Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland.
Department of Neural and Pain Sciences and Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Baltimore, Maryland.
J Neurophysiol. 2020 Feb 1;123(2):462-472. doi: 10.1152/jn.00331.2019. Epub 2019 Oct 9.
Although hypervigilance may play a role in some clinical pain syndromes, experimental vigilance toward painful stimuli has been studied infrequently. We evaluated vigilance toward pain by using a continuous performance task (CPT), in which subjects responded to moderately intense painful target stimuli, occurring in a train of mildly painful nontargets. We assessed nondetected targets (misses), reaction times (RTs), and psychological activation (tense arousal). During time on task in CPTs of other sensory modalities, there is an increase in misses and RTs (vigilance decrement). We hypothesized that our CPT would influence vigilance performance related to pain, anxiety, and limitation of attentional resources. The results showed a decrement in vigilance over time as misses increased, although RTs were unchanged. While mind-wandering did not influence vigilance performance, intrinsic attention to pain drove both hit RTs and number of misses. This resulted in pain-focused subjects performing worse on the CPT pain task with slower RTs and more misses per block. During the CPT, the change in stimulus salience was related to the change in pain intensity, while pain unpleasantness correlated with tense arousal. CPT performance during experimental vigilance to pain and psychological activation were related to trait anxiety, as measured by the Spielberger State-Trait Anxiety Inventory and neuroticism, as measured by the NEO five factor inventory. Trait anxiety and neuroticism may play important roles in an individual's predisposition to dwell on pain and interpret pain as threatening. Subjects detected moderately painful target stimuli in a train of mildly painful nontarget stimuli, which resulted in vigilance performance metrics including missed targets, reaction times, and psychological activation. These performance metrics were related to intrinsic attention to pain and trait anxiety. Subjects with high trait anxiety and neuroticism scores, with a predisposition to attend to pain, had greater tense arousal and poorer vigilance performance, which may be important psychological aspects of vigilance to pain.
虽然高度警惕可能在某些临床疼痛综合征中起作用，但对疼痛刺激的实验性警惕性研究却很少。我们使用连续性能任务（CPT）评估对疼痛的警惕性，在该任务中，受试者对中等强度的疼痛目标刺激做出反应，这些刺激发生在轻度疼痛的非目标刺激的序列中。我们评估了未检测到的目标（遗漏）、反应时间（RT）和心理激活（紧张觉醒）。在 CPT 的其他感觉模态的任务期间，会出现遗漏和 RT 增加（警惕性下降）。我们假设我们的 CPT 将影响与疼痛、焦虑和注意力资源限制相关的警惕性表现。结果表明，随着遗漏的增加，警惕性随时间呈下降趋势，尽管 RT 保持不变。虽然心不在焉不会影响警惕性表现，但对疼痛的内在关注会影响击中 RT 和遗漏次数。这导致专注于疼痛的受试者在 CPT 疼痛任务中的表现更差，每个块的 RT 更慢，遗漏更多。在 CPT 期间，刺激显着性的变化与疼痛强度的变化有关，而疼痛的不愉快与紧张觉醒有关。CPT 在实验性警惕性和心理激活期间对疼痛的性能与特质焦虑有关，特质焦虑通过 Spielberger 状态-特质焦虑量表测量，神经质通过 NEO 五因素量表测量。特质焦虑和神经质可能在个体对疼痛的关注和将疼痛解释为威胁的倾向中起重要作用。受试者在轻度疼痛的非目标刺激序列中检测到中等强度的疼痛目标刺激，这导致警惕性表现指标包括遗漏的目标、反应时间和心理激活。这些表现指标与对疼痛的内在关注和特质焦虑有关。具有高特质焦虑和神经质评分、倾向于关注疼痛的受试者，紧张觉醒度更高，警惕性表现更差，这可能是对疼痛警惕性的重要心理方面。
