Neural correlates of deficits in pain-related affective meaning construction in patients with chronic pain disorder

Michael Noll-Hussong, Alexander Otti, Afra M. Wohlschlaeger, Claus Zimmer, Peter Henningsen, Claas Lahmann, Joram Ronel, Claudia Subic-Wrana, Richard D Lane, Jean Decety, Harald Guendel

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: Psychological and neural mechanisms of the affective dimension of pain are known to be disturbed in patients with chronic pain disorder. The aim of this functional magnetic resonance imaging study was to assess the neurofunctional and behavioral measures underlying the ability to construct pain-related affective meaning in a painful situation by comparing 21 clinically and psychometrically well-characterized patients with persistent non-nociceptive somatoform pain with 19 healthy controls. METHODS: The functional magnetic resonance imaging task involved viewing pictures depicting human hands and feet in different painful and nonpainful situations. Participants were asked to estimate the perceived pain intensity. These data were correlated with behavioral measures of depression, alexithymia, and general cognitive and emotional empathy. RESULTS: In a hypothesis-driven region-of-interest analysis, the healthy control group exhibited greater activation of the left perigenual anterior cingulate cortex than patients with pain (Montreal Neurological Institute coordinates (x y z) = -8 38 0; cluster extent = 54 voxels; T = 4.28; p = .006 corrected for multiple comparisons at cluster level). No group differences in the activation of the anterior insular cortex were found. Scores on self-assessment instruments (Beck Depression Inventory I, Interpersonal Reactivity Index, and 20-item Toronto Alexithymia Scale) did not influence neuroimaging results. CONCLUSIONS: Our results suggest that patients with chronic medically unexplained pain have an altered neural pain perception process owing to decreased activation of empathetic-affective networks, which we interpret as a deficit in pain-related affective meaning construction. These findings may lead to a more specific and detailed neurobiological understanding of the clinical impression of disturbed affect in patients with chronic pain disorder.

Original languageEnglish (US)
Pages (from-to)124-136
Number of pages13
JournalPsychosomatic Medicine
Volume75
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Somatoform Disorders
Chronic Pain
Pain
Affective Symptoms
Magnetic Resonance Imaging
Depression
Pain Perception
Aptitude
Gyrus Cinguli
Affective
Neural Correlates
Neuroimaging
Cerebral Cortex
Foot
Hand
Psychology
Equipment and Supplies
Control Groups

Keywords

  • affective meaning
  • affective neuroscience
  • empathy
  • functional magnetic resonance imaging
  • pain disorder
  • somatoform pain disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology
  • Arts and Humanities (miscellaneous)
  • Developmental and Educational Psychology

Cite this

Noll-Hussong, M., Otti, A., Wohlschlaeger, A. M., Zimmer, C., Henningsen, P., Lahmann, C., ... Guendel, H. (2013). Neural correlates of deficits in pain-related affective meaning construction in patients with chronic pain disorder. Psychosomatic Medicine, 75(2), 124-136. https://doi.org/10.1097/PSY.0b013e31827e60f3

Neural correlates of deficits in pain-related affective meaning construction in patients with chronic pain disorder. / Noll-Hussong, Michael; Otti, Alexander; Wohlschlaeger, Afra M.; Zimmer, Claus; Henningsen, Peter; Lahmann, Claas; Ronel, Joram; Subic-Wrana, Claudia; Lane, Richard D; Decety, Jean; Guendel, Harald.

In: Psychosomatic Medicine, Vol. 75, No. 2, 02.2013, p. 124-136.

Research output: Contribution to journalArticle

Noll-Hussong, M, Otti, A, Wohlschlaeger, AM, Zimmer, C, Henningsen, P, Lahmann, C, Ronel, J, Subic-Wrana, C, Lane, RD, Decety, J & Guendel, H 2013, 'Neural correlates of deficits in pain-related affective meaning construction in patients with chronic pain disorder', Psychosomatic Medicine, vol. 75, no. 2, pp. 124-136. https://doi.org/10.1097/PSY.0b013e31827e60f3
Noll-Hussong, Michael ; Otti, Alexander ; Wohlschlaeger, Afra M. ; Zimmer, Claus ; Henningsen, Peter ; Lahmann, Claas ; Ronel, Joram ; Subic-Wrana, Claudia ; Lane, Richard D ; Decety, Jean ; Guendel, Harald. / Neural correlates of deficits in pain-related affective meaning construction in patients with chronic pain disorder. In: Psychosomatic Medicine. 2013 ; Vol. 75, No. 2. pp. 124-136.
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abstract = "OBJECTIVE: Psychological and neural mechanisms of the affective dimension of pain are known to be disturbed in patients with chronic pain disorder. The aim of this functional magnetic resonance imaging study was to assess the neurofunctional and behavioral measures underlying the ability to construct pain-related affective meaning in a painful situation by comparing 21 clinically and psychometrically well-characterized patients with persistent non-nociceptive somatoform pain with 19 healthy controls. METHODS: The functional magnetic resonance imaging task involved viewing pictures depicting human hands and feet in different painful and nonpainful situations. Participants were asked to estimate the perceived pain intensity. These data were correlated with behavioral measures of depression, alexithymia, and general cognitive and emotional empathy. RESULTS: In a hypothesis-driven region-of-interest analysis, the healthy control group exhibited greater activation of the left perigenual anterior cingulate cortex than patients with pain (Montreal Neurological Institute coordinates (x y z) = -8 38 0; cluster extent = 54 voxels; T = 4.28; p = .006 corrected for multiple comparisons at cluster level). No group differences in the activation of the anterior insular cortex were found. Scores on self-assessment instruments (Beck Depression Inventory I, Interpersonal Reactivity Index, and 20-item Toronto Alexithymia Scale) did not influence neuroimaging results. CONCLUSIONS: Our results suggest that patients with chronic medically unexplained pain have an altered neural pain perception process owing to decreased activation of empathetic-affective networks, which we interpret as a deficit in pain-related affective meaning construction. These findings may lead to a more specific and detailed neurobiological understanding of the clinical impression of disturbed affect in patients with chronic pain disorder.",
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N2 - OBJECTIVE: Psychological and neural mechanisms of the affective dimension of pain are known to be disturbed in patients with chronic pain disorder. The aim of this functional magnetic resonance imaging study was to assess the neurofunctional and behavioral measures underlying the ability to construct pain-related affective meaning in a painful situation by comparing 21 clinically and psychometrically well-characterized patients with persistent non-nociceptive somatoform pain with 19 healthy controls. METHODS: The functional magnetic resonance imaging task involved viewing pictures depicting human hands and feet in different painful and nonpainful situations. Participants were asked to estimate the perceived pain intensity. These data were correlated with behavioral measures of depression, alexithymia, and general cognitive and emotional empathy. RESULTS: In a hypothesis-driven region-of-interest analysis, the healthy control group exhibited greater activation of the left perigenual anterior cingulate cortex than patients with pain (Montreal Neurological Institute coordinates (x y z) = -8 38 0; cluster extent = 54 voxels; T = 4.28; p = .006 corrected for multiple comparisons at cluster level). No group differences in the activation of the anterior insular cortex were found. Scores on self-assessment instruments (Beck Depression Inventory I, Interpersonal Reactivity Index, and 20-item Toronto Alexithymia Scale) did not influence neuroimaging results. CONCLUSIONS: Our results suggest that patients with chronic medically unexplained pain have an altered neural pain perception process owing to decreased activation of empathetic-affective networks, which we interpret as a deficit in pain-related affective meaning construction. These findings may lead to a more specific and detailed neurobiological understanding of the clinical impression of disturbed affect in patients with chronic pain disorder.

AB - OBJECTIVE: Psychological and neural mechanisms of the affective dimension of pain are known to be disturbed in patients with chronic pain disorder. The aim of this functional magnetic resonance imaging study was to assess the neurofunctional and behavioral measures underlying the ability to construct pain-related affective meaning in a painful situation by comparing 21 clinically and psychometrically well-characterized patients with persistent non-nociceptive somatoform pain with 19 healthy controls. METHODS: The functional magnetic resonance imaging task involved viewing pictures depicting human hands and feet in different painful and nonpainful situations. Participants were asked to estimate the perceived pain intensity. These data were correlated with behavioral measures of depression, alexithymia, and general cognitive and emotional empathy. RESULTS: In a hypothesis-driven region-of-interest analysis, the healthy control group exhibited greater activation of the left perigenual anterior cingulate cortex than patients with pain (Montreal Neurological Institute coordinates (x y z) = -8 38 0; cluster extent = 54 voxels; T = 4.28; p = .006 corrected for multiple comparisons at cluster level). No group differences in the activation of the anterior insular cortex were found. Scores on self-assessment instruments (Beck Depression Inventory I, Interpersonal Reactivity Index, and 20-item Toronto Alexithymia Scale) did not influence neuroimaging results. CONCLUSIONS: Our results suggest that patients with chronic medically unexplained pain have an altered neural pain perception process owing to decreased activation of empathetic-affective networks, which we interpret as a deficit in pain-related affective meaning construction. These findings may lead to a more specific and detailed neurobiological understanding of the clinical impression of disturbed affect in patients with chronic pain disorder.

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