Spatiotemporal Brain Patterns Elicited during Pain Perception in fMRI
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Background and Purpose: Task-based functional magnetic resonance imaging (fMRI) has identified distributed patterns of brain activity associated with the experience of pain, including a collection of regions involved in nociceptive processing traditionally referred to as the pain matrix (PM). However, pain perception is not determined by bottom-up nociceptive input alone, but can also be influenced by top-down cognitive regulation. In the current study, we analyzed an open-source fMRI dataset in which participants cognitively up- or down-regulated their perceived pain to identify and separate the spatiotemporal patterns of blood-oxygen-level-dependent (BOLD) activity associated with bottom-up nociception and top-down regulation of pain perception. Methods: fMRI data from 33 healthy participants performing a thermal pain perception task were analyzed. Participants experienced varying levels of thermal pain and rated perceived intensity, and were also instructed to either increase (Regulate-up) or decrease (Regulate-down) their perceived pain. Spatiotemporal BOLD patterns were retrieved by applying multivariate multiple regression with a finite impulse response model of the task timing, followed by dimension reduction. Results: The PM was retrieved and showed greater activation in response to high relative to low heat. In addition, four other spatiotemporal patterns were retrieved, with one, Re-evaluation (RE-EV), showing high activation during down-regulation of intense pain. Discussion and Conclusions: The PM was retrieved and showed an increased response with pain intensity. RE-EV was active during the down-regulation of intense pain, and activation in this same spatiotemporal pattern has previously been observed during down-regulation of negative emotions. Three other cognitive modes were retrieved, and their spatiotemporal patterns are discussed. A more complete understanding of the full set of fMRI-derived spatiotemporal patterns involved in pain perception has an important role to play in clinical aspects of negative emotional and physical pain/affect regulation.
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