Operant and classical learning principles underlying mind–body interaction in pain modulation: a pilot fMRI study

Abstract

The operant conditioning has been less studied than the classical conditioning as a mechanism of placebo-like effect, and two distinct learning mechanisms have never been compared to each other in terms of their neural activities. Twenty-one participants completed cue-learning based pain rating tasks while their brain responses were measured using functional magnetic resonance imaging. After choosing (instrumental) or viewing (classical) one of three predictive cues (low- and high-pain cues with different level of certainty), they received painful stimuli according to the selected cues. Participants completed the same task during the test session, except that they received only a high pain stimulus regardless of the selected cues to identify the effects of two learning paradigms. While receiving a high pain stimulation, low-pain cue significantly reduced pain ratings compared to high-pain cue, and the overall ratings were significantly lower under operant than under classical conditioning. Operant behavior activated the temporoparietal junction significantly more than the passive behavior did, and neural activity in the primary somatosensory cortex was significantly reduced during pain in instrumental as compared with classical conditioning trials. The results suggest that pain modulation can be induced by classical and operant conditioning, and mechanisms of attention and context change are involved in instrumental learning.

The Science and Social Validity of Companion Animal Welfare: Functionally Defined Parameters in a Multidisciplinary Field

“…This may explain why animals who are given a choice to participate in medical handling do so even when the handling is occasionally painful. Many repetitions of pain-free trials, in addition to the choice component of the intervention, may have a similar pain modulating effect as what Lee et al [164] demonstrated with humans.…”

“…Operant learning can cause a pain modulation effect. Lee et al [164] taught 21 human participants to select from low or high pain cues, which would be followed, respectively, by mildly or severely painful stimuli. After this training, participants who selected low pain cues expected to receive mildly painful stimuli, but instead received the high pain stimuli.…”

The Integration of Assistive Technology and Virtual Reality for Assessment and Recovery of Post-coma Patients With Disorders of Consciousness: A New Hypothesis

“…On one hand, based on classical paradigm they include the capacity of the patient to positively associate pairs of stimuli (Ricchi et al, 2022 ). On the other hand, based on the operant paradigm, they consist on the capacity of the patient to correctly match a behavioral response with an environmental consequence (Lee et al, 2021 ). Empirical evidences of learning between both approaches (i.e., a correct association between events or its positive achievement) may be considered as a non-reflective response and suggest a diagnosis of minimally conscious state (Lancioni et al, 2008b ).…”

Placebo and nocebo effects: from observation to harnessing and clinical application

“…Placebo analgesia was successfully established by rewarding low ratings and punishing high ratings, and, interestingly, seemed resistant to extinction. Another study revealed that operant conditioning generated greater placebo analgesia than classical conditioning and that mechanical pain-induced brain activities in the ipsilateral S1 and contralateral lingual gyrus were reduced more by operant conditioning [ 32 ]. These findings revealed that patients can learn placebo analgesia as a result of operant learning.…”