CoChat
Sign Up
Cited by 892Fibromyalgia and Chronic Fatigue Syndrome ResearchPain Management and Placebo EffectPain Mechanisms and Treatments

The DOI matches its Crossref record; 44 of the 45 references it cites were found in a registry or an index.

Pain catastrophizing and neural responses to pain among persons with fibromyalgia

Gracely, R. H.·2004·Brain
DOI 10.1093/brain/awh098
Open this paper in CoChat — free account

Abstract

Pain catastrophizing, or characterizations of pain as awful, horrible and unbearable, is increasingly being recognized as an important factor in the experience of pain. The purpose of this investigation was to examine the association between catastrophizing, as measured by the Coping Strategies Questionnaire Catastrophizing Subscale, and brain responses to blunt pressure assessed by functional MRI among 29 subjects with fibromyalgia. Since catastrophizing has been suggested to augment pain perception through enhanced attention to painful stimuli, and heightened emotional responses to pain, we hypothesized that catastrophizing would be positively associated with activation in structures believed to be involved in these aspects of pain processing. As catastrophizing is also strongly associated with depression, the influence of depressive symptomatology was statistically removed. Residual scores of catastrophizing controlling for depressive symptomatology were significantly associated with increased activity in the ipsilateral claustrum (r = 0.51, P < 0.05), cerebellum (r = 0.43, P < 0.05), dorsolateral prefrontal cortex (r = 0.47, P < 0.05), and parietal cortex (r = 0.41, P < 0.05), and in the contralateral dorsal anterior cingulate gyrus (ACC; r = 0.43, P < 0.05), dorsolateral prefrontal cortex (r = 0.41, P < 0.05), medial frontal cortex (r = 0.40, P < 0.05) and lentiform nuclei (r = 0.40, P < 0.05). Analysis of subjects classified as high or low catastrophizers, based on a median split of residual catastrophizing scores, showed that both groups displayed significant increases in ipsilateral secondary somatosensory cortex (SII), although the magnitude of activation was twice as large among high catastrophizers. Both groups also had significant activations in contralateral insula, SII, primary somatosensory cortex (SI), inferior parietal lobule and thalamus. High catastrophizers displayed unique activation in the contralateral anterior ACC, and the contralateral and ipsilateral lentiform. Both groups also displayed significant ipsilateral activation in SI, anterior and posterior cerebellum, posterior cingulate gyrus, and superior and inferior frontal gyrus. These findings suggest that pain catastrophizing, independent of the influence of depression, is significantly associated with increased activity in brain areas related to anticipation of pain (medial frontal cortex, cerebellum), attention to pain (dorsal ACC, dorsolateral prefrontal cortex), emotional aspects of pain (claustrum, closely connected to amygdala) and motor control. These results support the hypothesis that catastrophizing influences pain perception through altering attention and anticipation, and heightening emotional responses to pain. Activation associated with catastrophizing in motor areas of the brain may reflect expressive responses to pain that are associated with greater pain catastrophizing.

Overview

Integrity signals

Registry

Crossref · 10.1093/brain/awh098

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Flagged first, then by citations

1 of the 45 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

See all 892

Related

See all

Metadata

Authors
Gracely, R. H.
Affiliations
University of Michigan (US)
Corresponding author
Gracely, R. H.
Venue
Brain
Publisher
Oxford University Press (OUP)
Published
2004-01-14
Volume
127
Issue
4
Pages
835-843
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
DOI
10.1093/brain/awh098
OpenAlex
W2114943199
Cited by
892
References
45
Citations by year
2026: 28 · 2025: 25 · 2024: 31 · 2023: 40 · 2022: 28 · 2021: 20 · 2020: 47 · 2019: 40 · 2018: 49 · 2017: 36 · 2016: 43 · 2015: 43 · 2014: 45 · 2013: 43 · 2012: 34
FWCI
18.94
Type
journal article
Language
en
Open access
closed
Locations
  • Brain (publishedVersion)
  • PubMed (publishedVersion)
Funders
Georgetown University
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords
pain catastrophizing, fibromyalgia, brain activation, claustrum, anterior cingulate cortex, dorsolateral prefrontal cortex, cerebellum, somatosensory cortex, insula, lentiform nucleus, depression, attention to pain, emotional response to pain, secondary somatosensory cortex
MeSH terms
Adaptation, Psychological, Adolescent, Adult, Brain, Depression, Female, Fibromyalgia, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pain, Pain Measurement, Perception

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review