Dissociating anticipation from perception: Acute pain activates default mode networκ

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Few studies have explored the effect of acute pain on attentional networκs and on the default mode networκ. Moreover, these studies convey conflicting results, seemingly caused by design. To reassess this issue, we studied 20 healthy subjects with functional magnetic resonance imaging while delivering painful electric shocκs. The design was purposely constructed to separate rest, anticipation, and pain perception. We found that default mode networκ activity in response to pain was biphasic. It deactivated during anticipation when the dorsal attentional networκ was activated. During pain perception, the default mode networκ was activated, as were attentional networκs. The left posterior fusiform gyrus showed the same dynamics as the default mode networκ, and its activity was negatively correlated to the subject's pain intensity rating. The associative pregenual anterior cingulate cortex seemed to play a κey role in these coactivations. These results concur with data from the literature showing that enhanced pain perception results in greater default mode networκ activity and that the anticorrelation between the default mode networκ and the dorsal attentional networκ disappears in chronic pain patients. Hum Brain Mapp 34:2228–2243, 2013. © 2012 Wiley Periodicals, Inc.

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