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The Journal of Neuroscience, August 11, 2004, 24(32):7199-7203; doi:10.1523/JNEUROSCI.1315-04.2004

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BRIEF COMMUNICATION
Perceived Controllability Modulates the Neural Response to Pain

Tim V. Salomons,^1,2 Tom Johnstone,^1,3 Misha-Miroslav Backonja,⁴ and Richard J. Davidson^1,2,3

¹W. M. Keck Laboratory for Functional Brain Imaging and Behavior and Departments of ²Psychology, ³Psychiatry, and ⁴Neurology, University of Wisconsin-Madison, Madison, Wisconsin 53706

The response to painful stimulation depends not only on peripheral nociceptive input but also on the cognitive and affective context in which pain occurs. One contextual variable that affects the neural and behavioral response to nociceptive stimulation is the degree to which pain is perceived to be controllable. Previous studies indicate that perceived controllability affects pain tolerance, learning and motivation, and the ability to cope with intractable pain, suggesting that it has profound effects on neural pain processing. To date, however, no neuroimaging studies have assessed these effects. We manipulated the subjects' belief that they had control over a nociceptive stimulus, while the stimulus itself was held constant. Using functional magnetic resonance imaging, we found that pain that was perceived to be controllable resulted in attenuated activation in the three neural areas most consistently linked with pain processing: the anterior cingulate, insular, and secondary somatosensory cortices. This suggests that activation at these sites is modulated by cognitive variables, such as perceived controllability, and that pain imaging studies may therefore overestimate the degree to which these responses are stimulus driven and generalizable across cognitive contexts.

Key words: pain; control; imaging; insula; cingulate; cognitive

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Received April 7, 2004; revised May 27, 2004; accepted June 21, 2004.

This article has been cited by other articles:

				T. V. Salomons, T. Johnstone, M.-M. Backonja, A. J. Shackman, and R. J. Davidson Individual differences in the effects of perceived controllability on pain perception: critical role of the prefrontal cortex. J. Cogn. Neurosci., June 1, 2007; 19(6): 993 - 1003. [Abstract] [Full Text] [PDF]

				K. Wiech, R. Kalisch, N. Weiskopf, B. Pleger, K. E. Stephan, and R. J. Dolan Anterolateral Prefrontal Cortex Mediates the Analgesic Effect of Expected and Perceived Control over Pain. J. Neurosci., November 1, 2006; 26(44): 11501 - 11509. [Abstract] [Full Text] [PDF]

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