Individual Differences in the Effects of Perceived Controllability on Pain Perception: Critical Role of the Prefrontal Cortex

• Published in: Journal of cognitive neuroscience 2007-06, Vol.19 (6), p.993-1003
• Main Authors: Salomons, Tim V., Johnstone, Tom, Backonja, Misha-Miroslav, Shackman, Alexander J., Davidson, Richard J.
• Format: Article
• Language: English
• Subjects: Adult; Anatomical correlates of behavior; Behavioral psychophysiology; Biological and medical sciences; Brain Mapping; Brain research; Cues; Female; Fundamental and applied biological sciences. Psychology; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging - methods; Male; Neurosciences; NMR; Nuclear magnetic resonance; Pain; Pain - etiology; Pain - pathology; Pain - physiopathology; Pain Measurement - methods; Pain Threshold - physiology; Perceptions; Physical Stimulation - adverse effects; Prefrontal Cortex - blood supply; Prefrontal Cortex - physiopathology; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Regression analysis
• ISSN: 0898-929X; 1530-8898
• DOI: 10.1162/jocn.2007.19.6.993

The degree to which perceived controllability alters the way a stressor is experienced varies greatly among individuals. We used functional magnetic resonance imaging to examine the neural activation associated with individual differences in the impact of perceived controllability on self-reported pain perception. Subjects with greater activation in response to uncontrollable (UC) rather than controllable (C) pain in the pregenual anterior cingulate cortex (pACC), periaqueductal gray (PAG), and posterior insula/SII reported higher levels of pain during the UC versus C conditions. Conversely, subjects with greater activation in the ventral lateral prefrontal cortex (VLPFC) in anticipation of pain in the UC versus C conditions reported less pain in response to UC versus C pain. Activation in the VLPFC was significantly correlated with the acceptance and denial subscales of the COPE inventory [Carver, C. S., Scheier, M. F., & Weintraub, J. K. Assessing coping strategies: A theoretically based approach. , 267–283, 1989], supporting the interpretation that this anticipatory activation was associated with an attempt to cope with the emotional impact of uncontrollable pain. A regression model containing the two prefrontal clusters (VLPFC and pACC) predicted 64% of the variance in pain rating difference, with activation in the two additional regions (PAG and insula/SII) predicting almost no additional variance. In addition to supporting the conclusion that the impact of perceived controllability on pain perception varies highly between individuals, these findings suggest that these effects are primarily top-down, driven by processes in regions of the prefrontal cortex previously associated with cognitive modulation of pain and emotion regulation.