Is my pain your pain? How we perceive pain varies strongly –not only between people, but interestingly also within a person. For example, people often report less pain in the mornings compared to evenings and pain is typically perceived as less intense and less unpleasant when we are distracted, for example, by an exciting football match or a movie. While peripheral biological factors, such as hormones, autonomic arousal, sensitivity of nociceptive sensors cause some of this variation, a large amount of this variation is mediated by central and psychological processes. One of the most impressive examples of such processes is placebo analgesia. Without any external modulation or influence, the mind causes strong endogenous inhibition of perceived pain. This inhibition is induced by only the expectation of reduced pain and learning. Importantly, such psychological pain modulation is not just a response bias or an experimental artefact. Corresponding changes in brain activation and functional networks have been found and often replicated. Here, I will introduce the phenomenon of psychological pain modulation mediated by central processing. Specifically, I will give an overview of brain mechanisms underlying the modulation of perceived pain, focusing on the examples of endogenous pain modulation induced by reward and perceived pain un-/controllability. Further, I will introduce new approaches that use multivariate brain activation signatures to create patterns that allow sensitive and specific tracking of perceive changes in pain. Such methods have been discussed as objective measurements of subjective pain perception and even as biomarkers of pain. This hotly debated topic will be critically examined, particularly in the light of known strong variations of pain perception between and within people.

Acknowledgements

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References

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