Neural mechanisms of detecting and orienting attention toward unattended threatening somatosensory target stimuli. II. Intensity effects

Group membership modulates empathic neural responses to pain in deaf individuals

Empathy deficiencies are prevalent among deaf individuals. It has yet to be determined whether they exhibit an ingroup bias in empathic responses. This study employed explicit and implicit empathy tasks (i.e. attention-to-pain-cue [A-P] task and attention-to-nonpain-cue [A-N] task) to explore the temporal dynamics of neural activities when deaf individuals were processing painful/nonpainful stimuli from both ingroup models (deaf people) and outgroup models (hearing people), which aims to not only assist deaf individuals in gaining a deeper understanding of their intergroup empathy traits but also to aid in the advancement of inclusive education. In the A-P task, we found that (i) ingroup priming accelerated the response speed to painful/nonpainful pictures; (ii) the N2 amplitude of painful pictures was significantly more negative than that of nonpainful pictures in outgroup priming trials, whereas the N2 amplitude difference between painful and nonpainful pictures was not significant in ingroup priming trials. For N1 amplitude of the A-N task, we have similar findings. However, this pattern was reversed for P3/late positive component amplitude of the A-P task. These results suggest that the deaf individuals had difficulty in judging whether hearing individuals were in pain. However, their group identification and affective responses could shape the relatively early stage of pain empathy.

The neural basis underlying impaired attentional control in problematic smartphone users

As a portable media device that enables ubiquitous access to friends and entertainment, smartphones are inextricably linked with our lives. Although there is growing concern about the detrimental effect of problematic smartphone use on attentional control, the underlying neural mechanisms of impaired attentional control in problematic smartphone users (PSU) has yet to be investigated. Using a modified cognitive conflict task, we examined behavioral performance in the presence of distracting words during functional magnetic resonance imaging in 33 PSU and 33 control participants (CON). Compared with the CON group, the PSU group demonstrated impaired performance that was accompanied by constantly enhanced but not differentiated activation in the frontoparietal regions across all conditions, regardless of distractor saliency. The inferior parietal lobule (IPL) activation in the PSU group, in particular, showed an association with performance deficits in the distractor conditions. Furthermore, the PSU group exhibited decreased functional connectivity of the right IPL with the right superior temporal gyrus of the ventral attention system in the attention-demanding condition relative to the easiest condition, which was associated with the severe dependence on smartphone use. Our findings suggest that greater distractibility in the PSU group during the attentional control task may be associated with inefficient recruitment of the ventral attention network involved in bottom-up attentional processing, as indicated by hyperactivation but less coherence within the network. The present study provides evidence for understanding the neural mechanisms underlying the impaired ability to keep attention from being oriented to task-irrelevant stimuli observed in PSU.

Reliability of measurements for sub-painful and painful perception on artificial electrical stimulations

Artificial electrical stimulation is a common type of stimulus to induce sub-painful and painful sensation in clinical or neuroscience experiments. The Numerical Rating Scale (NRS) is often used to evaluate subjective perception due to external stimulations. Yet the relationship between the intensity levels of electrical stimulations and self-perception has seldom been examined. The aim of the study was to obtain evidence on the reliability and accuracy of sub-painful and painful perceptions of healthy participants using the NRS under different levels of electrical stimulus. A total of 72 pain-free healthy volunteers (female=44) were recruited. In the first experiment, each participant was given different levels of a non-nociceptive or nociceptive electrical stimulus and then asked to give a perception rating based on an 11-point NRS. In the second experiment, each participant was asked to memorize 5 levels of sub-nociceptive or nociceptive stimuli and to recognize the level of stimulus given each time. For the NRS rating task, intraclass coefficients (ICCs) reached satisfactory level for sub-nociceptive (0.85<ICC<0.93) and nociceptive stimulation (0.90<ICC<0.96). The ICCs were the highest for the weakest sub-nociceptive and nociceptive stimuli. For the stimulus recognition task, accuracy was also found to be highest for the weakest sub-nociceptive stimulus (κ=0.67) and lowest for the strongest nociceptive stimulus (κ=0.34). The results suggest that, with adequate training, NRS can be a reliable measurement tool for both sub-painful and painful rating due to electrical stimulation.

Influence of transient spatial attention on the P3 component and perception of painful and non-painful electric stimuli in crossed and uncrossed hands positions

Recent reports show that focusing attention on the location where pain is expected can enhance its perception. Moreover, crossing the hands over the body’s midline is known to impair the ability to localise stimuli and decrease tactile and pain sensations in healthy participants. The present study investigated the role of transient spatial attention on the perception of painful and non-painful electrical stimuli in conditions in which a match or a mismatch was induced between skin-based and external frames of reference (uncrossed and crossed hands positions, respectively). We measured the subjective experience (Numerical Rating Scale scores) and the electrophysiological response elicited by brief electric stimuli by analysing the P3 component of Event-Related Potentials (ERPs). Twenty-two participants underwent eight painful and eight non-painful stimulus blocks. The electrical stimuli were applied to either the left or the right hand, held in either a crossed or uncrossed position. Each stimulus was preceded by a direction cue (leftward or rightward arrow). In 80% of the trials, the arrow correctly pointed to the spatial regions where the stimulus would appear (congruent cueing). Our results indicated that congruent cues resulted in increased pain NRS scores compared to incongruent ones. For non-painful stimuli such an effect was observed only in the uncrossed hands position. For both non-painful and painful stimuli the P3 peak amplitudes were higher and occurred later for incongruently cued stimuli compared to congruent ones. However, we found that crossing the hands substantially reduced the cueing effect of the P3 peak amplitudes elicited by painful stimuli. Taken together, our results showed a strong influence of transient attention manipulations on the NRS ratings and on the brain activity. Our results also suggest that hand position may modulate the strength of the cueing effect, although differences between painful and non-painful stimuli exist.

A connectionist modeling study of the neural mechanisms underlying pain's ability to reorient attention

Connectionist modeling was used to investigate the brain mechanisms responsible for pain's ability to shift attention away from another stimulus modality and toward itself. Different connectionist model architectures were used to simulate the different possible brain mechanisms underlying this attentional bias, where nodes in the model simulated the brain areas thought to mediate the attentional bias, and the connections between the nodes simulated the interactions between the brain areas. Mathematical optimization techniques were used to find the model parameters, such as connection strengths, that produced the best quantitative fits of reaction time and event-related potential data obtained in our previous work. Of the several architectures tested, two produced excellent quantitative fits of the experimental data. One involved an unexpected pain stimulus activating somatic threat detectors in the dorsal posterior insula. This threat detector activity was monitored by the medial prefrontal cortex, which in turn evoked a phasic response in the locus coeruleus. The locus coeruleus phasic response resulted in a facilitation of the cortical areas involved in decision and response processes time-locked to the painful stimulus. The second architecture involved the presence of pain causing an increase in general arousal. The increase in arousal was mediated by locus coeruleus tonic activity, which facilitated responses in the cortical areas mediating the sensory, decision, and response processes involved in the task. These two neural network architectures generated competing predictions that can be tested in future studies.

Neural mechanisms underlying pain's ability to reorient attention: evidence for sensitization of somatic threat detectors

Pain typically signals damage to the body, and as such can be perceived as threatening and can elicit a strong emotional response. This ecological significance undoubtedly underlies pain's well-known ability to demand attention. However, the neural mechanisms underlying this ability are poorly understood. Previous work from the author's laboratory has reported behavioral evidence suggesting that participants disengage their attention from an incorrectly cued visual target stimulus and reorient it toward a somatic target more rapidly when the somatic target is painful than when it is nonpainful. Furthermore, electrophysiological data suggest that this effect is mediated by a stimulus-driven process, in which somatic threat detectors located in the dorsal posterior insula activate the medial and lateral prefrontal cortex areas involved in reorienting attention toward the painful target. In these previous studies, the painful and nonpainful somatic targets were given in separate experiments involving different participants. Here, the nonpainful and painful somatic targets were presented in random order within the same block of trials. Unlike in the previous studies, both the nonpainful and painful somatic targets activated the somatic threat detectors, and the times taken to disengage and reorient attention were the same for both. These electrophysiological and behavioral data suggest that somatic threat detectors can become sensitized to nonpainful somatic stimuli that are presented in a context that includes painful stimuli.

Orienting attention modulates pain perception: an ERP study

Introduction

Research has shown that people with chronic pain have difficulty directing their attention away from pain. A mental strategy that incorporates focused attention and distraction has been found to modulate the perception of pain intensity. That strategy involves placing attention on the nociceptive stimulus felt and shifting attention to a self-generated sub-nociceptive image and rehearsing it. Event-related potential was used to study the possible processes associated with the focus-then-orient strategy.

Methods

Eighteen pain-free participants received different levels of 50-ms nociceptive stimulations elicited by electric shocks at the right lateral malleolus (ankle). In perception trials, participants maintained the perceived nociceptive stimulus in working memory for 3,000 ms. In imagery trials, participants mentally generated and maintained the corresponding sub-nociceptive image they had learned previously. After both types of trials, participants evaluated the pain intensity of the incoming stimulus by recalling the feeling of the nociceptive stimulation at the beginning of the trial.

Results

Shifting attention from the incoming nociceptive to a self-generated sub-nociceptive image elicited central P2 and centro-parietal P3 waves, which were found to correlate with proportional scores on the Stroop Test. They were followed by a frontal N400 and a parietal P600, denoting generation of sub-nociceptive images in working memory. The voltages elicited in these potentials correlated moderately with attenuation of the pain ratings of the recalled nociceptive stimulations.

Conclusions

Focus-and-orient attention across nociceptive and sub-nociceptive images appears to be related to response inhibition. Mental rehearsal of the sub-nociceptive images was found to modulate the perception of the nociceptive sensation felt prior to the imagery. Such modulation seems to be mediated by generating and maintaining sub-nociceptive images in working memory. Future studies should explore the mental processes associated with orienting attention for pain modulation among people with pathological pain and frontal lobe dysfunction.

PET-based investigation of cerebral activation following intranasal trigeminal stimulation

The present study aimed to investigate cerebral activation following intranasal trigeminal chemosensory stimulation using O15-H2O-PET. A total of 12 healthy male participants underwent a PET scan presented with four scanning conditions; two left-sided intranasal CO(2)-stimuli and two matched baseline conditions consisting of odorless air. CO(2) was used as it produces burning and stinging sensations. Stimulation started 20 s before intravenous injection of the isotope and lasted for the first 60 s of the 5 min scan time. A comparison between CO(2) and baseline showed a pronounced activation of the trigeminal projection area at the base of the postcentral gyrus (primary and secondary somatosensory cortex) which was more intense for the right hemisphere, contralateral to the side of stimulation. In addition, activation was also found in the piriform cortex which is typically activated following odor presentation and thus thought of as primary olfactory cortex. In conclusion, and in line with previously published work, our data suggest that intranasal trigeminal stimulation not only activates somatosensory projection areas, but that it also leads to activation in cerebral areas associated with the processing of olfactory information. This may be interpreted in terms of the intimate relation between the intranasal chemosensory systems.

EEG indices of tonic pain-related activity in the somatosensory cortices

OBJECTIVE

To identify EEG features that index pain-related cortical activity, and to identify factors that can mask the pain-related EEG features and/or produce features that can be misinterpreted as pain-specific.

METHODS

The EEG was recorded during three conditions presented in counterbalanced order: a tonic cold pain condition, and pain anticipation and arithmetic control conditions. The EEG was also recorded while the subjects made a wincing facial expression to estimate the contribution of scalp EMG artifacts to the pain-related EEG features.

RESULTS

Alpha amplitudes decreased over the contralateral temporal scalp and increased over the posterior scalp during the cold pain condition. There was an increase in gamma band activity during the cold pain condition at most electrode locations that was due to EMG artifacts.

CONCLUSIONS

The decrease in alpha over the contralateral temporal scalp during cold pain is consistent with pain-related activity in the primary somatosensory cortex and/or the somatosensory association areas located in the parietal operculum and/or insula. This study also identified factors that might mask the pain-related EEG features and/or generate EEG features that could be misinterpreted as being pain-specific. These include (but are not limited to) an increase in alpha generated in the visual cortex that results from attention being drawn towards the pain; the widespread increase in gamma band activity that results from scalp EMG generated by the facial expressions that often accompany pain; and the possibility that non-specific changes in the EEG over time mask the pain-related EEG features when the pain and control conditions are given in the same order across subjects.

SIGNIFICANCE

This study identified several factors that need to be controlled and/or isolated in order to successfully record EEG features that index pain-related activity in the somatosensory cortices.

Neural mechanisms of detecting and orienting attention toward unattended threatening somatosensory targets. I. Intermodal effects

Our previous work has identified four components of the somatosensory-evoked potential elicited by painful electrical stimulation of the sural nerve that might index an involuntary process that detects and orients attention toward threatening somatosensory stimuli. These components include a negativity over the central scalp at 70-110 ms poststimulus (CN70-110), a contralateral temporal negativity at 100-180 ms (CTN100-180), a frontocentral negativity at 130-200 ms, and a positive potential at 270-340 ms (the pain-related P2). The results of the endogenous cuing experiment used here suggest that the CN70-110 and CTN100-180 index somatosensory cortex activity that detects a threatening somatosensory stimulus when the subject's attention is focused on another stimulus modality but not another location. The P2, on the other hand, appears to index inferior parietal cortex activity that is specifically involved in orienting spatial attention.