Modulation of pain ratings by expectation and uncertainty: Behavioral characteristics and anticipatory neural correlates
Open accessAbstract
Expectations about the magnitude of impending pain exert a substantial effect on subsequent perception. However, the neural mechanisms that underlie the predictive processes that modulate pain are poorly understood. In a combined behavioral and high-density electrophysiological study we measured anticipatory neural responses to heat stimuli to determine how predictions of pain intensity, and certainty about those predictions, modulate brain activity and subjective pain ratings. Prior to receiving randomized laser heat stimuli at different intensities (low, medium or high) subjects (n=15) viewed cues that either accurately informed them of forthcoming intensity (certain expectation) or not (uncertain expectation). Pain ratings were biased towards prior expectations of either high or low intensity. Anticipatory neural responses increased with expectations of painful vs. non-painful heat intensity, suggesting the presence of neural responses that represent predicted heat stimulus intensity. These anticipatory responses also correlated with the amplitude of the Laser-Evoked Potential (LEP) response to painful stimuli when the intensity was predictable. Source analysis (LORETA) revealed that uncertainty about expected heat intensity involves an anticipatory cortical network commonly associated with attention (left dorsolateral prefrontal, posterior cingulate and bilateral inferior parietal cortices). Relative certainty, however, involves cortical areas previously associated with semantic and prospective memory (left inferior frontal and inferior temporal cortex, and right anterior prefrontal cortex). This suggests that biasing of pain reports and LEPs by expectation involves temporally precise activity in specific cortical networks.
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In contemporary theories of perception, the influence of expectation on perceived pain is also modulated by the certainty (the inverse variability) of the pain stimulus intensity.
“Finally, in contemporary theories of perception, the influence of expectation on perceived pain is also modulated by the certainty (the inverse variability) of the pain stimulus intensity10,35,37,55,56.”
From Boundary effects of expectation in human pain perception (2019) · cites this paper as [56]
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Predictability modulates the anticipation and perception of pain in both self and others
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- Authors
- Brown, C. A., Seymour, B., Boyle, Y., El-Deredy, W., & Jones, A. K. P.
- Affiliations
- University of Manchester (GB)
- Wellcome Centre for Human Neuroimaging (GB)
- Salford Royal Hospital (GB)
- Corresponding author
- Brown, Christopher A.
- Venue
- Pain
- Published
- 2008-04
- Volume
- 135
- Issue
- 3
- Pages
- 240-250
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2164512758
- Cited by
- 218
- References
- 66
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 13 · 2023: 16 · 2022: 12 · 2021: 12 · 2020: 15 · 2019: 9 · 2018: 10 · 2017: 17 · 2016: 12 · 2015: 11 · 2014: 13 · 2013: 15 · 2012: 12
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Cambridge University Engineering Department Publications Database (submittedVersion)
- Funders
- University of Manchester
- Versus Arthritis
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- pain anticipation, uncertainty, pain perception, laser-evoked potentials, thermal pain, subjective pain ratings, predictive processing, attentional networks, dorsolateral prefrontal cortex, posterior cingulate cortex, inferior parietal cortex, inferior frontal cortex, inferior temporal cortex, anterior prefrontal cortex, source localization
- MeSH terms
- Adult, Attention, Behavior, Brain Mapping, Cerebral Cortex, Cognition, Cues, Electroencephalography, Evoked Potentials, Humans, Lasers, Functional Laterality, Memory, Mental Processes, Middle Aged, Nerve Net, Neuropsychological Tests, Pain, Pain Measurement, Physical Stimulation, Pain Threshold, Uncertainty
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