Neurocognitive aspects of pain perception

Wiech, Katja; Ploner, Markus; Tracey, Irene

doi:10.1016/j.tics.2008.05.005

Cited by 585 publications

(495 citation statements)

References 69 publications

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“…Engagement of the descending pain modulatory system and decreased activation in regions supporting the salience of pain (e.g., aINS) are in agreement with explicit manipulation studies (10). Fluctuations in DMN activity and functional connectivity have not generally been emphasized previously as part of the pain modulation process.…”

Section: Discussionsupporting

confidence: 82%

“…The PAG sends antinociceptive signals to the rostroventral medulla, which projects to the spinal cord dorsal horn to inhibit incoming nociceptive information (30). fMRI studies suggest that explicit cognitive manipulation of pain engages this pathway (4,7,9,10). Furthermore, the painmodulatory action of this pathway during placebo manipulations and attentional tasks is inhibited when opiate activity is blocked (4,7).…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive manipulations, such as alterations of attention/distraction (3)(4)(5), placebo effects (6)(7)(8)(9), changing expectations, and other strategies (10), have shown some efficacy in altering perceptions and neural responses elicited by painful stimuli. It is generally assumed that these effects involve enhanced endogenous analgesic activity within the descending pain modulatory system [e.g., prefrontal cortex, perigenual cingulate cortex, periaqueductal gray (PAG), and rostroventral medulla] and decreased activity in regions that support the salience of pain [e.g., insula and midcingulate cortex (MCC)] (10).…”

mentioning

confidence: 99%

“…It is generally assumed that these effects involve enhanced endogenous analgesic activity within the descending pain modulatory system [e.g., prefrontal cortex, perigenual cingulate cortex, periaqueductal gray (PAG), and rostroventral medulla] and decreased activity in regions that support the salience of pain [e.g., insula and midcingulate cortex (MCC)] (10).…”

mentioning

confidence: 99%

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Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks

Kucyi

Salomons

Davis

2013

Proc. Natl. Acad. Sci. U.S.A.

339

314

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Human minds often wander away from their immediate sensory environment. It remains unknown whether such mind wandering is unsystematic or whether it lawfully relates to an individual's tendency to attend to salient stimuli such as pain and their associated brain structure/function. Studies of pain-cognition interactions typically examine explicit manipulation of attention rather than spontaneous mind wandering. Here we sought to better represent natural fluctuations in pain in daily life, so we assessed behavioral and neural aspects of spontaneous disengagement of attention from pain. We found that an individual's tendency to attend to pain related to the disruptive effect of pain on his or her cognitive task performance. Next, we linked behavioral findings to neural networks with strikingly convergent evidence from functional magnetic resonance imaging during pain coupled with thought probes of mind wandering, dynamic resting state activity fluctuations, and diffusion MRI. We found that (i) pain-induced default mode network (DMN) deactivations were attenuated during mind wandering away from pain; (ii) functional connectivity fluctuations between the DMN and periaqueductal gray (PAG) dynamically tracked spontaneous attention away from pain; and (iii) across individuals, stronger PAG-DMN structural connectivity and more dynamic resting state PAG-DMN functional connectivity were associated with the tendency to mind wander away from pain. These data demonstrate that individual tendencies to mind wander away from pain, in the absence of explicit manipulation, are subserved by functional and structural connectivity within and between default mode and antinociceptive descending modulation networks.pain modulation | salience network | stimulus-independent thought | ventral attention network | experience sampling H umans spend nearly half their time on thoughts unrelated to their present sensory environment (1), a phenomenon referred to as "mind wandering." These thoughts can persist even when engaged in salient and challenging everyday activities (1, 2), such as driving a car through traffic. In such situations, mind wandering can be deleterious. However, in some situations, mind wandering may be beneficial, such as when an individual needs to cope with pain.Cognitive manipulations, such as alterations of attention/distraction (3-5), placebo effects (6-9), changing expectations, and other strategies (10), have shown some efficacy in altering perceptions and neural responses elicited by painful stimuli. It is generally assumed that these effects involve enhanced endogenous analgesic activity within the descending pain modulatory system [e.g., prefrontal cortex, perigenual cingulate cortex, periaqueductal gray (PAG), and rostroventral medulla] and decreased activity in regions that support the salience of pain [e.g., insula and midcingulate cortex (MCC)] (10).A crucial assumption in previous studies of explicit pain manipulation is that there is a static, invariant neurocognitive state during incoming nociceptive activit...

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks

Kucyi

Salomons

Davis

2013

Proc. Natl. Acad. Sci. U.S.A.

339

314

View full text Add to dashboard Cite

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“…Pain is a subjective sensation with a complex, non-linear relationship between nociceptive information and pain perception 12 . Numerous methods of pain assessment have been developed.…”

Section: Introductionmentioning

confidence: 99%

Pain in older people with frailty

Brown

Young

Clegg

et al. 2015

Rev. Clin. Gerontol.

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In this review we identified cohort and cross-sectional studies which assessed pain in community-dwelling older people (> 65 years) reliably characterised as frail. Secondly, we considered biologically plausible mechanisms which may alter pain perception, or contribute to, or exacerbate pain in an older person with frailty. Thirdly, we considered specific implications of pain management for this group of people. From the limited data from the seven included studies, it would appear that the presence of pain is higher in older people with frailty compared to people characterised as pre-frail or not frail. Thus, older people reporting pain are more likely to be frail. However, a lack of prospective data precludes inferences about the direction of the relationship: that is whether pain or frailty is the antecedent. Further research is needed to understand the direction of the relationship, and to identify appropriate pain management strategies for older people with frailty.

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Irritable Bowel Syndrome

Videlock¹,

Chang²

2015

Yamada' S Textbook of Gastroenterology

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Neurocognitive aspects of pain perception

Cited by 585 publications

References 69 publications

Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks

Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks

Pain in older people with frailty

Irritable Bowel Syndrome

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