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Dysfunctional pain modulation in somatoform pain disorder patients

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An Erratum to this article was published on 13 November 2010

Abstract

To date, pain perception is thought to be a creative process of modulation carried out by an interplay of pro- and anti-nociceptive mechanisms. Recent research demonstrates that pain experience constitutes the result of top–down processes represented in cortical descending pain modulation. Cortical, mainly medial and frontal areas, as well as subcortical structures such as the brain stem, medulla and thalamus seem to be key players in pain modulation. An imbalance of pro- and anti-nociceptive mechanisms are assumed to cause chronic pain disorders, which are associated with spontaneous pain perception without physiologic scaffolding or exaggerated cortical activation in response to pain exposure. In contrast to recent investigations, the aim of the present study was to elucidate cortical activation of somatoform pain disorder patients during baseline condition. Scalp EEG, quantitative Fourier-spectral analyses and LORETA were employed to compare patient group (N = 15) to age- and sex-matched controls (N = 15) at rest. SI, SII, ACC, SMA, PFC, PPC, insular, amygdale and hippocampus displayed significant spectral power reductions within the beta band range (12–30 Hz). These results suggest decreased cortical baseline arousal in somatoform pain disorder patients. We finally conclude that obtained results may point to an altered baseline activity, maybe characteristic for chronic somatoform pain disorder.

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Abbreviations

EEG:

Electroencephalogram

BA:

Brodman area

rCBF:

Regional cerebral blood flow

SMA:

Supplementary motor area

PPC:

Posterior parietal cortex

PFC:

Prefrontal cortex

SI:

Primary somatosensory cortex

SII:

Secondary somatosensory cortex

ACC:

Anterior cingulate cortex

rACC:

Rostral anterior cingulate cortex

PAG:

Periaqueductal grey

AI:

Anterior insula

CBP:

Chronic back pain patients

IBS:

Irritable bowel syndrome

GI:

Gastrointestinal

EOG:

Electrooculogram

ICA:

Independent component analysis

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, General Hospital of Vienna, Medical University of Vienna, Währinger-Gürtel 18-20, 1090, Vienna, Austria

    Klug Stefanie, Anderer Peter, Saletu-Zyhlarz Gerda, Freidl Marion, Saletu Bernd, Prause Wolfgang & Aigner Martin

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  1. Klug Stefanie
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  2. Anderer Peter
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  3. Saletu-Zyhlarz Gerda
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Correspondence to Klug Stefanie.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00406-010-0168-0

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Stefanie, K., Peter, A., Gerda, SZ. et al. Dysfunctional pain modulation in somatoform pain disorder patients. Eur Arch Psychiatry Clin Neurosci 261, 267–275 (2011). https://doi.org/10.1007/s00406-010-0148-4

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  • DOI: https://doi.org/10.1007/s00406-010-0148-4

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