Background
Depressed mood alters the pain experience. Yet, despite its clear clinical relevance,
little is known about the cognitive and neural mechanisms underlying this phenomenon.
We tested an experimental manipulation to unravel the interaction between depressed
mood and pain. We hypothesized that dysregulation of the neural circuitry underlying
emotion regulation is the mechanism whereby pain processing is affected during depressed
mood.
Methods
Using functional magnetic resonance imaging, we compared the effects of sad and neutral
cognitive mood inductions on affective pain ratings, pain-specific cognitions, and
central pain processing of a tonic noxious heat stimulus in 20 healthy volunteers.
Results
The increase in negative pain-specific cognitions during depressed mood predicted
the perceived increase in pain unpleasantness. Following depressed mood induction,
brain responses to noxious thermal stimuli were characterized by increased activity
in a broad network including prefrontal areas, subgenual anterior cingulate cortex,
and hippocampus, as well as significantly less deactivation when compared with pain
responses in a neutral mood. The participants who reported the largest increase in
pain unpleasantness after the sad mood induction showed greater inferior frontal gyrus
and amygdala activation, linking changes in emotion regulation mechanisms with enhancement
of pain affect.
Conclusions
Our results inform how depressed mood and chronic pain co-occur clinically and may
serve to develop and translate effective interventions using pharmacological or psychological
treatment.
Key Words
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Article info
Publication history
Published online: March 19, 2010
Accepted:
January 10,
2010
Received in revised form:
January 7,
2010
Received:
June 27,
2009
Identification
Copyright
© 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
