The importance of context: when relative relief renders pain pleasant.

Details

Serval ID
serval:BIB_26B9C97C2E11
Type
Article: article from journal or magazin.
Collection
Publications
Title
The importance of context: when relative relief renders pain pleasant.
Journal
Pain
Author(s)
Leknes S., Berna C., Lee M.C., Snyder G.D., Biele G., Tracey I.
ISSN
1872-6623 (Electronic)
ISSN-L
0304-3959
Publication state
Published
Issued date
03/2013
Peer-reviewed
Oui
Volume
154
Number
3
Pages
402-410
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Context can influence the experience of any event. For instance, the thought that "it could be worse" can improve feelings towards a present misfortune. In this study we measured hedonic feelings, skin conductance, and brain activation patterns in 16 healthy volunteers who experienced moderate pain in two different contexts. In the "relative relief context," moderate pain represented the best outcome, since the alternative outcome was intense pain. However, in the control context, moderate pain represented the worst outcome and elicited negative hedonic feelings. The context manipulation resulted in a "hedonic flip," such that moderate pain elicited positive hedonics in the relative relief context. Somewhat surprisingly, moderate pain was even rated as pleasant in this context, despite being reported as painful in the control context. This "hedonic flip" was corroborated by physiological and functional neuroimaging data. When moderate pain was perceived as pleasant, skin conductance and activity in insula and dorsal anterior cingulate were significantly attenuated relative to the control moderate stimulus. "Pleasant pain" also increased activity in reward and valuation circuitry, including the medial orbitofrontal and ventromedial prefrontal cortices. Furthermore, the change in outcome hedonics correlated with activity in the periacqueductal grey (PAG) of the descending pain modulatory system (DPMS). The context manipulation also significantly increased functional connectivity between reward circuitry and the PAG, consistent with a functional change of the DPMS due to the altered motivational state. The findings of this study point to a role for brainstem and reward circuitry in a context-induced "hedonic flip" of pain.

Keywords
Adult, Cerebral Cortex/physiopathology, Cues, Female, Frontal Lobe/physiopathology, Galvanic Skin Response, Gyrus Cinguli/physiopathology, Hot Temperature/adverse effects, Humans, Magnetic Resonance Imaging, Male, Nociception/physiology, Pain Measurement, Periaqueductal Gray/physiopathology, Pleasure/physiology, Prefrontal Cortex/physiopathology, Reward, Young Adult
Pubmed
Web of science
Create date
07/02/2018 17:44
Last modification date
20/08/2019 13:05
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