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Chronic pain - A maladaptive compensation to unbalanced hierarchical predictive processing.
Jorge Castejón1, Feifan Chen2, Anusha Yasoda-Mohan3
1Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, Ireland; Senior MSK Physiotherapist CompassPhysio LTD, Ireland.
Neuroimage
|June 28, 2024
Summary
Chronic pain (CP) impairs the brain's ability to adapt by disrupting predictive processing. This study shows CP leads to heightened local and reduced global deviance in auditory processing, suggesting maladaptive learning.
Area of Science:
- Neuroscience
- Cognitive Science
- Pain Research
Background:
- Chronic pain (CP) hinders environmental adaptation, unlike acute pain.
- CP may result from maladaptive sensory predictive processing, affecting forward model updating.
- Hierarchical rule learning and irregularity processing are crucial for adaptation.
Purpose of the Study:
- To investigate how chronic pain impacts hierarchical learning using a local-global oddball paradigm.
- To examine prediction error (PE) processing in individuals with CP compared to healthy controls.
- To explore the relationship between altered auditory processing and subjective pain perception.
Main Methods:
- Utilized the local-global oddball paradigm to assess hierarchical learning and prediction error processing.
- Compared brain responses (theta phase locking) in chronic pain patients and healthy controls.
- Analyzed stimulus-driven and context-driven prediction errors in auditory stimuli.
Main Results:
- Chronic pain patients exhibited increased local deviance and decreased global deviance in stimulus-driven PEs.
- Altered theta phase locking correlated with subjective pain intensity.
- No significant differences were found in context-driven PEs between groups.
- Dampened attention-related responses may explain changes in global deviance.
Conclusions:
- Chronic pain is associated with maladaptive forward model updating, disrupting processing in non-nociceptive domains.
- Altered auditory processing in CP may indicate domain-general neural dysfunction.
- The identified auditory-based biomarker warrants further investigation for diagnostic potential.
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