Brain-behaviour correlates of habitual motivation in chronic back pain

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Abstract

Chronic pain may sap the motivation for positive events and stimuli. This may lead to a negative behavioural cycle reducing the establishment of appetitive habitual engagement. One potential mechanism for this might be biased learning. In our experiment, chronic back pain patients and healthy controls completed an appetitive Pavlovian-instrumental transfer procedure. We examined participants` behaviour and brain activity and reported pain, depression and anxiety. Patients showed reduced habitual behaviour and increased responses in the hippocampus than controls. This behavioural bias was related to motivational value and reflected in the updating of brain activity in prefrontal–striatal–limbic circuits. Moreover, this was influenced by pain symptom duration, depression and anxiety (explained variance: up to 50.7%). Together, findings identify brain-behaviour pathways for maladaptive habitual learning and motivation in chronic back pain, which helps explaining why chronic pain can be resistant to change, and where clinical characteristics are significant modulators.

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Most cited references 43

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Measuring emotion: the Self-Assessment Manikin and the Semantic Differential.

M M Bradley, P J Lang (1994)

The Self-Assessment Manikin (SAM) is a non-verbal pictorial assessment technique that directly measures the pleasure, arousal, and dominance associated with a person's affective reaction to a wide variety of stimuli. In this experiment, we compare reports of affective experience obtained using SAM, which requires only three simple judgments, to the Semantic Differential scale devised by Mehrabian and Russell (An approach to environmental psychology, 1974) which requires 18 different ratings. Subjective reports were measured to a series of pictures that varied in both affective valence and intensity. Correlations across the two rating methods were high both for reports of experienced pleasure and felt arousal. Differences obtained in the dominance dimension of the two instruments suggest that SAM may better track the personal response to an affective stimulus. SAM is an inexpensive, easy method for quickly assessing reports of affective response in many contexts.

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Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits.

Javeria A Hashmi, Marwan N Baliki, Lejian Huang … (2013)

Chronic pain conditions are associated with abnormalities in brain structure and function. Moreover, some studies indicate that brain activity related to the subjective perception of chronic pain may be distinct from activity for acute pain. However, the latter are based on observations from cross-sectional studies. How brain activity reorganizes with transition from acute to chronic pain has remained unexplored. Here we study this transition by examining brain activity for rating fluctuations of back pain magnitude. First we compared back pain-related brain activity between subjects who have had the condition for ∼2 months with no prior history of back pain for 1 year (early, acute/subacute back pain group, n = 94), to subjects who have lived with back pain for >10 years (chronic back pain group, n = 59). In a subset of subacute back pain patients, we followed brain activity for back pain longitudinally over a 1-year period, and compared brain activity between those who recover (recovered acute/sub-acute back pain group, n = 19) and those in which the back pain persists (persistent acute/sub-acute back pain group, n = 20; based on a 20% decrease in intensity of back pain in 1 year). We report results in relation to meta-analytic probabilistic maps related to the terms pain, emotion, and reward (each map is based on >200 brain imaging studies, derived from neurosynth.org). We observed that brain activity for back pain in the early, acute/subacute back pain group is limited to regions involved in acute pain, whereas in the chronic back pain group, activity is confined to emotion-related circuitry. Reward circuitry was equally represented in both groups. In the recovered acute/subacute back pain group, brain activity diminished in time, whereas in the persistent acute/subacute back pain group, activity diminished in acute pain regions, increased in emotion-related circuitry, and remained unchanged in reward circuitry. The results demonstrate that brain representation for a constant percept, back pain, can undergo large-scale shifts in brain activity with the transition to chronic pain. These observations challenge long-standing theoretical concepts regarding brain and mind relationships, as well as provide important novel insights regarding definitions and mechanisms of chronic pain.

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A common neurobiology for pain and pleasure.

Siri Leknes, Irene Tracey (2008)

Pain and pleasure are powerful motivators of behaviour and have historically been considered opposites. Emerging evidence from the pain and reward research fields points to extensive similarities in the anatomical substrates of painful and pleasant sensations. Recent molecular-imaging and animal studies have demonstrated the important role of the opioid and dopamine systems in modulating both pain and pleasure. Understanding the mutually inhibitory effects that pain and reward processing have on each other, and the neural mechanisms that underpin such modulation, is important for alleviating unnecessary suffering and improving well-being.

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Author and article information

Contributors

Frauke Nees: frauke.nees@zi-mannheim.de

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 6 July 2020

Publication date PMC-release: 6 July 2020

Publication date Collection: 2020

Volume: 10

Electronic Location Identifier: 11090

Affiliations

[1 ]ISNI 0000 0001 2190 4373, GRID grid.7700.0, Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, , Heidelberg University, ; J5, 68159 Mannheim, Germany

[2 ]ISNI 0000 0001 2190 4373, GRID grid.7700.0, Computer Assisted Clinical Medicine, Medical Faculty Mannheim, , Heidelberg University, ; Mannheim, Germany

[3 ]ISNI 0000000419368710, GRID grid.47100.32, Department of Radiology and Biomedical Imaging, , Yale University, ; New Haven, CT USA

[4 ]Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany

Article

Publisher ID: 67386

DOI: 10.1038/s41598-020-67386-8

PMC ID: 7338353

PubMed ID: 32632166

SO-VID: 8d5bb98c-cc6b-4f7b-9eb8-cbd6994e4dae

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 14 February 2020

Date accepted : 4 June 2020

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ScienceOpen disciplines: Uncategorized

Keywords: cognitive neuroscience,learning and memory,motivation,reward,diseases

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ScienceOpen disciplines: Uncategorized

Keywords: cognitive neuroscience, learning and memory, motivation, reward, diseases

Brain-behaviour correlates of habitual motivation in chronic back pain

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NeuroImaging Methods

Most cited references 43

Measuring emotion: the Self-Assessment Manikin and the Semantic Differential.

Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits.

A common neurobiology for pain and pleasure.

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