Nees Frauke, Usai Katrin, Kandić Mina, Zidda Francesca, Heukamp Nils Jannik, Moliadze Vera, Löffler Martin, Flor Herta
Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Neurobiol Pain. 2023 Feb 22;13:100122. doi: 10.1016/j.ynpai.2023.100122. eCollection 2023 Jan-Jul.
Social interactions affect individual behaviours, preferences, and attitudes. This is also critical in the context of experiencing pain and expressing pain behaviours, and may relate to learned emotional responses. In this respect, individual variability in the medial prefrontal cortex (mPFC), which is involved in adjusting an organism's behaviour to its environment by evaluating and interpreting information within the context of past experiences, is important. It is critical for selecting suitable behavioural responses within a social environment and may reinforce maladaptation in chronic pain. In our study, we used brain imaging during appetitive and aversive pavlovian conditioning in persons with chronic back pain (CBP), subacute back pain (SABP), and healthy controls (HC), together with information on spouse responses to pain behaviours. We also examined the relationship of these responses with pain-related interference in the patients. Our findings yielded a significant negative association between mPFC responses to appetitive and aversive learning in CBP. We also observed a significant negative association for mPFC responses during aversive learning and distracting spouse responses, and a significant positive association between mPFC responses during appetitive learning and solicitous spouse responses in CBP. Both significantly predicted pain-related interference in the CBP group (explained variance up to 53%). Significant associations were not found for SABP or HC. Our findings support an association between appetitive and aversive pavlovian learning, related brain circuits and spouse responses to pain in CBP, where appetitive and aversive learning processes seem to be differentially involved. This can inform prevention and early intervention in a mechanistic approach.
社交互动会影响个体行为、偏好和态度。这在经历疼痛和表现出疼痛行为的背景下也至关重要，并且可能与习得的情绪反应有关。在这方面，内侧前额叶皮质（mPFC）的个体差异很重要，该区域通过在过去经历的背景下评估和解释信息，参与使生物体的行为适应其环境。它对于在社交环境中选择合适的行为反应至关重要，并且可能会强化慢性疼痛中的适应不良。在我们的研究中，我们对慢性背痛（CBP）患者、亚急性背痛（SABP）患者和健康对照者（HC）在进行巴甫洛夫式条件性食欲和厌恶刺激时进行了脑成像，并收集了其配偶对疼痛行为反应的信息。我们还研究了这些反应与患者疼痛相关干扰之间的关系。我们的研究结果显示，CBP患者的mPFC对食欲和厌恶学习的反应之间存在显著的负相关。我们还观察到，在厌恶学习过程中mPFC反应与配偶分散注意力的反应之间存在显著的负相关，而在食欲学习过程中mPFC反应与配偶关切的反应之间存在显著的正相关。这两者都能显著预测CBP组中与疼痛相关的干扰（解释方差高达53%）。在SABP组或HC组中未发现显著相关性。我们的研究结果支持在CBP患者中，巴甫洛夫式食欲和厌恶学习、相关脑回路以及配偶对疼痛的反应之间存在关联，其中食欲和厌恶学习过程似乎有不同程度的参与。这可以为以机制为导向的预防和早期干预提供依据。
