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Pavy F, Zaman J, Van den Noortgate W, Scarpa A, von Leupoldt A, Torta DM. The effect of unpredictability on the perception of pain: a systematic review and meta-analysis. Pain 2024; 165:1702-1718. [PMID: 38422488 DOI: 10.1097/j.pain.0000000000003199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024]
Abstract
ABSTRACT Despite being widely assumed, the worsening impact of unpredictability on pain perception remains unclear because of conflicting empirical evidence, and a lack of systematic integration of past research findings. To fill this gap, we conducted a systematic review and meta-analysis focusing on the effect of unpredictability on pain perception. We also conducted meta-regression analyses to examine the moderating effect of several moderators associated with pain and unpredictability: stimulus duration, calibrated stimulus pain intensity, pain intensity expectation, controllability, anticipation delay, state and trait negative affectivity, sex/gender and age of the participants, type of unpredictability (intensity, onset, duration, location), and method of pain induction (thermal, electrical, mechanical pressure, mechanical distention). We included 73 experimental studies with adult volunteers manipulating the (un)predictability of painful stimuli and measuring perceived pain intensity and pain unpleasantness in predictable and unpredictable contexts. Because there are insufficient studies with patients, we focused on healthy volunteers. Our results did not reveal any effect of unpredictability on pain perception. However, several significant moderators were found, ie, targeted stimulus pain intensity, expected pain intensity, and state negative affectivity. Trait negative affectivity and uncontrollability showed no significant effect, presumably because of the low number of included studies. Thus, further investigation is necessary to clearly determine their role in unpredictable pain perception.
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Affiliation(s)
- Fabien Pavy
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Jonas Zaman
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
- School of Social Sciences, Hasselt University, Hasselt, Belgium
| | - Wim Van den Noortgate
- Methodology of Educational Sciences, Faculty of Psychology and Educational Sciences, & Itec, an Imec Research Group, KU Leuven, Belgium
| | - Aurelia Scarpa
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Andreas von Leupoldt
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Diana M Torta
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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2
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van der Meulen M, Rischer KM, González Roldán AM, Terrasa JL, Montoya P, Anton F. Age-related differences in functional connectivity associated with pain modulation. Neurobiol Aging 2024; 140:1-11. [PMID: 38691941 DOI: 10.1016/j.neurobiolaging.2024.04.008] [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: 11/10/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
Growing evidence suggests that aging is associated with impaired endogenous pain modulation, and that this likely underlies the increased transition from acute to chronic pain in older individuals. Resting-state functional connectivity (rsFC) offers a valuable tool to examine the neural mechanisms behind these age-related changes in pain modulation. RsFC studies generally observe decreased within-network connectivity due to aging, but its relevance for pain modulation remains unknown. We compared rsFC within a set of brain regions involved in pain modulation between young and older adults and explored the relationship with the efficacy of distraction from pain. This revealed several age-related increases and decreases in connectivity strength. Importantly, we found a significant association between lower pain relief and decreased strength of three connections in older adults, namely between the periaqueductal gray and right insula, between the anterior cingulate cortex (ACC) and right insula, and between the ACC and left amygdala. These findings suggest that the functional integrity of the pain control system is critical for effective pain modulation, and that its function is compromised by aging.
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Affiliation(s)
- Marian van der Meulen
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Luxembourg.
| | - Katharina M Rischer
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Luxembourg
| | - Ana María González Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, University of the Balearic Islands, Palma, Spain
| | - Juan Lorenzo Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, University of the Balearic Islands, Palma, Spain
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, University of the Balearic Islands, Palma, Spain
| | - Fernand Anton
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Luxembourg
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3
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Wyatt KP, Eberle JW, Ruork AK, Neacsiu AD. Mechanisms of change in treatments for transdiagnostic emotion dysregulation: The roles of skills use, perceived control and mindfulness. Clin Psychol Psychother 2023; 30:1380-1392. [PMID: 37408301 PMCID: PMC11295203 DOI: 10.1002/cpp.2879] [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: 10/17/2022] [Revised: 05/06/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
Emotion dysregulation (ED) is a key target for change among empirically supported treatments for emotional disorders, including dialectical behaviour therapy skills training (DBT-ST), yet how treatments improve ED is poorly understood. Using data from a randomised trial of DBT-ST versus supportive group therapy for transdiagnostic ED, we tested whether three mechanistic variables-behavioural skills use, mindfulness, and perceived control-explain variability in ED within people over time. We additionally explored the mediating roles of these variables between conditions. Adults with transdiagnostic ED (N = 44) participated in weekly groups for 4 months, with assessments at pre-, mid- and post-treatment and at 2-month follow-up. As hypothesised, multilevel models disaggregating within- and between-person effects indicated that skills use, mindfulness, and perceived control each had significant total and unique within-person associations with ED at concurrent time points, net the effect of time. Unexpectedly, these within-person relations were not significant for mechanistic variables predicting ED 2 months later. Further, unique between-person variability in skills use, mindfulness, and perceived control did not significantly mediate the relationship between condition and ED improvements. The present study is an important step in clarifying ED mechanisms of change, both within and between persons.
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Affiliation(s)
- Kristin P. Wyatt
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Arise Psychological Wellness and Consulting, PLLC, Carrboro, North Carolina, USA
| | - Jeremy W. Eberle
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Allison K. Ruork
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Andrada D. Neacsiu
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
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Blythe JS, Mansueto AC, Duken SB, Cremers HR. The generalization of behavioral control over physical threats to social stressors in humans: A pilot fMRI study. Psychiatry Res Neuroimaging 2023; 329:111598. [PMID: 36680844 DOI: 10.1016/j.pscychresns.2023.111598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
Behavioral control, the ability to manage one's exposure to a given stressor, influences the impacts of both the present and future stressors. Behavioral control over a stressor may decrease stress caused by the stressor, and promote resilience towards future stressors. A lack of behavioral control may exacerbate the stress response and lead to learned helplessness, a generalized view that one cannot control other, unrelated stressors in their environment. The ventromedial prefrontal cortex (vmPFC) may detect the presence of behavioral control over a stressor and communicate this to subcortical regions involved in stress responses, such as the nucleus accumbens (NAc). Building on previous research in animals and humans, we piloted a paradigm to investigate how behavioral control over a physical threat (electric shocks), generalized to responses for a subsequent social stressor (anticipation of public speaking). Our manipulation of behavioral control effected perceived control between groups, increased stress across but not between groups, and no effects generalized to the subsequent social stressor in behavioral, physiological, or neural responses. We discuss refinements to the paradigm to strengthen the manipulation, the potential impacts of statistical power on the present results, and metrics to measure the generalization of behavioral control in addition to vmPFC-subcortical connectivity.
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Affiliation(s)
- Joseph S Blythe
- University of Amsterdam, Department of Clinical Psychology, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands; Leiden University, Health, Medical and Neuropsychology Unit, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - Alessandra C Mansueto
- University of Amsterdam, Department of Clinical Psychology, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands; University of Amsterdam, Department of Developmental Psychology, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands; University of Amsterdam, Department of Psychological Methods, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands; University of Amsterdam, Center for Urban Mental Health, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands; University of Amsterdam, Amsterdam School of Communication Research (ASCoR), Postbus 15791, 1001 NG Amsterdam, The Netherlands
| | - Sascha B Duken
- University of Amsterdam, Department of Clinical Psychology, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands
| | - Henk R Cremers
- University of Amsterdam, Department of Clinical Psychology, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands
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Li X, Wang W, Zhang X, Gong Z, Tian M, Zhang Y, You X, Wu J. Neuroinflammation in the medial prefrontal cortex exerts a crucial role in bone cancer pain. Front Mol Neurosci 2022; 15:1026593. [PMID: 36385763 PMCID: PMC9642970 DOI: 10.3389/fnmol.2022.1026593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/03/2022] [Indexed: 12/10/2023] Open
Abstract
Bone cancer pain (BCP) is one of the most common types of pain in cancer patients which compromises the patient's functional status, quality of life, and survival. Central hyperalgesia has increasingly been identified as a crucial factor of BCP, especially in the medial prefrontal cortex (mPFC) which is the main cortical area involved in the process of pain and consequent negative emotion. To explore the genetic changes in the mPFC during BCP occurrence and find possible targets for prediction, we performed transcriptome sequencing of mPFC in the BCP rat model and found a total of 147 differentially expressed mRNAs (DEmRNAs). A protein-protein interaction (PPI) network revealed that the DEmRNAs mainly participate in the inflammatory response. Meanwhile, microglia and astrocytes were activated in the mPFC of BCP rats, further confirming the presence of neuroinflammation. In addition, Gene Ontology (GO) analysis showed that DEmRNAs in the mPFC are mainly involved in antigen processing, presentation of peptide antigen, and immune response, occurring in the MHC protein complex. Besides, the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that DEmRNAs are mainly enriched in the pathways of phagosome, staphylococcus aureus infection, and antigen processing, in which MHCII participate. Furthermore, immunostaining showed that MHCII is mainly located in the microglia. Microglia are believed to be involved in antigen processing, a key cause of BCP. In vivo, minocycline (MC) treatment inhibits the activation of microglia and reduces the expression of MHCII and proinflammatory cytokines, thereby alleviating BCP and pain-related anxiety. Taken together, our study identified differentially expressed genes in the BCP process and demonstrated that the activation of microglia participates in the inflammatory response and antigen process, which may contribute to BCP.
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Affiliation(s)
- Xin Li
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
- School of Medicine, Shanghai University, Shanghai, China
| | - Wei Wang
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoxuan Zhang
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
- School of Medicine, Shanghai University, Shanghai, China
| | - Zhihao Gong
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mi Tian
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuxin Zhang
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xingji You
- School of Medicine, Shanghai University, Shanghai, China
| | - Jingxiang Wu
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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Romero-Godoy R, Romero-Godoy SR, Romero-Acebal M, Gutiérrez-Bedmar M. Psychiatric Comorbidity and Emotional Dysregulation in Chronic Tension-Type Headache: A Case-Control Study. J Clin Med 2022; 11:jcm11175090. [PMID: 36079022 PMCID: PMC9457147 DOI: 10.3390/jcm11175090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/18/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Chronic tension-type headache (CTTH) is frequently associated with a psychiatric comorbidity of depression and anxiety. Most studies focus their attention on this association, and only few link CTTH with psycho-affective emotional regulation disorders. Objective: To evaluate the association of CTTH with anxiety, depression, positive and negative affectivity, and emotional management in CTTH patients with neither a previous diagnosis of psychiatric disorder nor use of psychoactive drugs or abuse of analgesics. Design: Case-control study. Methods: Validated scores for state and trait anxiety, depression, positive and negative state and trait affect, cognitive reappraisal, and expressive suppression were assessed in 40 subjects with CTTH and 40 healthy subjects. Associations between CTTH and psychological status were assessed through linear multivariate regression models. Results: CTTH was associated with higher scores for depression (Beta = 5.46, 95% CI: 1.04–9.88), state and trait anxiety (Beta = 12.77, 95% CI: 4.99–20.56 and Beta = 8.79, 95% CI: 2.29–15.30, respectively), and negative state affect (Beta = 5.26, 95% CI: 0.88–9.64). Conclusions: CTTH is directly associated with depression, anxiety, and negative affectivity signs despite the absence of a previously diagnosed psychiatric disorder or psychopharmacological intake. The recognition of these comorbid and psycho-affective disorders is essential to adapt the emotional management of these patients for better control.
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Affiliation(s)
- Rosalinda Romero-Godoy
- Department of Nursing and Physiotherapy, University of Balearic Islands, 07122 Palma, Spain
- Cognitive Affective Neuroscience Clinical Psychology Research Group, Institute of Health Science Research (IUNICS-IdISBa), ECYCS Research Group, University of Balearic Islands, 07120 Palma, Spain
- Correspondence: (R.R.-G.); (M.G.-B.)
| | | | - Manuel Romero-Acebal
- Neurology Department, Virgen de la Victoria University Hospital, 29010 Malaga, Spain
| | - Mario Gutiérrez-Bedmar
- Preventive Medicine and Public Health Department, School of Medicine, University of Málaga, 29010 Malaga, Spain
- Biomedical Research Institute of Malaga-IBIMA, 29010 Malaga, Spain
- CIBERCV Cardiovascular Diseases, Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence: (R.R.-G.); (M.G.-B.)
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7
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Sensory Thresholds and Peripheral Nerve Responses in Chronic Tension-Type Headache and Neuropsychological Correlation. J Clin Med 2022; 11:jcm11071905. [PMID: 35407512 PMCID: PMC8999240 DOI: 10.3390/jcm11071905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Chronic tension-type headache (CTTH) is a common disease with no fully defined pathophysiological processes. We designed a study to value electrophysiological responses in these patients and their correlation with possible psychopathological manifestations in order to deepen understanding of central and peripheral mechanisms of CTTH. In 40 patients with CTTH and 40 healthy controls, we used electrical stimulation to determine sensory threshold (SPT) and pain perception threshold (PPT) and the characteristics of the electrophysiological sensory nerve action potential (SNAP): initial sensory response (ISR) and supramaximal response (SMR). We then calculated the intensity differences between thresholds (IDT), namely SPT-PPT, ISR-SMR and SMR-PPT, and correlated these IDTs with psychological characteristics: trait and state anxiety, depression, and emotional regulation. The SPT, together with the ISR and SMR thresholds, were higher (p < 0.01) in CTTH patients. The SMR-PPT IDT was smaller and correlated with significantly higher indicators of depression, state and trait anxiety, and poorer cognitive reappraisal. CTTH patients have less capacity to recognize non-nociceptive sensory stimuli, greater tendency toward pain facilitation, and a poor central pain control requiring higher stimulation intensity thresholds to reach the start and the peak amplitude of the SNAP. This is consistent with relative hypoexcitability of the Aβ nerve fibers in distant regions from the site of pain, and therefore, it could be considered a generalized dysfunction with a focal expression. Pain facilitation is directly associated with psychological comorbidity.
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Meine LE, Meier J, Meyer B, Wessa M. Don't stress, it's under control: Neural correlates of stressor controllability in humans. Neuroimage 2021; 245:118701. [PMID: 34758383 DOI: 10.1016/j.neuroimage.2021.118701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 10/23/2021] [Accepted: 10/30/2021] [Indexed: 01/04/2023] Open
Abstract
Animal research has repeatedly shown that control is a key variable in the brain's stress response. Uncontrollable stress triggers a release of monoamines, impairing prefrontal functions while enhancing subcortical circuits. Conversely, control over an adverse event involves prefrontally mediated downregulation of monoamine nuclei and is considered protective. However, it remains unclear to what extent these findings translate to humans. During functional magnetic resonance imaging, we subjected participants to controllable and uncontrollable aversive but non-painful electric stimuli, as well as to a control condition without aversive stimulation. In each trial, a symbol signalled whether participants could terminate the stressor through correct performance in a button-matching task or whether the stressor would be randomly terminated, i.e., uncontrollable. Along with neural responses, we assessed participants' accuracy, reaction times, and heart rate. To relate neural activations and subjective experience, we asked participants to rate perceived control, helplessness, and stress. Results were largely in line with our hypotheses. The vmPFC was generally deactivated by aversive stimulation, but this effect was attenuated when participants could terminate the stressor compared to when their responses had no effect. Furthermore, activation in stress-responsive regions, including the bilateral insula, was reduced during controllable trials. Under uncontrollable aversive stimulation, greater vmPFC recruitment was linked to reduced feelings of helplessness. An investigation of condition-dependant differences in vmPFC connectivity yielded no significant results. Our findings further corroborate animal research and emphasise the role of the vmPFC in controllability-dependant regulation of stress responses. Based on the results, we discuss future directions in the context of resilience research and mental health promotion.
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Affiliation(s)
- Laura E Meine
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, Wallstraße 3, 55122 Mainz, Germany
| | - Jana Meier
- Leibniz Institute for Resilience Research, Research Group Wessa, Wallstraße 7, 55122 Mainz, Germany
| | - Benjamin Meyer
- Leibniz Institute for Resilience Research, Research Group Kalisch, Wallstraße 7, 55122 Mainz, Germany; Neuroimaging Center, Focus Program Translational Neuroscience, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, Wallstraße 3, 55122 Mainz, Germany; Leibniz Institute for Resilience Research, Research Group Wessa, Wallstraße 7, 55122 Mainz, Germany.
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10
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Kaiser J, Buciuman M, Gigl S, Gentsch A, Schütz-Bosbach S. The Interplay Between Affective Processing and Sense of Agency During Action Regulation: A Review. Front Psychol 2021; 12:716220. [PMID: 34603140 PMCID: PMC8481378 DOI: 10.3389/fpsyg.2021.716220] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023] Open
Abstract
Sense of agency is the feeling of being in control of one's actions and their perceivable effects. Most previous research identified cognitive or sensory determinants of agency experience. However, it has been proposed that sense of agency is also bound to the processing of affective information. For example, during goal-directed actions or instrumental learning we often rely on positive feedback (e.g., rewards) or negative feedback (e.g., error messages) to determine our level of control over the current task. Nevertheless, we still lack a scientific model which adequately explains the relation between affective processing and sense of agency. In this article, we review current empirical findings on how affective information modulates agency experience, and, conversely, how sense of agency changes the processing of affective action outcomes. Furthermore, we discuss in how far agency-related changes in affective processing might influence the ability to enact cognitive control and action regulation during goal-directed behavior. A preliminary model is presented for describing the interplay between sense of agency, affective processing, and action regulation. We propose that affective processing could play a role in mediating the influence between subjective sense of agency and the objective ability to regulate one's behavior. Thus, determining the interrelation between affective processing and sense of agency will help us to understand the potential mechanistic basis of agency experience, as well as its functional significance for goal-directed behavior.
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Affiliation(s)
- Jakob Kaiser
- LMU Munich, Department of Psychology, General and Experimental Psychology, Munich, Germany
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11
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Neural and behavioral correlates of human pain avoidance in participants with and without episodic migraine. Pain 2021; 163:1023-1034. [PMID: 34510134 DOI: 10.1097/j.pain.0000000000002472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
ABSTRACT The innate motivation to avoid pain can be disrupted when individuals experience uncontrollable stress, such as pain. This can lead to maladaptive behaviors, including passivity, and negative affect. Despite its importance, motivational aspects of pain avoidance are understudied in humans and their neural mechanisms vastly unknown. Rodent models suggest an important role of the periaqueductal gray, but it is unknown whether it subserves a similar role in humans. Furthermore, it is unclear whether pain avoidance is associated with individual differences in pain coping. Using functional magnetic resonance imaging, networks underlying pain avoidance behavior were examined in 32 participants with and without episodic migraine. Pain avoidance behavior was assessed using an adaptation of the incentive delay task. In each trial of the task, participants tried to avoid a painful stimulus and receive a nonpainful one instead while the difficulty to succeed varied across trials (3 difficulty levels: safe, easy, and difficult). After unsuccessful pain avoidance on the preceding trial, participants showed reduced pain avoidance behavior, especially in the difficult condition. This reduction in behavior was associated with higher helplessness scores only in participants with migraine. Higher helplessness in participants with migraine was further correlated with a stronger decrease in activation of cortical areas associated with motor behavior, attention, and memory after unsuccessful pain avoidance. Of these areas, specifically posterior parietal cortex activation predicted individual's pain avoidance behavior on the next trial. The results link individual pain coping capacity to patterns of neural activation associated with altered pain avoidance in patients with migraine.
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12
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Cattaneo LA, Franquillo AC, Grecucci A, Beccia L, Caretti V, Dadomo H. Is Low Heart Rate Variability Associated with Emotional Dysregulation, Psychopathological Dimensions, and Prefrontal Dysfunctions? An Integrative View. J Pers Med 2021; 11:872. [PMID: 34575648 PMCID: PMC8465800 DOI: 10.3390/jpm11090872] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
Several studies have suggested a correlation between heart rate variability (HRV), emotion regulation (ER), psychopathological conditions, and cognitive functions in the past two decades. Specifically, recent data seem to support the hypothesis that low-frequency heart rate variability (LF-HRV), an index of sympathetic cardiac control, correlates with worse executive performances, worse ER, and specific psychopathological dimensions. The present work aims to review the previous findings on these topics and integrate them from two main cornerstones of this perspective: Porges' Polyvagal Theory and Thayer and Lane's Neurovisceral Integration Model, which are necessary to understand these associations better. For this reason, based on these two approaches, we point out that low HRV is associated with emotional dysregulation, worse cognitive performance, and transversal psychopathological conditions. We report studies that underline the importance of considering the heart-brain relation in order to shed light on the necessity to implement psychophysiology into a broader perspective on emotions, mental health, and good cognitive functioning. This integration is beneficial not only as a theoretical ground from which to start for further research studies but as a starting point for new theoretical perspectives useful in clinical practice.
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Affiliation(s)
| | - Anna Chiara Franquillo
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy;
- Consorzio Universitario Humanitas, 00193 Rome, Italy
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Science, DiPSCo, University of Trento, Corso Bettini, 38068 Rovereto, Italy;
- Center for Medical Sciences, CISMed, University of Trento, 38122 Trento, Italy
| | - Laura Beccia
- Schema Therapy Center, 21047 Saronno, Italy; (L.A.C.); (L.B.)
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy;
- Consorzio Universitario Humanitas, 00193 Rome, Italy
| | - Harold Dadomo
- Neuroscience Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
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13
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The dynamics of pain reappraisal: the joint contribution of cognitive change and mental load. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 20:276-293. [PMID: 31950439 PMCID: PMC7105446 DOI: 10.3758/s13415-020-00768-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study was designed to investigate the neural mechanism of cognitive modulation of pain via a reappraisal strategy with high temporal resolution. The EEG signal was recorded from 29 participants who were instructed to down-regulate, up-regulate, or maintain their pain experience. The L2 minimum norm source reconstruction method was used to localize areas in which a significant effect of the instruction was present. Down-regulating pain by reappraisal exerted a robust effect on pain processing from as early as ~100 ms that diminished the activity of limbic brain regions: the anterior cingulate cortex, right orbitofrontal cortex, left anterior temporal region, and left insula. However, compared with the no-regulation condition, the neural activity was similarly attenuated in the up- and down-regulation conditions. We suggest that this effect could be ascribed to the cognitive load that was associated with the execution of a cognitively demanding reappraisal task that could have produced a general attenuation of pain-related areas regardless of the aim of the reappraisal task (i.e., up- or down-regulation attempts). These findings indicate that reappraisal effects reflect the joint influence of both reappraisal-specific (cognitive change) and unspecific (cognitive demand) factors, thus pointing to the importance of cautiously selected control conditions that allow the modulating impact of both processes to be distinguished.
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González-Roldán AM, Terrasa JL, Prats-Sedano MA, Sitges C, van der Meulen M, Anton F, Montoya P. Intact pain modulation through manipulation of controllability and expectations in aging. Eur J Pain 2021; 25:1472-1481. [PMID: 33666318 DOI: 10.1002/ejp.1760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/03/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pain expectation and controllability can modulate pain processing. However, little is known about age-related effects on these cognitive factors involved in pain control. This study assessed age-related brain changes associated with pain expectation and controllability. METHODS 17 healthy older adults (9 men; 65.65 ± 4.34 years) and 18 healthy younger adults (8 men; 20.56 ± 5.56 years) participated in the study. Pain evoked potentials and pain ratings were recorded while participants received painful electrical stimuli under two different conditions of pain controllability over the intensity of the stimulation (self-controlled vs. computer controlled) and two conditions of pain expectations (high vs. low pain). RESULTS Although the intensity of the painful stimulation was kept constant, all participants showed reduced pain perception in the controllable and low pain expectancy conditions. However, older participants showed reduced amplitudes of pain evoked potentials in the time window between 150 and 500 ms after stimulus onset as compared to younger participants. Moreover, younger participants showed greater negative amplitudes from 80 to 150 ms after stimulus onset for uncontrollable versus controllable pain. CONCLUSIONS These results suggest that although cognitive pain modulation is preserved during ageing, neural processing of pain is reduced in older adults. SIGNIFICANCE This research describes the impact of age on cognitive pain modulation evoked by the manipulation of pain controllability and pain expectations. Our findings constitute a first step in the understanding of the greater vulnerability of older individuals to chronic pain. Moreover, we show that older adults can benefit from cognitive pain control mechanisms to increase the efficacy of pain treatments.
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Affiliation(s)
- Ana María González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Juan Lorenzo Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | | | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Marian van der Meulen
- Department of Behavioural and Cognitive Sciences, Institute of Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Fernand Anton
- Department of Behavioural and Cognitive Sciences, Institute of Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
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15
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Limbachia C, Morrow K, Khibovska A, Meyer C, Padmala S, Pessoa L. Controllability over stressor decreases responses in key threat-related brain areas. Commun Biol 2021; 4:42. [PMID: 33402686 PMCID: PMC7785729 DOI: 10.1038/s42003-020-01537-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022] Open
Abstract
Controllability over stressors has major impacts on brain and behavior. In humans, however, the effect of controllability on responses to stressors is poorly understood. Using functional magnetic resonance imaging (fMRI), we investigated how controllability altered responses to a shock-plus-sound stressor with a between-group yoked design, where participants in controllable and uncontrollable groups experienced matched stressor exposure. Employing Bayesian multilevel analysis at the level of regions of interest and voxels in the insula, and standard voxelwise analysis, we found that controllability decreased stressor-related responses across threat-related regions, notably in the bed nucleus of the stria terminalis and anterior insula. Posterior cingulate cortex, posterior insula, and possibly medial frontal gyrus showed increased responses during control over stressor. Our findings support the idea that the aversiveness of stressors is reduced when controllable, leading to decreased responses across key regions involved in anxiety-related processing, even at the level of the extended amygdala.
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Affiliation(s)
- Chirag Limbachia
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Kelly Morrow
- Department of Psychology, University of Maryland, College Park, MD, USA
- Neuroscience and Cognitive Sciences program, University of Maryland, College Park, MD, USA
| | - Anastasiia Khibovska
- Department of Psychology, University of Maryland, College Park, MD, USA
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Christian Meyer
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | | | - Luiz Pessoa
- Department of Psychology, University of Maryland, College Park, MD, USA.
- Neuroscience and Cognitive Sciences program, University of Maryland, College Park, MD, USA.
- Maryland Neuroimaging Center, University of Maryland, College Park, MD, USA.
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD, USA.
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16
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Zhang S, Yoshida W, Mano H, Yanagisawa T, Mancini F, Shibata K, Kawato M, Seymour B. Pain Control by Co-adaptive Learning in a Brain-Machine Interface. Curr Biol 2020; 30:3935-3944.e7. [PMID: 32795441 PMCID: PMC7575198 DOI: 10.1016/j.cub.2020.07.066] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 11/21/2022]
Abstract
Innovation in the field of brain-machine interfacing offers a new approach to managing human pain. In principle, it should be possible to use brain activity to directly control a therapeutic intervention in an interactive, closed-loop manner. But this raises the question as to whether the brain activity changes as a function of this interaction. Here, we used real-time decoded functional MRI responses from the insula cortex as input into a closed-loop control system aimed at reducing pain and looked for co-adaptive neural and behavioral changes. As subjects engaged in active cognitive strategies orientated toward the control system, such as trying to enhance their brain activity, pain encoding in the insula was paradoxically degraded. From a mechanistic perspective, we found that cognitive engagement was accompanied by activation of the endogenous pain modulation system, manifested by the attentional modulation of pain ratings and enhanced pain responses in pregenual anterior cingulate cortex and periaqueductal gray. Further behavioral evidence of endogenous modulation was confirmed in a second experiment using an EEG-based closed-loop system. Overall, the results show that implementing brain-machine control systems for pain induces a parallel set of co-adaptive changes in the brain, and this can interfere with the brain signals and behavior under control. More generally, this illustrates a fundamental challenge of brain decoding applications-that the brain inherently adapts to being decoded, especially as a result of cognitive processes related to learning and cooperation. Understanding the nature of these co-adaptive processes informs strategies to mitigate or exploit them.
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Affiliation(s)
- Suyi Zhang
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK; Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto 619-0237, Japan; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9DU, UK.
| | - Wako Yoshida
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto 619-0237, Japan
| | - Hiroaki Mano
- Center for Information and Neural Networks, National Institute for Information and Communications Technology, Osaka 565-0871, Japan
| | - Takufumi Yanagisawa
- Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Osaka 565-0043, Japan
| | - Flavia Mancini
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK
| | - Kazuhisa Shibata
- Lab for Human Cognition and Learning, Center for Brain Science, RIKEN, Wako, Saitama 351-0198, Japan
| | - Mitsuo Kawato
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto 619-0237, Japan.
| | - Ben Seymour
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK; Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto 619-0237, Japan; Center for Information and Neural Networks, National Institute for Information and Communications Technology, Osaka 565-0871, Japan; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9DU, UK.
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17
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Meine LE, Schüler K, Richter-Levin G, Scholz V, Wessa M. A Translational Paradigm to Study the Effects of Uncontrollable Stress in Humans. Int J Mol Sci 2020; 21:ijms21176010. [PMID: 32825491 PMCID: PMC7503322 DOI: 10.3390/ijms21176010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023] Open
Abstract
Theories on the aetiology of depression in humans are intimately linked to animal research on stressor controllability effects. However, explicit translations of established animal designs are lacking. In two consecutive studies, we developed a translational paradigm to study stressor controllability effects in humans. In the first study, we compared three groups of participants, one exposed to escapable stress, one yoked inescapable stress group, and a control group not exposed to stress. Although group differences indicated successful stress induction, the manipulation failed to differentiate groups according to controllability. In the second study, we employed an improved paradigm and contrasted only an escapable stress group to a yoked inescapable stress group. The final design successfully induced differential effects on self-reported perceived control, exhaustion, helplessness, and behavioural indices of adaptation to stress. The latter were examined in a new escape behaviour test which was modelled after the classic shuttle box animal paradigm. Contrary to the learned helplessness literature, exposure to uncontrollable stress led to more activity and exploration; however, these behaviours were ultimately not adaptive. We discuss the results and possible applications in light of the findings on learning and agency beliefs, inter-individual differences, and interventions aimed at improving resilience to stress-induced mental dysfunction.
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Affiliation(s)
- Laura E. Meine
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (L.E.M.); (K.S.); (V.S.)
| | - Katja Schüler
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (L.E.M.); (K.S.); (V.S.)
| | - Gal Richter-Levin
- Department of Psychology, University of Haifa, Haifa 3498838, Israel;
- Sagol Department of Neurobiology, University of Haifa, Haifa 3498838, Israel
- The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Vanessa Scholz
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (L.E.M.); (K.S.); (V.S.)
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 HR Nijmegen, The Netherlands
| | - Michele Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (L.E.M.); (K.S.); (V.S.)
- Leibniz Institute for Resilience Research, Research Group Wessa, 55122 Mainz, Germany
- Correspondence:
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18
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Pardo-García TR, Yusif-Rodriguez N, Yudowski G, Maldonado-Vlaar CS. Blockade of the endovanilloid receptor, TRPV1, and of the endocannabinoid enzyme, FAAH, within the nucleus accumbens shell elicits anxiolytic-like effects in male rats. Neurosci Lett 2020; 732:135023. [PMID: 32422166 DOI: 10.1016/j.neulet.2020.135023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/15/2020] [Accepted: 04/28/2020] [Indexed: 11/17/2022]
Abstract
RATIONALE The functional role of the endocannabinoid system (ECS) and Transient Receptor Potential Vanilloid type-1 (TRPV1) within the Nucleus Accumbens shell (NAc shell) remains unknown. Preclinical studies in rodents have reported that the ECS modulates emotional responses such as anxiety. The NAc shell has a high density of synaptically co-localized cannabinoid receptor type-1 (CB1R) and TRPV1, suggesting a potential involvement in the modulation of anxiety. OBJECTIVES The present study aims to establish the role of ECS-TRPV1 interactions within the NAc shell and its effects on anxiety. It is hypothesized that the neurochemical regulation elicited by ECS within the NAc shell mediates anxiety-like behaviors in rodents. METHODS In this study, male Sprague Dawley rats were implanted with bilateral brain cannula targeting the NAc shell. Following recovery from surgery, animals received microinfusion pretreatments (0, 0.125, 0.5 nmol/0.4 μl) of N-arachidonoyl-serotonin (AA-5-HT), a dual blocker of the endocannabinoid-inactivating enzyme, fatty acid amide hydrolase (FAAH) and a TRPV1 antagonist in the NAc shell. Following treatment, animals were tested in an elevated plus maze (EPM) paradigm for a period of 5 minutes. At the end of the experiment, animals were sacrificed and their brains collected for histological and biochemical analysis. RESULTS Results showed that animals treated with AA-5-HT in a dose dependent manner spent significantly more time in the open arms than vehicle-treated animals. In addition, AA-5-HT administration induced a significant downregulation of CB1R expression in the NAc shell. CONCLUSIONS The present findings suggest that the ECS within the NAc shell modulates anxiety-like behaviors via FAAH and CB1R activity.
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Affiliation(s)
- Thibaut R Pardo-García
- University of Puerto Rico-Rio Piedras Campus, Department of Biology, PO Box 23360, San Juan, 00931, Puerto Rico.
| | - Nadira Yusif-Rodriguez
- University of Puerto Rico-Rio Piedras Campus, Department of Biology, PO Box 23360, San Juan, 00931, Puerto Rico.
| | - Guillermo Yudowski
- University of Puerto Rico-Medical School, Institute of Neurobiology, San Juan, 00936, Puerto Rico
| | - Carmen S Maldonado-Vlaar
- University of Puerto Rico-Rio Piedras Campus, Department of Biology, PO Box 23360, San Juan, 00931, Puerto Rico.
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19
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Abstract
Engaging in altruistic behaviors is costly, but it contributes to the health and well-being of the performer of such behaviors. The present research offers a take on how this paradox can be understood. Across 2 pilot studies and 3 experiments, we showed a pain-relieving effect of performing altruistic behaviors. Acting altruistically relieved not only acutely induced physical pain among healthy adults but also chronic pain among cancer patients. Using functional MRI, we found that after individuals performed altruistic actions brain activity in the dorsal anterior cingulate cortex and bilateral insula in response to a painful shock was significantly reduced. This reduced pain-induced activation in the right insula was mediated by the neural activity in the ventral medial prefrontal cortex (VMPFC), while the activation of the VMPFC was positively correlated with the performer's experienced meaningfulness from his or her altruistic behavior. Our findings suggest that incurring personal costs to help others may buffer the performers from unpleasant conditions.
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Affiliation(s)
- Yilu Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 100871 Beijing, China
| | - Jianqiao Ge
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, 100871 Beijing, China
| | - Hanqi Zhang
- School of Economics and Management, Key Laboratory for Behavioral Economic Science & Technology, South China Normal University, 510006 Guangzhou, China
| | - Haixia Wang
- Management School, Jinan University, 510632 Guangzhou, China
| | - Xiaofei Xie
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 100871 Beijing, China;
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20
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Seymour B. Pain: A Precision Signal for Reinforcement Learning and Control. Neuron 2019; 101:1029-1041. [PMID: 30897355 DOI: 10.1016/j.neuron.2019.01.055] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/18/2019] [Accepted: 01/27/2019] [Indexed: 12/18/2022]
Abstract
Since noxious stimulation usually leads to the perception of pain, pain has traditionally been considered sensory nociception. But its variability and sensitivity to a broad array of cognitive and motivational factors have meant it is commonly viewed as inherently imprecise and intangibly subjective. However, the core function of pain is motivational-to direct both short- and long-term behavior away from harm. Here, we illustrate that a reinforcement learning model of pain offers a mechanistic understanding of how the brain supports this, illustrating the underlying computational architecture of the pain system. Importantly, it explains why pain is tuned by multiple factors and necessarily supported by a distributed network of brain regions, recasting pain as a precise and objectifiable control signal.
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Affiliation(s)
- Ben Seymour
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, 1-4 Yamadaoka, Suita, Osaka 565-0871, Japan; Computational and Biological Learning Lab, Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK.
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21
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Becker S, Bräscher AK, Bannister S, Bensafi M, Calma-Birling D, Chan RCK, Eerola T, Ellingsen DM, Ferdenzi C, Hanson JL, Joffily M, Lidhar NK, Lowe LJ, Martin LJ, Musser ED, Noll-Hussong M, Olino TM, Pintos Lobo R, Wang Y. The role of hedonics in the Human Affectome. Neurosci Biobehav Rev 2019; 102:221-241. [PMID: 31071361 PMCID: PMC6931259 DOI: 10.1016/j.neubiorev.2019.05.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/25/2019] [Accepted: 05/03/2019] [Indexed: 01/06/2023]
Abstract
Experiencing pleasure and displeasure is a fundamental part of life. Hedonics guide behavior, affect decision-making, induce learning, and much more. As the positive and negative valence of feelings, hedonics are core processes that accompany emotion, motivation, and bodily states. Here, the affective neuroscience of pleasure and displeasure that has largely focused on the investigation of reward and pain processing, is reviewed. We describe the neurobiological systems of hedonics and factors that modulate hedonic experiences (e.g., cognition, learning, sensory input). Further, we review maladaptive and adaptive pleasure and displeasure functions in mental disorders and well-being, as well as the experience of aesthetics. As a centerpiece of the Human Affectome Project, language used to express pleasure and displeasure was also analyzed, and showed that most of these analyzed words overlap with expressions of emotions, actions, and bodily states. Our review shows that hedonics are typically investigated as processes that accompany other functions, but the mechanisms of hedonics (as core processes) have not been fully elucidated.
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Affiliation(s)
- Susanne Becker
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Wallstr. 3, 55122 Mainz, Germany.
| | | | - Moustafa Bensafi
- Research Center in Neurosciences of Lyon, CNRS UMR5292, INSERM U1028, Claude Bernard University Lyon 1, Lyon, Centre Hospitalier Le Vinatier, 95 bd Pinel, 69675 Bron Cedex, France.
| | - Destany Calma-Birling
- Department of Psychology, University of Wisconsin-Oshkosh, 800 Algoma, Blvd., Clow F011, Oshkosh, WI 54901, USA.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Tuomas Eerola
- Durham University, Palace Green, DH1 RL3, Durham, UK.
| | - Dan-Mikael Ellingsen
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, CNY149-2301, 13th St, Charlestown, MA 02129, USA.
| | - Camille Ferdenzi
- Research Center in Neurosciences of Lyon, CNRS UMR5292, INSERM U1028, Claude Bernard University Lyon 1, Lyon, Centre Hospitalier Le Vinatier, 95 bd Pinel, 69675 Bron Cedex, France.
| | - Jamie L Hanson
- University of Pittsburgh, Department of Psychology, 3939 O'Hara Street, Rm. 715, Pittsburgh, PA 15206, USA.
| | - Mateus Joffily
- Groupe d'Analyse et de Théorie Economique (GATE), 93 Chemin des Mouilles, 69130, Écully, France.
| | - Navdeep K Lidhar
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada.
| | - Leroy J Lowe
- Neuroqualia (NGO), 36 Arthur Street, Truro, NS, B2N 1X5, Canada.
| | - Loren J Martin
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada.
| | - Erica D Musser
- Department of Psychology, Center for Childen and Families, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA.
| | - Michael Noll-Hussong
- Clinic for Psychiatry and Psychotherapy, Division of Psychosomatic Medicine and Psychotherapy, Saarland University Medical Centre, Kirrberger Strasse 100, D-66421 Homburg, Germany.
| | - Thomas M Olino
- Temple University, Department of Psychology, 1701N. 13th St, Philadelphia, PA 19010, USA.
| | - Rosario Pintos Lobo
- Department of Psychology, Center for Childen and Families, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA.
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
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Hancock L, Bryant RA. Posttraumatic stress, uncontrollability, and emotional distress tolerance. Depress Anxiety 2018; 35:1040-1047. [PMID: 29989315 DOI: 10.1002/da.22783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 03/03/2018] [Accepted: 04/23/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although individuals with posttraumatic stress disorder (PTSD) report poor tolerance for distress, the mechanisms underpinning this are unknown. Cognitive models of PTSD propose that appraisals of lacking or losing control impair adaptation to trauma. This study investigated whether avoidance of emotional distress was affected by loss of control in a web-based community sample with and without PTSD symptomatology, expecting that those with PTSD may show more detrimental effects following greater loss of control. METHODS PTSD-symptomatic (N = 104) and nonsymptomatic (N = 102) participants initially had baseline controllability appraisals indexed during a task designed to induce an illusion of control over an unwanted stimulus. Participants were then randomized to be able to delay the onset and also control the termination of interference trials during an effortful visual search task, and separately randomized to receive pretask instructions implying either doubtful or certain controllability. Following the manipulation, participants completed a task indexing delay between selecting and playing a purportedly distressing video at their maximum tolerable distress level. RESULTS Controlling for age, sex, and instructional condition, those who experienced greater violation of their initial perceptions of control tended to be more avoidant of emotional distress. There was a significant interaction whereby loss of control was more detrimental for those with PTSD symptoms. CONCLUSIONS These initial data suggest that posttraumatic stress exacerbates sensitivity to loss of control, and this appears to directly impact capacity to approach distressing stimuli.
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Affiliation(s)
- Lisa Hancock
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
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Abstract
Supplemental Digital Content is Available in the Text. Introduction: Chronic pain and pain-related suffering are major health problems. The lack of controllability of experienced pain seems to greatly contribute to the extent of suffering. This study examined how controllability affects the perception of pain and pain-related suffering, and the modulation of this effect by beliefs and emotions such as locus of control of reinforcement, pain catastrophizing, and fear of pain. Methods: Twenty-six healthy subjects received painful electric stimulation in both controllable and uncontrollable conditions. Visual analogue scales and the “Pictorial Representation of Illness and Self Measure” were used to assess pain intensity, unpleasantness, pain-related suffering, and the level of perceived control. We also investigated nonverbal indicators of pain and suffering such as heart rate, skin conductance, and corrugator electromyogram. Results: Controllability selectively reduced the experience of pain-related suffering, but did not affect pain intensity or pain unpleasantness. This effect was modulated by chance locus of control but was unrelated to fear of pain or catastrophizing. Physiological responses were not affected by controllability. In a second sample of 25 participants, we varied the instruction. The effect of controllability on pain-related suffering was only present when instructions focused on the person being able to stop the pain. Discussion: Our data suggest that the additional measure of pain-related suffering may be important in the assessment of pain and may be more susceptible to the effects of perceived control than pain intensity and unpleasantness. We also show that this effect depends on personal involvement.
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Opioid-Independent and Opioid-Mediated Modes of Pain Modulation. J Neurosci 2018; 38:9047-9058. [PMID: 30201765 DOI: 10.1523/jneurosci.0854-18.2018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/20/2018] [Accepted: 08/14/2018] [Indexed: 12/13/2022] Open
Abstract
Pain is regulated endogenously through both opioid and non-opioid mechanisms. We hypothesized that two novel pain modulation tasks, one drawing on context/expectations and one using voluntary reappraisal, would show differing levels of opioid dependence. Specifically, we expected that naloxone would block context-related analgesia, whereas mental imagery-based pain reappraisal would be opioid-independent.A double-blind, placebo-controlled intravenous naloxone versus saline crossover design was used. Twenty healthy volunteers completed the two modulation tasks with acute heat stimuli calibrated to induce moderate pain. In the mental imagery task, participants imagined either a "pleasant" or a "comparison" scenario during painful heat. In the relative relief task, moderate heat stimuli coincided with visual cues eliciting relief from the expectation of intense pain, and were compared with moderate heat stimuli delivered under the expectation of non-painful warmth. Both "pleasant imagery" and "relative relief" conditions significantly improved ratings of pain intensity and pleasantness during saline treatment. Indeed, the target stimuli in both tasks, which had been calibrated to induce moderate pain, were rated as mildly pleasant. Furthermore, consistently with the main hypothesis, blocking endogenous opioid signaling with naloxone did not significantly affect imagery-induced regulation of pain intensity or pleasantness. In contrast, the relative relief-induced pain regulation (i.e., context/expectation) was blocked by naloxone. We conclude that endogenous opioid signaling is necessary for expectation-related relative relief analgesia, but not for pain reappraisal through mental imagery. These results support mental imagery as a powerful and clinically relevant strategy for regulating pain affect also in patients where endogenous opioid mechanisms might be compromised.SIGNIFICANCE STATEMENT Neurotransmitter systems in the human brain can be probed through antagonist drugs. Studies using the opioid antagonist naloxone have demonstrated that the brain relies on both opioid and non-opioid mechanisms to downregulate pain. This holds clinical relevance given altered endogenous opioid processes in many chronic pain conditions. The present study used a double-blinded, placebo-controlled naloxone blockage of endogenous opioids in healthy humans to show differential opioid involvement in two pain modulation tasks. Context/expectation-driven (relative relief-related) analgesia was blocked by naloxone. In contrast, pain reappraisal through mental imagery was intact despite opioid receptor blockade, suggesting opioid independence. These results support mental imagery as a powerful, clinically relevant strategy for regulating pain as it does not rely on a functioning opioidergic system.
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Laboratory-induced learned helplessness attenuates approach motivation as indexed by posterior versus frontal theta activity. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2018; 17:904-916. [PMID: 28585017 DOI: 10.3758/s13415-017-0521-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Research suggests that midline posterior versus frontal electroencephalographic (EEG) theta activity (PFTA) may reflect a novel neurophysiological index of approach motivation. Elevated PFTA has been associated with approach-related tendencies both at rest and during laboratory tasks designed to enhance approach motivation. PFTA is sensitive to changes in dopamine signaling within the fronto-striatal neural circuit, which is centrally involved in approach motivation, reward processing, and goal-directed behavior. To date, however, no studies have examined PFTA during a laboratory task designed to reduce approach motivation or goal-directed behavior. Considerable animal and human research supports the hypothesis put forth by the learned helplessness theory that exposure to uncontrollable aversive stimuli decreases approach motivation by inducing a state of perceived uncontrollability. Accordingly, the present study examined the effect of perceived uncontrollability (i.e., learned helplessness) on PFTA. EEG data were collected from 74 participants (mean age = 19.21 years; 40 females) exposed to either Controllable (n = 26) or Uncontrollable (n = 25) aversive noise bursts, or a No-Noise Condition (n = 23). In line with prediction, individuals exposed to uncontrollable aversive noise bursts displayed a significant decrease in PFTA, reflecting reduced approach motivation, relative to both individuals exposed to controllable noise bursts or the No-Noise Condition. There was no relationship between perceived uncontrollability and frontal EEG alpha asymmetry, another commonly used neurophysiological index of approach motivation. Results have implications for understanding the neurophysiology of approach motivation and establishing PFTA as a neurophysiological index of approach-related tendencies.
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Moayedi M, Salomons TV, Atlas LY. Pain Neuroimaging in Humans: A Primer for Beginners and Non-Imagers. THE JOURNAL OF PAIN 2018; 19:961.e1-961.e21. [PMID: 29608974 PMCID: PMC6192705 DOI: 10.1016/j.jpain.2018.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/22/2018] [Accepted: 03/19/2018] [Indexed: 01/06/2023]
Abstract
Human pain neuroimaging has exploded in the past 2 decades. During this time, the broader neuroimaging community has continued to investigate and refine methods. Another key to progress is exchange with clinicians and pain scientists working with other model systems and approaches. These collaborative efforts require that non-imagers be able to evaluate and assess the evidence provided in these reports. Likewise, new trainees must design rigorous and reliable pain imaging experiments. In this article we provide a guideline for designing, reading, evaluating, analyzing, and reporting results of a pain neuroimaging experiment, with a focus on functional and structural magnetic resonance imaging. We focus in particular on considerations that are unique to neuroimaging studies of pain in humans, including study design and analysis, inferences that can be drawn from these studies, and the strengths and limitations of the approach.
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Affiliation(s)
- Massieh Moayedi
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
| | - Tim V Salomons
- School of Psychology and Clinical Language Science, University of Reading, Reading, UK; Centre for Integrated Neuroscience and Neurodynamics, University of Reading, Reading, UK
| | - Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland; National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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Zhang S, Mano H, Lee M, Yoshida W, Kawato M, Robbins TW, Seymour B. The control of tonic pain by active relief learning. eLife 2018; 7:31949. [PMID: 29482716 PMCID: PMC5843408 DOI: 10.7554/elife.31949] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/08/2018] [Indexed: 01/04/2023] Open
Abstract
Tonic pain after injury characterises a behavioural state that prioritises recovery. Although generally suppressing cognition and attention, tonic pain needs to allow effective relief learning to reduce the cause of the pain. Here, we describe a central learning circuit that supports learning of relief and concurrently suppresses the level of ongoing pain. We used computational modelling of behavioural, physiological and neuroimaging data in two experiments in which subjects learned to terminate tonic pain in static and dynamic escape-learning paradigms. In both studies, we show that active relief-seeking involves a reinforcement learning process manifest by error signals observed in the dorsal putamen. Critically, this system uses an uncertainty ('associability') signal detected in pregenual anterior cingulate cortex that both controls the relief learning rate, and endogenously and parametrically modulates the level of tonic pain. The results define a self-organising learning circuit that reduces ongoing pain when learning about potential relief.
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Affiliation(s)
- Suyi Zhang
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, United Kingdom.,Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Hiroaki Mano
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, United Kingdom.,Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan.,Center for Information and Neural Networks, National Institute for Information and Communications Technology, Osaka, Japan
| | - Michael Lee
- Division of Anaesthesia, University of Cambridge, Cambridge, United Kingdom
| | - Wako Yoshida
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Mitsuo Kawato
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Ben Seymour
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, United Kingdom.,Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan.,Center for Information and Neural Networks, National Institute for Information and Communications Technology, Osaka, Japan
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van Dijke A, Hopman JAB, Ford JD. Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder. Eur J Psychotraumatol 2018; 9:1400878. [PMID: 29410773 PMCID: PMC5795767 DOI: 10.1080/20008198.2017.1400878] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 10/22/2017] [Indexed: 01/06/2023] Open
Abstract
Objective: Complex posttraumatic stress disorder (CPTSD) as defined by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) formulation is associated with childhood relational trauma and involves relational impairment, affect dysregulation, and identity alterations. However, the distinct contributions of relational impairment (operationalized in the form fears of closeness or abandonment), affect dysregulation (operationalized in the form of overregulation and under-regulation of affect), and identity alterations (operationalized in the form of positive or negative psychoform or somatoform dissociation) to the relationship between childhood trauma and CPTSD/DESNOS have not been systematically tested. Method and Results: In a clinical sample of adults diagnosed with severe and chronic psychiatric and personality disorders (n = 472; M = 34.7 years, SD = 10.1), structural equation modelling with bootstrap 95% confidence intervals demonstrated that the association between childhood trauma and CPTSD/DESNOS symptoms in adulthood was partially mediated by under-regulation of affect, negative psychoform dissociation, and adult relational fears of closeness and of abandonment. These results also were independent of the effects of borderline personality disorder (BPD) symptoms. Conclusions: Some, but not all, hypothesized components of the DESNOS formulation of CPTSD statistically mediate the relationship between childhood trauma and adult CPTSD/DESNOS. These relationships appear specific to CPTSD/DESNOS and not to the effects of another potential sequelae of childhood trauma BPD. Replication with prospective longitudinal studies is needed.
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Affiliation(s)
- Annemiek van Dijke
- Yulius Academy/Yulius/COLK Centre for Psychosomatics Yulius, Dordrecht - Zaandam, the Netherlands.,Department of Clinical Psychology, VU University Amsterdam, Rotterdam, the Netherlands.,PsyQ Zaandam & Parnassia Academy, the Netherlands
| | - Juliette A B Hopman
- Yulius Academy/Yulius/COLK Centre for Psychosomatics Yulius, Dordrecht - Zaandam, the Netherlands.,Department of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
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Konietzny K, Suchan B, Kreddig N, Hasenbring MI, Chehadi O. [Emotion regulation and pain : Behavioral and neuronal correlates: a transdiagnostic approach]. Schmerz 2017; 30:412-420. [PMID: 27658393 DOI: 10.1007/s00482-016-0162-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Emotions and emotion regulation are of special importance in the perception and modulation of pain but the mechanisms underlying this reciprocal relationship remain unclear. The transdiagnostic model provides an approach to explain the link between pain and emotion regarding cognitive and neuronal mechanisms and aims to identify mutual processes, which are relevant for both. Structural and functional imaging studies of pain indicate the involvement of specific cortical and subcortical structures, which also play an important role in emotion regulation. While numerous studies have investigated emotion regulation and their correlates in the central nervous system in pathological states, the research on emotion regulation in pain is still young. The purpose of this review is to provide an overview of experimental and clinical studies of neuronal and behavioral correlates of pain-related emotion regulation. The current transdiagnostic approach may be able to enhance pain relief in the future.
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Affiliation(s)
- K Konietzny
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Medizinische Fakultät, Ruhr-Universität Bochum, Universitätsstr. 150, MA 0/145, 44780, Bochum, Deutschland
| | - B Suchan
- Institut für Kognitive Neurowissenschaft, Abteilung Neuropsychologie, Fakultät für Psychologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - N Kreddig
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Medizinische Fakultät, Ruhr-Universität Bochum, Universitätsstr. 150, MA 0/145, 44780, Bochum, Deutschland
| | - M I Hasenbring
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Medizinische Fakultät, Ruhr-Universität Bochum, Universitätsstr. 150, MA 0/145, 44780, Bochum, Deutschland
| | - O Chehadi
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Medizinische Fakultät, Ruhr-Universität Bochum, Universitätsstr. 150, MA 0/145, 44780, Bochum, Deutschland.
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Pain Catastrophizing and Anxiety are Associated With Heat Pain Perception in a Community Sample of Adults With Chronic Pain. Clin J Pain 2017; 32:875-81. [PMID: 26626297 DOI: 10.1097/ajp.0000000000000333] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The principle aim of this study was to investigate the associations between heat pain (HP) perception, pain catastrophizing, and pain-related anxiety in a heterogenous cohort of community-dwelling adults with chronic pain admitted to a 3-week outpatient pain rehabilitation program. METHODS All adults consecutively admitted to an outpatient pain rehabilitation program from July 2009 through January 2011 were eligible for study recruitment (n=574). Upon admission, patients completed the Pain Catastrophizing Scale (PCS), the short version of the Pain Anxiety Symptoms Scale (PASS-20), and HP perception was assessed using a standardized quantitative sensory testing (QST) method of levels. RESULTS Greater PCS scores were significantly correlated with lower standardized values of HP threshold (HP 0.5) (P=0.006) and tolerance (HP 5) (P=0.003). In a multiple variable model adjusted for demographic and clinical factors known to influence HP perception, every 10-point increase in the PCS was associated with a -0.124 point change in HP 0.5 (P=0.014) and a -0.142 change in HP 5 (P=0.014) indicating that participants with higher PCS scores had lower HP thresholds and tolerances, respectively. Similarly, greater PASS-20 scores significantly correlated with lower standardized values of HP 0.5 and HP 5. In a multiple variable model, every 10-point increase in the PASS-20 was associated with a -0.084 point change in HP 0.5 (P=0.005) and a -0.116 point change in HP 5 (P=0.001) indicating that participants with higher PASS-20 scores had lower HP thresholds and tolerances, respectively. CONCLUSIONS The findings of this study extend the use of a standardized method for assessing HP in a heterogenous sample of adults with chronic pain. Although pain catastrophizing shares significant variance with pain-related anxiety, our findings suggest that either measure would be appropriate for use in future studies that incorporate the QST method of levels.
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Patient action as means and end of chronic pain care: risks and routes to meaningful action. Pain 2017; 158:1403-1404. [PMID: 28541257 DOI: 10.1097/j.pain.0000000000000929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms. THE JOURNAL OF PAIN 2017; 18:359.e1-359.e38. [DOI: 10.1016/j.jpain.2016.11.004] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 10/15/2016] [Accepted: 11/16/2016] [Indexed: 01/01/2023]
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Abstract
Repeated sensory exposures shape the brain's function and its responses to environmental stimuli. An important clinical and scientific question is how exposure to pain affects brain network activity and whether that activity is modifiable with training. We sought to determine whether repeated pain exposure would impact brain network activity and whether these effects can be reversed by cognitive behavioral therapy (CBT)-based training. Healthy subjects underwent 8 experimental sessions on separate days on which they received painful thermal stimuli. They were randomly assigned to groups receiving either CBT-based training (regulate group, n = 17) or a non-pain-focused treatment (control group, n = 13). Before and after these sessions, participants underwent functional magnetic resonance imaging (fMRI) during painful stimulation and at rest. The effect of repeated pain over time in the control group was a decrease in the neurotypical pain-evoked default mode network (DMN) deactivation. The regulate group did not show these DMN effects but rather had decreased deactivation of the right ventrolateral prefrontal cortex (R vlPFC) of the executive control network. In the regulate group, reduced pain-evoked DMN deactivation was associated with greater individual reduction in pain intensity and unpleasantness over time. Finally, the regulate group showed enhanced resting functional connectivity between areas of the DMN and executive control network over time, compared with the control group. Our study demonstrates that trainable cognitive states can alter the effect of repeated sensory exposure on the brain. The findings point to the potential utility of cognitive training to prevent changes in brain network connectivity that occur with repeated experience of pain.
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Garland EL, Bryan CJ, Nakamura Y, Froeliger B, Howard MO. Deficits in autonomic indices of emotion regulation and reward processing associated with prescription opioid use and misuse. Psychopharmacology (Berl) 2017; 234:621-629. [PMID: 27933366 PMCID: PMC5266620 DOI: 10.1007/s00213-016-4494-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 11/27/2016] [Indexed: 12/16/2022]
Abstract
RATIONALE Prescription opioid misuse and high-dose opioid use may result in allostatic dysregulation of hedonic brain circuitry, leading to reduced emotion regulation capacity. In particular, opioid misuse may blunt the ability to experience and upregulate positive affect from natural rewards. OBJECTIVES The purpose of this study was to examine associations between opioid use/misuse and autonomic indices of emotion regulation capability in a sample of chronic pain patients receiving prescription opioid pharmacotherapy. METHODS Chronic pain patients taking long-term opioid analgesics (N = 40) completed an emotion regulation task while heart rate variability (HRV) was recorded, and also completed self-report measures of opioid misuse, craving, pain severity, and emotional distress. Based on a validated cut-point on the Current Opioid Misuse Measure, participants were grouped as opioid misusers or non-misusers. Opioid misuse status and morphine equivalent daily dose (MEDD) were examined as predictors of HRV and self-reports of emotion regulation. RESULTS Opioid misusers exhibited significantly less HRV during positive and negative emotion regulation, and significantly less positive effect, than non-misusers, after controlling for confounders including pain severity and emotional distress. MEDD was inversely associated with positive emotion regulation efficacy. CONCLUSION Findings implicate the presence of reward processing deficits among chronic pain patients with opioid-misusing behaviors, and opioid dosage was associated with deficient emotion regulation, suggesting the presence of compromised top-down cognitive control over bottom-up hedonic processes. Emotion regulation among opioid misusers may represent an important treatment target.
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Chakraborty N, Meyerhoff J, Jett M, Hammamieh R. Genome to Phenome: A Systems Biology Approach to PTSD Using an Animal Model. Methods Mol Biol 2017; 1598:117-154. [PMID: 28508360 DOI: 10.1007/978-1-4939-6952-4_6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating illness that imposes significant emotional and financial burdens on military families. The understanding of PTSD etiology remains elusive; nonetheless, it is clear that PTSD is manifested by a cluster of symptoms including hyperarousal, reexperiencing of traumatic events, and avoidance of trauma reminders. With these characteristics in mind, several rodent models have been developed eliciting PTSD-like features. Animal models with social dimensions are of particular interest, since the social context plays a major role in the development and manifestation of PTSD.For civilians, a core trauma that elicits PTSD might be characterized by a singular life-threatening event such as a car accident. In contrast, among war veterans, PTSD might be triggered by repeated threats and a cumulative psychological burden that coalesced in the combat zone. In capturing this fundamental difference, the aggressor-exposed social stress (Agg-E SS) model imposes highly threatening conspecific trauma on naïve mice repeatedly and randomly.There is abundant evidence that suggests the potential role of genetic contributions to risk factors for PTSD. Specific observations include putatively heritable attributes of the disorder, the cited cases of atypical brain morphology, and the observed neuroendocrine shifts away from normative. Taken together, these features underscore the importance of multi-omics investigations to develop a comprehensive picture. More daunting will be the task of downstream analysis with integration of these heterogeneous genotypic and phenotypic data types to deliver putative clinical biomarkers. Researchers are advocating for a systems biology approach, which has demonstrated an increasingly robust potential for integrating multidisciplinary data. By applying a systems biology approach here, we have connected the tissue-specific molecular perturbations to the behaviors displayed by mice subjected to Agg-E SS. A molecular pattern that links the atypical fear plasticity to energy deficiency was thereby identified to be causally associated with many behavioral shifts and transformations.PTSD is a multifactorial illness sensitive to environmental influence. Accordingly, it is essential to employ the optimal animal model approximating the environmental condition that elicits PTSD-like symptoms. Integration of an optimal animal model with a systems biology approach can contribute to a more knowledge-driven and efficient next-generation care management system and, potentially, prevention of PTSD.
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Affiliation(s)
- Nabarun Chakraborty
- Integrative Systems Biology, Geneva Foundation, USACEHR, 568 Doughten Drive, Fredrick, MD, 21702-5010, USA
| | - James Meyerhoff
- Integrative Systems Biology, Geneva Foundation, USACEHR, 568 Doughten Drive, Fredrick, MD, 21702-5010, USA
| | - Marti Jett
- Integrative Systems Biology, US Army Center for Environmental Health Research, USACEHR, 568 Doughten Drive, Frederick, MD, 21702-5010, USA
| | - Rasha Hammamieh
- Integrative Systems Biology, US Army Center for Environmental Health Research, USACEHR, 568 Doughten Drive, Frederick, MD, 21702-5010, USA.
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Murayama K, Izuma K, Aoki R, Matsumoto K. “Your Choice” Motivates You in the Brain: The Emergence of Autonomy Neuroscience. ADVANCES IN MOTIVATION AND ACHIEVEMENT 2016. [DOI: 10.1108/s0749-742320160000019004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Vallerand AH, Crawley J, Pieper B, Templin TN. The Perceived Control Over Pain Construct and Functional Status. PAIN MEDICINE 2016; 17:692-703. [PMID: 26350223 DOI: 10.1111/pme.12924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Belief in one's ability to control pain is a significant predictor of health outcomes and is related to improved functional status. The purpose of this study was to introduce a novel formulation of the construct, Perceived Control Over Pain and to test its effects on functional status. METHODS Participants (N = 301) were primarily African American (92%); and were adults with low income attending a primary care clinic and reporting pain within the past 2 weeks. A cross-sectional design was used with confirmatory factor analysis and structural equation modeling. The Perceived Control Over Pain construct consisted of four measures-two specific measures of control over pain and two general measures of control over life events. Perceived Control Over Pain has not been defined in this way previously. RESULTS Mean worst pain scores for the past week were 8.4, where "0" (no pain) to "10" (pain as bad as you can imagine). The model demonstrated good construct validity for the components of pain, Perceived Control Over Pain and functional status. Mediation by Perceived Control Over Pain was partial but strong, accounting for a reduction of 29% in the effect of pain on functional status. DISCUSSION In minority populations with low income, factors such as perceived control over pain and its effect on the outcome of patient function need to be considered. Improving Perceived Control Over Pain has the potential for improving patients' feelings of life control and purpose or meaning in life, and psychological and physical functioning for adults living with pain.
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Affiliation(s)
| | - Jamie Crawley
- University of Windsor, Faculty of Nursing, Windsor, Canada
| | - Barbara Pieper
- *Wayne State University, College of Nursing, Detroit, Michigan, USA
| | - Thomas N Templin
- *Wayne State University, College of Nursing, Detroit, Michigan, USA
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Xiao Y, Friederici AD, Margulies DS, Brauer J. Development of a selective left-hemispheric fronto-temporal network for processing syntactic complexity in language comprehension. Neuropsychologia 2015; 83:274-282. [PMID: 26352468 PMCID: PMC4780430 DOI: 10.1016/j.neuropsychologia.2015.09.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 08/21/2015] [Accepted: 09/02/2015] [Indexed: 01/11/2023]
Abstract
The development of language comprehension abilities in childhood is closely related to the maturation of the brain, especially the ability to process syntactically complex sentences. Recent studies proposed that the fronto-temporal connection within left perisylvian regions, supporting the processing of syntactically complex sentences, is still immature at preschool age. In the current study, resting state functional magnetic resonance imaging data were acquired from typically developing 5-year-old children and adults to shed further light on the brain functional development. Children additionally performed a behavioral syntactic comprehension test outside the scanner. The amplitude of low-frequency fluctuations was analyzed in order to identify the functional correlation networks of language-relevant brain regions. Results showed an intrahemispheric correlation between left inferior frontal gyrus (IFG) and left posterior superior temporal sulcus (pSTS) in adults, whereas an interhemispheric correlation between left IFG and its right-hemispheric homolog was predominant in children. Correlation analysis between resting-state functional connectivity and sentence processing performance in 5-year-olds revealed that local connectivity within the left IFG is associated with competence of processing syntactically simple canonical sentences, while long-range connectivity between IFG and pSTS in left hemisphere is associated with competence of processing syntactically relatively more complex non-canonical sentences. The present developmental data suggest that a selective left fronto-temporal connectivity network for processing complex syntax is already in functional connection at the age of 5 years when measured in a non-task situation. The correlational findings provide new insight into the relationship between intrinsic functional connectivity and syntactic language abilities in preschool children. resting state ALFF correlated in adults between left IFG and left pSTS. resting state ALFF correlated in children between left IFG and right homolog area. intrahemispheric connectivity co-varies with syntactic processing skills in children.
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Affiliation(s)
- Yaqiong Xiao
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Angela D Friederici
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Daniel S Margulies
- Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jens Brauer
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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