Nociception and prediction
Chapter 10 endnote 20, from Lisa Feldman Barrett.
Some context is:
...your body-budgeting regions issue predictions that can dial pain up and down like a volume control. Those predictions can influence your brain’s simulation of pain, and they also reach down to your body and can amplify or dampen its status reports to your brain.
My hypothesis: if nociception works the same as every other sense, as the anatomy of the brain suggests, then body-budgeting regions send the same predictions to primary nociceptive cortex as well, sending information that effectively says “Here are the nociceptive sensations that should occur, based on last time the core of the body was in this state while in this particular situation.” So nociceptive sensations, like all other sensations, are influenced by the state of your body budget. The implication is profound: your brain's predictions of inner body motion can create the feeling more intense or less intense pain, by acting like a volume control for your nociceptive sensations. (And sure enough, new evidence indicates that the body budgets do tune up, and tune down, nociception.)
Body-budgeting predictions to the body (that descend through the brainstem to the spinal cord) are also in the perfect position to act like a second volume knob for nociceptive sensations, because they can amplify or dampen your body’s status reports to the brain. As predictions head from your body-budgeting regions down to your spinal cord (to control your autonomic nervous system, immune system, and endocrine system), nociceptive inputs (reporting on tissue damage, etc.) and interoceptive input (reporting on changes in the body’s internal tissues) head up from body to brain. Body-budgeting predictions are therefore anatomically in a position to talk to the nociceptive input that is ascending as prediction error.
Notes on the Notes
- Traub, Richard J., Dong-Yuan Cao, Jane Karpowicz, Sangeeta Pandya, Yaping Ji, Susan G. Dorsey, and Dean Dessem. 2014. "A Clinically Relevant Animal Model of Temporomandibular Disorder and Irritable Bowel Syndrome Comorbidity." The Journal of Pain 15 (9): 956-966.
- Colloca, Luana, and Fabrizio Benedetti. 2007. "Nocebo hyperalgesia: how anxiety is turned into pain." Current Opinion in Anesthesiology 20 (5): 435-439.
- Damasio, Antonio, and Gil B. Carvalho. 2013. “The Nature of Feelings: Evolutionary and Neurobiological Origins.” Nature Reviews Neuroscience 14 (2): 143–152.