对安慰剂增强疼痛的预期处理的电生理标志物。

Electrophysiological markers for anticipatory processing of nocebo-augmented pain.

机构信息

Health, Medical & Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.

Leiden Institute for Brain and Cognition, Leiden, The Netherlands.

出版信息

PLoS One. 2023 Jul 26;18(7):e0288968. doi: 10.1371/journal.pone.0288968. eCollection 2023.

Abstract

Nocebo effects on pain are widely thought to be driven by negative expectations. This suggests that anticipatory processing, or some other form of top-down cognitive activity prior to the experience of pain, takes place to form sensory-augmenting expectations. However, little is known about the neural markers of anticipatory processing for nocebo effects. In this event-related potential study on healthy participants (n = 42), we tested whether anticipatory processing for classically conditioned nocebo-augmented pain differed from pain without nocebo augmentation using stimulus preceding negativity (SPN), and Granger Causality (GC). SPN is a slow-wave ERP component thought to measure top-down processing, and GC is a multivariate time series analysis used to measure functional connectivity between brain regions. Fear of pain was assessed with the Fear of Pain Questionnaire-III and tested for correlation with SPN and GC metrics. We found evidence that both anticipatory processing measured with SPN and functional connectivity from frontal to temporoparietal brain regions measured with GC were increased for nocebo pain stimuli relative to control pain stimuli. Other GC node pairs did not yield significant effects, and a lag in the timing of nocebo pain stimuli limited interpretation of the results. No correlations with trait fear of pain measured after the conditioning procedure were detected, indicating that while differences in neural activity could be detected between the anticipation of nocebo and control pain trials, they likely were not related to fear. These results highlight the role that top-down processes play in augmenting sensory perception based on negative expectations before sensation occurs.

摘要

人们普遍认为,疼痛的负面效应是由负面预期驱动的。这表明,在体验疼痛之前,预期处理或其他形式的自上而下的认知活动会发生,从而形成增强感觉的预期。然而,对于预示性处理的神经标记物知之甚少。在这项针对健康参与者的事件相关电位研究(n=42)中,我们使用刺激前负波(SPN)和格兰杰因果关系(GC)来测试经典条件作用的预示性处理是否与没有增强的疼痛不同。SPN 是一种被认为衡量自上而下处理的慢波 ERP 成分,而 GC 是一种用于测量大脑区域之间功能连接的多变量时间序列分析。使用疼痛问卷 III 评估对疼痛的恐惧,并测试其与 SPN 和 GC 指标的相关性。我们发现,与对照疼痛刺激相比,预示性处理(通过 SPN 测量)和从额区到颞顶叶的功能连接(通过 GC 测量)都增加了,这为预示性疼痛刺激提供了证据。其他 GC 节点对没有产生显著影响,预示性疼痛刺激的时间滞后限制了结果的解释。在条件作用过程后测量的特质性疼痛恐惧没有相关性,表明尽管可以在预示性疼痛和对照疼痛试验的预期之间检测到神经活动的差异,但它们可能与恐惧无关。这些结果强调了自上而下的过程在感觉发生之前基于负面预期增强感觉感知的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7d/10370880/0892c18228c4/pone.0288968.g001.jpg

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