Brain-to-brain mechanisms underlying pain empathy and social modulation of pain in the patient-clinician interaction.
Pain
empathy
fMRI
hyperscanning
supportive care
Journal
Proceedings of the National Academy of Sciences of the United States of America
ISSN: 1091-6490
Titre abrégé: Proc Natl Acad Sci U S A
Pays: United States
ID NLM: 7505876
Informations de publication
Date de publication:
27 06 2023
27 06 2023
Historique:
pmc-release:
20
12
2023
medline:
22
6
2023
pubmed:
20
6
2023
entrez:
20
6
2023
Statut:
ppublish
Résumé
Social interactions such as the patient-clinician encounter can influence pain, but the underlying dynamic interbrain processes are unclear. Here, we investigated the dynamic brain processes supporting social modulation of pain by assessing simultaneous brain activity (fMRI hyperscanning) from chronic pain patients and clinicians during video-based live interaction. Patients received painful and nonpainful pressure stimuli either with a supportive clinician present (Dyadic) or in isolation (Solo). In half of the dyads, clinicians performed a clinical consultation and intake with the patient prior to hyperscanning (Clinical Interaction), which increased self-reported therapeutic alliance. For the other half, patient-clinician hyperscanning was completed without prior clinical interaction (No Interaction). Patients reported lower pain intensity in the Dyadic, relative to the Solo, condition. In Clinical Interaction dyads relative to No Interaction, patients evaluated their clinicians as better able to understand their pain, and clinicians were more accurate when estimating patients' pain levels. In Clinical Interaction dyads, compared to No Interaction, patients showed stronger activation of the dorsolateral and ventrolateral prefrontal cortex (dlPFC and vlPFC) and primary (S1) and secondary (S2) somatosensory areas (Dyadic-Solo contrast), and clinicians showed increased dynamic dlPFC concordance with patients' S2 activity during pain. Furthermore, the strength of S2-dlPFC concordance was positively correlated with self-reported therapeutic alliance. These findings support that empathy and supportive care can reduce pain intensity and shed light on the brain processes underpinning social modulation of pain in patient-clinician interactions. Our findings further suggest that clinicians' dlPFC concordance with patients' somatosensory processing during pain can be boosted by increasing therapeutic alliance.
Identifiants
pubmed: 37339198
doi: 10.1073/pnas.2212910120
pmc: PMC10293846
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2212910120Subventions
Organisme : NCCIH NIH HHS
ID : R61 AT009306
Pays : United States
Organisme : NCRR NIH HHS
ID : P41 RR014075
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025758
Pays : United States
Organisme : NCCIH NIH HHS
ID : R33 AT009306
Pays : United States
Organisme : NIDA NIH HHS
ID : R90 DA023427
Pays : United States
Organisme : NCRR NIH HHS
ID : S10 RR019254
Pays : United States
Organisme : NCRR NIH HHS
ID : S10 RR023043
Pays : United States
Organisme : NCRR NIH HHS
ID : S10 RR023401
Pays : United States
Organisme : NCRR NIH HHS
ID : S10 RR019307
Pays : United States
Organisme : NCRR NIH HHS
ID : S10 RR019254
Pays : United States
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