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Healthcare 2016, 4(3), 54;

Enhanced Brain Responses to Pain-Related Words in Chronic Back Pain Patients and Their Modulation by Current Pain

Department of Biological and Clinical Psychology, Friedrich Schiller University of Jena, Am Steiger 3, Haus 1, Jena D-07743, Germany
Section of Neurological Rehabilitation, Hans–Berger Department of Neurology at Jena University Hospital, Erlanger Allee 101, Jena D-07747, Germany
Department of Sports Medicine and Health Promotion, Friedrich Schiller University of Jena, Wöllnitzer Str. 42, Jena D-07749, Germany
These authors contributed equally to this work.
Author to whom correspondence should be addressed.
Academic Editor: Robert J. Gatchel
Received: 14 April 2016 / Revised: 15 July 2016 / Accepted: 1 August 2016 / Published: 10 August 2016
(This article belongs to the Special Issue Low Back Pain: Recent Advances And Perspectives)
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Previous functional magnetic resonance imaging (fMRI) studies in healthy controls (HC) and pain-free migraine patients found activations to pain-related words in brain regions known to be activated while subjects experience pain. The aim of the present study was to identify neural activations induced by pain-related words in a sample of chronic back pain (CBP) patients experiencing current chronic pain compared to HC. In particular, we were interested in how current pain influences brain activations induced by pain-related adjectives. Subjects viewed pain-related, negative, positive, and neutral words; subjects were asked to generate mental images related to these words during fMRI scanning. Brain activation was compared between CBP patients and HC in response to the different word categories and examined in relation to current pain in CBP patients. Pain-related words vs. neutral words activated a network of brain regions including cingulate cortex and insula in subjects and patients. There was stronger activation in medial and dorsolateral prefrontal cortex (DLPFC) and anterior midcingulate cortex in CPB patients than in HC. The magnitude of activation for pain-related vs. negative words showed a negative linear relationship to CBP patients’ current pain. Our findings confirm earlier observations showing that pain-related words activate brain networks similar to noxious stimulation. Importantly, CBP patients show even stronger activation of these structures while merely processing pain-related words. Current pain directly influences on this activation. View Full-Text
Keywords: chronic back pain; semantic processing; current pain; fMRI chronic back pain; semantic processing; current pain; fMRI

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Ritter, A.; Franz, M.; Puta, C.; Dietrich, C.; Miltner, W.H.R.; Weiss, T. Enhanced Brain Responses to Pain-Related Words in Chronic Back Pain Patients and Their Modulation by Current Pain. Healthcare 2016, 4, 54.

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