Abstract
Although humans differ widely in how sensitive they are to painful stimuli, the neural correlates underlying such variability remains poorly understood. A better understanding of this is important given that baseline pain sensitivity scores relate closely to the risk of developing refractory, chronic pain. To address this, we used a matched perception paradigm which allowed us to control for individual variations in subjective experience. By measuring subjective pain, nociceptive flexion reflexes, and, somatosensory evoked brain potentials (with source localization analysis), we were able to map the brain’s sequential response to pain while also investigating its relationship to pain sensitivity (i.e. change in the stimulation strength necessary to experience pain) and spinal cord activity. We found that pain sensitivity in healthy adults was closely tied to pain-evoked responses in the contralateral precuneus. Importantly, the precuneus did not contribute to the actual representation of pain in the brain, suggesting that pain sensitivity and pain representation depend on separate neuronal sub-systems.
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Notes
Although we could have used a matched stimulation intensity paradigm, where stimulation strength was matched across participants and subjective experience was left free to vary, this approach was not favoured because it cannot guarantee that all (if any) participants will actually experience a transition from a non-painful to a painful state. As a result, the data would not have been interpretable specifically in terms of pain sensitivity.
Although descending, supra-spinal control(s) can affect the withdrawal reflex response, it is important to keep in mind that the amplitude of the withdrawal reflex response represents the net, integrated set of influences impacting nociceptive signals at the spinal level (and also ascending from the spine to the brain). Thus, the withdrawal reflex response serves as a useful, non-invasive marker of net, integrated nociceptive activity occurring at the spinal level.
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Acknowledgments
This work was funded by the Fonds de Recherche du Québec—Santé (P. G.), the Canadian Institutes of Health Research (S. M., P. G.), the Canada Research Chair program (K. W.), and, the Natural Sciences and Engineering Research Council of Canada (K. W.). We thank all participating volunteers.
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The authors declare that they have no conflict of interest with any of the work presented in this manuscript.
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Goffaux, P., Girard-Tremblay, L., Marchand, S. et al. Individual Differences in Pain Sensitivity Vary as a Function of Precuneus Reactivity. Brain Topogr 27, 366–374 (2014). https://doi.org/10.1007/s10548-013-0291-0
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DOI: https://doi.org/10.1007/s10548-013-0291-0