Voluntary inhibition of pain avoidance behavior: an fMRI study.

Behavioral inhibition has classically been considered to rely upon a neural network centered at the right inferior frontal cortex [rIFC; Aron et al. (8:170-177, 2004; 18:177-185, 2014)]. However, the vast majority of inhibition studies have entailed exogenous stop signals instructing participants to withhold responding. More recent work has begun to examine the neural underpinnings of endogenous inhibition, revealing a distinct cortical basis in the dorsal fronto-median cortex [dFMC; Brass and Haggard (27:9141-9145, 2007); Kühn et al. (30:2834-3843, 2009)]. Yet, contrary to everyday experiences of voluntary behavioral suppression, the paradigms employed to investigate action inhibition have thus far been somewhat artificial, and involve little persuasive motivation to act. Accordingly, the present fMRI study seeks to compare and contrast intentional with instructed inhibition in a novel pain paradigm that recruits 'hot' incentive response systems. Participants received increasing thermal stimulation to their inner wrists, and were required to occasionally withhold their natural impulse to withdraw from the compelling pain sensation at peak temperature, in both instructed and free-choice conditions. Consistent with previous research, we observed inhibition-related activity in the dFMC and the rIFC. However, these regions displayed equivalent activation levels for both inhibition types. These data extend previous research by demonstrating that under ecologically valid conditions with a strong motivation to act, both stopping networks operate in concert to enable suppression of unwanted behavior.