Can anxiety help us tolerate pain?

Absi, Mustafa Al; Rokke, Paul D.

doi:10.1016/0304-3959(91)90032-s

Cited by 180 publications

(101 citation statements)

References 33 publications

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“…Experimental studies have also confirmed the enhancing effect of anxiety on pain for different components and measures of pain, e.g., ratings of pain intensity [243] and unpleasantness [244] , and pain threshold [245] . However, little is known about the human forebrain mechanisms underlying emotional modulation of pain, especially by anxiety.…”

Section: Anxietymentioning

confidence: 81%

Roles of the hippocampal formation in pain information processing

2009

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Abstract:Pain is a complex experience consisting of sensory-discriminative, affective-motivational, and cognitive-evaluative dimensions. Now it has been gradually known that noxious information is processed by a widely-distributed, hierarchicallyinterconnected neural network, referred to as neuromatrix, in the brain. Thus, identifying the multiple neural networks subserving these functional aspects and harnessing this knowledge to manipulate the pain response in new and beneficial ways are challenging tasks. Albeit with elaborate research efforts on the cortical responses to painful stimuli or clinical pain, involvement of the hippocampal formation (HF) in pain is still a matter of controversy. Here, we integrate previous animal and human studies from the viewpoint of HF and pain, sequentially representing anatomical, behavioral, electrophysiological, molecular/ biochemical and functional imaging evidence supporting the role of HF in pain processing. At last, we further expound on the relationship between pain and memory and present some unresolved issues.

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Section: Anxietymentioning

confidence: 81%

Roles of the hippocampal formation in pain information processing

2009

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“…For example, anxiety levels have been shown to predict pain severity and pain behavior in acute and chronic pain patients (Kain et al, 2000;van den Hout et al, 2001), and anxiety reduction techniques and anxiolytic drugs have been reported to be successful in ameliorating pain associated with medical procedures (Suls and Wan, 1989;Dellemijn and Fields, 1994). Experimental studies have confirmed the enhancing effect of anxiety on pain for different components and measures of pain, e.g., ratings of pain intensity (Al Absi and Rokke, 1991) and unpleasantness (Weisenberg et al, 1984), pain threshold (Rhudy and Meagher, 2000), and pain discrimination (Schumacher and Velden, 1984). Anxiolytic drugs reverse the experimental effect (Gracely et al, 1978;Janssen and Arntz, 1999).…”

Section: Abstract: Hyperalgesia; Hippocampus; Classical Fear Conditimentioning

confidence: 90%

Exacerbation of Pain by Anxiety Is Associated with Activity in a Hippocampal Network

et al. 2001

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It is common clinical experience that anxiety about pain can exacerbate the pain sensation. Using event-related functional magnetic resonance imaging (FMRI), we compared activation responses to noxious thermal stimulation while perceived pain intensity was manipulated by changes in either physical intensity or induced anxiety. One visual signal, which reliably predicted noxious stimulation of moderate intensity, came to evoke low anxiety about the impending pain. Another visual signal was followed by the same, moderate-intensity stimulation on most of the trials, but occasionally by discriminably stronger noxious stimuli, and came to evoke higher anxiety. We found that the entorhinal cortex of the hippocampal formation responded differentially to identical noxious stimuli, dependent on whether the perceived pain intensity was enhanced by pain-relevant anxiety. During this emotional pain modulation, entorhinal responses predicted activity in closely connected, affective (perigenual cingulate), and intensity coding (midinsula) areas. Our finding suggests that accurate preparatory information during medical and dental procedures alleviates pain by disengaging the hippocampus. It supports the proposal that during anxiety, the hippocampal formation amplifies aversive events to prime behavioral responses that are adaptive to the worst possible outcome.

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“…Chronic stress is also a well-recognised predisposing factor in anxiety disorders and clinical studies have provided evidence that there is high comorbidity between pain and anxiety (Asmundson and Katz, 2009;Atkinson et al, 1991). Furthermore, a persistent anxiety state can exacerbate pain leading to anxietyinduced hyperalgesia (al Absi and Rokke, 1991;Dougher, 1979;Rhudy and Meagher, 2000). Thus, preclinical and clinical studies provide substantial evidence for hyperalgesia associated with chronic stress or anxiety (SIH), but the underlying neuronal mechanisms are still not well understood.…”

Section: Introductionmentioning

confidence: 99%