Anterolateral prefrontal cortex mediates the analgesic effect of expected and perceived control over pain
Open accessAbstract
Perceived control attenuates pain and pain-directed anxiety, possibly because it changes the emotional appraisal of pain. We examined whether brain areas associated with voluntary reappraisal of emotional experiences also mediate the analgesic effect of perceived control over pain. Using functional magnetic resonance imaging, we compared self-controlled noxious stimuli with physically identical stimuli that were externally controlled. Self-controlled stimulation was accompanied by less pain and anxiety and higher activation in dorsal anterior cingulate (dACC), right dorsolateral, and bilateral anterolateral prefrontal (alPFC) cortices. Activation in dACC and right alPFC was negatively correlated with pain intensity ratings. For externally controlled pain, activation in right alPFC was inversely correlated with the participants' general belief to have control over their lives. Our results are consistent with a reappraisal view of control and suggest that the analgesic effect of perceived control relies on activation of right alPFC. Failure to activate right alPFC may explain the maladaptive effects of strong general control beliefs during uncontrollable pain.
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Of the 37 methodologically most rigorous studies, three (8%) found the opposite (worse SRH with R/S).
“Of the 37 methodologically most rigorous studies, 21 (57%) reported significant positive relationships between R/S and SRH [503, 508–527], whereas three (8%) found the opposite [528–530].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [529]
The Results section, “Behavioral effects of perceived control” (page unavailable), reports pain and anxiety ratings under self-controlled and externally controlled stimulation. Searches for religion or spirituality, self-rated health, and the 37-study count found no passage addressing the claimed association or identifying this study as one of the three negative findings. (LLM, conf=0.78)
Experimental — accuracy not yet measuredPerceived control of pain is associated with activation of the right dorsolateral prefrontal cortex.
“perceived control of pain was associated with activation of the right DLPFC109”
From The dorsolateral prefrontal cortex in acute and chronic pain (2017) · cites this paper as [109]
The dorsolateral prefrontal cortex has a role in cognitive components of the pain experience.
“There is converging evidence that the DLPFC has a role in cognitive components of the pain experience.”
From The dorsolateral prefrontal cortex in acute and chronic pain (2017) · cites this paper as [109]
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- Authors
- Wiech, K., Kalisch, R., Weiskopf, N., Pleger, B., Stephan, K. E., & Dolan, R. J.
- Affiliations
- Wellcome Centre for Human Neuroimaging (GB)
- Venue
- The Journal of Neuroscience
- Publisher
- Society for Neuroscience
- Published
- 2006-11-01
- Volume
- 26
- Issue
- 44
- Pages
- 11501-11509
- ISSN
- 0270-6474 (ISSN-L)
- 1529-2401
- PMC
- PMC2635565
- OpenAlex
- W2081172822
- Cited by
- 323
- References
- 58
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 11 · 2023: 15 · 2022: 13 · 2021: 19 · 2020: 13 · 2019: 27 · 2018: 18 · 2017: 20 · 2016: 18 · 2015: 17 · 2014: 18 · 2013: 22 · 2012: 16
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Neuroscience (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Max Planck Digital Library (submittedVersion, other-oa)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Wellcome Trust (078865)
- European Commission
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- analgesia, dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, emotional reappraisal, external control, pain intensity
- MeSH terms
- Adult, Analgesia, Brain Mapping, Electric Stimulation, Female, Humans, Pain, Pain Measurement, Perception, Pain Threshold, Prefrontal Cortex
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