Transforming pain with prosocial meaning: an fMRI study.

Psychosom Med. 2018 May 24;:

Authors: López-Solà M, Koban L, Wager TD

Abstract
OBJECTIVES: Contextual factors can transform how we experience pain, particularly if pain is associated with other positive outcomes. Here we test a novel meaning-based intervention: Participants were given the opportunity to choose to receive pain on behalf of their romantic partners, situating pain experience in a positive, prosocial meaning context. We predicted that the ventromedial prefrontal cortex (vmPFC), a key structure for pain regulation and generation of affective meaning, would mediate the transformation of pain experience by this prosocial interpersonal context.
METHODS: We studied fMRI activity and behavioral responses in 29 heterosexual female participants during (1) a baseline pain challenge and (2) a task in which participants decided to accept a self-selected number of additional pain trials in order to reduce pain in their male romantic partners ("Accept Partner-Pain" condition).
RESULTS: Enduring extra pain for the benefit of the romantic partner reduced pain-related unpleasantness (t=-2.54,p=.016) but not intensity, and increased positive thoughts (t=3.60,p=.001) and pleasant feelings (t=5.39,p<.0005). Greater willingness to accept one's partner pain predicted greater unpleasantness reductions (t=3.94,p=.001) and increases in positive thoughts (r=.457,p=.013). The vmPFC showed significant increases (q<.05 FDR-corrected) in activation during Accept-Partner-Pain, especially for women with greater willingness to relieve their partner's pain (t=2.63, p=.014). Reductions in brain regions processing pain and aversive emotion significantly mediated reductions in pain unpleasantness (q<.05 FDR-corrected).
CONCLUSIONS: The vmPFC has a key role in transforming the meaning of pain, which is associated with a cascade of positive psychological and brain effects, including changes in affective meaning, value, and pain-specific neural circuits.

PMID: 29846310 [PubMed - as supplied by publisher]