Abstract
Sex differences in pain perception are still poorly understood, but they may be related
to the way the brains of men and women respond to the affective dimensions of pain.
Using a matched pain intensity paradigm, where pain intensity was kept constant across
participants but pain unpleasantness was left free to vary among participants, we
studied the relationship between pain unpleasantness and pain-evoked brain activity
in healthy men and women separately. Experimental pain was provoked using transcutaneous
electrical stimulation of the sural nerve while pain-related brain activity was measured
using somatosensory-evoked brain potentials with source localization. Cardiac responses
to pain were also measured using electrocardiac recordings. Results revealed that
subjective pain unpleasantness was strongly associated with increased perigenual anterior
cingulate cortex activity in women, whereas it was strongly associated with decreased
ventromedial prefrontal cortex activity in men. Only ventromedial prefrontal cortex
deactivations in men were additionally associated with increased autonomic cardiac
arousal. These results suggest that in order to deal with pain's objectionable properties,
men preferentially deactivate prefrontal suppression regions, leading to the mobilization
of threat-control circuits, whereas women recruit well-known emotion-processing areas
of the brain.
Perspective
This article presents neuroimaging findings demonstrating that subjective pain unpleasantness
ratings are associated with different pain-evoked brain responses in men and women,
which has potentially important implications regarding sex differences in the risk
of developing chronic pain.
Key words
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Article info
Publication history
Published online: May 30, 2014
Accepted:
May 20,
2014
Received in revised form:
May 7,
2014
Received:
July 30,
2013
Footnotes
This work was supported by grants from the Fonds de Recherche du Québec - Santé (P.G.), the Canada Chair program (K.W.) and the Natural Sciences and Engineering Research Council of Canada of Canada (K.W. and P.G.).
The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
