A magnetoencephalography study of visual processing of pain anticipation.
Anticipating pain is important for avoiding injury; however, in chronic pain patients, anticipatory behavior can become maladaptive, leading to sensitization and limiting function. Knowledge of networks involved in pain anticipation and conditioning over time could help devise novel, better-targeted therapies. With the use of magnetoencephalography, we evaluated in 10 healthy subjects the neural processing of pain anticipation. Anticipatory cortical activity elicited by consecutive visual cues that signified imminent painful stimulus was compared with cues signifying nonpainful and no stimulus. We found that the neural processing of visually evoked pain anticipation involves the primary visual cortex along with cingulate and frontal regions. Visual cortex could quickly and independently encode and discriminate between visual cues associated with pain anticipation and no pain during preconscious phases following object presentation. When evaluating the effect of task repetition on participating cortical areas, we found that activity of prefrontal and cingulate regions was mostly prominent early on when subjects were still naive to a cue's contextual meaning. Visual cortical activity was significant throughout later phases. Although visual cortex may precisely and time efficiently decode cues anticipating pain or no pain, prefrontal areas establish the context associated with each cue. These findings have important implications toward processes involved in pain anticipation and maladaptive pain conditioning.
Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; and machada@ccf.org.
Andre G
AG
Machado
Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio;
Raghavan
R
Gopalakrishnan
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; and.
Ela B
EB
Plow
Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Richard C
RC
Burgess
Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
John C
JC
Mosher
D000328:Adult; D059031:Anticipation, Psychological; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D017397:Prefrontal Cortex / Q000502:physiology*; D014793:Visual Cortex / Q000502:physiology*; D014796:Visual Perception
magnetoencephalography; neuromatrix; pain; pain anticipation; visual cortex