Cerebral responses and role of the prefrontal cortex in conditioned pain modulation: An fMRI study in healthy subjects
Behavioural Brain Research. 2015-03-01; 281: 187-198
DOI: 10.1016/j.bbr.2014.11.028
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Bogdanov VB(1), Viganò A(2), Noirhomme Q(3), Bogdanova OV(4), Guy N(5), Laureys S(3), Renshaw PF(4), Dallel R(5), Phillips C(6), Schoenen J(7).
Author information:
(1)INRA, Nutrition et Neurobiologie Intégrée and Bordeaux Segalen University, UMR
1286, 146 rue Léo-Saignat, Bordeaux Cedex, 33076, France; Headache Research Unit,
Department of Neurology, CHR Citadelle, University of Liège, Liège, Belgium.
Electronic address: .
(2)Headache Research Unit, Department of Neurology, CHR Citadelle, University of
Liège, Liège, Belgium; SAMILAL- Dept. Anatomy, Histology, Forensic Medicine,
Orthopaedics – La Sapienza, University of Rome; Dept. of Neurology and Psychiatry
– La Sapienza, University of Rome.
(3)Cyclotron Research Centre, University of Liège, Liège, Belgium; Coma Science
Group, Department of Neurology, University and University Hospital of Liège,
Liège, Belgium.
(4)University of Utah, Salt Lake City, USA.
(5)Clermont Université, Université d’Auvergne, BP 10448, F-63000
Clermont-Ferrand; Inserm, UMR1107, Trigeminal pain and Migraine F-63000
Clermont-Ferrand; CHU, Clermont-Ferrand.
(6)Cyclotron Research Centre, University of Liège, Liège, Belgium; Department of
electrical engineering and computer science, University of Liège, Liège, Belgium.
(7)Headache Research Unit, Department of Neurology, CHR Citadelle, University of
Liège, Liège, Belgium.
The mechanisms underlying conditioned pain modulation (CPM) are multifaceted. We
searched for a link between individual differences in prefrontal cortex activity
during multi-trial heterotopic noxious cold conditioning and modulation of the
cerebral response to phasic heat pain. In 24 healthy female subjects, we
conditioned laser heat stimuli to the left hand by applying alternatively
ice-cold or lukewarm compresses to the right foot. We compared pain ratings with
cerebral fMRI BOLD responses. We also analyzed the relation between CPM and BOLD
changes produced by the heterotopic cold conditioning itself, as well as the
impact of anxiety and habituation of cold-pain ratings. Specific cerebral
activation was identified in precuneus and left posterior insula/SII,
respectively, during early and sustained phases of cold application. During cold
conditioning, laser pain decreased (n=7), increased (n=10) or stayed unchanged
(n=7). At the individual level, the psychophysical effect was directly
proportional to the cold-induced modulation of the laser-induced BOLD response in
left posterior insula/SII. The latter correlated with the BOLD response recorded
80s earlier during the initial 10-s phase of cold application in anterior
cingulate, orbitofrontal and lateral prefrontal cortices. High anxiety and
habituation of cold pain were associated with greater laser heat-induced pain
during heterotopic cold stimulation. The habituation was also linked to the early
cold-induced orbitofrontal responses. We conclude that individual differences in
conditioned pain modulation are related to different levels of prefrontal
cortical activation by the early part of the conditioning stimulus, possibly due
to different levels in trait anxiety.
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