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

Abstract

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

Migraine and Reward System—Or Is It Aversive?

“…Altered activity, functional connectivity, and grey matter density of this brain structure have also been reported in migraineurs [60,69]. Indeed, migraineurs were identified to have structural and functional cerebral abnormalities in the prefrontal cortex, the rostral ACC, the somatosensory cortex, the orbitofrontal cortex, and insular cortex [70,71]. Migraineurs were found to have reduced cortical thickness in both the ACC and the insular cortex, another brain structure involved in processing the emotional component of pain.…”

“…Responsive salience networks in the brain are disrupted or dysregulated in chronic pain patients, whereby dysregulated brain salience systems may be overly responsive to certain types of stimuli because they cannot properly filter/process information [79]. This hypothesis is evident in migraineurs where functional imaging studies identified that migraine patients viewing pain-related words exhibited enhanced activation in the insular cortex and orbitofrontal cortex, compared to healthy control subjects [71]. The orbitofrontal cortex is involved in judging the affective value of reinforcing stimuli and driving the individual towards goal-directed behavior, and makes substantial connections with the amygdala, striatum, and the ACC [80].…”

‘Tough love’: The experiences of midwives giving women sterile water injections for the relief of back pain in labour

“…Research suggests that pain receptor areas of the brain may be activated by trigger words and/or descriptions of pain that then act as verbal primers for perception (Eck, Richter, Straube, Miltner, & Weiss, 2011;Richter, Eck, Straube, Miltner, & Weiss, 2010). During the focus groups the midwives discussed how they presented information about the injection pain to women in their care; references to everyday phenomena and language that emphasized the brevity of the sensation were common:…”

Journal Club: Change in brain network connectivity during PACAP38-induced migraine attacks

“…Abnormalities in the connectivity and activity of these resting-state networks have previously been reported during the interictal phase of migraine. 4,5 Patients were recruited as part of a larger study investigating the migraine-inducing properties of PACAP38 and VIP and their effects on extracranial and intracranial arterial diameter among other factors. …”

“…Abnormalities in the connectivity and activity of these resting-state networks have previously been reported during the interictal phase of migraine. 4,5 Patients were recruited as part of a larger study investigating the migraine-inducing properties of PACAP38 and VIP and their effects on extracranial and intracranial arterial diameter among other factors. 3 A double-blind randomized design was used to allocate 24 patients to receive an IV infusion of either PACAP38 (10 pmol/kg/min) or VIP (8 pmol/kg/min) over 20 minutes on the first study day.…”