Romano Daniele, Maravita Angelo
Psychology Department, Università degli studi di Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy.
Neuropsychologia. 2014 May;57:93-100. doi: 10.1016/j.neuropsychologia.2014.03.002. Epub 2014 Mar 18.
How to reduce pain is a fundamental clinical and experimental question. Acute pain is a complex experience which seems to emerge from the co-activation of two main processes, namely the nociceptive/discriminative analysis and the affective/cognitive evaluation of the painful stimulus. Recently it has been found that pain threshold increases following the visual magnification of the body part targeted by the painful stimulation. This finding is compatible with the well-known notion that body representation and perceptual experience relay on complex, multisensory factors. However, the level of cognitive processing and the physiological mechanisms underlying this analgesic effect are still to be investigated. In the present work we found that following the visual magnification of a body part, the Skin Conductance Responses (SCR), to an approaching painful stimulus increases before contact and decreases following the real stimulation, compared to the non-distorted view of the hand. By contrast, an unspecific SCR increase is found when the hand is visually shrunk. Moreover a reduction of subjective pain experience was found specifically for the magnified hand in explicit pain ratings. These findings suggest that the visual increase of body size enhances the cognitive, anticipatory component of pain processing; such an anticipatory reaction reduces the response to the following contact with the noxious stimulus. The present results support the idea that cognitive aspects of pain experience relay on the multisensory representation of the body, and that could be usefully exploited for inducing a significant reduction of subjective pain experience.
如何减轻疼痛是一个基本的临床和实验问题。急性疼痛是一种复杂的体验,似乎源于两个主要过程的共同激活,即伤害性/辨别性分析和对疼痛刺激的情感/认知评估。最近发现,在对疼痛刺激所针对的身体部位进行视觉放大后,疼痛阈值会升高。这一发现与身体表征和感知体验依赖于复杂的多感官因素这一众所周知的观点相一致。然而,这种镇痛作用背后的认知加工水平和生理机制仍有待研究。在本研究中,我们发现,与手部的正常视觉相比,对身体部位进行视觉放大后,皮肤电反应(SCR)在接近疼痛刺激时在接触前增加,在实际刺激后减少。相比之下,当手部在视觉上缩小时,会出现非特异性的SCR增加。此外,在明确的疼痛评分中,专门针对放大的手部发现主观疼痛体验有所减轻。这些发现表明,身体大小的视觉增加增强了疼痛加工的认知、预期成分;这种预期反应减少了对随后与有害刺激接触的反应。目前的结果支持这样一种观点,即疼痛体验的认知方面依赖于身体的多感官表征,并且这可以有效地用于显著减轻主观疼痛体验。