The neural correlates of pain-related fear: A meta-analysis comparing fear conditioning studies using painful and non-painful stimuli

Emma E. Biggs*, Inge Timmers, Ann Meulders, Johan W.S. Vlaeyen, Rainer Goebel, Amanda L. Kaas

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

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Abstract

Compared to the field of anxiety research, the use of fear conditioning paradigms for studying chronic pain is relatively novel. Developments in identifying the neural correlates of pain-related fear are important for understanding the mechanisms underlying chronic pain and warrant synthesis to establish the state-of-the-art. Using effect-size signed differential mapping, this meta-analysis combined nine MRI studies and compared the overlap in these correlates of pain-related fear to those of other non-pain-related conditioned fears (55 studies). Pain-related fear was characterized by neural activation of the supramarginal gyrus, middle temporal gyrus, inferior/middle frontal gyri, frontal operculum and insula, pre-/post-central gyri, medial frontal and (para-)cingulate cortex, hippocampus, thalamus, and putamen. There were differences with other non-pain-related conditioned fears, specifically in the inferior frontal gyrus, medial superior frontal gyrus, post-central gyrus, middle temporal gyrus, parieto-occipital sulcus, and striatum. We conclude that pain-related and non-pain-related conditioned fears recruit overlapping but distinguishable networks, with potential implications for understanding the mechanisms underlying different psychopathologies.

Original languageEnglish
Pages (from-to)52-65
Number of pages14
JournalNeuroscience and Biobehavioral Reviews
Volume119
Early online date1 Oct 2020
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Pain
  • Fear
  • Conditioning
  • Meta-analysis
  • Magnetic resonance imaging
  • Chronic pain
  • PRIMARY SOMATOSENSORY CORTEX
  • VENTROMEDIAL PREFRONTAL CORTEX
  • MOVEMENT-RELATED PAIN
  • INDIVIDUAL-DIFFERENCES
  • MUSCULOSKELETAL PAIN
  • AMYGDALA ACTIVATION
  • COGNITIVE CONTROL
  • ANXIETY DISORDER
  • AVOIDANCE MODEL
  • VISCERAL PAIN

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