Starts:

Thursday, September 22nd
10:45am-12:15pm EDT

Category:

Topical Workshop

Tracks:

Mechanisms

Room

713 B

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Translational Evidence for Pain-Cognition Interactions: Insights from Laboratory Animal, Human Experimental and Clinical Studies

Pain perception is not linearly related to nociceptive input, but is subject to many modulatory factors including cognitive processes (e.g. catastrophizing, perceived self-efficacy and distraction). Pain is not only shaped by cognitive processes, pain also interferes with cognition. Patients with chronic pain report cognitive deficits, further reducing their quality of life. Acute pain also interferes with cognition, affecting task performance, decision-making, and learning. This workshop will review pain-cognition interactions in (1) laboratory animal models, (2) acute/experimental pain models in healthy individuals, and (3) people with chronic pain. The presentation of work in animal models will focus on the modulatory effects of distraction and fear-related learning on pain-related behavior in rodents, evidence for cognitive impairment in rodent models of chronic pain, and the neurobiological mechanisms underlying these phenomena, focusing on the endocannabinoid system. Next, individual differences in the effects of pain on human cognition will be discussed focusing on value-based resource competition, and the underlying brain circuitry. Last, we will discuss effects of chronic pain on decision-making and learning using a computational approach, focusing on dopaminergic systems. Together, we will discuss cross-species evidence and the neurobiology of pain-cognition interactions. These data will help improve the efficacy of cognitive interventions for pain.

Presentations

Time
10:45am EDT–12:15pm EDT

Mechanisms of Pain-Related Decision-Making, Prediction Errors, and Learning in Acute and Chronic Pain

Tracks: Mechanisms
Categories: Topical Workshop
Presented By: Susanne Becker

Daily life requires constant decision-making, with some decisions having strong effects on quality of life and well-being. Cognitive capabilities, including cognitive flexibility, as basic elements needed for decision-making are impaired in patients with chronic pain. Such impaired decision-making can also result in impaired learning. In addition to effects of long-term pain on cognition, cognition can strongly modulate how pain is perceived, indicating bidirectional and reciprocal effects. Despite this knowledge, the mechanisms underlying the interaction decision-making and related learning and pain remain largely unknown. Dr. Becker will present results on the role of the neurotransmitter dopamine in prediction errors during pain-related decision making and the association of such prediction errors with reward-induced pain inhibition based on computational reinforcement learning models. She will present novel data  on alterations in pain-related decision-making in patients with fibromyalgia and chronic back pain. In particular, she will discuss findings of altered learning related to prediction-errors in chronic pain, and how these can be captured by computational models. She will further discuss the neural underpinnings of these behavioural findings, and their relationship to clinical pain characteristics.

10:45am EDT–12:15pm EDT

Pain-Cognition Interactions in Healthy Individuals: Evidence for a Rewards-Based Resource Competition

Tracks: Mechanisms
Categories: Topical Workshop
Presented By: Dr. Massieh Moayedi

Pain can interfere with cognitive processes, resulting in forgetfulness, inability to focus, and difficulties in abstract thinking, problem solving and decision-making. A fundamental gap in our understanding is the mechanism of this interference, which would serve as a therapeutic target for pain. Prevailing models of this interference rely on distraction or salience competition, but these do not adequately fit behavioural data. Our imaging studies reveal a potentially different mechanism for this interaction. Specifically, the frontal polar cortex has abnormal structure and function in chronic pain. The frontal pole is implicated in cognitive branching –the ability to select a task based on its perceived value while tracking the perceived value of a competing task. Based on these findings, we propose that pain competition is not distraction or salience based, but is value-based. We performed an experiment that controls for salience, while testing the value-based framework. We show novel data supporting this concept: painful stimuli, but not salience-matched somatosensory stimuli, adversely affect task performance on a low-value, but not a high-value task. This indicates that value, and not salience, drive priority of task versus pain selection. In sum, we provide evidence for a value-based model of pain-cognition interactions in the human brain.

10:45am EDT–12:15pm EDT

Reciprocal Interactions Between Pain and Cognition: Role of the Endocannabinoid System

Tracks: Mechanisms
Categories: Topical Workshop
Presented By: Prof. David Finn

This presentation will focus largely on rodent studies of reciprocal pain-cognition interactions, and how they have informed our understanding of the underlying neurobiological sites and mechanisms, with a particular emphasis on the endocannabinoid system. Dr. Finn will present an overview of studies demonstrating altered cognition-related behaviour in rodent models of pain, and also how cognition-related phenomena such as distraction and fear-learning modulate nociceptive behaviour in rodents. He will present evidence for a role of the endocannabinoid system in pain-cognition interactions, and further expand on related signalling systems and brain circuitry that may be involved.

Presenters

Susanne Becker

Professor for Clinical Psychology
Heinrich Heine University Duesseldorf

Prof. David Finn

Professor and Head of Pharmacology and Therapeutics, Co-Director of the Centre for Pain Research
National University of Ireland Galway

Dr. Massieh Moayedi

Assistant Professor
University of Toronto