Highlights
- •Transcranial stimulation of the prefrontal cortex altered spinal nociception.
- •Reducing neural excitability abolished emotional control of spinal nociception
- •Emotional modulation of pain ratings was not impacted by brain stimulation
- •Reducing neural excitability increased spinal nociception and pain ratings.
Abstract
Emotion has a strong modulatory effect on pain perception and spinal nociception.
Pleasure inhibits pain and nociception, whereas displeasure facilitates pain and nociception.
Dysregulation of this system has been implicated in development and maintenance of
chronic pain. The current study sought to examine whether emotional modulation of
pain could be altered through the use of transcranial direct current stimulation (tDCS)
to enhance (via anodal stimulation) or depress (via cathodal stimulation) cortical
excitability in the dorsolateral prefrontal cortex. Thirty-two participants (15 female,
17 male) received anodal, cathodal, and sham tDCS on three separate occasions, followed
immediately by testing to examine the impact of pleasant and unpleasant images on
pain and nociceptive flexion reflex (NFR) responses to electrocutaneous stimulation.
Results indicated that tDCS modulated the effect of image content on NFR, F(2, 2175.06) = 3.20, P= .04, with the expected linear slope following anodal stimulation (ie, pleasant <
neutral < unpleasant) but not cathodal stimulation. These findings provide novel evidence
that the dorsolateral prefrontal cortex is critical to emotional modulation of spinal
nociception. Moreover, the results suggest a physiological basis for a previously
identified phenotype associated with risk for chronic pain and thus a potentially
new target for chronic pain prevention efforts.
Perspective
This study demonstrated that reduction of dorsolateral prefrontal cortical excitability
by transcranial direct current stimulation attenuates the impact of emotional image
viewing on nociceptive reflex activity during painful electrocutaneous stimulation.
This result confirms there is cortical involvement in emotional modulation of spinal
nociception and opens avenues for future clinical research.
Key words
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Article info
Publication history
Published online: November 27, 2020
Accepted:
October 17,
2020
Received in revised form:
September 28,
2020
Received:
June 9,
2020
Footnotes
Disclosures: This study was funded by an Ohio University Student Enhancement Award that was awarded to P.M. Slepian.
The authors have no financial or other relationship that might lead to a conflict of interest.
Identification
Copyright
© 2020 by United States Association for the Study of Pain, Inc.
