Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study

The down-regulation of pain through beliefs is commonly discussed as a form of emotion regulation. In line with this interpretation, the analgesic effect has been shown to co-occur with reduced anxiety and increased activity in the ventrolateral prefrontal cortex (VLPFC), which is a key region of em...

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Main Authors: Wiech, K, Edwards, R, Moseley, G, Berna, C, Ploner, M, Tracey, I
Format: Journal article
Language:English
Published: Public Library of Science 2014
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author Wiech, K
Edwards, R
Moseley, G
Berna, C
Ploner, M
Tracey, I
author_facet Wiech, K
Edwards, R
Moseley, G
Berna, C
Ploner, M
Tracey, I
author_sort Wiech, K
collection OXFORD
description The down-regulation of pain through beliefs is commonly discussed as a form of emotion regulation. In line with this interpretation, the analgesic effect has been shown to co-occur with reduced anxiety and increased activity in the ventrolateral prefrontal cortex (VLPFC), which is a key region of emotion regulation. This link between pain and anxiety modulation raises the question whether the two effects are rooted in the same neural mechanism. In this pilot fMRI study, we compared the neural basis of the analgesic and anxiolytic effect of two types of threat modulation: a "behavioral control" paradigm, which involves the ability to terminate a noxious stimulus, and a "safety signaling" paradigm, which involves visual cues that signal the threat (or absence of threat) that a subsequent noxious stimulus might be of unusually high intensity. Analgesia was paralleled by VLPFC activity during behavioral control. Safety signaling engaged elements of the descending pain control system, including the rostral anterior cingulate cortex that showed increased functional connectivity with the periaqueductal gray and VLPFC. Anxiety reduction, in contrast, scaled with dorsolateral prefrontal cortex activation during behavioral control but had no distinct neural signature during safety signaling. Our pilot data therefore suggest that analgesic and anxiolytic effects are instantiated in distinguishable neural mechanisms and differ between distinct stress- and pain-modulatory approaches, supporting the recent notion of multiple pathways subserving top-down modulation of the pain experience. Additional studies in larger cohorts are needed to follow up on these preliminary findings.
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spelling oxford-uuid:9930d95a-0cb5-4016-a69c-f73f90d04a352022-03-27T00:12:27ZDissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9930d95a-0cb5-4016-a69c-f73f90d04a35EnglishSymplectic Elements at OxfordPublic Library of Science2014Wiech, KEdwards, RMoseley, GBerna, CPloner, MTracey, IThe down-regulation of pain through beliefs is commonly discussed as a form of emotion regulation. In line with this interpretation, the analgesic effect has been shown to co-occur with reduced anxiety and increased activity in the ventrolateral prefrontal cortex (VLPFC), which is a key region of emotion regulation. This link between pain and anxiety modulation raises the question whether the two effects are rooted in the same neural mechanism. In this pilot fMRI study, we compared the neural basis of the analgesic and anxiolytic effect of two types of threat modulation: a "behavioral control" paradigm, which involves the ability to terminate a noxious stimulus, and a "safety signaling" paradigm, which involves visual cues that signal the threat (or absence of threat) that a subsequent noxious stimulus might be of unusually high intensity. Analgesia was paralleled by VLPFC activity during behavioral control. Safety signaling engaged elements of the descending pain control system, including the rostral anterior cingulate cortex that showed increased functional connectivity with the periaqueductal gray and VLPFC. Anxiety reduction, in contrast, scaled with dorsolateral prefrontal cortex activation during behavioral control but had no distinct neural signature during safety signaling. Our pilot data therefore suggest that analgesic and anxiolytic effects are instantiated in distinguishable neural mechanisms and differ between distinct stress- and pain-modulatory approaches, supporting the recent notion of multiple pathways subserving top-down modulation of the pain experience. Additional studies in larger cohorts are needed to follow up on these preliminary findings.
spellingShingle Wiech, K
Edwards, R
Moseley, G
Berna, C
Ploner, M
Tracey, I
Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study
title Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study
title_full Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study
title_fullStr Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study
title_full_unstemmed Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study
title_short Dissociable neural mechanisms underlying the modulation of pain and anxiety? An FMRI pilot study
title_sort dissociable neural mechanisms underlying the modulation of pain and anxiety an fmri pilot study
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