Disrupted physical pain sensation by social exclusion in women with dysmenorrhea

Abstract

PurposeDysmenorrhea (DM), which involves both acute and chronic pain, is associated with abnormalities in pain modulation. Previous studies have shown that social pain relies on some of the same neural regions that process physical pain, highlighting a possible physical–social pain overlap. However, evidence suggesting that social pain modulates the sensitivity to physical pain remains controversial. The present study aimed to assess the effects of social pain manipulation on sensitivity to physical pain in DM sufferers and healthy female controls (HC).Materials and methodsFifty-nine otherwise healthy patients with DM and 55 HC matched for age, education, calendar age, and gynecological age were randomly assigned to inclusion or exclusion conditions of Cyberball, a virtual ball tossing game used to induce social pain (social exclusion). Pain threshold and pain tolerance in response to nociceptive pressure and cold stimuli were assessed before and after the study condition.ResultsIn response to cold stimulation, pain threshold and tolerance significantly reduced in DM compared to HC participants in the inclusion condition, indicating increased pain sensitivity in DM group. However, exclusion increased the pain threshold and tolerance compared to inclusion in DM but decreased pain threshold and tolerance in HC. Neither inclusion nor exclusion altered pressure pain sensitivity in DM, but, after social exclusion, DM participants were more fearful of being evaluated unfavorably. No significant differences were observed in self-esteem scores between DM and HC after both inclusion and exclusion.ConclusionWe observed altered pain sensation in DM participants in response to social pain manipulation, suggesting that DM not only impacts menstruation but also modulates the perception of pain more generally, especially its affective processes. The present study suggests that the effect of social pain on pain sensation and certain psychometric properties depends on previous pain experience, implicating a reciprocal influence of social and physical pain processes.

Pelvic Pain Alters Functional Connectivity Between Anterior Cingulate Cortex and Hippocampus in Both Humans and a Rat Model

“…Given that PPI values are negative here (Figure 3E), higher PPI values (FC) indicate that PDM females demonstrate a smaller reduction in connectivity during social exclusion, suggesting that PDM alters the response of the ACC-HIPP pathway under social pain conditions. Interestingly, our previous behavioral evaluations showed that PDM females have a higher physical pain threshold in social exclusion situations (Yu et al, 2018). Therefore, the smaller reduction in FC between the ACC and the HIPP, as reported here, seems to be associated with a higher threshold of physical pain and reduced pain perception during social exclusion in PDM females.…”

“…Interestingly, our previous behavioral evaluations showed that PDM females have a higher physical pain threshold in social exclusion situations ( Yu et al, 2018 ). Therefore, the smaller reduction in FC between the ACC and the HIPP, as reported here, seems to be associated with a higher threshold of physical pain and reduced pain perception during social exclusion in PDM females.…”

“…Considering ACC theta oscillations modulate HIPP high frequency activities via both direct and indirect ways in contextual processing during remote recall ( Wirt and Hyman, 2019 ), it is likely that the increase in the ACC theta is an attempt by the regulatory circuit to compensate for the abnormally enhanced HIPP-gamma oscillations observed, although clearly this regulation is insufficient to restore normal levels. This might suggest that ineffective regulation of HIPP activity by the ACC may contribute, at least in part, to the abnormal ACC-HIPP FC and altered physical pain threshold in social exclusion situations ( Yu et al, 2018 ) in PDM females. Thus, manipulating the ACC-HIPP circuit may ameliorate processing of physical and emotional pain in subjects with pelvic, such as PDM.…”

“…Pelvic pain, such as primary dysmenorrhea (PDM) which is menstrual pain without organic causes affecting approximately half of menstruating females ( Iacovides et al, 2015 ), contains both acute and chronic components of pain ( Wei et al, 2016 ) associated with impaired sensory and affective processes ( Rhudy and Bartley, 2010 ), and structural and functional brain alterations ( Low et al, 2018 ). It is becoming increasingly clear that PDM results in aberrant processing of physical and social pain ( Pitangui et al, 2013 ; Yu et al, 2018 ). Interactional processing of physical and social pain ( Borsook and MacDonald, 2010 ) involves similar brain regions, including the anterior cingulate cortex (ACC) and the adjacent medial prefrontal cortex ( Bliss et al, 2016 ).…”

When loss hurts: Psychobiological basis of frustration

“…Además de la intensidad del dolor psicológico, las características de los participantes también parecen determinar el impacto de la exclusión social sobre la percepción de dolor físico. Yu et al (2018) analizaron el papel modulador del dolor social sobre la sensación de dolor físico agudo en mujeres con dismenorrea y sanas. El umbral y la tolerancia al dolor fue comparado en 59 mujeres con dismenorrea y en 55 mujeres controles sanas expuestas a exclusión vs. inclusión social con la prueba cyberball.…”