Neural and sociocultural mediators of ethnic differences in pain

• Published in: Nature human behaviour Vol. 4; no. 5; pp. 517 - 530
• Main Authors: Losin, Elizabeth A. Reynolds, Woo, Choong-Wan, Medina, Natalia A., Andrews-Hanna, Jessica R., Eisenbarth, Hedwig, Wager, Tor D.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2020; Nature Publishing Group
• Subjects: 4007/4003; 59/36; 631/378; 631/477; Adult; African Americans; Behavioral Sciences; Biomedical and Life Sciences; Black or African American - psychology; Brain; Brain - diagnostic imaging; Brain - physiopathology; Brain mechanisms; Cultural differences; Culture; Ethnic differences; Ethnicity; Experimental Psychology; Female; Functional magnetic resonance imaging; Functional Neuroimaging; Hispanic Americans; Hispanic or Latino - psychology; Humans; Life Sciences; Magnetic Resonance Imaging; Male; Microeconomics; Neurobiology; Neuroimaging; Neurosciences; Pain; Pain - diagnostic imaging; Pain - ethnology; Pain - physiopathology; Pain Measurement; Pain Perception - physiology; Personality and Social Psychology; Psychology; Racial differences; Racial discrimination; Racial Groups - psychology; Racism - psychology; Sociocultural factors; White people; White People - psychology
• ISSN: 2397-3374; 2397-3374
• DOI: 10.1038/s41562-020-0819-8

Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities. Losin et al. use neuroimaging to identify a brain mechanism underlying increased pain sensitivity in African Americans. This mechanism correlated with racial discrimination and implicated brain systems involved in context-based pain evaluation.