Poster No:
2053
Submission Type:
Abstract Submission
Authors:
Kai-Cing Yang1, Ming-Tsung Tseng1
Institutions:
1Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
First Author:
Kai-Cing Yang
Graduate Institute of Brain and Mind Sciences, National Taiwan University
Taipei, Taiwan
Co-Author:
Ming-Tsung Tseng
Graduate Institute of Brain and Mind Sciences, National Taiwan University
Taipei, Taiwan
Introduction:
Stimulus and treatment expectancies modulate pain perception, either decreasing or increasing pain. Stimulus expectancy, also known as cue-based expectancy, is induced by pain-predictive cues, and the expectation is brief, acute, and specific to the upcoming painful stimulus. In contrast, treatment expectancy, which includes placebo analgesia and nocebo hyperalgesia, arises from beliefs about the effects of inert treatments. Although both types of pain expectancy substantially modulate human pain processing, the interaction between stimulus and treatment expectancy remain largely unclear. The present study aims to elucidate the neural basis underlying the interaction between stimulus and treatment expectancies.
Methods:
Our experiment combined paradigms of both stimulus and treatment expectancies while using functional MRI to record participants' blood-oxygen-level-dependent (BOLD) signals during pain experiences. We recruited 15 healthy adults for the placebo group and 13 for the nocebo group. In the conditioning phase, participants learned to associate different visual cues with three levels of stimulus intensity during a cue conditioning session. Before treatment conditioning, participants were informed that we would test the effect of an analgesic cream (placebo) or a cream with skin-sensitizing side effects that increase pain (nocebo). However, the stimulus intensity was secretly manipulated at the treatment and control positions. To investigate the interaction effect of the two expectancies, a modified stimulus expectancy paradigm was performed under different treatment conditions. Both positive and negative stimulus expectancies were assessed, and treatment expectancy was calculated using the unconditioned cue.
Results:
At the behavioral level, we examined the effect of stimulus expectancy under different treatment conditions. Compared to control condition, placebo manipulation enhanced negative stimulus expectancy effects on pain, while positive stimulus expectancy effects remained unaffected. This finding suggests that placebo treatment amplifies the pain induced by high-pain cues but does not influence the reduction of pain induced by low-pain cues. As for nocebo manipulation, both positive and negative stimulus expectancy effects on pain became increased, indicating that the pain induced by high-pain cues intensified, while the reduction of pain from low-pain cues diminished. In our model-based analysis, treatment expectancy aligned with the precision integration model, whereas stimulus expectancy was best explained by the emotion integration model. At the neural level, preliminary imaging data analysis revealed that both expectancies activated the rostral anterior cingulate cortex and the anterior insula cortex, indicating a potential neural interaction.
Conclusions:
In conclusion, our study demonstrates the precision of treatment expectancy modulates pain by integrating prior experience with sensory input, while emotion serves as the integrative factor for stimulus expectancy. Although stimulus and treatment expectancy involve distinct computatoional mechanisms, there exists an interaction between both types of expectancy, with shared neural substrates. These findings clarify whether the neural mechanisms underlying these expectancies are identical or distinct, enhance our understanding of pain expectations, and contribute to improving treatment outcomes in clinical pain conditions.
Emotion, Motivation and Social Neuroscience:
Emotional Perception
Modeling and Analysis Methods:
Bayesian Modeling
Novel Imaging Acquisition Methods:
BOLD fMRI 2
Perception, Attention and Motor Behavior:
Perception: Pain and Visceral 1
Perception: Visual
Keywords:
Cognition
Computational Neuroscience
Emotions
fMRI CONTRAST MECHANISMS
FUNCTIONAL MRI
NORMAL HUMAN
Pain
Perception
Treatment
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Task-activation
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Healthy subjects
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
NOTE: Any human subjects studies without IRB approval will be automatically rejected.
Yes
Were any animal research approved by the relevant IACUC or other animal research panel?
NOTE: Any animal studies without IACUC approval will be automatically rejected.
Not applicable
Please indicate which methods were used in your research:
Functional MRI
Behavior
Computational modeling
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
SPM
Provide references using APA citation style.
1. Atlas, L. Y. (2021). A social affective neuroscience lens on placebo analgesia. Trends in cognitive sciences, 25(11), 992–1005.
2. Grahl, A. (2018). The periaqueductal gray and Bayesian integration in placebo analgesia, eLife, vol. 7.
3. Shih, Y. W. (2019). Effects of positive and negative expectations on human pain perception engage separate but interrelated and dependently regulated cerebral mechanisms, Journal of Neuroscience, vol. 39, 1261-1274.
4. Tsai, H. Y. (2024). Integration of prior expectations and suppression of prediction errors during expectancy-induced pain modulation: The influence of anxiety and pleasantness. Journal of Neuroscience, 44(17), e1627232024.
No