title: The differential effect of trigeminal vs. peripheral pain stimulation on visual processing and memory encoding is influenced by pain-related fear.
abstract: Compared to peripheral pain, trigeminal pain elicits higher levels of fear, which is assumed to enhance the interruptive effects of pain on concomitant cognitive processes. In this fMRI study we examined the behavioral and neural effects of trigeminal (forehead) and peripheral (hand) pain on visual processing and memory encoding. Cerebral activity was measured in 23 healthy subjects performing a visual categorization task that was immediately followed by a surprise recognition task. During the categorization task subjects received concomitant noxious electrical stimulation on the forehead or hand. Our data show that fear ratings were significantly higher for trigeminal pain. Categorization and recognition performance did not differ between pictures that were presented with trigeminal and peripheral pain. However, object categorization in the presence of trigeminal pain was associated with stronger activity in task-relevant visual areas (lateral occipital complex, LOC), memory encoding areas (hippocampus and parahippocampus) and areas implicated in emotional processing (amygdala) compared to peripheral pain. Further, individual differences in neural activation between the trigeminal and the peripheral condition were positively related to differences in fear ratings between both conditions. Functional connectivity between amygdala and LOC was increased during trigeminal compared to peripheral painful stimulation. Fear-driven compensatory resource activation seems to be enhanced for trigeminal stimuli, presumably due to their exceptional biological relevance.
authors.affiliation: Department of Neurology, University Hospital Essen, 45147 Essen, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. Electronic address: katharina.schmidt@uk-essen.de.
authors.forename: K
authors.initials: K
authors.lastname: Schmidt
authors.affiliation: Department of Neurology, University Hospital Essen, 45147 Essen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Forkmann
authors.affiliation: Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Sinke
authors.affiliation: Erwin L. Hahn Institute for Magnetic Resonance Imaging, 45141 Essen, Germany; Highfield and Hybrid MR-Imaging, University Hospital Essen, 45147 Essen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gratz
authors.affiliation: Division of Medical Physics in Radiology, German Cancer Research Center, 69121 Heidelberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bitz
authors.affiliation: Department of Neurology, University Hospital Essen, 45147 Essen, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Bingel
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D004558:Electric Stimulation; D005157:Facial Pain / Q000150:complications / Q000503:physiopathology*; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009415:Nerve Net / Q000503:physiopathology; D009778:Occipital Lobe / Q000503:physiopathology; D010525:Peripheral Nerves / Q000503:physiopathology*; D014277:Trigeminal Neuralgia / Q000150:complications / Q000503:physiopathology*; D014793:Visual Cortex / Q000503:physiopathology; D014796:Visual Perception
keywords: Face pain; Facial pain; Interruptive function of pain; Pain-related fear; Trigeminal pain; fMRI