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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

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      Is Open Access

      Does monetary reward operantly enhance pain sensitivity over time? An experiment in healthy individuals

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          Abstract

          Aim

          Operant conditioning has long been believed to influence the pain experience through a psychological reward pathway. This study was formulated to test the hypothesis that pain sensitivity may be enhanced >3 months if a monetary reward works as a reinforcement.

          Methods

          Forty healthy subjects volunteered to participate in this study. The subjects repeatedly underwent pain testing via mechanical stimuli, and they rolled dice three (or six) times to gain money at the following five time points: baseline, three reinforcement sessions, and last session. The payoff was determined by roll of the dice. The subjects were instructed to roll the dice into a masked stand three times per session and informed that no one monitored the number of dice actually appeared. The subjects were also informed that they could roll the dice another three times when they reported strong pain during reinforcement sessions.

          Results

          The amount of individual payoff had significantly increased at last session compared with the values obtained at baseline; however, no changes were identified in terms of the pain ratings for mechanical stimuli during all sessions.

          Conclusion

          The results suggest that the psychological reward pathway does not always involve pain perception, and it is difficult to conclude whether pain sensitivity is operantly changed through the monetary reward in healthy individuals. Further investigation is required.

          Most cited references21

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          Pain and the brain: specificity and plasticity of the brain in clinical chronic pain.

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            The symbolic power of money: reminders of money alter social distress and physical pain.

            People often get what they want from the social system, and that process is aided by social popularity or by having money. Money can thus possibly substitute for social acceptance in conferring the ability to obtain benefits from the social system. Moreover, past work has suggested that responses to physical pain and social distress share common underlying mechanisms. Six studies tested relationships among reminders of money, social exclusion, and physical pain. Interpersonal rejection and physical pain caused desire for money to increase. Handling money (compared with handling paper) reduced distress over social exclusion and diminished the physical pain of immersion in hot water. Being reminded of having spent money, however, intensified both social distress and physical pain.
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              Mood influences supraspinal pain processing separately from attention.

              Studies show that inducing a positive mood or diverting attention from pain decreases pain perception. Nevertheless, induction manipulations, such as viewing interesting movies or performing mathematical tasks, often influence both emotional and attentional states. Imaging studies have examined the neural basis of psychological pain modulation, but none has explicitly separated the effects of emotion and attention. Using odors to modulate mood and shift attention from pain, we previously showed that the perceptual consequences of changing mood differed from those of altering attention, with mood primarily altering pain unpleasantness and attention preferentially altering pain intensity. These findings suggest that brain circuits involved in pain modulation provoked by mood or attention are partially separable. Here we used functional magnetic resonance imaging to directly compare the neurocircuitry involved in mood- and attention-related pain modulation. We manipulated independently mood state and attention direction, using tasks involving heat pain and pleasant and unpleasant odors. Pleasant odors, independent of attentional focus, induced positive mood changes and decreased pain unpleasantness and pain-related activity within the anterior cingulate (ACC), medial thalamus, and primary and secondary somatosensory cortices. The effects of attentional state were less robust, with only the activity in anterior insular cortex (aIC) showing possible attentional modulation. Lateral inferior frontal cortex [LinfF; Brodmann's area (BA) 45/47] activity correlated with mood-related modulation, whereas superior posterior parietal (SPP; BA7) and entorhinal activity correlated with attention-related modulation. ACC activity covaried with LinfF and periacqueductal gray activity, whereas aIC activity covaried with SPP activity. These findings suggest that separate neuromodulatory circuits underlie emotional and attentional modulation of pain.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2018
                04 October 2018
                : 11
                : 2161-2167
                Affiliations
                [1 ]Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Aichi, Japan
                [2 ]Department of Orthopaedics, Aichi Medical University, Aichi, Japan, tatsunon31@ 123456gmail.com
                [3 ]Department of Rehabilitation, Aichi Medical University, Aichi, Japan
                [4 ]Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Aichi, Japan
                [5 ]National Hospital Organization Hizen Psychiatric Center, Saga, Japan
                Author notes
                Correspondence: Tatsunori Ikemoto, Department of Orthopaedics, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi 480-1195, Japan, Tel +81 56 162 3311, Email tatsunon31@ 123456gmail.com
                Article
                jpr-11-2161
                10.2147/JPR.S175494
                6174898
                9c036420-501e-491f-93db-6b9b76e9b2d6
                © 2018 Shiro et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Anesthesiology & Pain management
                pain sensitivity,chronic pain,behavioral manipulation,reinforcement

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