Department of Psychology, University of Miami, Coral Gables, FL, USA.
Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea.
Nat Hum Behav. 2020 May;4(5):517-530. doi: 10.1038/s41562-020-0819-8. Epub 2020 Feb 3.
Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities.
了解疼痛的种族差异对于解决疼痛护理方面的差异很重要。人们普遍认为，与白人相比，非裔美国人对疼痛的敏感性较低，但非裔美国人在临床和实验室环境中表现出更高的疼痛敏感性。这些差异的神经生物学机制尚不清楚。我们使用功能磁共振成像技术，对来自不同种族和性别的非裔美国人、西班牙裔和非西班牙裔白人进行了研究，这些人在接受热痛刺激时会产生功能性磁共振成像。非裔美国人的疼痛报告更高，这与歧视和与疼痛评分、歧视、实验者信任以及其他部位非伤害性疼痛相关的额-纹状体回路激活有关。相比之下，神经疼痛特征是一种对伤害性疼痛敏感且特异的神经标志物，它在很大程度上介导了疼痛热效应对非裔美国人和其他人群疼痛报告的影响。研究结果确定了非裔美国人疼痛程度更高的大脑基础，与人际环境和非伤害性中枢疼痛机制有关，并表明伤害性疼痛处理在不同种族之间可能相似。
