Herpertz Sabine C, Schmitgen Mike M, Fuchs Christine, Roth Corinna, Wolf Robert Christian, Bertsch Katja, Flor Herta, Grinevich Valery, Boll Sabrina
Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany.
Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany.
J Pain. 2019 Oct;20(10):1187-1198. doi: 10.1016/j.jpain.2019.04.002. Epub 2019 Apr 19.
There is an ongoing debate whether the neuropeptide oxytocin (OT) modulates pain processing in humans. This study differentiates behavioral and neuronal OT effects on pain perception and pain anticipation by using a Pavlovian conditioning paradigm. Forty-six males received intranasally administered OT in a randomized, double-blind, placebo-controlled group design. Although OT exerted no direct effect on perceived pain, OT was found to modulate the blood oxygen level-dependent response in the ventral striatum for painful versus warm unconditioned stimuli and to decrease activity in the anterior insula (IS) with repeated thermal pain stimuli. Regarding pain anticipation, OT increased responses to CS versus CS in the nucleus accumbens. Furthermore, in the OT condition increased correct expectations, particularly for the most certain conditioned stimuli (CS)-unconditioned stimuli associations (CS and CS) were found, as well as greatest deactivations in the right posterior IS in response to the least certain condition (CS) with posterior IS activity and correct expectancies being positively correlated. In conclusion, OT seems to have both a direct effect on pain processing via the ventral striatum and by inducing habituation in the anterior IS as well as on pain anticipation by boostering associative learning in general and the neuronal conditioned fear of pain response in particular. PERSPECTIVE: The neuropeptide OT has recently raised the hope to offer a novel avenue for modulating pain experience. This study found OT to modulate pain processing and to facilitate the anticipation of pain, inspiring further research on OT effects on the affective dimension of the pain experience.
关于神经肽催产素（OT）是否调节人类疼痛处理，目前仍存在争议。本研究通过使用经典条件反射范式，区分了行为和神经元OT对疼痛感知和疼痛预期的影响。46名男性在随机、双盲、安慰剂对照的组设计中接受鼻内给予OT。虽然OT对感知疼痛没有直接影响，但发现OT可调节腹侧纹状体对疼痛与温暖非条件刺激的血氧水平依赖性反应，并随着重复热痛刺激降低前脑岛（IS）的活动。关于疼痛预期，OT增加了伏隔核中对条件刺激（CS）与非条件刺激（CS）的反应。此外，在OT条件下，发现正确预期增加，特别是对于最确定的条件刺激（CS）-非条件刺激关联（CS和CS），并且在最不确定条件（CS）下，右侧后脑岛的失活最大，而后脑岛活动与正确预期呈正相关。总之，OT似乎通过腹侧纹状体对疼痛处理有直接影响，并通过在前脑岛诱导习惯化，以及通过增强一般的联想学习，特别是对疼痛反应的神经元条件恐惧，对疼痛预期产生影响。观点：神经肽OT最近为调节疼痛体验提供了一条新途径带来了希望。本研究发现OT可调节疼痛处理并促进对疼痛的预期，激发了对OT对疼痛体验情感维度影响的进一步研究。
