Highlights
- •We induced a classical conditioning effect of a specific location on pain expectancy.
- •The increase in pain expectancy generalized to nearby, novel locations.
- •Rendering visual input imprecise during acquisition (training) resulted in greater pain expectancies, but did not change generalization.
- •Extinction of pain expectancy did not occur when visual input during training was imprecise.
Abstract
We tested the hypotheses that rendering sensory input about hand location imprecise
increases a classically conditioned pain expectancy effect, increases generalization
of the effect to novel locations and reduces extinction of the effect. Forty healthy
volunteers performed movements with their right hand along predefined paths. Each
path passed through 2 locations that were defined as either i) the conditioned stimulus
(CS+; paired with a painful unconditioned stimulus), or ii) unpaired (CS−). During
acquisition phase, participants watched their hand as they moved it. Participants
were randomly allocated to an Imprecise group, for whom visual feedback of the hand
was offset 30 to 50 mm from its true location, or a Precise group, for whom vision
was not disrupted. In the test phase, participants moved their hands to 5 locations—the
CS+, CS−, and 3 locations that lay between the 2 (“generalization stimuli”). Our primary
hypothesis was supported—pain expectancy was greater at the CS+ location in the Imprecise
group than in the Precise group (6.9 [SD = 1.9] vs 5.4 [SD = 2.5], P= .02). Pain expectancies generalized to novel locations similarly in both groups
and there was no difference in extinction between groups. Our primary hypothesis was
supported but our subsequent hypotheses were not.
Perspective
We conditioned pain expectancy at a certain location of one hand, even though most
participants were unaware of the contingency. Conditioned pain expectancy was greater
when sensory information about location was less precise. This adds support to the
possibility that associative learning may play a role in the progression of an acute
pain episode to a more generalized pain disorder.
Key words
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Article info
Publication history
Published online: January 29, 2021
Accepted:
January 3,
2021
Received in revised form:
November 27,
2020
Received:
August 14,
2020
Footnotes
T.C.C. was supported by FAPESP (São Paulo Research Foundation) - grant process 2016/15365-2. T.R.S. was supported by Career Development Fellowship from the National Health & Medical Research Council of Australia ID 1141735. B.W.P.’s PhD is supported by a University President's Scholarship (University of South Australia). V.J.M. is supported by an Innovation postdoctoral research fellowship from the National Research Foundation of South Africa. G.L.M. is supported by a Leadership Investigator Grant from the National Health & Medical Research Council of Australia ID 1178444.
T.R.S. received support from Eli Lilly Ltd for travel expenses; this is unrelated to the present topic. B.W.P. has received personal fees for scientific writing for Cosmos Magazine, and honoraria from Elsevier for contributing to a textbook on an unrelated subject. He is a volunteer for PainChats LLC., and for Pain Revolution. V.J.M. receives speakers’ fees for talks on pain and rehabilitation. R.N. and T.C.C. discloses no conflict of interest. G.L.M. has received support from Reality HealthÓ, ConnectHealthÓ UK, AIA Australia, SwissRe, Gallagher Bassett, Kaiser Permanente, Workers' Compensation Boards in Australia, Europe and North America, the International Olympic Committee, Port Adelaide Football Club, Arsenal Football Club, Pfizer, Seqirus and various professional organisations and learned societies. He receives royalties for several books on pain and speakers’ fees for talks on pain and rehabilitation.
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© 2021 by United States Association for the Study of Pain, Inc.
