Pain and Decision-Making: Interrelated Through Homeostasis

Abstract

Background:Pain is a multidimensional experience that motivates organisms to engage in behavioral repertoire to deal with potential life-threatening situations that are a threat to homeostatic function. The aim of this mini-review was to highlight the nature of pain, the role that pain has as a motivational drive to impact higher-order cognitive processes, such as decision making, and how these processes are intimately integrated with homeostatic mechanisms.Conclusion:Both conceptual and neurobiological overlap suggest a close interaction of decision-making, pain, and homeostasis. Pain, decision-making and homeostasis are interconnected through a common denominator of survival and must be considered when assessing pain-related issues and treatments.

The Use of an FR1 Schedule Operant Approach-Avoidance Paradigm to Measure the Aversiveness of Neuropathic and Inflammatory Pain

“…However, the similarity in continued approach behaviors within both pain conditions may not highlight a similarity in aversiveness, but rather a deep complexity between the cognitive and motivational drives associated with hunger and pain, in relation to the ability of various schedules of reinforcement to be able to tease this relationship apart. The presence of pain inevitably elicits the demand for decision-making, but homeostatic function, such as hunger, has been further identified to mediate this relationship in regard to attentional demand spent on each imbalance at a time [LaGraize et al, 2004; ( 56 )]. Thus, highlighting the impact of timing and duration of the response/reinforcer contingency as well as the schedule of reinforcement on behavioral outcomes could help to disentangle the competing cognitive and motivational drives associated with potential dissimilarities in the affective nature of each pain state.…”

The Fibromyalgia Pain Experience: A Scoping Review of the Preclinical Evidence for Replication and Treatment of the Affective and Cognitive Pain Dimensions

“…Applying this operationalization to pain affect formulates the experience of pain as a homeostatic emotion that may be approached in the same manner as drive-reduction theory. When pain is experienced (i.e., drive) it disrupts homeostasis (i.e., need) and creates an unpleasant state wherein an animal is motivated to respond behaviorally [8]. Measuring this behavioral response to punishers and rewards is the overarching methodological goal employed to quantify pain affect.…”

Pain, from perception to action: A computational perspective

“…Pain presents as a strong motivational drive to impact decision-making, and there is also a neurobiological overlap between decision-making and pain. 18 , 76 , 77 , 78 The adaptive pain behaviors in animals and humans may have originated evolutionarily to promote survival by minimizing harm, and may further involve higher order cognitive processes and planning. Therefore, the decision on how to plan an action to escape from or endure potential harm in order to maximize future reward can be formulated as a temporal credit assignment problem.…”