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Related Experiment Video

Updated: Jul 12, 2025

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Longitudinal changes in human supraspinal processing after RIII-feedback training to improve descending pain

Philipp Graeff1, Ruth Ruscheweyh2, Virginia L Flanagin3

  • 1Research Training Group (RTG) 2175 perception in Context and Its Neural Basis, Ludwig-Maximilians-University Munich, 82152 Planegg, Germany; Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University Munich, 82152 Planegg, Germany.

Neuroimage
|November 1, 2023
PubMed
Summary

Positive mental imagery and feedback training enhance the body's natural pain control system. This study reveals how these techniques activate brain regions for pain inhibition and reduce pain processing, offering new insights into pain modulation.

Keywords:
Cognitive strategyFeedback trainingPainPain modulation

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Area of Science:

  • Neuroscience
  • Pain Research
  • Psychophysiology

Background:

  • The human body modulates pain via descending pain inhibition, originating supraspinally.
  • Positive mental imagery is a known activator of this inhibition, but its mechanisms are unclear.

Purpose of the Study:

  • To investigate brain activity during pain modulation using positive mental imagery and a feedback paradigm.
  • To elucidate the neural mechanisms underlying descending pain inhibition.

Main Methods:

  • Longitudinal functional magnetic resonance imaging (fMRI) design.
  • Application of positive mental imagery before and after a RIII-feedback paradigm.
  • Analysis of brain activity preceding and during painful electrical stimulation.

Main Results:

  • Increased activity in prefrontal cortex (PFC), anterior cingulate cortex (ACC), insula, thalamus, and hypothalamus preceding stimulation.
  • Decreased reaction to painful stimuli post-training in the brainstem, thalamus, insula, and dorsolateral PFC.
  • Evidence suggests enhanced pain inhibition and reduced pain processing.

Conclusions:

  • Feedback training amplifies activity in pain inhibition areas and reduces responses in pain processing areas.
  • This points to activation of decreased spinal nociception.
  • The insula and thalamus may be more critical in pain modulation than previously understood.