Predicting Value of Pain and Analgesia: Nucleus Accumbens Response to Noxious Stimuli Changes in the Presence of Chronic Pain

Marwan N. Baliki, Paul Y. Geha, Howard L. Fields, A. Vania Apkarian*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

319 Scopus citations

Abstract

We compared brain activations in response to acute noxious thermal stimuli in controls and chronic back pain (CBP) patients. Pain perception and related cortical activation patterns were similar in the two groups. However, nucleus accumbens (NAc) activity differentiated the groups at a very high accuracy, exhibiting phasic and tonic responses with distinct properties. Positive phasic NAc activations at stimulus onset and offset tracked stimulus salience and, in normal subjects, predicted reward (pain relief) magnitude at stimulus offset. In CBP, NAc activity correlated with different cortical circuitry from that of normals and phasic activity at stimulus offset was negative in polarity, suggesting that the acute pain relieves the ongoing back pain. The relieving effect was confirmed in a separate psychophysical study in CBP. Therefore, in contrast to somatosensory pathways, which reflect sensory properties of acute noxious stimuli, NAc activity in humans encodes its predicted value and anticipates its analgesic potential on chronic pain. Video Abstract:

Original languageEnglish (US)
Pages (from-to)149-160
Number of pages12
JournalNeuron
Volume66
Issue number1
DOIs
StatePublished - Apr 2010

Keywords

  • Humdisease
  • Sysneuro

ASJC Scopus subject areas

  • Neuroscience(all)

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