Der Einfluss von negativen Emotionen und Stress auf die neuronale Verarbeitung viszeraler Schmerzreize: Aktuelle Befunde aus der Bildgebung

While it has long been known that emotional factors can influence the experience of pain, imaging studies analyzing the neuronal basis of this effect particularly for visceral stimuli remain scarce. A clarification of this association is of scientific and clinical interest, particularly in the context of common functional gastrointestinal disorders which are characterized by a worsening of symptoms during states of emotional stress. Previous studies addressing the modulation of the neural response to pain by negative emotions and stress are critically reviewed herein. Overall, this evidence supports that the emotional modulation of the neural response to pain involves several brain regions, including the cingulate cortex – a structure which is activated by emotions as well as by painful stimuli. Additionally, the insula and prefrontal cortex play a role. All three brain areas have in common that they mediate especially the affective components of pain processing. These findings are apparently not specific for visceral pain since studies applying somatic pain stimuli show similar results. Together, these results are relevant for the pathophysiology of various functional pain syndromes given that they could reveal a neural correlate for the influence stress and negative emotions on symptom exacerbation. Furthermore, there are a number of important methodological implications which should be taken into account when designing and conducting future imaging studies on the neural response to pain.