The subjective experience of pain: Where expectations become reality
The subjective experience of pain: Where expectations become reality
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DOI：
10.1073/pnas.0408576102
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发表时间：
2005-09-06
影响因子：
11.1
通讯作者：
Coghill, RC
中科院分区：
文献类型：
--
作者：
Koyama, T;McHaffie, JG;Coghill, RC
我们的主观感官体验被认为是由期望和传入的感官信息之间的相互作用严重塑造的。然而，支持这些相互作用的神经机制仍然知之甚少。通过使用心理物理和功能磁共振成像技术相结合，大脑激活相关的强度预期的疼痛和经历的疼痛的特点。随着预期疼痛程度的增加，丘脑、丘脑、前额叶皮层、前扣带皮层（ACC）和其他大脑区域的激活增加。疼痛强度相关的脑激活在一组广泛分布的脑区中被确定，但在包括前额叶和前扣带回在内的区域中与预期相关的激活部分重叠。当预期疼痛被操纵时，对疼痛减少的预期强烈地降低了疼痛的主观体验和疼痛相关脑区的激活，如初级躯体感觉皮层、岛叶皮层、这些结果证实，一个即将到来的感觉事件的心理表征可以显着塑造神经过程的基础上制定的实际感觉经验，并提供洞察力，积极的期望如何减少慢性疾病状态的严重程度。
Our subjective sensory experiences are thought to be heavily shaped by interactions between expectations and incoming sensory information. However, the neural mechanisms supporting these interactions remain poorly understood. By using combined psychophysical and functional MRI techniques, brain activation related to the intensity of expected pain and experienced pain was characterized. As the magnitude of expected pain increased, activation increased in the thalamus, insula, prefrontal cortex, anterior cingulate cortex (ACC) and other brain regions. Pain-intensity-related brain activation was identified in a widely distributed set of brain regions but overlapped partially with expectation-related activation in regions, including the anterior insula and ACC. When expected pain was manipulated, expectations of decreased pain powerfully reduced both the subjective experience of pain and activation of pain-related brain regions, such as the primary somatosensory cortex, insular cortex, and ACC. These results confirm that a mental representation of an impending sensory event can significantly shape neural processes that underlie the formulation of the actual sensory experience and provide insight as to how positive expectations diminish the severity of chronic disease states.