Deficient modulation of pain by a positive emotional context in fibromyalgia patients

TY - JOUR

T1 - Deficient modulation of pain by a positive emotional context in fibromyalgia patients

AU - Kamping, Sandra

AU - Bomba, Isabelle C

AU - Kanske, Philipp

AU - Diesch, Eugen

AU - Flor, Herta

N1 - Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

PY - 2013/9

Y1 - 2013/9

N2 - This study aimed to investigate the modulating effects of emotional context on pain perception in 16 patients with fibromyalgia syndrome (FMS) and 16 healthy control (HC) subjects. An infrared laser was used to apply individually adapted painful stimuli to the dorsum of the left hand. The emotional background of the painful stimuli was modulated by concurrent presentations of negative, neutral, and positive picture stimuli selected from the International Affective Picture System. As control conditions, painful stimuli and the pictures were also presented by themselves. During each of the 5 laser-picture trials, subjects received 10 painful stimuli and were asked to rate the average intensity and unpleasantness of the experienced pain. Functional magnetic resonance images were obtained, using a T2(∗) sensitive echo planar sequence. HC subjects showed a linear increase in pain intensity and unpleasantness ratings when painful stimuli were presented during positive, neutral, and negative pictures. In contrast, FMS patients showed a quadratic trend for pain intensity ratings indicating a lack of pain reduction by the positive pictures. In addition, the FMS patients showed less activation in secondary somatosensory cortex, insula, orbitofrontal cortex, and anterior cingulate cortex during the positive picture pain trials. Our results suggest that fibromyalgia patients are less efficient in modulating pain by positive affect and may benefit less from appetitive events than healthy control subjects.

AB - This study aimed to investigate the modulating effects of emotional context on pain perception in 16 patients with fibromyalgia syndrome (FMS) and 16 healthy control (HC) subjects. An infrared laser was used to apply individually adapted painful stimuli to the dorsum of the left hand. The emotional background of the painful stimuli was modulated by concurrent presentations of negative, neutral, and positive picture stimuli selected from the International Affective Picture System. As control conditions, painful stimuli and the pictures were also presented by themselves. During each of the 5 laser-picture trials, subjects received 10 painful stimuli and were asked to rate the average intensity and unpleasantness of the experienced pain. Functional magnetic resonance images were obtained, using a T2(∗) sensitive echo planar sequence. HC subjects showed a linear increase in pain intensity and unpleasantness ratings when painful stimuli were presented during positive, neutral, and negative pictures. In contrast, FMS patients showed a quadratic trend for pain intensity ratings indicating a lack of pain reduction by the positive pictures. In addition, the FMS patients showed less activation in secondary somatosensory cortex, insula, orbitofrontal cortex, and anterior cingulate cortex during the positive picture pain trials. Our results suggest that fibromyalgia patients are less efficient in modulating pain by positive affect and may benefit less from appetitive events than healthy control subjects.

KW - Adult

KW - Affective Symptoms

KW - Aged

KW - Brain Mapping

KW - Female

KW - Fibromyalgia

KW - Hand

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Magnetic Resonance Imaging

KW - Middle Aged

KW - Pain

KW - Pain Measurement

KW - Pain Threshold

KW - Photic Stimulation

KW - Regression Analysis

KW - Surveys and Questionnaires

KW - Time Factors

U2 - 10.1016/j.pain.2013.06.003

DO - 10.1016/j.pain.2013.06.003

M3 - SCORING: Journal article

C2 - 23752177

VL - 154

SP - 1846

EP - 1855

JO - PAIN

JF - PAIN

SN - 0304-3959

IS - 9

ER -