RT Journal Article
SR Electronic
T1 Exacerbation of Pain by Anxiety Is Associated with Activity in a Hippocampal Network
JF The Journal of Neuroscience
JO J. Neurosci.
FD Society for Neuroscience
SP 9896
OP 9903
DO 10.1523/JNEUROSCI.21-24-09896.2001
VO 21
IS 24
A1 Alexander Ploghaus
A1 Charvy Narain
A1 Christian F. Beckmann
A1 Stuart Clare
A1 Susanna Bantick
A1 Richard Wise
A1 Paul M. Matthews
A1 J. Nicholas P. Rawlins
A1 Irene Tracey
YR 2001
UL http://www.jneurosci.org/content/21/24/9896.abstract
AB 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.