Cooke Megan E, Edwards Robert R, Wheeler Grace L, Schmitt William A, Nielsen Lindsay V, Streck Joanna M, Schuster Randi M, Potter Kevin, Evins A Eden, Gilman Jodi M
Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
Athinoula A. Martinos Center in Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
Front Pain Res (Lausanne). 2023 Sep 7;4:1129353. doi: 10.3389/fpain.2023.1129353. eCollection 2023.
Pain catastrophizing, a measure of an individual's negative emotional and cognitive appraisals of pain, has been included as a key treatment target in many psychological interventions for pain. However, the neural correlates of pain catastrophizing have been understudied. Prior neuroimaging evidence suggests that adults with pain show altered reward processing throughout the mesocorticolimbic reward circuitry.
In this study, we tested the association between Pain Catastrophizing Scale (PCS) scores and neural activation to the Monetary Incentive Delay (MID) reward neuroimaging task in 94 adults reporting a range of pain, insomnia, and mood symptoms.
Results indicated that PCS score but not pain intensity was significantly associated with blunted activation in the caudate and putamen in response to feedback of successful vs. unsuccessful trials on the MID task. Mediation analyses indicated that PCS score fully mediated the relationship between depression symptoms and reward activation.
These findings provide evidence that pain catastrophizing is independently associated with altered striatal function apart from depression symptoms and pain intensity. Thus, in individuals experiencing pain and/or co- morbid conditions, reward dysfunction is directly related to pain catastrophizing.
疼痛灾难化是衡量个体对疼痛的负面情绪和认知评估的指标，已被纳入许多疼痛心理干预的关键治疗目标。然而，疼痛灾难化的神经相关性研究较少。先前的神经影像学证据表明，患有疼痛的成年人在整个中脑边缘奖赏回路中表现出奖赏处理的改变。
在本研究中，我们测试了94名报告有一系列疼痛、失眠和情绪症状的成年人的疼痛灾难化量表（PCS）得分与对金钱激励延迟（MID）奖赏神经影像学任务的神经激活之间的关联。
结果表明，在MID任务中，PCS得分而非疼痛强度与尾状核和壳核在成功与失败试验反馈时的激活减弱显著相关。中介分析表明，PCS得分完全介导了抑郁症状与奖赏激活之间的关系。
这些发现提供了证据，表明疼痛灾难化除了与抑郁症状和疼痛强度外，还与纹状体功能改变独立相关。因此，在经历疼痛和/或共病的个体中，奖赏功能障碍与疼痛灾难化直接相关。
