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

It is common clinical experience that anxiety about pain can exacerbate the pain sensation. Using event-related functional magnetic resonance imaging (FMRI), we compared activation responses to noxious thermal stimulation while perceived pain intensity was manipulated by changes in either physical i...

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Main Authors: Ploghaus, A, Narain, C, Beckmann, C, Clare, S, Bantick, S, Wise, R, Matthews, P, Rawlins, J, Tracey, I
Format: Journal article
Language:English
Published: 2001
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author Ploghaus, A
Narain, C
Beckmann, C
Clare, S
Bantick, S
Wise, R
Matthews, P
Rawlins, J
Tracey, I
author_facet Ploghaus, A
Narain, C
Beckmann, C
Clare, S
Bantick, S
Wise, R
Matthews, P
Rawlins, J
Tracey, I
author_sort Ploghaus, A
collection OXFORD
description It is common clinical experience that anxiety about pain can exacerbate the pain sensation. Using event-related functional magnetic resonance imaging (FMRI), we compared activation responses to noxious thermal stimulation while perceived pain intensity was manipulated by changes in either physical intensity or induced anxiety. One visual signal, which reliably predicted noxious stimulation of moderate intensity, came to evoke low anxiety about the impending pain. Another visual signal was followed by the same, moderate-intensity stimulation on most of the trials, but occasionally by discriminably stronger noxious stimuli, and came to evoke higher anxiety. We found that the entorhinal cortex of the hippocampal formation responded differentially to identical noxious stimuli, dependent on whether the perceived pain intensity was enhanced by pain-relevant anxiety. During this emotional pain modulation, entorhinal responses predicted activity in closely connected, affective (perigenual cingulate), and intensity coding (mid-insula) areas. Our finding suggests that accurate preparatory information during medical and dental procedures alleviates pain by disengaging the hippocampus. It supports the proposal that during anxiety, the hippocampal formation amplifies aversive events to prime behavioral responses that are adaptive to the worst possible outcome.
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spelling oxford-uuid:5deab150-d19f-4105-a4ac-6c2ed63b66482022-03-26T17:37:22ZExacerbation of pain by anxiety is associated with activity in a hippocampal network.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5deab150-d19f-4105-a4ac-6c2ed63b6648EnglishSymplectic Elements at Oxford2001Ploghaus, ANarain, CBeckmann, CClare, SBantick, SWise, RMatthews, PRawlins, JTracey, IIt is common clinical experience that anxiety about pain can exacerbate the pain sensation. Using event-related functional magnetic resonance imaging (FMRI), we compared activation responses to noxious thermal stimulation while perceived pain intensity was manipulated by changes in either physical intensity or induced anxiety. One visual signal, which reliably predicted noxious stimulation of moderate intensity, came to evoke low anxiety about the impending pain. Another visual signal was followed by the same, moderate-intensity stimulation on most of the trials, but occasionally by discriminably stronger noxious stimuli, and came to evoke higher anxiety. We found that the entorhinal cortex of the hippocampal formation responded differentially to identical noxious stimuli, dependent on whether the perceived pain intensity was enhanced by pain-relevant anxiety. During this emotional pain modulation, entorhinal responses predicted activity in closely connected, affective (perigenual cingulate), and intensity coding (mid-insula) areas. Our finding suggests that accurate preparatory information during medical and dental procedures alleviates pain by disengaging the hippocampus. It supports the proposal that during anxiety, the hippocampal formation amplifies aversive events to prime behavioral responses that are adaptive to the worst possible outcome.
spellingShingle Ploghaus, A
Narain, C
Beckmann, C
Clare, S
Bantick, S
Wise, R
Matthews, P
Rawlins, J
Tracey, I
Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
title Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
title_full Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
title_fullStr Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
title_full_unstemmed Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
title_short Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
title_sort exacerbation of pain by anxiety is associated with activity in a hippocampal network
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