The role of working memory in the attentional control of pain

Attention is acknowledged as an important factor in the modulation of pain. A recent model proposed that an effective control of pain by attention should not only involve the disengagement of selective attention away from nociceptive stimuli, but should also guarantee that attention is maintained on the processing of pain-unrelated information without being recaptured by the nociceptive stimuli. This model predicts that executive functions are involved in the control of selective attention by preserving goal priorities throughout the achievement of cognitive activities. In the present study, we tested the role of working memory in the attentional control of nociceptive stimuli. In the control condition, participants had to discriminate the color of visually presented circles preceded by tactile distracters. In some trials (20%), tactile stimuli were replaced by novel nociceptive distracters in order to manipulate the attentional capture. In the working memory condition, participants had to respond to the visual stimulus presented one trial before, and were thus required to maintain the color of the visual stimulus in working memory during the entire inter-trial time interval. Results showed that, while novel nociceptive stimuli induced greater distraction than regular tactile stimuli in the control condition, the distractive effect was suppressed in the working memory condition. This suggests that actively rehearsing the feature of pain-unrelated and task-relevant targets successfully prevents attention from being captured by novel nociceptive distracters, independently of general task demands. Working memory can help to inhibit the involuntary capture of attention by pain by preserving cognitive goal priorities.