title: Patient-centered interviewing is associated with decreased responses to painful stimuli: an initial fMRI study.
abstract: OBJECTIVE
  To identify the functional magnetic resonance imaging (fMRI) changes associated with a patient-centered interview (PCI) and a positive provider-patient relationship (PPR).
  
  
  METHODS
  Nine female patients participated, five randomly selected to undergo a replicable, evidence-based PCI, the other four receiving standard clinician-centered interviews (CCI). To verify that PCI differed from CCI, we rated the interviews and administered a patient satisfaction with the provider-patient relationship (PPR) questionnaire. Patients were then scanned as they received painful stimulation while viewing pictures of the interviewing doctor and control images (unknown doctor).
  
  
  RESULTS
  Interview ratings and questionnaire results confirmed that PCIs and CCIs were performed as planned and PCIs led to a much more positive PPR. We found significantly reduced pain-related neural activation in the left anterior insula region in the PCI group when the interviewing doctor's picture was shown.
  
  
  CONCLUSIONS
  This study identifies an association between a PCI that produced a positive PPR and reduced pain-related neural responses in the anterior insula. This is an initial step in understanding the neural underpinnings of a PCI.
  
  
  CONCLUSIONS
  If confirmed, our results indicate one neurobiological underpinning of an effective PCI, providing an additional scientific rationale for its use clinically.
authors.affiliation: Department of Radiology, Michigan State University, East Lansing, MI, USA. isarinop@msu.edu
authors.forename: Issidoros
authors.initials: I
authors.lastname: Sarinopoulos
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Hesson
authors.forename: Chelsea
authors.initials: C
authors.lastname: Gordon
authors.forename: Seungcheol A
authors.initials: SA
authors.lastname: Lee
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Francesca
authors.initials: F
authors.lastname: Dwamena
authors.forename: Robert C
authors.initials: RC
authors.lastname: Smith
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000502:physiology*; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008279:Magnetic Resonance Imaging; D010147:Pain Measurement; D058748:Pain Perception / Q000502:physiology*; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010775:Photic Stimulation; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires