Gougeon Véronique, Gaumond Isabelle, Goffaux Philippe, Potvin Stéphane, Marchand Serge
*Département de chirurgie, Service de neurochirurgie, Équipe de recherche sur la douleur †École de réadaptation, Faculté de Médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke ‡Département de psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada.
Clin J Pain. 2016 Mar;32(3):238-45. doi: 10.1097/AJP.0000000000000244.
Recent studies demonstrate that empathy-evoked brain responses include the activation of brainstem structures responsible for triggering descending pain inhibition. Unfortunately, direct evidence linking empathy for pain and descending inhibitory controls (conditioned pain modulation) is lacking. This study, therefore, aimed to determine if the observation of ourselves or a loved-one in pain could activate descending pain inhibition without exposure to a noxious stimulation; which is otherwise required.
Descending pain inhibition was triggered by immersing the right arm of participants (15 heterosexual couples; mean age±SE: 28.89±2.14) in a bath of cold water. The effects of empathy on descending pain inhibition were observed by immersing the right arm of participants in a bath of lukewarm water while having them watch a video of either themselves or their spouse during a previous nociceptive immersion. Immersion of the arm in a bath of lukewarm water without empathic (video) observation was also included as a control condition.
A strong inhibitory response activated by the mere observation of the video of themselves or their spouse in pain without a nociceptive conditioning stimulus. Associative statistics also showed that strong pain catastrophizing responses while watching the video resulted in stronger pain inhibition. Moreover, high levels of empathy were associated with stronger pain inhibition, but only for women.
This study showed that observing someone in pain triggers descending pain inhibition. Results also demonstrate how empathy and gender are affecting pain modulation mechanisms.
近期研究表明,由共情引发的大脑反应包括激活脑干结构,这些结构负责触发下行性疼痛抑制。遗憾的是,缺乏将对疼痛的共情与下行性抑制控制(条件性疼痛调制)联系起来的直接证据。因此,本研究旨在确定观察自己或爱人处于疼痛中是否能在不接触有害刺激的情况下激活下行性疼痛抑制;而在其他情况下这是必需的。
通过将参与者(15对异性恋夫妇;平均年龄±标准误:28.89±2.14)的右臂浸入冷水浴中来触发下行性疼痛抑制。在参与者观看自己或配偶先前伤害性浸入过程的视频时,将其右臂浸入温水浴中,观察共情对下行性疼痛抑制的影响。将手臂浸入温水浴且无共情(视频)观察的情况也作为对照条件。
仅仅观察自己或配偶处于疼痛中的视频,在没有伤害性条件刺激的情况下激活了强烈的抑制反应。相关性统计还表明,观看视频时强烈的疼痛灾难化反应会导致更强的疼痛抑制。此外,高水平的共情与更强的疼痛抑制相关,但仅适用于女性。
本研究表明,观察他人处于疼痛中会触发下行性疼痛抑制。结果还证明了共情和性别如何影响疼痛调制机制。