Unpleasantness or arousal. METHODS Thirty volunteers were subjected to thermal painful and olfactory disgusting events, and subsequently were asked to classify computer-generated faces expressing pain (characterized by high Unpleasantness and arousal), disgust (high Unpleasantness and low arousal), surprise (low Unpleasantness and high arousal) and hybrid combinations thereof. RESULTS Thermal and olfactory events were associated with comparable Unpleasantness ratings and heart rate (but stronger galvanic response was found for painful temperatures). Furthermore, we found that the appraisal of facial expressions was biased by the prior stimulus, with more frequent pain classifications following thermal stimuli, and more frequent disgust classifications following olfactory stimuli. Critically, this modulation was cross-modal in nature, as each first-hand stimulation influenced in comparable fashion facial traits diagnostic of both pain and disgust, without instead generalizing to features of surprise. CONCLUSION Overall, these data support the presence of shared coding between one's aversive experiences and the appraisal of others' facial responses, which is best describable as supramodal representation of the Unpleasantness of the experience. SIGNIFICANCE These results extend previous findings about common representational coding between the experience of first-hand and others' pain. In particular, they highlight that reliable part of the information shared is supramodal in nature and relates to a broad dimension of Unpleasantness common also to painless aversive states such as disgust.
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Affiliation(s)
- Lia Antico
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Eugénie Cataldo
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Corrado Corradi-Dell'Acqua
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
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18
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Sharvit G, Vuilleumier P, Corradi-Dell'Acqua C. Sensory-specific predictive models in the human anterior insula. F1000Res 2019; 8:164. [PMID: 30863539 PMCID: PMC6402078 DOI: 10.12688/f1000research.17961.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2019] [Indexed: 11/20/2022] Open
Abstract
Expectations affect the subjective experience of pain by increasing sensitivity to noxious events, an effect underlain by brain regions such as the insula. However, it has been debated whether these neural processes operate on pain-specific information or on more general signals encoding expectation of unpleasant events. To dissociate these possibilities, two independent studies ( Sharvit et al., 2018, Pain; Fazeli and Büchel, 2018, J. Neurosci) implemented a cross-modal expectancy paradigm, testing whether responses to pain could also be modulated by the expectation of similarly unpleasant, but painless, events. Despite their differences, the two studies report remarkably convergent (and in some cases complementary) findings. First, the middle-anterior insula response to noxious stimuli is modulated only by expectancy of pain but not of painless adverse events, suggesting coding of pain-specific information. Second, sub-portions of the middle-anterior insula mediate different aspects of pain predictive coding, related to expectancy and prediction error. Third, complementary expectancy effects are also observed for other negative experiences (i.e., disgust), suggesting that the insular cortex holds prospective models of a wide range of events concerning their sensory-specific features. Taken together, these studies have strong theoretical implications on the functional properties of the insular cortex.
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Affiliation(s)
- Gil Sharvit
- Haas School of Business, University of California, Berkeley, Berkeley, USA
| | - Patrik Vuilleumier
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland.,Laboratory for Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Geneva, Switzerland
| | - Corrado Corradi-Dell'Acqua
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland.,Theory of Pain Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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19
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Antico L, Guyon A, Mohamed ZK, Corradi-Dell'Acqua C. Beyond unpleasantness. Social exclusion affects the experience of pain, but not of equally-unpleasant disgust. Cognition 2018; 181:1-11. [PMID: 30099365 DOI: 10.1016/j.cognition.2018.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 07/28/2018] [Accepted: 08/01/2018] [Indexed: 12/15/2022]
Abstract
Seminal theories posit that social and physical suffering underlie partly-common representational code. It is unclear, however, if this shared information reflects a modality-specific component of pain, or alternatively a supramodal code for properties common to many aversive experiences (unpleasantness, salience, etc.). To address this issue, we engaged participants in a gaming experience in which they were excluded or included by virtual players. After each game session, participants were subjected to comparably-unpleasant painful or disgusting stimuli. Subjective reports and cardiac responses revealed a reduced sensitivity to pain following exclusion relative to inclusion, an effect which was more pronounced in those participants who declared to feel more affected by the gaming manipulation. Such modulation was not observed for disgust. These findings indicate that the relationship between social and physical suffering does not generalize to disgust, thus suggesting a shared representational code at the level of modality-specific components of pain.
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Affiliation(s)
- Lia Antico
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
| | - Amelie Guyon
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Zainab K Mohamed
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Corrado Corradi-Dell'Acqua
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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