Cognitive and Affective Neuroscience Lab
Dartmouth College
“Clinician-patient movement synchrony mediates social group effects on interpersonal trust and perceived pain”
Our new study published in the Journal of Pain suggests that interpersonal movement synchrony between the patient and the provider could mediate concordance effects on trust in the clinician and reduce the pain perceived by the patient. Continue reading “Can interpersonal synchrony enhance patient-provider interaction outcomes?”
“Discovery and validation of biomarkers to aid the development of safe and effective pain therapeutics: challenges & opportunities”
In 2018, the NIH-led Discovery and Validation of Biomarkers to Develop Non-Addictive Therapeutics for Pain workshop convened scientific leaders from academia, industry, government and patient advocacy groups to discuss progress, challenges, gaps and ideas to facilitate the development of biomarkers and end points for pain. The outcomes of this workshop are outlined in this Consensus Statement.
“Inferring the infant pain experience: a translational fMRI-based signature study”
This study translates validated adult pain fMRI brain signatures to a nonverbal patient population in which the assessment and management of pain presents a significant clinical challenge. Here we demonstrate that the basic encoding of the sensory discriminative aspects of pain, as represented by the Neurologic Pain Signature (NPS), occurs in both adults and infants, whereas higher-level cognitive modulation of pain, represented by the Stimulus Intensity Independent Pain Signature (SIIPS1) is only present in adults and not observed in infants. This work allows us to use quantitative fMRI observations to make stronger inferences related to pain experience in nonverbal infants. Continue reading “A novel approach that could advance the discovery and assessment of analgesic interventions in infancy”
The new study, “Multiple Brain Networks Mediating Stimulus–Pain Relationships in Humans”, published in the journal of Cerebral Cortex suggests a new high-dimensional mediation analysis technique to estimate distributed, network-level patterns that formally mediate the relationship between stimulus intensity and pain.
“Neural and Sociocultural Mediators of Ethnic Differences in Pain”
The common belief that African Americans feel less pain has been related to undertreatment of pain in this ethnic group, which contributes to widespread and persistent racial and ethnic health disparities. Paradoxically, African Americans actually report more pain than White Americans in both clinical and laboratory settings. In this study, we examined nociceptive sensitivity by looking at the activity in brain regions previously linked to nociception in whole-brain analyses and tested responses in a multivariate fMRI activity pattern that closely tracks the intensity and affect of evoked nociceptive pain, termed the neurologic pain signature (NPS). Our findings suggest that the link between chronic pain and ethnic differences in pain sensitivity may lie in the chronic stress associated with discrimination.
“Let it be: Mindful-acceptance down-regulates pain and negative emotion”
Behavioral studies have shown that mindfulness- or acceptance-based treatments ameliorate depression, anxiety, addiction, and chronic pain; improve functionality and quality of life in cancer and other conditions. Brain imaging studies have examined individuals who were trained or regularly engage in mindfulness meditation. While promising, such studies do not directly address the use of mindful acceptance as an emotion regulation strategy in individuals who do not practice meditation, and findings could depend on cumulative effects of training or characteristics of individuals who seek it. We addressed this using functional magnetic resonance imaging (fMRI) and adapting a well-established emotion regulation task to assess the effects of mindful acceptance on affective and neural responses in meditation-naïve adults. Identifying and understanding the mechanisms supporting such strategies could lead to improved treatments for emotionally vulnerable populations.
“Different brain networks mediate the effects of social and conditioned expectations on pain”
Beliefs and expectations shape human experience and behavior in many important ways. Expectations could be based on what we have learned from our own prior experience, via classical conditioning or other forms of associative learning or they can stem from secondary sources, such as what others tell us about their experiences. However, it remains unclear whether similar or different neural systems mediate direct experience-driven and vicarious influences. In this study, we used fMRI to dissociate the brain mediators of social influence and associative learning effects on pain and observed that social information and conditioned stimuli each had significant effects on pain ratings, and both effects were mediated by self-reported expectations. Yet, these effects were mediated by largely separable brain activity patterns, involving different large-scale functional networks. These results show that learned versus socially instructed expectations modulate pain via partially different mechanisms—a distinction that should be accounted for by theories of predictive coding and related top-down influences.