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Interrelationships between anxiety proneness and central autonomic processing during pain: A psychophysical and functional magnetic resonance imaging (fMRI) study

2009; Elsevier BV; Volume: 10; Issue: 4 Linguagem: Inglês

10.1016/j.jpain.2009.01.116

1528-8447

M. Hadsel, Alexandre Silva de Quevedo, Y. Oshiro, Timothy T. Houle, Jacob Schmidt, Jennifer Stapleton, Robert Kraft, Robert C. Coghill,

Psychosomatic Disorders and Their Treatments

Heart rate (HR) and heart rate variability (HRV) measures in general exhibit great variance during diverse pain related conditions. Brain areas of cardiovascular control have been localized to a central autonomic network (CAN) that encompasses several cognitive-emotional processing regions. The aim of the present study was to elucidate the relationship between inter-individual differences in natural variation in dispositional anxiety in a healthy, non-treatment seeking population (anxiety proneness), perceived acute pain and associated heart rate responses and brain correlates. Employing a block design, we acquired fMRI data from 12 healthy volunteers who were given cutaneous painful heat stimuli. HR was recorded with a pulse-oximeter, and stimulus-related pain intensity and unpleasantness was rated retrospectively on a 0-10 VAS scale. The Anxiety Scale raw scores of the Brief Symptom Inventory® were used to dichotomize the group into anxiety-prone (n = 6) and non-anxious subjects (n = 6). HRV was analyzed with HRV Analysis Software 1.1 (University of Kuopio, Finland). The fMRI analysis was performed with a general linear model, with continuous heart rate as the main regressor and anxiety scores as a covariate. Psychophysical/-metric analyses revealed that anxiety correlated negatively with perceived pain intensity (r = -0.69, p = 0.01) and unpleasantness (r = -0.59, p = 0.05). The anxiety-prone group revealed significantly lower HR and greater HRV (SDNN) during both the stimulus and peri-stimulus periods. HR was associated with activity in several brain areas, some of which were confined to the CAN. Anxiety-specific HR-correlated activations were found in the brainstem, hippocampal and amygdalar regions, while such deactivations were localized to the posterior cingulate cortex, subgenual and mid/dorsal anterior cingulate cortex. Our preliminary results suggest that variability in anxiety-proneness not only contributes to experiential, but also to autonomic effects of acute pain perception, and indicate that brain areas involved in self-referential processing are involved in modulation of the CAN. (Supported by NIH NS39426.) Heart rate (HR) and heart rate variability (HRV) measures in general exhibit great variance during diverse pain related conditions. Brain areas of cardiovascular control have been localized to a central autonomic network (CAN) that encompasses several cognitive-emotional processing regions. The aim of the present study was to elucidate the relationship between inter-individual differences in natural variation in dispositional anxiety in a healthy, non-treatment seeking population (anxiety proneness), perceived acute pain and associated heart rate responses and brain correlates. Employing a block design, we acquired fMRI data from 12 healthy volunteers who were given cutaneous painful heat stimuli. HR was recorded with a pulse-oximeter, and stimulus-related pain intensity and unpleasantness was rated retrospectively on a 0-10 VAS scale. The Anxiety Scale raw scores of the Brief Symptom Inventory® were used to dichotomize the group into anxiety-prone (n = 6) and non-anxious subjects (n = 6). HRV was analyzed with HRV Analysis Software 1.1 (University of Kuopio, Finland). The fMRI analysis was performed with a general linear model, with continuous heart rate as the main regressor and anxiety scores as a covariate. Psychophysical/-metric analyses revealed that anxiety correlated negatively with perceived pain intensity (r = -0.69, p = 0.01) and unpleasantness (r = -0.59, p = 0.05). The anxiety-prone group revealed significantly lower HR and greater HRV (SDNN) during both the stimulus and peri-stimulus periods. HR was associated with activity in several brain areas, some of which were confined to the CAN. Anxiety-specific HR-correlated activations were found in the brainstem, hippocampal and amygdalar regions, while such deactivations were localized to the posterior cingulate cortex, subgenual and mid/dorsal anterior cingulate cortex. Our preliminary results suggest that variability in anxiety-proneness not only contributes to experiential, but also to autonomic effects of acute pain perception, and indicate that brain areas involved in self-referential processing are involved in modulation of the CAN. (Supported by NIH NS39426.)