Document Detail

Exacerbation of pain by anxiety is associated with activity in a hippocampal network.
MedLine Citation:
PMID:  11739597     Owner:  NLM     Status:  MEDLINE    
It is common clinical experience that anxiety about pain can exacerbate the pain sensation. Using event-related functional magnetic resonance imaging (FMRI), we compared activation responses to noxious thermal stimulation while perceived pain intensity was manipulated by changes in either physical intensity or induced anxiety. One visual signal, which reliably predicted noxious stimulation of moderate intensity, came to evoke low anxiety about the impending pain. Another visual signal was followed by the same, moderate-intensity stimulation on most of the trials, but occasionally by discriminably stronger noxious stimuli, and came to evoke higher anxiety. We found that the entorhinal cortex of the hippocampal formation responded differentially to identical noxious stimuli, dependent on whether the perceived pain intensity was enhanced by pain-relevant anxiety. During this emotional pain modulation, entorhinal responses predicted activity in closely connected, affective (perigenual cingulate), and intensity coding (mid-insula) areas. Our finding suggests that accurate preparatory information during medical and dental procedures alleviates pain by disengaging the hippocampus. It supports the proposal that during anxiety, the hippocampal formation amplifies aversive events to prime behavioral responses that are adaptive to the worst possible outcome.
A Ploghaus; C Narain; C F Beckmann; S Clare; S Bantick; R Wise; P M Matthews; J N Rawlins; I Tracey
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of neuroscience : the official journal of the Society for Neuroscience     Volume:  21     ISSN:  1529-2401     ISO Abbreviation:  J. Neurosci.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-12     Completed Date:  2002-01-23     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8102140     Medline TA:  J Neurosci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  9896-903     Citation Subset:  IM    
Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
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MeSH Terms
Anxiety / complications,  physiopathology*
Brain Mapping
Conditioning, Classical
Entorhinal Cortex / anatomy & histology,  physiopathology
Heart Rate
Hippocampus / anatomy & histology,  physiopathology*
Hot Temperature
Hyperalgesia / complications,  physiopathology*
Magnetic Resonance Imaging
Nerve Net / physiopathology*
Pain / complications,  physiopathology*
Parahippocampal Gyrus / anatomy & histology,  physiopathology
Physical Stimulation

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