Modulation of pain processing in hyperalgesia by cognitive demand

The relationship between pain and cognitive function is of theoretical and clinical interest, exemplified by observations that attention-demanding activities reduce pain in chronically afflicted patients. Previous studies have concentrated on phasic pain, which bears little correspondence to clinica...

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Bibliographic Details
Published in:NeuroImage (Orlando, Fla.) Fla.), 2005-08, Vol.27 (1), p.59-69
Main Authors: Wiech, Katja, Seymour, Ben, Kalisch, Raffael, Enno Stephan, Klaas, Koltzenburg, Martin, Driver, Jon, Dolan, Raymond J.
Format: Article
Language:English
Subjects:
Adult
Attention - physiology
Behavior
Brain
Capsaicin
Cognition - physiology
Cognitive demand
Experiments
Female
fMRI
Hot Temperature
Humans
Hyperalgesia
Hyperalgesia - chemically induced
Hyperalgesia - physiopathology
Hyperalgesia - psychology
Magnetic Resonance Imaging
Male
Medical imaging
Middle Aged
Nerve Net - physiopathology
Pain
Pain - chemically induced
Pain - physiopathology
Pain - psychology
Pain management
Psychomotor Performance - physiology
Reaction Time - physiology
Studies
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Summary:The relationship between pain and cognitive function is of theoretical and clinical interest, exemplified by observations that attention-demanding activities reduce pain in chronically afflicted patients. Previous studies have concentrated on phasic pain, which bears little correspondence to clinical pain conditions. Indeed, phasic pain is often associated with differential or opposing effects to tonic pain in behavioral, lesion, and pharmacological studies. To address how cognitive engagement interacts with tonic pain, we assessed the influence of an attention-demanding cognitive task on pain-evoked neural responses in an experimental model of chronic pain, the capsaicin-induced heat hyperalgesia model. Using functional magnetic resonance imaging (fMRI), we show that activity in the orbitofrontal and medial prefrontal cortices, insula, and cerebellum correlates with the intensity of tonic pain. This pain-related activity in medial prefrontal cortex and cerebellum was modulated by the demand level of the cognitive task. Our findings highlight a role for these structures in the integration of motivational and cognitive functions associated with a physiological state of injury. Within the limitations of an experimental model of pain, we suggest that the findings are relevant to understanding both the neurobiology and pathophysiology of chronic pain and its amelioration by cognitive strategies.
ISSN:1053-8119
1095-9572
DOI:10.1016/j.neuroimage.2005.03.044