Salomons Tim V, Johnstone Tom, Backonja Misha-Miroslav, Shackman Alexander J, Davidson Richard J
University of Wisconsin-Madison, WI, USA.
J Cogn Neurosci. 2007 Jun;19(6):993-1003. 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. Journal of Personality and Social Psychology, 56, 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.
可感知的可控性改变压力源体验方式的程度在个体间差异很大。我们使用功能磁共振成像来检查与可感知的可控性对自我报告的疼痛感知影响的个体差异相关的神经激活情况。在前扣带回膝前部（pACC）、导水管周围灰质（PAG）和后岛叶/第二躯体感觉区（SII）中，对不可控（UC）而非可控（C）疼痛反应激活程度更高的受试者，在UC与C条件下报告的疼痛水平更高。相反，在预期UC与C条件下的疼痛时，腹外侧前额叶皮质（VLPFC）激活程度更高的受试者，对UC与C疼痛的反应报告的疼痛较少。VLPFC的激活与应对方式问卷[卡弗，C.S.，谢尔，M.F.，& 温特劳布，J.K.评估应对策略：一种基于理论的方法。《人格与社会心理学杂志》，56，267 - 283，1989]的接受和否认分量表显著相关，支持了这种预期激活与试图应对不可控疼痛的情绪影响相关的解释。一个包含两个前额叶簇（VLPFC和pACC）的回归模型预测了疼痛评分差异中64%的方差，另外两个区域（PAG和岛叶/ SII）的激活几乎没有预测到额外的方差。除了支持可感知的可控性对疼痛感知的影响在个体间差异很大这一结论外，这些发现还表明这些影响主要是自上而下的，由前额叶皮质区域中先前与疼痛认知调节和情绪调节相关的过程驱动。
