Anxious anticipation and pain: the influence of instructedvsconditioned threat on pain

Abstract

Negative emotions such as anxiety enhance pain perception. However, certain threat characteristics are discussed to have different or even divergent effects on pain (hypoalgesia vs hyperalgesia). In order to investigate the neurobiological basis of different threats, we compared the impact of conditioned threat (CT) vs instructed threat (IT) on pain using fMRI. In two groups, participants underwent either Pavlovian threat conditioning or an instructed threat procedure. Afterwards, in an identical test phase participants watched the same visual cues from the previous phase indicating potential threat or safety, and received painful thermal stimulation. In the test phase, pain ratings were increased in both groups under threat. Group comparisons show elevated responses in amygdala and hippocampus for pain under threat in the CT group, and higher activation of the mid-cingulate gyrus (MCC) in the IT group. Psychophysiological interaction analyses in CT demonstrated elevated connectivity of the amygdala and the insula for the comparison of pain under threat vs safety. In IT, the same comparison revealed elevated functional connectivity of the MCC and the insula. The results suggest a similar pain augmenting effect of CT and IT, which, however, seems to rely on different networks mediating the impact of threat on pain.

Influence of pain anticipation on brain activity and pain perception in Gulf War Veterans with chronic musculoskeletal pain

“…Although there was not enough variability in perceptual responses to the nonpainful stimuli to conduct a formal statistical analysis of differences between conditions or groups, Figure 3 clearly illustrates that pain ratings for some individual participants were affected by the experimental manipulation. The methodological approach used here may limit comparability to prior studies of healthy adult samples that used more rigorous nocebo conditioning models to examine the effect of pain anticipation on brain activity (Atlas et al, 2010;Keltner, 2006;Reicherts et al, 2016Reicherts et al, , 2017Wiech et al, 2010). However, our findings generally agree with the wider body of research showing that both neural and perceptual responses to somatosensory stimuli are affected by expectations.…”

“…The methodological approach used here may limit comparability to prior studies of healthy adult samples that used more rigorous nocebo conditioning models to examine the effect of pain anticipation on brain activity (Atlas et al, ; Keltner, ; Reicherts et al, , ; Wiech et al, ). However, our findings generally agree with the wider body of research showing that both neural and perceptual responses to somatosensory stimuli are affected by expectations.…”

“…Based on prior research that used an expectancy manipulation to augment the expectation of pain, we hypothesized that changes in activity in pain-relevant brain regions (Reicherts et al, 2017;Wiech et al, 2010) and pain ratings (Colloca et al, 2008;Wiech et al, 2010) would be greater in the pain condition than the no pain condition. Because patients with medically unexplained CMP show differential responses during pain anticipation (Burgmer et al, 2011) and elevated processing of painful stimuli (Cook et al, 2004;Gracely, Petzke, Wolf, & Clauw, 2002), we hypothesized that, in the pain condition, there would be a differential blood oxygen level-dependent (BOLD) response between CMP and CO Veterans and that CMP Veterans would perceive thermal stimuli as more painful than CO Veterans.…”

A neurophysiological investigation of anticipation to pain in Parkinson's disease

“…The clusters which are denoted with ‘◊’ in Table were used for correlation analysis with subsequent behavioural parameters. Source clusters were also reported at the uncorrected level if they were within regions previously associated with anticipation including the hippocampus (Reicherts et al., ), the postcentral gyrus (Yang, Jackson, & Huang, ) and the cingulate cortex (Shackman et al., ). Hence, there is evidence for a potential difference within the early anticipation between the two groups.…”

“…Research into chronic pain has largely focused on bottom‐up mechanisms amplifying the nociceptive information on its way from the peripheries to the brain (Reicherts et al., ; Watson et al., ). Bottom‐up processing refers to the transmission and encoding of sensory information from noxious stimuli, which is not affected by subjective modulation of pain perception.…”