Pain Affect Encoded in Human Anterior Cingulate But Not Somatosensory Cortex

Rainville, Pierre; Duncan, Gary E.; Price, Donald D.; Carrier, Benoı̂t; Bushnell, M. Catherine

doi:10.1126/science.277.5328.968

Cited by 2,313 publications

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“…For example, neuroimaging studies have revealed cingulate activity in response to heat stimuli that were judged as painful relative to stimuli that were judged merely as warm. Moreover, the cingulate appears to mediate the distress caused by pain rather than the intensity of the sensory stimulus itself (Rainville, Duncan, Price, Carrier, & Bushness, 1997). When an effort was made to control the distress produced by a given stimulus using hypnotic suggestion, the amount of cingulate activation reflected the felt distress, while other brain areas, such as somatosensory cortex, reflected the stimulus intensity.…”

Section: Executive Systemmentioning

confidence: 99%

Executive Attention and Metacognitive Regulation

Fernandez-Duque

Baird

Posner

2000

Consciousness and Cognition

541

316

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Metacognition refers to any knowledge or cognitive process that monitors or controls cognition. We highlight similarities between metacognitive and executive control functions, and ask how these processes might be implemented in the human brain. A review of brain imaging studies reveals a circuitry of attentional networks involved in these control processes, with its source located in midfrontal areas. These areas are active during conflict resolution, error correction, and emotional regulation. A developmental approach to the organization of the anatomy involved in executive control provides an added perspective on how these mechanisms are influenced by maturation and learning, and how they relate to metacognitive activity. © 2000 Academic PressMetacognitively sophisticated children or adults are like busy executives, analyzing new problems, judging how far they are from the goal, allocating attention, selecting a strategy, attempting a solution, monitoring the success or failure of current performance, and deciding whether to change to a different strategy.-J. H. Flavell, P. H. Miller, and S. A. Miller, Cognitive Development

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Section: Executive Systemmentioning

confidence: 99%

Executive Attention and Metacognitive Regulation

Fernandez-Duque

Baird

Posner

2000

Consciousness and Cognition

541

316

View full text Add to dashboard Cite

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“…In contrast, changes in activity in the ACC were not found for suggestions to decrease pain intensity. Suggestions for decreasing pain unpleasantness did not result in changes in activity in the somatosensory cortices, which process sensory information about nociception (e.g., pain severity) [35]. However, another study found that suggestions specific to decreasing pain intensity were associated with decreased activity in the S1 cortex, with a similar pattern for the S2 cortex but no decreased activity in the ACC [72].…”

Section: Neurophysiological Effects Of Hypnosismentioning

confidence: 93%

“…One site is the prefrontal cortex, which is thought to encode the cognitive aspects of both acute and chronic pain, including evaluating the meaning of pain and making executive decisions regarding how best to cope with pain [33]. Another site, the ACC, is related to the affective/emotional component of pain (i.e., suffering) [33,35] and the motivational-motor aspects of pain (e.g., preparing to do something about pain), including the initiation and facilitation of behavioral coping efforts [36,37]. The somatosensory cortices (S1 and S2) process sensory information about nociception, including location (e.g., left hand), severity, and identification (e.g., burn).…”

Section: Neurophysiological Mechanisms Involved In Pain Perception Anmentioning

confidence: 99%

“…Specifically, research indicates that hypnosis can impact activity in: (1) the periphery and spinal cord [67][68][69], (2) the thalamus [65,70,71], (3) the sensory cortices [72,73], (4) the insula [70,71,73], (5) the ACC [35,70,71,[73][74][75], and (6) the prefrontal cortex [70,71,73,76]. Given the extensiveness of these previous reviews, this section will briefly review past research that has examined the neurophysiological effects of hypnotic analgesia, specifically focused on the role of suggestion type [35,72,77]. Additionally, three studies that were not included in these previous reviews will be discussed, including one recent study evaluating the neurophysiological mechanisms associated with hypnotic induction and two studies that studied the neural processes correlated with suggestions [73,76,78].…”

Section: Neurophysiological Effects Of Hypnosismentioning

confidence: 99%

“…Studies have made beginning steps in pursuing this type of research [35,72,73,77]. As we learn more about the pain mechanisms that are specific to an individual's pain experience, we may be able to test specific suggestions that target those neural pathways [34].…”

Section: Research Implicationsmentioning

confidence: 99%

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Neurophysiology of pain and hypnosis for chronic pain

Dillworth

Mendoza

Jensen

2011

Behav. Med. Pract. Policy Res.

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In the past decade there has been a dramatic increase in (1) understanding the neurophysiological components of the pain experiences, (2) randomized clinical trials testing the efficacy of hypnotic treatments on chronic pain, and (3) laboratory research examining the effects of hypnosis on the neurophysiological processes implicated in pain. Work done in these areas has not only demonstrated the efficacy of hypnosis for treating chronic pain but is beginning to shed light on neurophysiological processes that may play a role in its effectiveness. This paper reviews a selection of published studies from these areas of research, focusing on recent findings that have the most potential to inform both clinical work and research in this area. The paper concludes with research and clinical recommendations for maximizing treatment efficacy based on the research findings that are available. KEYWORDSHypnosis, Hypnotic analgesia, Chronic pain, Neurophysiology, Hypnotic suggestions Chronic pain, defined as pain lasting longer than 6 months [1], is a complex experience that requires multifaceted approaches for both evaluation and treatment [1,2]. Chronic pain is considered to have an underlying biological basis, for which medications and physical treatments are commonly prescribed. Medical approaches for pain relief and management include pharmacological and surgical interventions as well as physical therapy. While nonsteroidal antiinflammatory drugs are commonly used to treat mild pain from inflammation, opioid analgesics are the mainstay of pharmacologic treatment of moderate to severe pain [2][3][4][5][6]. However, prolonged use of opioids may result in opioid tolerance and opioid-induced hyperalgesia, which is an increased sensitivity to pain. These problems, coupled with unpleasant medication side effects, may lead to discontinuation of treatment [7]. Depending on the patient's condition and cause of pain, surgery is typically considered for the treatment of chronic pain when it is deemed medically necessary or after other treatments have failed. These include intrathecal drug delivery [8], spinal cord stimulation [9], radiofrequency ablation [10], and chemical sympathectomy [11]. One concern is that even though surgical procedures can provide pain relief, they also may permanently damage the person's ability to perceive other sensations, such as light touch and temperature changes, and can cause different pain problems to occur.Medical approaches for pain reduction are only one element of an interdisciplinary approach, since gains in physical and social functioning are important goals as well [12]. Psychosocial and neuropsychological models of chronic pain show that pain treatment cannot focus solely on the sensation of pain itself (e.g., pain intensity) but must also consider the affective (e.g., emotional suffering), cognitive (e.g., beliefs about pain) and behavioral (e.g., inactivity) responses which also impact the overall experience of pain [13][14][15]. This idea has been further supported by research ev...

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Functional Brain Basis of Hypnotizability

Hoeft¹,

Gabrieli²,

Whitfield-Gabrieli³

et al. 2012

Arch Gen Psychiatry

122

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Context Focused hypnotic concentration is a model for brain control over sensation and behavior. Pain and anxiety can be effectively alleviated by hypnotic suggestion, which modulates activity in brain regions associated with focused attention, but the specific neural network underlying this phenomenon is not known. Objective The main goal of the study was to investigate the brain basis of hypnotizability. Design Cross sectional, in-vivo neuroimaging study. Setting Academic medical center at Stanford University School of Medicine. Patients 12 adults with high and 12 adults with low hypnotizability. Main Outcome Measures (1) functional MRI (fMRI) to measure functional connectivity networks at rest including default-mode, salience and executive-control networks, (2) structural T1 MRI to measure regional grey and white matter volumes, and (3) diffusion tensor imaging (DTI) to measure white matter microstructural integrity. Results High-compared to low-hypnotizable individuals showed greater functional connectivity between left dorsolateral prefrontal cortex (DLPFC), an executive-control region of the brain, and the salience network composed of the dorsal anterior cingulate cortex (dACC), anterior insula, amygdala, and ventral striatum, involved in detecting, integrating, and filtering relevant somatic, autonomic, and emotional information, using independent component analysis (ICA). Seed based analysis confirmed elevated functional coupling between the dACC and the DLPFC in high, compared to low, hypnotizables. These functional differences were not due to variation in brain structure in these regions, including regional grey and white matter volumes and white matter microstructure. Conclusions Our results provide novel evidence that altered functional connectivity in DLPFC and dACC may underlie hypnotizability. Future studies focusing on how these functional networks change and interact during hypnosis are warranted.

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Pain Affect Encoded in Human Anterior Cingulate But Not Somatosensory Cortex

Cited by 2,313 publications

References 24 publications

Executive Attention and Metacognitive Regulation

Executive Attention and Metacognitive Regulation

Neurophysiology of pain and hypnosis for chronic pain

Functional Brain Basis of Hypnotizability

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