Neural mechanisms of pain relief through paying attention to painful stimuli

Abstract

Copyright © 2021 International Association for the Study of Pain.ABSTRACT: A commonly held belief suggests that turning one's attention away from pain reduces it, whereas paying attention to pain increases it. However, some attention-based therapeutic strategies for pain, such as mindfulness-based interventions, suggest that paying attention to painful stimuli can reduce pain, resulting in seemingly contradictory conclusions regarding attention and pain. Here, we investigated the analgesic effects of attention modulation and provide behavioral and neural evidence that paying attention to pain can reduce pain when attention is directed toward the specific features of painful stimuli. The analgesic effects of paying attention to painful stimuli were mediated by the primary somatosensory cortex and goal-directed attention regions in the prefrontal and parietal cortex. These findings suggest that suppressing early somatosensory processing through top-down modulation is the key mechanism of the analgesic effects of paying attention to painful stimuli, providing evidence that pain itself can be used as a component of pain management.