Pain can be conditioned to voluntary movements through associative learning: an experimental study in healthy participants

Rafael Krasic Alaiti*, Pedro Fonseca Zuccolo, Maria Helena Leite Hunziker, J P Caneiro, Johan W.S. Vlaeyen, Marcelo Fernandes da Costa

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)
81 Downloads (Pure)

Abstract

Experimental data suggest that associative learning can influence defensive avoidance behavior and pain perception in humans. However, whether voluntary movements can become conditioned stimuli (CSs) and influence pain responses is yet to be evaluated. Forty healthy volunteers participated in this study. Electrocutaneous stimuli applied to the shoulder at pain threshold level (UStest) and at pain tolerance level (US) were determined before a movement-conditioning paradigm. First, reaching movements to visual cues shown on one side of a computer screen were associated with the US (CS+ movements) on 80% of trials, whereas reaching movements to visual stimuli shown on the other side were never associated with the nociceptive-US (CS- movements). Next, participants underwent a test phase in which movements to visual cues on both sides were paired with the US(test)on 50% of trials. During the test phase, participants were asked to evaluate whether the movement was painful (yes/no) and to rate pain intensity after each trial. Movement onset and duration as well as skin conductance responses were collected. The US(test)stimuli were more likely to be perceived as painful and were also rated as more painful during CS+ movements. Movement onset latency and skin conductance responses were significantly higher in anticipation of the CS+ movement as compared to the CS- movement. These findings suggest that pain can be conditioned to voluntary movements.

Original languageEnglish
Pages (from-to)2321-2329
Number of pages9
JournalPain
Volume161
Issue number10
Early online date11 May 2020
DOIs
Publication statusPublished - Oct 2020

Keywords

  • Pain
  • Associative learning
  • Pain conditioning
  • Classic conditioning
  • Pavlovian conditioning
  • CHRONIC MUSCULOSKELETAL PAIN
  • FEAR-AVOIDANCE MODEL
  • ACQUISITION
  • THRESHOLDS
  • EXERCISE
  • REINSTATEMENT
  • HYPOALGESIA
  • EXTINCTION
  • EXPECTANCY
  • MODULATION

Cite this