The underlying mechanisms of acupuncture for alleviating pain-induced negative emotions: Synergistic regulation of multiple brain regions.

Anterior Cingulate Cortex: Unique Role in Cognition and Emotion

Pain emotion is a negative emotion caused by pain, which seriously affects the patients' physical and psychological health. The anterior cingulate cortex (ACC) is a key brain region in the occurrence and regulation of pain and painful emotion. In this paper, we summed up the relevant progress of researches on acupuncture improvement of pain emotion from neurotransmitters and receptors, cellular signaling pathways and neural circuits of ACC, in order to provide a basis for further research. 1) Acupuncture can regulate the long-term potentiation of ACC synaptic transmission by down-regulating the expression of N-methyl-D-aspartic acid receptor (NMDAR)； and up-regulating the expression of μ-, delta- and κ-opioid receptors, neuropeptide S (NPS)/ NPS receptor, and the number of parvalbumin-expressing interneurons to reduce neuronal excitability, relieving pain emotion； 2) Acupuncture can regulate synaptic transmission of ACC neurons by inhibiting protein kinase Mζ (PKMζ)-GluR1 and cAMP/PKA-ERK-CREB signaling pathways, and modulate synaptic plasticity to ameliorate pain emotion； 3) Acupuncture intervention induced inhibition of rostral ACCGlu-thalamic circuit may result in relief of pain emotion but not pain sensation, whereas inhibition of the rostral ACCGlu-ventrolateral periaqueductal gray matter(vlPAG) circuit may relieve pain sensation but not pain emotion. In addition, our team found that in the treatment of painful diseases by acupuncture, the addition of "spirit-regulating" acupoints can not only improve patients' negative emotion, but also significantly relive patients' pain sensation.

Understanding Emotion Regulation in Borderline Personality Disorder: Contributions of Neuroimaging

Top-Down Control-Signal Dynamics in Anterior Cingulate and Prefrontal Cortex Neurons following Task Switching

People feel psychological pain when they are excluded, and this pain is often attenuated when emotional support is received. It is therefore likely that a specific neural mechanism underlies the detection of social exclusion. Similarly, specific neural mechanisms may underlie the beneficial effects of emotional support. Although neuroimaging researchers have recently examined the neural basis of social pain, there is presently no agreement as to which part of the anterior cingulate cortex (ACC) is involved in the perception and modulation of social pain. We hypothesized that activity in those brain regions that are associated with social pain would be correlated with decrements in social pain induced by emotional support. To examine the effects of emotional support on social pain caused by exclusion, we conducted an fMRI study in which participants played a virtual ball-tossing game. Participants were initially included and later excluded from the game. In the latter half of the session from which participants were excluded, participants received emotionally supportive text messages. We found that emotional support led to increased activity in the left lateral/medial prefrontal cortices and some temporal regions. Those individuals who experienced greater attenuation of social pain exhibited lower ventral ACC and higher left lateral prefrontal cortex activation. These results suggest that the ventral ACC underlies social pain, and that emotional support enhances prefrontal cortex activity, which in turn may lead to a weakened affective response.

Bipolar Disorder: Imaging State Versus Trait

Current theories suggest that social and physical pain overlap in their neurological and physiological outcomes. We investigated how social and physical pain overlap in their psychological responses by testing the hypothesis that both social and physical pain would thwart satisfaction on four human needs, worsen mood, and increase desire to aggress. In Experiment 1, recalling an experience of social or physical pain produced overlapping effects in the form of thwarted self‐esteem and control needs and increased negative affect and desire to aggress. In Experiment 2, we induced social (Cyberball ostracism) or physical pain (cold pressor) within the laboratory session, and found that both pain types produced feelings of being ignored and excluded, and thwarted belonging, self‐esteem, control, and meaningful existence. Our results provide further support to pain overlap theories and indicate that social and physical pain cause common psychological consequences, resulting in new ways to understand and manage pain. Copyright © 2011 John Wiley & Sons, Ltd.

Background and Aim: The present research performed to develop a conceptual model of adolescents’ psychological pain based on emotion (positive and negative) factor with the mediating role of emotion regulation for daily activities. Methods: The research method was the structural equations modeling. The statistical society of research included 14-18 years old girls and boys of Tehran city which among them 284 individuals selected as research sample by cluster random sampling method. Due to spread of Covid-19 pandemic, the research data collected by electronic questionnaires in social networks. To data collecting, PANAS (positive and negative affective scale) (Watson, Clark & Talgen, 1988), Orbach and Mikulincer’s “mental pain” questionnaire (Orbach et al, 2003) and Garnefski’s “cognitive emotion regulation” questionnaire (Garnefski et al, 2001) were used and the structural equations method used to data analysis. Results: The findings showed that indirect effect of positive emotions in psychological pain is equal to -0.20 that by given to t=-3.65, it was significant at 0.05 level. The indirect effect of negative emotions on psychological pain is equal to 0.26 that by given to t=4.81, it was significant at 0.07 level. These indirect effects are taking place via mediation of emotion regulation strategies. Thus, the positive and negative emotions have an indirect effect on adolescents’ psychological pain by mediating of emotions regulation strategies. Also, by given to RMSEA=0.070, it can conclude that the final conceptual model has a good fit. Conclusion: It can be concluded that the psychological pain of adolescents can be explained based on positive and negative emotions and through the mediation of emotion regulation for daily activities.

Negative emotionality, emotion regulation, and achievement: Cross-lagged relations and mediation of academic engagement

Although social and physical pain recruit overlapping neural activity in regions associated with the affective component of pain, the two pains can diverge in their phenomenology. Most notably, feelings of social pain can be re-experienced or “relived,” even when the painful episode has long passed, whereas feelings of physical pain cannot be easily relived once the painful episode subsides. Here, we observed that reliving social (vs. physical) pain led to greater self-reported re-experienced pain and greater activity in affective pain regions (dorsal anterior cingulate cortex and anterior insula). Moreover, the degree of relived pain correlated positively with affective pain system activity. In contrast, reliving physical (vs. social) pain led to greater activity in the sensory-discriminative pain system (primary and secondary somatosensory cortex and posterior insula), which did not correlate with relived pain. Preferential engagement of these different pain mechanisms may reflect the use of different top-down neurocognitive pathways to elicit the pain. Social pain reliving recruited dorsomedial prefrontal cortex, often associated with mental state processing, which functionally correlated with affective pain system responses. In contrast, physical pain reliving recruited inferior frontal gyrus, known to be involved in body state processing, which functionally correlated with activation in the sensory pain system. These results update the physical-social pain overlap hypothesis: while overlapping mechanisms support live social and physical pain, distinct mechanisms guide internally-generated pain.

Using whole-brain functional magnetic resonance imaging, we aimed to investigate abnormal spontaneous brain activity in the resting state of patients with trigeminal neuralgia (TN) and explore their relationship with pain symptoms and negative emotions. This study included 46 patients with TN diagnosed at our hospital from December 2022 to June 2023 and 35 healthy controls. All patients with TN completed questionnaires related to pain and emotions. The data analysis compared amplitude of low-frequency fluctuation (ALFF) in the brain between TN and healthy control groups. Pearson correlation analysis was used to explore the intricate relationships between pain symptoms, negative emotions, and brain functional abnormalities in patients with TN. Compared with healthy controls, patients with TN exhibited significantly reduced ALFF in the left superior frontal gyrus (SFG), bilateral middle frontal gyrus, bilateral inferior frontal gyrus, right precentral gyrus, right superior temporal gyrus, bilateral middle temporal gyrus, left inferior temporal gyrus, and right cingulate gyrus (CG) (P < 0.05). In correlation analysis, ALFF in the left SFG and right CG was negatively correlated with pain symptoms and negative emotions in patients with TN. Patients with TN show functional abnormalities in several key brain regions that are involved in pain perception and emotion regulation. These abnormalities primarily manifest as a reduction in spontaneous neural activity. ALFF in the left SFG and right CG is negatively correlated with the severity of pain and negative emotions, indicating that as pain and negative emotions become more severe in patients with TN, neural activity decreases more significantly in specific brain regions. This suggests that the left SFG and right CG may be characteristic brain regions in the pathophysiological mechanism of TN.

Research on brain areas involved in experiencing emotion and physical pain is abundant; however, psychological pain has received little attention in studies of the brain. The purpose of this systematic review was to provide an overview of studies on brain function related to psychological pain. The review was limited to studies in which participants experienced actual psychological pain or recalled a significant autobiographical event that may be assumed to have involved psychological pain. Based on results of the studies (N = 18), a tentative neural network for psychological pain is proposed that includes the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. Results indicated that grief may be a more accurate exemplar of psychological pain than recalled sadness, with indications of greater arousal during psychological pain. The proposed neural network for psychological pain overlaps to some extent with brain regions involved in physical pain, but results suggest a markedly reduced role for the insula, caudate, and putamen during psychological pain. Psychological pain is well known for its association with depression and as a precursor of suicidal behavior. Thus, identification of brain areas involved in psychological pain may help guide development of interventions to decrease mortality and morbidity.

If I do A, B will happen: Dissecting circuits detecting causal relations between actions and outcomes in marmoset prefrontal cortex

Age-related reduction in trait anxiety: Behavioral and neural evidence of automaticity in negative facial emotion processing

Negative emotionality and emotion regulation: A person-centered approach to predicting socioemotional adjustment in young adolescents