Disruption of working memory and contralateral delay activity by nociceptive stimuli is modulated by task demands.

Top-down processes allow the selection and prioritization of information by limiting attentional capture by distractors, and these mechanisms depend on task demands such as working memory (WM) load. However, bottom-up processes give salient stimuli a stronger neuronal representation and provoke attentional capture. The aim of this study was to examine the effect of salient nociceptive stimuli on WM while manipulating task demands. Twenty-one healthy participants performed a change detection task during which they had to determine whether 2 successive visual arrays were different or the same. Task demands were modulated by manipulating the WM load (set size included 2 or 4 objects to recall) and by the correspondence between the 2 successive visual arrays (change vs no change). Innocuous stimuli (control) or nociceptive stimuli (distractors) were delivered during the delay period between the 2 visual arrays. Contralateral delay activity and laser-evoked potentials were recorded to examine neural markers of visual WM and nociceptive processes. Nociceptive stimuli decreased WM performance depending on task demands (all P < 0.05). Moreover, compared with control stimuli, nociceptive stimuli abolished the increase in contralateral delay activity amplitude for set size 4 vs set size 2 (P = 0.04). Consistent with these results, laser-evoked potential amplitude was not decreased when task demands were high (P = 0.5). These findings indicate that WM may shield cognition from nociceptive stimuli, but nociceptive stimuli disrupt WM and alter task performance when cognitive resources become insufficient to process all task-relevant information.