Dissociating Pain from Its Anticipation in the Human Brain

TLDR

Pain is subjectively distinct from the fear and anxiety of its threat, and anticipation itself can provoke mood changes and behavioral adaptations that worsen chronic pain. The study aims to explore whether selective manipulation of anticipation‑related brain sites could provide therapeutic avenues for chronic pain. The authors used fMRI in healthy participants to differentiate neural activation patterns of acute pain versus its anticipation. Pain anticipation activated medial frontal lobe, insular cortex, and cerebellum sites that are distinct yet adjacent to those mediating pain experience.

Abstract

The experience of pain is subjectively different from the fear and anxiety caused by threats of pain. Functional magnetic resonance imaging in healthy humans was applied to dissociate neural activation patterns associated with acute pain and its anticipation. Expectation of pain activated sites within the medial frontal lobe, insular cortex, and cerebellum distinct from, but close to, locations mediating pain experience itself. Anticipation of pain can in its own right cause mood changes and behavioral adaptations that exacerbate the suffering experienced by chronic pain patients. Selective manipulations of activity at these sites may offer therapeutic possibilities for treating chronic pain.