Expecto ergo sentio – I expect therefore I feel

Imagine yourself suffering from lower back pain, wanting to grasp a newspaper from the floor. While trying to reach it, you might be afraid to feel pain. As a result, you might scan your back for bodily sensations that possibly signal pain or physical harm.

Pain symptoms fulfill a vital warning function to prevent us from getting damaged. It thus makes sense that our brain prioritizes information that is related to (anticipated) pain. In our recently published paper in Pain [1], we examined if fearful anticipation of pain leads to the prioritization of somatosensory sensations at body locations where pain is expected to occur. More specifically, we investigated if one becomes more quickly aware of -even innocuous- somatosensory sensations at regions of the body where we expect pain, compared to other ‘pain free’ regions.

Healthy volunteers had to indicate which of two innocuous tactile sensations that were administered to each hand was presented first. Crucially, participants were told that on one hand they could expect a painful stimulus (which, occasionally, was actually administered). Interestingly, we observed that our participants became more quickly aware of innocuous tactile sensations presented on the hand on which pain was expected compared to the other hand. This finding suggests that our brain prioritizes tactile information at threatened body parts. In other words, when someone is afraid to get hurt at a particular body part, attention is biased towards that body part.

Considering these findings, it may be interesting to explore whether these results also apply to chronic pain patients. Keeping the former example in mind, it may be that chronic lower back pain patients spontaneously focus their attention on the region of the back. This may particularly be the case, in situations that evoke bodily threat, such as the execution of a movement involving the back [2]. It thus might be that chronic pain patients are characterized by somatosensory hypervigilance, i.e. an excessive focus of attention to somatosensory signals in the affected body part. Consequently, it would also be interesting to examine if the prioritization of somatosensory attention results in more disability, distractibility and interference with daily life functioning [3]. In future research, we hope to extend our findings to clinical pain populations and explore some key issues that may help to improve therapeutic interventions.

About Charlotte Vanden Bulcke

Charlotte Vanden BulckeI am a PhD researcher in the department of Experimental-Clinical and Health Psychology at the University of Ghent, under the supervision of Prof. dr. Stefaan Van Damme. My main interests are exploring the role of bodily threat in attentional processing, hypervigilance and attentional bias processes in chronic pain patients. Comments or questions on our work can be addressed to Charlotte.VandenBulcke@UGent.be

References

[1] Vanden Bulcke, C, Van Damme, S, Durnez, W and Crombez, G (2013). The anticipation of pain at a specific location of the body prioritizes tactile stimuli at that location Pain, 154, 1464-1468 DOI: 10.1016/j.pain.2013.05.009

[2] Van Hulle L, Juravle G, Spence C, Crombez G, & Van Damme S (2013). Attention modulates sensory suppression during back movements. Consciousness and cognition, 22 (2), 420-9 PMID: 23454431

[3] Van Ryckeghem DM, Crombez G, Goubert L, De Houwer J, Onraedt T, & Van Damme S (2013). The predictive value of attentional bias towards pain-related information in chronic pain patients: a diary study. Pain, 154 (3), 468-75 PMID: 23375161