Quantifying cerebral contributions to pain beyond nociception

• Published in: Nature communications Vol. 8; no. 1; p. 14211
• Main Authors: Woo, Choong-Wan, Schmidt, Liane, Krishnan, Anjali, Jepma, Marieke, Roy, Mathieu, Lindquist, Martin A., Atlas, Lauren Y., Wager, Tor D.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14.02.2017; Nature Publishing Group; Nature Portfolio
• Subjects: 59/36; 631/378/1689/2610; 631/477/2811; 692/53; 692/700/1421/65; Brain; Brain - diagnostic imaging; Brain - physiopathology; Brain Mapping; Cerebral Cortex; Cerebral Cortex - physiology; Chronic pain; Human health and pathology; Humanities and Social Sciences; Humans; Life Sciences; Magnetic Resonance Imaging; multidisciplinary; Neurosciences; Nociception; Nociception - physiology; Nucleus Accumbens; Nucleus Accumbens - physiology; Pain; Pain - diagnostic imaging; Pain - physiopathology; Pain - psychology; Perception; Physical Stimulation; Prefrontal Cortex; Prefrontal Cortex - physiology; Psychology; Science; Science (multidisciplinary); Self-Control; Topography; Netherlands; South Korea; France; United States > US; Maryland; Colorado; Biomarkers; Brain imaging; Human behaviour; Chronic pain
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/ncomms14211

Cerebral processes contribute to pain beyond the level of nociceptive input and mediate psychological and behavioural influences. However, cerebral contributions beyond nociception are not yet well characterized, leading to a predominant focus on nociception when studying pain and developing interventions. Here we use functional magnetic resonance imaging combined with machine learning to develop a multivariate pattern signature—termed the stimulus intensity independent pain signature-1 (SIIPS1)—that predicts pain above and beyond nociceptive input in four training data sets (Studies 1–4, N =137). The SIIPS1 includes patterns of activity in nucleus accumbens, lateral prefrontal and parahippocampal cortices, and other regions. In cross-validated analyses of Studies 1–4 and in two independent test data sets (Studies 5–6, N =46), SIIPS1 responses explain variation in trial-by-trial pain ratings not captured by a previous fMRI-based marker for nociceptive pain. In addition, SIIPS1 responses mediate the pain-modulating effects of three psychological manipulations of expectations and perceived control. The SIIPS1 provides an extensible characterization of cerebral contributions to pain and specific brain targets for interventions. Pain is affected by cerebral processes in addition to afferent nociceptive input. Here the authors develop an fMRI-based signature that predicts pain independent of the intensity of nociceptive signals and mediates the pain-modulating effects of several cognitive interventions.