Pain anticipation: An activation likelihood estimation meta‐analysis of brain imaging studies

Abstract

The anticipation of pain has been investigated in a variety of brain imaging studies. Importantly, today there is no clear overall picture of the areas that are involved in different studies and the exact role of these regions in pain expectation remains especially unexploited. To address this issue, we used activation likelihood estimation meta-analysis to analyze pain anticipation in several neuroimaging studies. A total of 19 functional magnetic resonance imaging were included in the analysis to search for the cortical areas involved in pain anticipation in human experimental models. During anticipation, activated foci were found in the dorsolateral prefrontal, midcingulate and anterior insula cortices, medial and inferior frontal gyri, inferior parietal lobule, middle and superior temporal gyrus, thalamus, and caudate. Deactivated foci were found in the anterior cingulate, superior frontal gyrus, parahippocampal gyrus and in the claustrum. The results of the meta-analytic connectivity analysis provide an overall view of the brain responses triggered by the anticipation of a noxious stimulus. Such a highly distributed perceptual set of self-regulation may prime brain regions to process information where emotion, action and perception as well as their related subcategories play a central role. Not only do these findings provide important information on the neural events when anticipating pain, but also they may give a perspective into nocebo responses, whereby negative expectations may lead to pain worsening.

Pain anticipatory phenomena in patients with central poststroke pain: a magnetoencephalography study

“…Unlike the nonaffected extremity, early increased frontoparietal attention to PS (relative to NOS1) was not evident on the affected side. Instead, we recorded a late (just prior to stimuli) increased activity in entorhinal cortex and aMCC, regions that have been associated with conditioned hyperalgesia (Ploghaus et al 2001). Interestingly, MCC activity has been reported to interrupt attention network during pain anticipation .…”

“…Our regions of interest (ROI) were restricted to networks associated with visual anticipation of pain (Machado et al 2014;Senkowski et al 2014). These included the frontoparietal networks (Lloyd et al 2016;Palermo et al 2015) including all of the prefrontal and parietal cortex, salience networks including operculoinsular (Lutz et al 2013;Ploghaus et al 1999) and cingulate cortices Brown et al 2008aBrown et al , 2008bVogt 2005), and medial temporal (Bauch et al 2014) including entorhinal cortex (Ploghaus et al 2001). The sensory cortices including somatosensory (Worthen et al 2011) andvisual cortex (Machado et al 2014) were also included in the analysis.…”

“…Anticipation of pain is a typical feature in chronic pain patients and involves continuous cognitive appraisal of sensory signals and heightened emotional processing to perceived imminent threat (Garland 2012;Palermo et al 2015). We expect that electrical stimulation of the pathways related to the control of emotion will modulate the learned affective response to painful stimuli.…”

Love as a Modulator of Pain

“…A decreased pain threshold in the presence of a romantic partner was associated with the activation of the thalamus, parahippocampal gyrus and hippocampus, while an increased pain threshold when accompanied by a romantic partner was associated with activation of all parts of the cingulate cortex (Figure 1). The cingulate cortex plays an important role in processing anticipation (41) and expectation (42) in relation to pain, as well as positive emotions in the social context (43). Therefore, it is likely to be involved in processing expectations regarding romantic partners.…”

Beliefs modulate the effects of drugs on the human brain

“…This question has been extensively investigated for the placebo effect, particularly as it pertains to analgesia, including the relationships between anticipation of pain and the magnitude of the placebo/nocebo effect (10). As for prior studies on conditioning, the placebo analgesic effect also points to dopamine as a mediator of these learned responses (11).…”