Real-Time fMRI Feedback Effects on Pain Perception

Medical University of South Carolina (MUSC)

Status: Completed

Conditions: Cognitive Pain Control

Treatments: Behavioral: Attention/Distraction Strategy; Behavioral: Control Strategy; Behavioral: Stimulus Quality/Severity Strategy

Study type: Interventional

Funder types: Other

Identifiers

NCT01588197

HR # 20270

Details and patient eligibility

About

The purpose of this study is to determine whether real-time functional magnetic resonance imaging may be a viable treatment for chronic pain in the future.

Full description

Twenty-four healthy volunteers will undergo a series of four fMRI scanning sessions wherein thermal pain stimuli will be used to elicit activation of the pain neuro-matrix. All participants will undergo thermal pain threshold testing before and after fMRI scan. Participants will also rate the painfulness and unpleasantness of the thermal stimuli applied before fMRI and after fMRI. All participants will be given prompts to apply a set of cognitive pain-control strategies. Half of the participants will receive real-time fMRI feedback of activity in the Right Anterior Cingulate Cortex (rACC) and the other half will receive real-time fMRI feedback of activity in the Prefrontal Cortex (PFC). It is hypothesized that those receiving real-time feedback of brain activity thought to be involved with analgesic effects will demonstrate greater analgesia associated with the application of the cognitive control techniques after fMRI paradigm (decreased pain intensity and unpleasantness ratings and increased thermal pain thresholds) than those who are not given feedback before fMRI paradigm.

Enrollment: 20 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Healthy adults ages 18-65

Exclusion criteria

• Clinical depression
• Anxiety
• Substance dependence or chronic pain
• Ferrous metal implants
• Cardiac pacemakers or other implanted medical devices that might be adversely impacted by the MRI scanner magnetic field

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

ACC Real Time fMRI Feedback

Experimental group

Description:

Each participant will undergo thermal pain threshold assessments ten times using the Medoc Pathway System with MRI-compatible ATS Thermode (30mmX30mm; Medoc Inc, Israel). Participants will be instructed to "focus on the thermal stimuli" for the first 5 trials, and to engage in three cognitive pain inhibition strategies (Attention/Distraction Strategy, Stimulus Quality/Severity Strategy, and the Control Strategy. The participants will be randomly assigned to receive Real Time fMRI Feedback of inverse activation in the rACC after each pain/rest block during the last 3 fMRI scans in the form of two simple thermometer images on the in-scanner computer display.

Treatment:

Behavioral: Stimulus Quality/Severity Strategy

Behavioral: Control Strategy

Behavioral: Attention/Distraction Strategy

PFC Real Time fMRI Feedback

Experimental group

Description:

Each participant will undergo thermal pain threshold assessments ten times using the Medoc Pathway System with MRI-compatible ATS Thermode (30mmX30mm; Medoc Inc, Israel). Participants will be instructed to "focus on the thermal stimuli" for the first 5 trials, and to engage in three cognitive pain inhibition strategies (Attention/Distraction Strategy, Stimulus Quality/Severity Strategy, and the Control Strategy. The participants will be randomly assigned to receive Real Time fMRI Feedback of inverse activation in the PFC after each pain/rest block during the last 3 fMRI scans in the form of two simple thermometer images on the in-scanner computer display.

Treatment:

Behavioral: Stimulus Quality/Severity Strategy

Behavioral: Control Strategy

Behavioral: Attention/Distraction Strategy