Publication

Multiple faces of pain: effects of chronic pain on the brain regulation of facial expression

Vachon-Presseau, E., Roy, M., Woo, C-W., Kunz, M., Martel, M-O., Sullivan, M. J., Jackson, P. L., Wager, T. D. & Rainville, P., Aug-2016, In : Pain. 157, 8, p. 1819-1830 12 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Etienne Vachon-Presseau
  • Mathieu Roy
  • Choong-Wan Woo
  • Miriam Kunz
  • Marc-Olivier Martel
  • Michael J. Sullivan
  • Philip L. Jackson
  • Tor D. Wager
  • Pierre Rainville

Pain behaviors are shaped by social demands and learning processes, and chronic pain has been previously suggested to affect their meaning. In this study, we combined functional magnetic resonance imaging with in-scanner video recording during thermal pain stimulations and use multilevel mediation analyses to study the brain mediators of pain facial expressions and the perception of pain intensity (self-reports) in healthy individuals and patients with chronic back pain (CBP). Behavioral data showed that the relation between pain expression and pain report was disrupted in CBP. In both patients with CBP and healthy controls, brain activity varying on a trial-by-trial basis with pain facial expressions was mainly located in the primary motor cortex and completely dissociated from the pattern of brain activity varying with pain intensity ratings. Stronger activity was observed in CBP specifically during pain facial expressions in several nonmotor brain regions such as the medial prefrontal cortex, the precuneus, and the medial temporal lobe. In sharp contrast, no moderating effect of chronic pain was observed on brain activity associated with pain intensity ratings. Our results demonstrate that pain facial expressions and pain intensity ratings reflect different aspects of pain processing and support psychosocial models of pain suggesting that distinctive mechanisms are involved in the regulation of pain behaviors in chronic pain.

Original languageEnglish
Pages (from-to)1819-1830
Number of pages12
JournalPain
Volume157
Issue number8
Publication statusPublished - Aug-2016
Externally publishedYes

    Keywords

  • Chronic pain, Facial expression, fMRI, Frontal cortex, Pain behaviors, EMOTIONAL EXPERIENCE, REWARD CIRCUITRY, BACK-PAIN, CORTEX, CONNECTIVITY, MODULATION, MEDIATORS, SIGNATURE, STIMULI

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