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Cited by 325Pain Mechanisms and TreatmentsPain Management and TreatmentPain Management and Placebo Effect

Gender differences in pain perception and patterns of cerebral activation during noxious heat stimulation in humans

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Paulson, Pamela E, Minoshima, Satoshi, Morrow, Thomas J, Casey, Kenneth L·1998·Pain
DOI 10.1016/s0304-3959(98)00048-7PMC PMC1828033
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Abstract

The purpose of the present study was to determine whether gender differences exist in the forebrain cerebral activation patterns of the brain during pain perception. Accordingly, positron emission tomography (PET) with intravenous injection of H2(15)O was used to detect increases in regional cerebral blood flow (rCBF) in normal right-handed male and female subjects as they discriminated differences in the intensity of innocuous and noxious heat stimuli applied to the left forearm. Each subject was instructed in magnitude estimation based on a scale for which 0 indicated 'no heat sensation'; 7, 'just barely painful' and 10, 'just barely tolerable'. Thermal stimuli were 40 degrees C or 50 degrees C heat, applied with a thermode as repetitive 5-s contacts to the volar forearm. Both male and female subjects rated the 40 degrees C stimuli as warm but not painful and the 50 degrees C stimuli as painful but females rated the 50 degrees C stimuli as significantly more intense than did the males (P=0.0052). Both genders showed a bilateral activation of premotor cortex in addition to the activation of a number of contralateral structures, including the posterior insula, anterior cingulate cortex and the cerebellar vermis, during heat pain. However, females had significantly greater activation of the contralateral prefrontal cortex when compared to the males by direct image subtraction. Volume of interest comparison (t-statistic) also suggested greater activation of the contralateral insula and thalamus in the females (P < 0.05). These pain-related differences in brain activation may be attributed to gender, perceived pain intensity, or to both factors.

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  • Evidence suggests that ignoring pain is associated with both increased and decreased pain interference.

    “Evidence suggests an association between ignoring pain and both increased and decreased pain interference 281, 288–290.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [290]

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Authors
Paulson, P. E., Minoshima, S., Morrow, T. J., & Casey, K. L.
Affiliations
University of Michigan (US)
Corresponding author
Paulson, Pamela E
ORCID
Minoshima, Satoshi
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-05
Volume
76
Issue
1
Pages
223-229
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/s0304-3959(98)00048-7
PMC
PMC1828033
OpenAlex
W1981658220
Cited by
325
References
51
Citations by year
2026: 4 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 14 · 2020: 10 · 2019: 6 · 2018: 8 · 2017: 9 · 2016: 11 · 2015: 10 · 2014: 9 · 2013: 18 · 2012: 15
FWCI
9.01
Type
journal article
Language
en
Open access
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords
gender differences, pain perception, cerebral blood flow, thermal pain, pain intensity, prefrontal cortex, posterior insula, anterior cingulate cortex, thalamus, premotor cortex, cerebellar vermis, magnitude estimation
MeSH terms
Adolescent, Adult, Brain, Female, Hot Temperature, Humans, Functional Laterality, Male, Pain, Sex Characteristics, Stereotaxic Techniques, Tomography, Emission-Computed, Prosencephalon

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