Department of Anesthesia, Division of Pain Management, Stanford University, Palo Alto, California, USA.
Anesthesiology. 2011 Oct;115(4):844-51. doi: 10.1097/ALN.0b013e31822b79ea.
Cognitive strategies are a set of psychologic behaviors used to modulate one's perception or interpretation of a sensation or situation. Although the effectiveness of each cognitive strategy seems to differ between individuals, they are commonly used clinically to help patients with chronic pain cope with their condition. The neural basis of commonly used cognitive strategies is not well understood. Understanding the neural correlates that underlie these strategies will enhance understanding of the analgesic network of the brain and the cognitive modulation of pain.
The current study examines patterns of brain activation during two common cognitive strategies, external focus of attention and reappraisal, in patients with chronic pain using functional magnetic resonance imaging.
Behavioral results revealed interindividual variability in the effectiveness of one strategy versus another in the patients. Functional magnetic resonance imaging revealed distinct patterns of activity when the two strategies were used. During external focus of attention, activity was observed mainly in cortical areas including the postcentral gyrus, inferior parietal lobule, middle occipital gyrus, and precentral gyrus. The use of reappraisal evoked activity in the thalamus and amygdala in addition to cortical regions. Only one area, the postcentral gyrus, was observed to be active during both strategies.
The results of this study suggest that different cognitive behavioral strategies recruit different brain regions to perform the same task: pain modulation.
认知策略是一组用于调节个体对感觉或情况的感知或解释的心理行为。尽管每种认知策略的效果似乎因人而异，但临床上通常会使用这些策略来帮助慢性疼痛患者应对他们的病情。常用认知策略的神经基础尚未得到很好的理解。了解这些策略背后的神经关联将增强对大脑镇痛网络和疼痛认知调节的理解。
本研究使用功能磁共振成像检查慢性疼痛患者在两种常见认知策略（外部注意力焦点和重新评估）期间的大脑激活模式。
行为结果显示，在患者中，一种策略相对于另一种策略的有效性存在个体间的差异。功能磁共振成像显示，当使用两种策略时，会出现不同的活动模式。在外部注意力焦点时，活动主要发生在包括中央后回、下顶叶回、中枕叶回和中央前回在内的皮质区域。使用重新评估除了皮质区域外，还会引起丘脑和杏仁核的活动。只有一个区域，即中央后回，在两种策略中都被观察到活跃。
这项研究的结果表明，不同的认知行为策略会招募不同的大脑区域来执行相同的任务：疼痛调节。
