Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain

Prior expectations can bias how we perceive pain. Using a drift diffusion model, we recently showed that this influence is primarily based on changes in perceptual decision-making (indexed as shift in starting point). Only during unexpected application of high-intensity noxious stimuli, altered info...

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Main Authors: Wiech, K, Eippert, F, Vandekerckhove, J, Zaman, J, Placek, K, Tuerlinckx, F, Vlaeyen, J, Tracey, I
Format: Journal article
Language:English
Published: Elsevier 2021
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author Wiech, K
Eippert, F
Vandekerckhove, J
Zaman, J
Placek, K
Tuerlinckx, F
Vlaeyen, J
Tracey, I
author_facet Wiech, K
Eippert, F
Vandekerckhove, J
Zaman, J
Placek, K
Tuerlinckx, F
Vlaeyen, J
Tracey, I
author_sort Wiech, K
collection OXFORD
description Prior expectations can bias how we perceive pain. Using a drift diffusion model, we recently showed that this influence is primarily based on changes in perceptual decision-making (indexed as shift in starting point). Only during unexpected application of high-intensity noxious stimuli, altered information processing (indexed as increase in drift rate) explained the expectancy effect on pain processing. Here, we employed functional magnetic resonance imaging to investigate the neural basis of both these processes in healthy volunteers. On each trial, visual cues induced the expectation of high- or low-intensity noxious stimulation or signalled equal probability for both intensities. Participants categorised a subsequently applied electrical stimulus as either low- or high-intensity pain. Shift in starting point towards high pain correlated negatively with right dorsolateral prefrontal cortex (rDLPFC) activity during cue presentation underscoring its proposed role of "keeping pain out of mind". This anticipatory rDLPFC signal increase was positively correlated with periaqueductal gray (PAG) activity when the expected high-intensity stimulation was applied. Drift rate increase during unexpected high-intensity pain was reflected in amygdala engagement and increased functional connectivity between amygdala and PAG. Our findings suggest involvement of the PAG in both decision-making bias and altered information processing to implement expectancy effects on pain. Perspective: Modulation of pain through expectations has been linked to changes in perceptual decision-making and altered processing of afferent information. Our results suggest involvement of the dorsolateral prefrontal cortex, amygdala, and periaqueductal gray in these processes.
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spelling oxford-uuid:21a0ae59-b607-4e2f-8e0b-2645166ef94a2022-11-29T09:04:16ZCortico-brainstem mechanisms of biased perceptual decision-making in the context of painJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:21a0ae59-b607-4e2f-8e0b-2645166ef94aEnglishSymplectic ElementsElsevier2021Wiech, KEippert, FVandekerckhove, JZaman, JPlacek, KTuerlinckx, FVlaeyen, JTracey, IPrior expectations can bias how we perceive pain. Using a drift diffusion model, we recently showed that this influence is primarily based on changes in perceptual decision-making (indexed as shift in starting point). Only during unexpected application of high-intensity noxious stimuli, altered information processing (indexed as increase in drift rate) explained the expectancy effect on pain processing. Here, we employed functional magnetic resonance imaging to investigate the neural basis of both these processes in healthy volunteers. On each trial, visual cues induced the expectation of high- or low-intensity noxious stimulation or signalled equal probability for both intensities. Participants categorised a subsequently applied electrical stimulus as either low- or high-intensity pain. Shift in starting point towards high pain correlated negatively with right dorsolateral prefrontal cortex (rDLPFC) activity during cue presentation underscoring its proposed role of "keeping pain out of mind". This anticipatory rDLPFC signal increase was positively correlated with periaqueductal gray (PAG) activity when the expected high-intensity stimulation was applied. Drift rate increase during unexpected high-intensity pain was reflected in amygdala engagement and increased functional connectivity between amygdala and PAG. Our findings suggest involvement of the PAG in both decision-making bias and altered information processing to implement expectancy effects on pain. Perspective: Modulation of pain through expectations has been linked to changes in perceptual decision-making and altered processing of afferent information. Our results suggest involvement of the dorsolateral prefrontal cortex, amygdala, and periaqueductal gray in these processes.
spellingShingle Wiech, K
Eippert, F
Vandekerckhove, J
Zaman, J
Placek, K
Tuerlinckx, F
Vlaeyen, J
Tracey, I
Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain
title Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain
title_full Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain
title_fullStr Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain
title_full_unstemmed Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain
title_short Cortico-brainstem mechanisms of biased perceptual decision-making in the context of pain
title_sort cortico brainstem mechanisms of biased perceptual decision making in the context of pain
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