Exacerbation of pain by anxiety is associated with activity in a hippocampal network

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Ploghaus, Alexander ; Narain, Charvy ; Beckmann, Christian F. ; Clare, Stuart ; Bantick, Susanna ; Wise, Richard Geoffrey ; Matthews, Paul M. ; Rawlins, J. Nicholas P. ; Tracey, Irene (2001)
  • Publisher: Society for Neuroscience

It is common clinical experience that anxiety about pain can\ud exacerbate the pain sensation. Using event-related functional\ud magnetic resonance imaging (FMRI), we compared activation\ud responses to noxious thermal stimulation while perceived pain\ud intensity was manipulated by changes in either physical intensity\ud or induced anxiety. One visual signal, which reliably predicted\ud noxious stimulation of moderate intensity, came to\ud evoke low anxiety about the impending pain. Another visual\ud signal was followed by the same, moderate-intensity stimulation\ud on most of the trials, but occasionally by discriminably\ud stronger noxious stimuli, and came to evoke higher anxiety. We\ud found that the entorhinal cortex of the hippocampal formation\ud responded differentially to identical noxious stimuli, dependent\ud on whether the perceived pain intensity was enhanced by\ud pain-relevant anxiety. During this emotional pain modulation,\ud entorhinal responses predicted activity in closely connected,\ud affective (perigenual cingulate), and intensity coding (midinsula)\ud areas. Our finding suggests that accurate preparatory\ud information during medical and dental procedures alleviates\ud pain by disengaging the hippocampus. It supports the proposal\ud that during anxiety, the hippocampal formation amplifies aversive\ud events to prime behavioral responses that are adaptive to\ud the worst possible outcome.
  • References (81)
    81 references, page 1 of 9

    Al Absi M, Rokke PD (1991) C an anxiety help us tolerate pain? Pain 46:43-51.

    Amaral DG, Insausti R (1990) Hippocampal formation. In: The human nervous system (Paxinos G, ed), pp 711-755. San Diego, CA: Academic.

    American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (Ed 3, revised). Washington: APA.

    Archer DP, Roth SH (1997) Pharmacodynamics of thiopentone: nocifensive reflex threshold changes correlate with hippocampal electroencephalography. Br J Anaesth 79:744 -749.

    Becerra LR, Breiter HC, Stojanovic M, Fishman S, Edwards A, Comite AR, Gonzales RG, Borsook D (1999) Human brain activation under controlled thermal stimulation and habituation to noxious heat: an fMRI study. Magn Reson Med 41:1044 -1057.

    Beckmann C, Noble J, Smith S (2000) Artefact detection in FMRI data using independent component analysis. NeuroImage 11:614.

    Birn RM, Bandettini PA, Cox RW, Shaker R (1999) Event-related fMRI of tasks involving brief motion. Hum Brain Mapp 7:106 -114.

    Brown GD, Yamada S, Sejnowski TJ (2001) Independent component analysis at the neural cocktail party. Trends Neurosci 24:54 - 63.

    Bu¨chel C, Morris J, Dolan RJ, Friston K J (1998) Brain systems mediating aversive conditioning: an event-related fMRI study. Neuron 20:947-957.

    Bu¨chel C, Dolan RJ, Armony JL, Friston K J (1999) Amygdalahippocampal involvement in human aversive trace conditioning revealed through event-related f unctional magnetic resonance imaging. J Neurosci 19:10869 -10876.

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