期望和不确定性对疼痛评分的调节:行为特征及预期神经关联

Modulation of pain ratings by expectation and uncertainty: Behavioral characteristics and anticipatory neural correlates.

作者信息

Brown Christopher A, Seymour Ben, Boyle Yvonne, El-Deredy Wael, Jones Anthony K P

机构信息

Human Pain Research Group, Clinical Sciences Building, Hope Hospital, Salford M6 8HD, United Kingdom Wellcome Department of Imaging Neuroscience, Functional Imaging Laboratory, 12 Queen Square, London WC1N 3BG, United Kingdom School of Psychological Sciences, University of Manchester, Zochonis Building, Oxford Road, Manchester M13 9PL, United Kingdom.

出版信息

Pain. 2008 Apr;135(3):240-250. doi: 10.1016/j.pain.2007.05.022. Epub 2007 Jul 5.

Abstract

Expectations about the magnitude of impending pain exert a substantial effect on subsequent perception. However, the neural mechanisms that underlie the predictive processes that modulate pain are poorly understood. In a combined behavioral and high-density electrophysiological study we measured anticipatory neural responses to heat stimuli to determine how predictions of pain intensity, and certainty about those predictions, modulate brain activity and subjective pain ratings. Prior to receiving randomized laser heat stimuli at different intensities (low, medium or high) subjects (n=15) viewed cues that either accurately informed them of forthcoming intensity (certain expectation) or not (uncertain expectation). Pain ratings were biased towards prior expectations of either high or low intensity. Anticipatory neural responses increased with expectations of painful vs. non-painful heat intensity, suggesting the presence of neural responses that represent predicted heat stimulus intensity. These anticipatory responses also correlated with the amplitude of the Laser-Evoked Potential (LEP) response to painful stimuli when the intensity was predictable. Source analysis (LORETA) revealed that uncertainty about expected heat intensity involves an anticipatory cortical network commonly associated with attention (left dorsolateral prefrontal, posterior cingulate and bilateral inferior parietal cortices). Relative certainty, however, involves cortical areas previously associated with semantic and prospective memory (left inferior frontal and inferior temporal cortex, and right anterior prefrontal cortex). This suggests that biasing of pain reports and LEPs by expectation involves temporally precise activity in specific cortical networks.

摘要

对即将到来的疼痛程度的预期会对后续的感知产生重大影响。然而,调节疼痛的预测过程背后的神经机制却知之甚少。在一项行为学与高密度电生理学相结合的研究中,我们测量了对热刺激的预期神经反应,以确定疼痛强度的预测以及对这些预测的确定性如何调节大脑活动和主观疼痛评分。在接受不同强度(低、中或高)的随机激光热刺激之前,15名受试者观看了提示信息,这些提示要么准确告知他们即将到来的强度(确定预期),要么不告知(不确定预期)。疼痛评分偏向于对高强度或低强度的先前预期。与非疼痛性热强度相比,预期神经反应随着对疼痛性热强度的预期而增加,这表明存在代表预测热刺激强度的神经反应。当强度可预测时,这些预期反应也与对疼痛刺激的激光诱发电位(LEP)反应的幅度相关。源分析(LORETA)显示,预期热强度的不确定性涉及一个通常与注意力相关的预期皮质网络(左背外侧前额叶、后扣带回和双侧顶下小叶皮质)。然而,相对确定性涉及先前与语义和前瞻性记忆相关的皮质区域(左额下回和颞下回皮质,以及右前额叶皮质)。这表明,预期对疼痛报告和LEP的偏差涉及特定皮质网络中时间精确的活动。

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