The Neurobiology of Expectancy and Pain Perception

Massachusetts General Hospital38 enrolled

Overview

This study will use using fMRI (functional Magnetic Resonance Imaging) to elucidate how contextual learning/expectation relieves or aggravates pain experience in the same cohort of subjects and the same study session.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Pain

Interventions

Heat pain applied using TSA or CHEPSDEVICE

TSA-2001 Thermal Sensory Analyzer (Medoc LTD Advanced Medical Systems) or the Pathway Medoc (CHEPS model, Contact Heat-Evoked Potential Stimulator, Medoc LTD Advanced Medical Systems)

Eligibility

Sex: ALLMin age: 21 YearsMax age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * a) Healthy male and female adults aged 21-50 * b) No contraindications to fMRI scanning * c) Right handed Exclusion Criteria: * a) Current or past history of major medical, neurological, or psychiatric illness * b) Pregnancy or breast feeding, menopause, and irregular menstrual cycles (length of cycle must be within 26 to 32 days) * c) Claustrophobia * d) History of head trauma * e) History of impaired elimination * f) Instability of responses to experimental pain (see Study Procedures Section) * g) Use of psychotropic drugs, hormone treatments (including hormonal birth control) within 1 year * h) Non-fluent speaker of English

Locations (1)

Massachusetts General Hospital

Charlestown, Massachusetts, United States

Outcomes

Primary Outcomes

Subjective Response to Pain (0-20 Visual Analogue Scale)

Subjects received heat pain before and after the application of a neutral cream (told one application of neutral cream was lidocaine, one was capsaicin, and one was neutral) and rated pain intensity on a 0-20 Visual Analogue Scale (0-no pain, 20-intolerable pain). We only measure this outcome measure in session 3. The pain intensity for each cream was averaged amongst all participants for both the pre and post treatment in session 3. Subjects have up to 3 weeks to complete the 3 sessions.

Time frame: Weeks 1-3

fMRI Signal Changes in the Dorsal Anterior Cingulate Cortex

We used fMRI to investigate the signal changes associated with administration of identical pain stimuli before (pre) and after the treatment (post) with different creams in session 3. It is important to note that the subjects had multiple weeks to complete the study, but this measure was only taken during one session. The change was calculated from two time points as the value at the later time point (post treatment) minus the value at the earlier time point (pre treatment).

Time frame: Week 4

Data from ClinicalTrials.gov

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