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The Journal of Neuroscience, April 15, 2002, 22(8):3206-3214
Does Anticipation of Pain Affect Cortical Nociceptive
Systems?
Carlo A.
Porro1,
Patrizia
Baraldi2,
Giuseppe
Pagnoni2,
Marco
Serafini4,
Patrizia
Facchin1,
Marta
Maieron1, and
Paolo
Nichelli3
1 Dipartimento di Scienze e Tecnologie Biomediche,
Università di Udine, I-33100 Udine, Italy, Dipartimento di
2 Scienze Biomediche and 3 Patologia
Neuropsicosensoriale, Università di Modena e Reggio Emilia,
I-41100 Modena, Italy, and 4 Azienda Sanitazia
Locale Modena, I-41100 Modena, Italy
Anticipation of pain is a complex state that may influence the
perception of subsequent noxious stimuli. We used functional magnetic
resonance imaging (fMRI) to study changes of activity of cortical
nociceptive networks in healthy volunteers while they expected the
somatosensory stimulation of one foot, which might be painful
(subcutaneous injection of ascorbic acid) or not. Subjects had no
previous experience of the noxious stimulus.
Mean fMRI signal intensity increased over baseline values during
anticipation and during actual stimulation in the putative foot
representation area of the contralateral primary somatosensory cortex
(SI). Mean fMRI signals decreased during anticipation in other portions
of the contralateral and ipsilateral SI, as well as in the
anteroventral cingulate cortex.
The activity of cortical clusters whose signal time courses showed
positive or negative correlations with the individual psychophysical pain intensity curve was also significantly affected during the waiting
period. Positively correlated clusters were found in the contralateral
SI and bilaterally in the anterior cingulate, anterior insula, and
medial prefrontal cortex. Negatively correlated clusters were found in
the anteroventral cingulate bilaterally. In all of these areas, changes
during anticipation were of the same sign as those observed during pain
but less intense (~30-40% as large as peak changes during actual
noxious stimulation).
These results provide evidence for top-down mechanisms, triggered by
anticipation, modulating cortical systems involved in sensory and
affective components of pain even in the absence of actual noxious
input and suggest that the activity of cortical nociceptive networks
may be directly influenced by cognitive factors.
Key words:
anticipation of pain; pain perception; primary
somatosensory cortex; cingulate cortex; insular cortex; medial
prefrontal cortex; functional magnetic resonance imaging
Copyright © 2002 Society for Neuroscience 0270-6474/02/2283206-09$05.00/0
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