Distinct Brain Systems Mediate the Effects of Nociceptive Input and Self-Regulation on Pain

Summary

Cognitive self-regulation can strongly modulate pain and emotion. However, it is unclear whether self-regulation primarily influences primary nociceptive and affective processes or evaluative ones. In this study, participants engaged in self-regulation to increase or decrease pain while experiencing multiple levels of painful heat during functional magnetic resonance imaging (fMRI) imaging. Both heat intensity and self-regulation strongly influenced reported pain, but they did so via two distinct brain pathways. The effects of stimulus intensity were mediated by the neurologic pain signature (NPS), an a priori distributed brain network shown to predict physical pain with over 90% sensitivity and specificity across four studies. Self-regulation did not influence NPS responses; instead, its effects were mediated through functional connections between the nucleus accumbens and ventromedial prefrontal cortex. This pathway was unresponsive to noxious input, and has been broadly implicated in valuation, emotional appraisal, and functional outcomes in pain and other types of affective processes. These findings provide evidence that pain reports are associated with two dissociable functional systems: nociceptive/affective aspects mediated by the NPS, and evaluative/functional aspects mediated by a fronto-striatal system.

Related articles

• Multicenter, Randomized, Phase III Trial of Short-Term Radiotherapy Plus Chemotherapy Versus Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer (STELLAR)

  This study assesses the efficacy of preoperative short-term radiotherapy followed by chemotherapy compared to standard long-term chemoradiotherapy in patients with locally advanced rectal cancer, evaluating outcomes such as disease-free survival and treatment toxicity.

• Kappa Free Light Chain Index in the Diagnosis of Multiple Sclerosis

  This document discusses the adoption of the kappa free light chain (KFLC) index as a diagnostic tool for multiple sclerosis (MS), detailing its role alongside MRI and expert assessments to enhance diagnostic accuracy and reduce latency.

• Diagnostic Performance of Red Blood Cell Indices in the Differential Diagnosis of Iron Deficiency Anemia and the Thalassemia Trait in Chile: A Retrospective Study

  This retrospective study evaluates the diagnostic performance of 29 red blood cell indices in differentiating between iron deficiency anemia and the thalassemia trait in Chile, analyzing CBC results from 182 patients.

• MRI to guide clinical management of rectal cancer: updated consensus recommendations from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR): PART II-Restaging and response evaluation

  This document presents updated consensus recommendations for the use of MRI in the restaging and response evaluation of rectal cancer after neoadjuvant treatment, developed by a panel of experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR).

• NURSING BULLETS FUNDAMENTALS OF NURSING

  This document serves as a comprehensive guide for nursing fundamentals, covering essential topics and clinical practices for nurses, including patient safety, medication administration, and nursing processes.