Pain and attention
The ability to sense pain may be considered as a prerequisite for human survival. The experience of pain helps humans to avoid the execution of actions that can seriously endanger their lives; pain is therefore evolutionarily predisposed to interrupt and capture attention. However, this supposed interconnectedness between pain and attention is still sparsely examined. The aim of this dissertation was to gain further insight in this relation between pain and attention, and more specifically the underlying mechanisms that explain how attention affects pain. The electroencephalographic (EEG) technique was employed to examine and demonstrate the effects of both attention and distraction (achieved by different attentional manipulations) on the electrophysiological responses to experimentally induced nociceptive stimuli (delivered transcutaneous or intracutaneous) in healthy pain free participants.
The different studies revealed that the neural processing of pain is consistently affected by attention. However, to what extent attention affects pain is highly dependent on the type of manipulation used. Namely, only in the case of total irrelevance of nociceptive stimuli, when they occur at to be ignored locations and do not belong to the task set, then the orienting effect is no longer observed. A reduction in processing in somatosensory areas is observed when attention is directed away from the location of the pain stimuli or being occupied with a secondary task, but only if it is 100% sure that the pain stimulus can be ignored. This effect also occurs when the pain stimulus is part of the task set (i.e., when it contains target features).
The studies reported in this dissertation clearly highlight the interconnectedness between pain and attention. Distraction of attention to another modality (not within the same task set) has been shown to be most effective. These results underline the high potential of attention as part of behavioural or clinical therapies in treating and coping with pain (e.g., employing mindfulness, cognitive therapy or with the application of other techniques like virtual reality).
