Distraction and cognitive control independently impact parietal and prefrontal response to pain

Abstract

Pain engages and interacts with high-level cognitive processing. Previous studies documented that distracting someone through a challenging activity leads to hypoalgesia, an effect held to be mediated by parietal and prefrontal structures, who monitor pain-evoked neural response and maintain attention towards task-relevant events. Instead, alternative accounts suggest that challenging activities affect the ability to regulate one's aching experiences, due to partially-common neural substrate between cognitive control and pain at the level the medial prefrontal cortex, which could lead to hyperalgesic after-effects. Here we pulled apart effects of distraction and cognitive control on pain by delivering thermal painful stimulations either During or After (factor TIME) the engagement of a interfering Stroop paradigm (requiring high cognitive control) or a neutral condition (factor TASK). We found that TIME influenced individual assessment of pain, with less intense ratings associated to the During condition. This hypoalgesia was associated with increased activity at the level of dorsolateral prefrontal cortex and the posterior parietal cortex, in interaction with the insular cortex. This was complemented by multivariate pattern analysis who revealed that distraction altered the neural response to pain, by making it more similar to that associated with previous Stroop tasks. Critically, all these effects were observed independently of the nature of the TASK employed which, instead, led to a localized neural modulation at the level of anterior cingulate cortex. Overall, our study underscores the role played by two different faces of human executive functions, which exert independent influence in the neural response evoked by thermal pain.

Pain intensity and self‐perceived burden mediate the relationship between family functioning and pain catastrophizing in patients with neuropathic pain

“…One possible explanation is that for patients with good family functioning, family members communicate and care more about them. They discuss and mention their pain more frequently, which unintentionally increases the patient's attention to pain, which is not conducive to pain relief (Silvestrini & Corradi‐Dell'Acqua, 2023). Therefore, when constructing an effective model of family functioning for patients with NP, combining this with intervention programs that target pain concerns, such as distraction (Kim et al, 2022) or mindfulness‐based approaches (Riegner et al, 2023), maybe more advantageous.…”

Pain-sensorimotor interactions: New perspectives and a new model

“…While there have been some inconsistent findings, there is evidence that tasks that distract attention (e.g. Stroop task execution requiring high cognitive load) may have an effect on experimental pain intensity and sensorimotor reaction time ( Bushnell et al, 1985 , Seminowicz and Davis, 2007 , Van Ryckeghem et al, 2013 , Silvestrini and Corradi-Dell'Acqua, 2023 ). There is also evidence that distraction leads to decreases in brain activity in the sensorimotor cortical areas of humans in response to nociceptive stimuli ( Legrain et al, 2009 ).…”