BEHAVIORAL NEUROSCIENCE OF PAIN AVOIDANCE : COGNITIVE AND MOTIVATIONAL BIASES UNDERMINING PAIN CONTROLLABILITY

点击翻译按钮获取中文摘要

Pain signals the presence of an urgent threat to our corporal integrity; it calls for our complete attention and commands immediate action. However, pain also marks an error in the long chain of decisions that ultimately led us to expose ourselves to danger. Pain therefore also compels us to reassess our future action plans. The effects of pain thus resonate far beyond the immediate painful experience: anticipation of future pain based on past painful experiences influences our current decisions, mood, and pain sensitivity. Hence, from the standpoint of behavioral control systems, unremitting uncontrollable pain is the worst possible scenario one can be confronted with. Unfortunately, this is the challenge that millions of patients with chronic pain are facing every day. Alas, we are still lacking basic knowledge of the neurophysiological mechanisms underlying pain’s behavioral effects, as research in humans has so far predominantly focused on the immediate experiential properties of painful stimulations (i.e., how pain feels). The objective of the proposed research program will therefore be to identify the cerebral mechanisms underlying cognitive and motivational biases that can undermine successful control over pain. The proposed research program encompasses three studies, each comprising an electroencephalography (EEG) and a functional magnetic resonance imaging (fMRI) experiment. The combination of these two techniques will allow us to examine the precise spatial and temporal characteristics of the cerebral responses to pain and its anticipation as a function of controllability. More specifically, study 1 will examine the instrumental learning deficits that follow from a period of uncontrollable pain. This phenomenon, called “learned helplessness”, often leads people to stop trying to control the pain even when they could possibly learn to control it. Study 2 will examine risk and ambiguity aversion biases, i.e. cognitive biases that bring us to overestimate the risk of pain and often lead to disadvantageous decisions. Finally, study 3 will investigate confirmation biases that makes it difficult to learn that pain may not be as high as we expected. Altogether, these studies will further our understanding of the cerebral mechanisms underlying cognitive and motivational biases that can impair behavioral control over pain, a topic which is highly relevant for the millions of Canadians living with chronic pain every day.