The Hope and Reality of Pain Relief Using Psychological Manipulations.

Many patients suffer from chronic pain despite the absence of injury or sufficient biomedical disease to explain their pain. These pains are highly resistant to treatment. Psychological therapies designed to help patients undermine the negative thought and behavioral patterns that maintain pain provide only modest pain relief, leading to suspicion that such pain might be maintained by unconscious processes.

Offset analgesia is reduced on the palm and increases with stimulus duration.

Background: A noxious stimulus following a more intense stimulus often feels less painful than continuous noxious stimulation. This effect, known as offset analgesia (OA), may be due to descending inhibitory control, to changes in peripheral neural transmission or both. The timing and location of noxious thermal stimulation were manipulated to better understand the peripheral and central contributions to OA.

Stepwise increasing sequential offsets cannot be used to deliver high thermal intensities with little or no perception of pain.

Offset analgesia (OA) is the disproportionate decrease in pain experience following a slight decrease in noxious heat stimulus intensity. We tested whether sequential offsets would allow noxious temperatures to be reached with little or no perception of pain. Forty-eight participants continuously rated their pain experience during trials containing trains of heat stimuli delivered by Peltier thermode.

Suggestions to Reduce Clinical Fibromyalgia Pain and Experimentally Induced Pain Produce Parallel Effects on Perceived Pain but Divergent Functional MRI-Based Brain Activity.

Objective: Hypnotic suggestion is an empirically validated form of pain control; however, the underlying mechanism remains unclear.

Methods: Thirteen fibromyalgia patients received suggestions to alter their clinical pain, and 15 healthy controls received suggestions to alter experimental heat pain. Suggestions were delivered before and after hypnotic induction with blood oxygen level-dependent (BOLD) activity measured concurrently.

Distinct BOLD fMRI Responses of Capsaicin-Induced Thermal Sensation Reveal Pain-Related Brain Activation in Nonhuman Primates.

Background: Approximately 20% of the adult population suffer from chronic pain that is not adequately treated by current therapies, highlighting a great need for improved treatment options. To develop effective analgesics, experimental human and animal models of pain are critical. Topically/intra-dermally applied capsaicin induces hyperalgesia and allodynia to thermal and tactile stimuli that mimics chronic pain and is a useful translation from preclinical research to clinical investigation.

When Pain Brings Gain: Soccer Players Behavior and Admissions Suggest Feigning Injury to Maintain a Favorable Scoreline.

The rules of soccer dictate that play, once halted, cannot continue if a player is injured. Players may take advantage of this rule by feigning injury to preserve beneficial match positions. Thirty Euro 2008 matches, 90 Premier League matches and 63 World Cup 2010 matches were reviewed for the timing and severity of injuries.

'Imagined guilt' vs 'recollected guilt': implications for fMRI.

Guilt is thought to maintain social harmony by motivating reparation. This study compared two methodologies commonly used to identify the neural correlates of guilt. The first, imagined guilt, requires participants to read hypothetical scenarios and then imagine themselves as the protagonist.

Are mirror-sensations really synesthetic?

Mirror-sensations, including touch and pain, are often referred to as synesthetic. The term can be challenged, however, because mirror-sensations lack the incongruency and saliency of synesthesia, may involve problems of perspective rather than entangled sensations, and may be easier to generate with suggestion. If mirror-sensations are truly sensations then they might be expected to act like the true sensation and mirror-pain, for example, might inhibit pain at a distance or itch in the same location.

The use of neuroimaging to advance the understanding of chronic pain: from description to mechanism.

Functional imaging has comprehensively demonstrated that pain involves a number of cortical regions that are often collectively referred to as the pain neuromatrix. This neuromatrix is assumed to be necessary to process the sensory, affective, and cognitive components of pain. Patients who report pain in the apparent absence of injury or disease may experience their symptoms because of dysfunction in one or more components of the pain neuromatrix.

Feeling the pain of others is associated with self-other confusion and prior pain experience.

Some chronic pain patients and healthy individuals experience pain when observing injury or others in pain. To further understand shared pain, we investigated perspective taking, bodily ownership and tooth pain sensitivity. First, participants who reported shared pain (responders) and those who did not (non-responders) viewed an avatar on a screen.

Intrinsic variability in the human response to pain is assembled from multiple, dynamic brain processes.

The stimulus-evoked response is the principle measure used to elucidate the timing and spatial location of human brain activity. Brain and behavioural responses to pain are influenced by multiple intrinsic and extrinsic factors and display considerable, natural trial-by-trial variability. However, because the neuronal sources of this variability are poorly understood the functional information it contains is under-exploited for understanding the relationship between brain function and behaviour.

Blunted cardiac stress reactivity relates to neural hypoactivation.

The present study compared neural activity in participants with blunted (N = 9) or exaggerated (N = 8) cardiac stress reactions. Neural activity was recorded with fMRI while participants performed a validated stress task and control task. Exaggerated reactors exhibited significant increases in heart rate from control to stress task, whereas blunted reactors had no change in heart rate.

'A giant mess'--making sense of complexity in the accounts of people with fibromyalgia.

Objectives: The diagnosis of fibromyalgia is based on self-report and indirect measures and thus is unavoidably influenced by patients' own understanding of their symptoms. In order to provide appropriate support for people with fibromyalgia, it is important to understand variation in patients' interpretations of their own symptoms.

Methods: Twenty people with fibromyalgia participated in email interviews exploring their experiences, history and diagnosis.

Biases in children's and adults' moral judgments.

Two experiments examined biases in children's (5/6- and 7/8-year-olds) and adults' moral judgments. Participants at all ages judged that it was worse to produce harm when harm occurred (a) through action rather than inaction (omission bias), (b) when physical contact with the victim was involved (physical contact principle), and (c) when the harm was produced as a direct means to an end rather than as an unintended but foreseeable side effect of the action (intention principle). The youngest participants, however, did not incorporate benefit when making judgments about situations in which harm to one individual resulted in benefit to five individuals.

Foetal pain?

The majority of commentary on foetal pain has looked at the maturation of neural pathways to decide a lower age limit for foetal pain. This approach is sensible because there must be a minimal necessary neural development that makes pain possible. Very broadly, it is generally agreed that the minimal necessary neural pathways for pain are in place by 24 weeks gestation.

Pain sensation evoked by observing injury in others.

Observing someone else in pain produces a shared emotional experience that predominantly activates brain areas processing the emotional component of pain. Occasionally, however, sensory areas are also activated and there are anecdotal reports of people sharing both the somatic and emotional components of someone else's pain. Here we presented a series of images or short clips depicting noxious events to a large group of normal controls.

Cold pressor pain reduces phobic fear but fear does not reduce pain.

Unlabelled: Negative emotion has a variable effect on pain perception. This variability has been explained by the motivational priming hypothesis (MPH) which predicts that emotional stimuli generating low levels of arousal will facilitate pain, while stimuli generating high levels of arousal will inhibit pain. However, a study by Sneddon et al with rainbow trout discovers a relationship not found in the human literature, that fear-related behavior decreased in the presence of a nociceptive stimulus.

Optimizing the measurement of contact heat evoked potentials.

Our aim was to determine whether single trial averaging could improve quantification of contact heat evoked potentials measured from fixed position contact heat stimulation. Event-related brain potentials were measured in response to contact heat stimuli applied to the arm and the leg of 10 subjects via a circular thermode, using fixed and varied thermode positions at 41 degrees C and 51 degrees C. Contact heat evoked potentials were successfully recorded from varied position stimulation of the leg at 51 degrees C in 80% of subjects, but from only 60% of subjects using a fixed position.

The rebirth of neuroscience in psychosomatic medicine, Part II: clinical applications and implications for research.

During the second half of the last century, biopsychosocial research in psychosomatic medicine largely ignored the brain. Neuroscience has started to make a comeback in psychosomatic medicine research and promises to advance the field in important ways. In this paper we briefly review select brain imaging research findings in psychosomatic medicine in four key areas: cardiovascular regulation, visceral pain in the context of functional gastrointestinal disorders, acute and chronic somatic pain and placebo.

Fetal pain: do we know enough to do the right thing?

Raising the possibility of fetal pain continues as a tactic to undermine support for abortion in the US and the UK. This paper examines anatomical and psychological developments in the fetus to assess the possibility of fetal pain. Neurobiological features that develop at 7, 18 and 26 weeks gestation suggest an experience of pain in utero.

Fibromyalgia pain and its modulation by hypnotic and non-hypnotic suggestion: an fMRI analysis.

The neuropsychological status of pain conditions such as fibromyalgia, commonly categorized as 'psychosomatic' or 'functional' disorders, remains controversial. Activation of brain structures dependent upon subjective alterations of fibromyalgia pain experience could provide an insight into the underlying neuropsychological processes. Suggestion following a hypnotic induction can readily modulate the subjective experience of pain.

Modeling pain circuits: how imaging may modify perception.

Pain is the unpleasant sensory experience following tissue damage or the threat of damage. The activation of cortical regions during noxious stimulation is believed a result of the negative affect and sensations generated by the stimulus. How a noxious event is translated into pain experience remains uncertain, and pain that occurs in the absence of a noxious event remains mysterious.