title: Orbitofrontal cortex mediates pain inhibition by monetary reward.
abstract: Pleasurable stimuli, including reward, inhibit pain, but the level of the neuraxis at which they do so and the cerebral processes involved are unknown. Here, we characterized a brain circuitry mediating pain inhibition by reward. Twenty-four healthy participants underwent functional magnetic resonance imaging while playing a wheel of fortune game with simultaneous thermal pain stimuli and monetary wins or losses. As expected, winning decreased pain perception compared to losing. Inter-individual differences in pain modulation by monetary wins relative to losses correlated with activation in the medial orbitofrontal cortex (mOFC). When pain and reward occured simultaneously, mOFCs functional connectivity changed: the signal time course in the mOFC condition-dependent correlated negatively with the signal time courses in the rostral anterior insula, anterior-dorsal cingulate cortex and primary somatosensory cortex, which might signify moment-to-moment down-regulation of these regions by the mOFC. Monetary wins and losses did not change the magnitude of pain-related activation, including in regions that code perceived pain intensity when nociceptive input varies and/or receive direct nociceptive input. Pain inhibition by reward appears to involve brain regions not typically involved in nociceptive intensity coding but likely mediate changes in the significance and/or value of pain.
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec H3A 0C7, Canada.|Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada.|Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, J5 68159, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Becker
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec H3A 0C7, Canada.|Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Gandhi
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec H3A 0C7, Canada.|Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada.
authors.forename: Florence
authors.initials: F
authors.lastname: Pomares
authors.affiliation: Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
authors.forename: Tor D
authors.initials: TD
authors.lastname: Wager
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec H3A 0C7, Canada.|Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada.|Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 0C7, Canada.
authors.forename: Petra
authors.initials: P
authors.lastname: Schweinhardt
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000502:physiology; D005260:Female; D006179:Gyrus Cinguli / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009042:Motivation / Q000502:physiology*; D009415:Nerve Net / Q000502:physiology; D009433:Neural Inhibition / Q000502:physiology*; D058748:Pain Perception / Q000502:physiology*; D017397:Prefrontal Cortex / Q000502:physiology*; D012201:Reward; D055815:Young Adult
keywords: cognitive-emotional pain modulation; functional magnetic resonance imaging; pain biomarker; psychological pain modulation