Induction of Depressed Mood Disrupts Emotion Regulation Neurocircuitry and Enhances Pain Unpleasantness
Induction of Depressed Mood Disrupts Emotion Regulation Neurocircuitry and Enhances Pain Unpleasantness
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DOI：
10.1016/j.biopsych.2010.01.014
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发表时间：
2010-06-01
影响因子：
10.6
通讯作者：
Tracey, Irene
中科院分区：
文献类型：
--
作者：
Berna, Chantal;Leknes, Siri;Tracey, Irene
背景：抑郁情绪改变疼痛体验。然而，尽管它具有明确的临床意义，但人们对这种现象背后的认知和神经机制知之甚少。我们测试了一种实验性操作来揭示抑郁情绪和疼痛之间的相互作用。我们假设情绪调节下的神经回路失调是抑郁情绪影响疼痛加工的机制。方法：采用功能磁共振成像技术，比较了悲伤和中性认知情绪诱导对20名健康志愿者的情感性疼痛评分、疼痛特异性认知和补性毒热刺激中枢性疼痛加工的影响。结果：抑郁期负性疼痛特异性认知的增加预示着疼痛不愉快感的增加。在抑郁情绪诱导下，大脑对有害热刺激的反应表现为前额叶区、亚属前扣带皮层和海马体等广泛网络的活动增加，与中性情绪下的疼痛反应相比，大脑的失活明显减少。在悲伤情绪诱导后，报告疼痛不愉快增加最多的参与者表现出更大的额下回和杏仁核激活，将情绪调节机制的变化与疼痛影响的增强联系起来。结论：我们的研究结果揭示了抑郁情绪和慢性疼痛在临床上是如何共同发生的，并可能有助于开发和转化有效的药物或心理治疗干预措施。
Background: Depressed mood alters the pain experience. Yet, despite its clear clinical relevance, little is known about the cognitive and neural mechanisms underlying this phenomenon. We tested an experimental manipulation to unravel the interaction between depressed mood and pain. We hypothesized that dysregulation of the neural circuitry underlying emotion regulation is the mechanism whereby pain processing is affected during depressed mood.Methods: Using functional magnetic resonance imaging, we compared the effects of sad and neutral cognitive mood inductions on affective pain ratings, pain-specific cognitions, and central pain processing of a tonic noxious heat stimulus in 20 healthy volunteers.Results: The increase in negative pain-specific cognitions during depressed mood predicted the perceived increase in pain unpleasantness. Following depressed mood induction, brain responses to noxious thermal stimuli were characterized by increased activity in a broad network including prefrontal areas, subgenual anterior cingulate cortex, and hippocampus, as well as significantly less deactivation when compared with pain responses in a neutral mood. The participants who reported the largest increase in pain unpleasantness after the sad mood induction showed greater inferior frontal gyrus and amygdala activation, linking changes in emotion regulation mechanisms with enhancement of pain affect.Conclusions: Our results inform how depressed mood and chronic pain co-occur clinically and may serve to develop and translate effective interventions using pharmacological or psychological treatment.