2018 John J. Bonica Fellowship Award
Expectation, the subjective correlate of prediction, exerts powerful control over perceived pain intensity. Because pain is a powerful motivational force, predictions of future pain intensity contribute to behavioral choice, particularly when there is a concurrent conflicting motivation (e.g. feeding). If the decision is to respond to pain, nociceptive transmission is facilitated; conversely, if the decision is to ignore pain and pursue a conflicting motivation, nociceptive transmission is inhibited. This pain modulating process contributes to expectation mediated influences on pain including placebo and nocebo effects. The process involves central nervous circuits that include cortex, basal ganglia and brain stem regions and that exert bidirectional control over dorsal horn nociceptive neurons.
Learning Objectives:
Upon completion, participant will be able to:
- Describe the role of motivation in promoting behavioral responses to noxious stimulation.
- Describe how motivations that conflict with pain behaviors can modulate perceived pain intensity
- Know the top down circuits that exert bidirectional control over ascending nociceptive pathways.
The Annenberg Center for Health Sciences at Eisenhower designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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