<p>A systematic review of structural and functional MRI studies on pain catastrophizing</p>

Abstract

Objectives: Pain catastrophizing is reliably associated with pain reports during experimental pain in healthy, pain-free subjects and in people with chronic pain. It also correlates with self-reports of clinical pain intensity/severity in a variety of disorders characterized by chronic pain in adults, adolescents and children. However, processes, through which it exerts its effects are yet unclear. In this paper, our primary aim was to synthesize neuroimaging research to open a window to possible mechanisms underlying pain catastrophizing in both chronic pain patients and healthy controls. We also aimed to compare whether the neural correlates of pain catastrophizing are similar in these two groups. Methods: PubMed and the Web of Science were searched for magnetic resonance imaging (MRI) studies that explored neural correlates of pain catastrophizing. Results: Twenty articles met the inclusion criteria. The results of our review show a connection between pain catastrophizing and brain areas tightly connected to pain perception (including the somatosensory cortices, anterior insula, anterior cingulate cortex and thalamus) and/or modulation (eg, the dorsolateral prefrontal cortex). Our results also highlight that these processes - in relation to pain catastrophizing - are more pronounced in chronic pain patients, suggesting that structural and functional brain alterations (and perhaps mechanisms) related to pain catastrophizing may depend on prior and/or relatively stable/constant pain experience. However, we also found methodological issues and differences that could lead to divergent results. Discussion : Based on our results, pain catastrophizing might be related to salience detection, pain processing, and top-down attentional processes. More research is recommended to explore neural changes to specific types of catastrophizing thoughts (eg, experimentally induced and/or state). Furthermore, we provide ideas regarding pain catastrophizing studies in the future for a more standardized approach.

Neural correlates of conditioned pain responses in fibromyalgia subjects indicate preferential formation of new pain associations rather than extinction of irrelevant ones

“…Likewise, it has been suggested that the relationship between catastrophizing and heightened pain experience may be mediated through attentional processes, 41 which may explain why we observed neural correlations with PCS, but not between PCS and pain ratings per se. Furthermore, neuroimaging meta-analysis of pain catastrophizing 11 and instructed fear conditioning 29 report overlapping coactivation of the same regions that we observed in our whole-brain analysis to covary with increased PCS ratings in FMSs when stimulated with an identical mid-intensity painful pressure following green compared with red cue (ie, FM [P30green>P30red] × PCS) (Fig. 2 C), namely, in dACC/MCC, insula, bilateral thalamus, mPFC, putamen, superior, and middle parts of the temporal lobe.…”

<p>Examining Configural, Metric, and Scalar Invariance of the Pain Catastrophizing Scale in Native American and Non-Hispanic White Adults in the Oklahoma Study of Native American Pain Risk (OK-SNAP)</p>

“…[8][9][10][11] Unfortunately, the mechanisms by which pain catastrophizing increases pain are currently poorly understood; however, accumulating evidence suggests they involve supraspinal processes (eg, attention deployment, salience detection, amplification of activity in pain-related brain regions), rather than activation of descending facilitatory pain controls. 28,29 Because NAs have a higher prevalence of pain symptoms and pain conditions than other US ethnic/racial groups, 5 investigating the contribution of psychological variables, especially pain catastrophizing, is highly relevant. In fact, given that the current study established the measurement invariance of the PCS across NAs and NHWs, the PCS was used in subsequent analyses to examine racial/ethnic differences in catastrophic thoughts in response to painful stimuli.…”

Pain Catastrophizing Is Related to Static Postural Control Impairment in Patients with Nonspecific Chronic Low Back Pain: A Cross-Sectional Study

“…is would in turn affect the postural control in patients with chronic LBP. Pain catastrophizing is characterized by enhanced pain perception, increased attention to noxious stimuli, the reinforcement of emotional responses to pain, or the weakened modulation of pain [46,47]. People with greater pain catastrophizing demonstrated increased activity in cortical areas that are related to the anticipation of pain (medial frontal cortex, cerebellum), attention to pain (dorsal anterior cingulate cortex, dorsolateral prefrontal cortex), and emotional aspects of pain (claustrum) [47].…”