Wiech Katja, Kalisch Raffael, Weiskopf Nikolaus, Pleger Burkhard, Stephan Klaas Enno, Dolan Raymond J
Wellcome Department of Imaging Neuroscience, Institute of Neurology, London WC1N 3BG, United Kingdom.
J Neurosci. 2006 Nov 1;26(44):11501-9. doi: 10.1523/JNEUROSCI.2568-06.2006.
Perceived control attenuates pain and pain-directed anxiety, possibly because it changes the emotional appraisal of pain. We examined whether brain areas associated with voluntary reappraisal of emotional experiences also mediate the analgesic effect of perceived control over pain. Using functional magnetic resonance imaging, we compared self-controlled noxious stimuli with physically identical stimuli that were externally controlled. Self-controlled stimulation was accompanied by less pain and anxiety and higher activation in dorsal anterior cingulate (dACC), right dorsolateral, and bilateral anterolateral prefrontal (alPFC) cortices. Activation in dACC and right alPFC was negatively correlated with pain intensity ratings. For externally controlled pain, activation in right alPFC was inversely correlated with the participants' general belief to have control over their lives. Our results are consistent with a reappraisal view of control and suggest that the analgesic effect of perceived control relies on activation of right alPFC. Failure to activate right alPFC may explain the maladaptive effects of strong general control beliefs during uncontrollable pain.
感知控制可减轻疼痛及与疼痛相关的焦虑，这可能是因为它改变了对疼痛的情绪评估。我们研究了与情绪体验的自主重新评估相关的脑区是否也介导了感知控制对疼痛的镇痛作用。利用功能磁共振成像，我们将自我控制的有害刺激与外部控制的物理上相同的刺激进行了比较。自我控制的刺激伴随着较少的疼痛和焦虑，以及背侧前扣带回（dACC）、右侧背外侧和双侧前外侧前额叶（alPFC）皮质的更高激活。dACC和右侧alPFC的激活与疼痛强度评分呈负相关。对于外部控制的疼痛，右侧alPFC的激活与参与者对自己生活有控制权的总体信念呈负相关。我们的结果与控制的重新评估观点一致，并表明感知控制的镇痛作用依赖于右侧alPFC的激活。未能激活右侧alPFC可能解释了在无法控制的疼痛期间强烈的总体控制信念的适应不良影响。
