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Reduction of Pain and Spinal Nociceptive Transmission by Working Memory is Load Dependant

  • Zoha Deldar
    Affiliations
    Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada

    CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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  • Isabelle Blanchette
    Affiliations
    Department of Psychology, Université Laval, Québec, QC, Canada
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  • Mathieu Piché
    Correspondence
    Address reprint requests to Mathieu Piché, DC, PhD, Department of Anatomy, Université du Québec à Trois-Rivières, 3351 boul. des Forges, C.P. 500, Trois-Rivières, Québec G9A 5H7, Canada.
    Affiliations
    Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada

    CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
    Search for articles by this author
Published:February 09, 2021DOI:https://doi.org/10.1016/j.jpain.2021.02.001

      Highlights

      • Pain was reduced by WM engagement and more so for high WM load.
      • This effect partly depended on descending pathways, as indicated by NFR inhibition.
      • Increasing WM load increased this effect, but only to a certain point.
      • Beyond this point, additional load was not more effective.

      Abstract

      Working memory (WM) engagement produces pain inhibition. However, it remains unclear whether higher WM load increases this effect. The aim of this study was to investigate the interaction between WM load and pain inhibition by WM and examine the contribution of cerebrospinal mechanism. Thirty-eight healthy volunteers were assigned to one of 2 n-back groups for which WM load was different (2-back or 3-back). The experimental protocol comprised 5 counterbalanced conditions (0-back, n-back, pain, 0-back with pain, and n-back with pain). Pain and the nociceptive flexion reflex (NFR) were evoked by transcutaneous electrical stimulation of the sural nerve. Pain was significantly different between conditions, but not between n-back groups. Both the 0-back and n-back tasks reduced pain compared with pain alone, but the n-back task produced stronger pain inhibition compared with the 0-back task. NFR amplitude was significantly different between conditions but not between n-back groups. NFR was inhibited by the 0-back and n-back tasks, with no difference between the 2 tasks. These findings indicate that pain inhibition by WM is increased by WM load, but only to a certain point. NFR inhibition by WM suggests that inhibition of pain by WM depends, at least in part, on cerebrospinal mechanism.

      Perspective

      This behavioral and electrophysiological study shows that engaging in a cognitive task reduces pain by decreasing spinal nociceptive transmission, depending on task difficulty. These findings may yield better nonpharmacological pain therapies based on individual differences in working memory performance and capacity as well as several factors that regulate working memory.

      Key Words

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