The role of cognitive reappraisal in placebo analgesia: an fMRI study.
Placebo analgesia (PA) depends crucially on the prefrontal cortex (PFC), which is assumed to be responsible for initiating the analgesic response. Surprisingly little research has focused on the psychological mechanisms mediated by the PFC and underlying PA. One increasingly accepted theory is that cognitive reappraisal-the reinterpretation of the meaning of adverse events-plays an important role, but no study has yet addressed the possible functional relationship with PA. We studied the influence of individual differences in reappraisal ability on PA and its prefrontal mediation. Participants completed a cognitive reappraisal ability task, which compared negative affect evoked by pictures in a reappraise versus a control condition. In a subsequent fMRI session, PA was induced using thermal noxious stimuli and an inert skin cream. We found a region in the left dorsolateral PFC, which showed a positive correlation between placebo-induced activation and (i) the reduction in participants' pain intensity ratings; and (ii) cognitive reappraisal ability scores. Moreover, this region showed increased placebo-induced functional connectivity with the periaqueductal grey, indicating its involvement in descending nociceptive control. These initial findings thus suggest that cognitive reappraisal mechanisms mediated by the dorsolateral PFC may play a role in initiating pain inhibition in PA.
Institute for Health and Behaviour, University of Luxembourg, Campus Belval, Maison des Sciences Humaines, 11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg.
Marian
M
van der Meulen
Section Pain Medicine and Pain Psychology, Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Sandra
S
Kamping
Institute for Health and Behaviour, University of Luxembourg, Campus Belval, Maison des Sciences Humaines, 11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg.
Fernand
F
Anton
D000328:Adult; D000698:Analgesia / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000523:psychology*; D010919:Placebos; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging*; D055815:Young Adult
D010919:Placebos
cognitive reappraisal; dorsolateral prefrontal cortex; functional MRI; periaqueductal grey; placebo analgesia