title: Neurocognitive evidence for mental imagery-driven hypoalgesic and hyperalgesic pain regulation.
abstract: Mental imagery has the potential to influence perception by directly altering sensory, cognitive, and affective brain activity associated with imagined content. While it is well established that mental imagery can both exacerbate and alleviate acute and chronic pain, it is currently unknown how imagery mechanisms regulate pain perception. For example, studies to date have been unable to determine whether imagery effects depend upon a general redirection of attention away from pain or focused attentional mechanisms. To address these issues, we recorded subjective, behavioral and ERP responses using 64-channel EEG while healthy human participants applied a mental imagery strategy to decrease or increase pain sensations. When imagining a glove covering the forearm, participants reported decreased perceived intensity and unpleasantness, classified fewer high-intensity stimuli as painful, and showed a more conservative response bias. In contrast, when imagining a lesion on the forearm, participants reported increased pain intensity and unpleasantness, classified more low-intensity stimuli as painful, and displayed a more liberal response bias. Using a mass-univariate approach, we further showed differential modulation of the N2 potentials across conditions, with inhibition and facilitation respectively increasing and decreasing N2 amplitudes between 122 and 180 ms. Within this time window, source localization associated inhibiting vs. facilitating pain with neural activity in cortical regions involved in cognitive inhibitory control and in the retrieval of semantic information (i.e., right inferior frontal and temporal regions). In contrast, the main sources of neural activity associated with facilitating vs. inhibiting pain were identified in cortical regions typically implicated in salience processing and emotion regulation (i.e., left insular, inferior-middle frontal, supplementary motor and precentral regions). Overall, these findings suggest that the content of a mental image directly alters pain-related decision and evaluative processing to flexibly produce hypoalgesic and hyperalgesic outcomes.
authors.affiliation: MINDLab, Center of Functionally Integrative Neuroscience, Aarhus University, 8000 Aarhus, Denmark. Electronic address: francesca.fardo@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fardo
authors.affiliation: Institute of Cognitive Neuroscience, University College London, London WC1N 3AR, United Kingdom; Wellcome Trust Centre for Neuroimaging, University College London, London WC1N 3BG, United Kingdom.
authors.forename: Micah
authors.initials: M
authors.lastname: Allen
authors.affiliation: MINDLab, Center of Functionally Integrative Neuroscience, Aarhus University, 8000 Aarhus, Denmark; Interacting Minds Centre, Aarhus University, 8000 Aarhus, Denmark.
authors.forename: Else-Marie Elmholdt
authors.initials: EM
authors.lastname: Jegindø
authors.affiliation: Department of General Psychology, Padova University, 35131 Padova, Italy; CNR Institute of Neuroscience, Padova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Angrilli
authors.affiliation: MINDLab, Center of Functionally Integrative Neuroscience, Aarhus University, 8000 Aarhus, Denmark; Interacting Minds Centre, Aarhus University, 8000 Aarhus, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Roepstorff
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000502:physiology*; D004569:Electroencephalography / Q000379:methods*; D005071:Evoked Potentials / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology*; D007092:Imagination / Q000502:physiology*; D007266:Inhibition, Psychological; D008297:Male; D058748:Pain Perception / Q000502:physiology*; D055815:Young Adult