Attention modulates spinal cord responses to pain

Sprenger, Christian; Eippert, Falk; Finsterbusch, Jürgen; Bingel, Ulrike; Rose, Michael; Büchel, Christian

doi:10.1016/j.cub.2012.04.006

Cited by 208Pain Mechanisms and TreatmentsPain Management and Placebo EffectPain Management and Treatment

Attention modulates spinal cord responses to pain

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Sprenger, Christian, Eippert, Falk, Finsterbusch, Jürgen, Bingel, Ulrike, Rose, Michael, Büchel, Christian·2012·Current Biology

DOI 10.1016/j.cub.2012.04.006

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Abstract

Reduced pain perception while being distracted from pain is an everyday example of how cognitive processes can interfere with pain perception. Previous neuroimaging studies showed distraction-related modulations of pain-driven activations in various cortical and subcortical brain regions, but the precise neuronal mechanism underlying this phenomenon is unclear. Using high-resolution functional magnetic resonance imaging of the human cervical spinal cord in combination with thermal pain stimulation and a well-established working memory task, we demonstrate that this phenomenon relies on an inhibition of incoming pain signals in the spinal cord. Neuronal responses to painful stimulation in the dorsal horn of the corresponding spinal segment were significantly reduced under high working memory load compared to low working memory load. At the individual level, reductions of neuronal responses in the spinal cord predicted behavioral pain reductions. In a subsequent behavioral experiment, using the opioid antagonist naloxone in a double-blind crossover design with the same paradigm, we demonstrate a substantial contribution of endogenous opioids to this mechanism. Taken together, our results show that the reduced pain experience during mental distraction is related to a spinal process and involves opioid neurotransmission.

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Pain relief produced by attentional control is reversed by naloxone.
“Pain relief produced by placebo (Levine et al., 1978;Grevert et al., 1983;Amanzio and Benedetti, 1999;Zubieta et al., 2005;Eippert et al., 2009), conditioned pain modulation (King et al., 2013), and attentional control (Sprenger et al., 2012) is reversed by administration of the opioid antagonist naloxone.”
From Mindfulness-meditation-based pain relief is not mediated by endogenous opioids (2016) · cites this paper as Sprenger et al., 2012
Pain relief produced by placebo, acupuncture, conditioned pain modulation, distraction, and hypnosis is mediated, in part, by endogenous opioidergic systems.
“Pain relief produced by placebo,2,34,47,67,147 acupuncture,51 conditioned pain modulation,61 distraction,108 and hypnosis39,110 is meditated, in part, by endogenous opioidergic systems.”
From The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer (2019) · cites this paper as [108]
Some forms of cognitive regulation, e.g., distraction and placebo manipulations, may regulate pain at very early stages of processing in the spinal cord in some cases.
“some forms of cognitive regulation, e.g., distraction and placebo manipulations, may regulate pain at very early stages of processing in the spinal cord in some cases [30],[31].”
From Distinct Brain Systems Mediate the Effects of Nociceptive Input and Self-Regulation on Pain (2015) · cites this paper as [31]

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Mechanistic Dissection of The Attentional Modulation of Pain
Oliva, V. (2021) · Bristol Research (University of Bristol)

Authors: Sprenger, C., Eippert, F., Finsterbusch, J., Bingel, U., Rose, M., & Büchel, C.
Affiliations: University Medical Center Hamburg-Eppendorf (DE)
Corresponding author: Sprenger, Christian
ORCID: Sprenger, Christian
Eippert, Falk
Finsterbusch, Jürgen
Bingel, Ulrike
Rose, Michael
Büchel, Christian
Venue: Current Biology
Publisher: Elsevier BV
Published: 2012-06
Volume: 22
Issue: 11
Pages: 1019-1022
ISSN: 0960-9822 (ISSN-L)
DOI: 10.1016/j.cub.2012.04.006
OpenAlex: W2016587519
Cited by: 207
References: 41
Citations by year: 2026: 9 · 2025: 16 · 2024: 11 · 2023: 14 · 2022: 19 · 2021: 16 · 2020: 18 · 2019: 9 · 2018: 18 · 2017: 14 · 2016: 11 · 2015: 15 · 2014: 15 · 2013: 22
FWCI: 11.15
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 411 d)
Locations: Current Biology (publishedVersion)
PubMed (publishedVersion)
MPG.PuRe (Max Planck Society) (submittedVersion)
Topics: Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: pain distraction, cognitive modulation of pain, dorsal horn, working memory load, endogenous opioids, naloxone, thermal pain, pain perception, descending pain inhibition
MeSH terms: Adult, Attention, Humans, Male, Memory, Short-Term, Naloxone, Narcotic Antagonists, Posterior Horn Cells, Young Adult, Pain Perception

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Attention modulates spinal cord responses to pain

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