A10 – From Pavlov to pain: extinction learning in visceral pain
Sigrid Elsenbruch, Adriane Icenhour
Impaired extinction of pain-related fear may contribute to the pathophysiology of chronic pain, but remains incompletely understood. This proposal aims to address mechanisms and clinical implications of extinction learning with a focus on interoceptive, visceral pain in healthy volunteers and patients with irritable bowel syndrome (IBS). We will address if impaired extinction learning is modality-specific for visceral pain in IBS. We will test if the stress hormone cortisol enhances the reinstatement of pain-related fear, and will implement a new paradigm of contextual interoceptive conditioning with visceral conditioned stimuli in order to address context-dependent extinction processes.
Guiding questions of A10:
- Is altered learning and impaired extinction of pain-related fear specific to the visceral pain modality in patients with IBS?
- Are interoceptive signals effective conditioned stimuli in a new contextual interoceptive conditioning paradigm?
- Can we show reinstatement and renewal effects in this new paradigm?
- Does the stress hormone cortisol impair pain-related extinction learning?
Sigrid Elsenbruch
Projektleiterin A10, A12Ruhr-Universität Bochum
Adriane Icenhour
Projektleiterin A10Universität Duisburg-Essen
Franziska Labrenz
Postdoc A10, A12Ruhr-Universität Bochum / Universität Duisburg-Essen
Genisius Hartanto
Postdoc A10Ruhr-Universität Bochum
Laura R. Lanters née Koenen
Postdoc A10Ruhr-Universität Bochum
Dominic Pundt
Doktorand A10Ruhr-Universität Bochum
Katharina Koch
Doktorandin A10Ruhr-Universität Bochum
Cornelia Klukowski
Doktorandin A10Ruhr-Universität Bochum
10 project-relevant publications
Icenhour A, Petrakova L, Hazzan N, Theysohn N, Merz CJ, Elsenbruch S (2021) When gut feelings teach the brain to fear pain: Context-dependent activation of the central fear network in a novel interoceptive conditioning paradigm. Neuroimage 238:118229. https://doi.org/10.1016/j.neuroimage.2021.118229
Icenhour A, Kattoor J, Benson S, Boekstegers A, Schlamann M, Merz CJ, Forsting M, Elsenbruch S (2015a) Neural circuitry underlying effects of context on human pain-related fear extinction in a renewal paradigm. Hum Brain Mapp 36:3179–3193. https://doi.org/10.1002/hbm.22837
Icenhour A, Langhorst J, Benson S, Schlamann M, Hampel S, Engler H, Forsting M, Elsenbruch S (2015b) Neural circuitry of abdominal pain-related fear learning and reinstatement in irritable bowel syndrome. Neurogastroenterol Motil. 27:114–127. https://doi.org/10.1111/nmo.12489
Keefer L, Ballou SK, Drossman DA, Ringstrom G, Elsenbruch S, Ljótsson B (2022) A Rome Working Team Report on Brain-Gut Behavior Therapies for Disorders of Gut-Brain Interaction. Gastroenterology 162:300–315. https://doi.org/10.1053/j.gastro.2021.09.015
Koenen LR, Pawlik RJ, Icenhour A, Petrakova L, Forkmann K, Theysohn N, Engler H, Elsenbruch S (2021) Associative learning and extinction of conditioned threat predictors across sensory modalities. Commun Biol 4:553. https://doi.org/10.1038/s42003-021-02008-1
Koenen LR, Icenhour A, Forkmann K, Theysohn N, Forsting M, Bingel U, Elsenbruch S (2018) From Anticipation to the Experience of Pain: The Importance of Visceral Versus Somatic Pain Modality in Neural and Behavioral Responses to Pain-Predictive Cues. Psychosom Med 80:826–835. https://doi.org/10.1097/PSY.0000000000000612
Labrenz F, Spisák T, Ernst TM, Gomes CA, Quick HH, Axmacher N, Elsenbruch S, Timmann D (2022a) Temporal dynamics of fMRI signal changes during conditioned interoceptive pain-related fear and safety acquisition and extinction. Behav Brain Res 427:113868. https://doi.org/10.1016/j.bbr.2022.113868
Labrenz F, Icenhour A, Schlamann M, Forsting M, Bingel U, Elsenbruch S (2016) From Pavlov to pain: How predictability affects the anticipation and processing of visceral pain in a fear conditioning paradigm. Neuroimage 130:104–114. https://doi.org/10.1016/j.neuroimage.2016.01.064
Lanters LR, Öhlmann H, Langhorst J, Theysohn N, Engler H, Icenhour A*, Elsenbruch S* (2024) Disease-specific alterations in central fear network engagement during acquisition and extinction of conditioned interoceptive fear in inflammatory bowel disease. Mol Psychiatry 29:3527–3536. (*equal contribution) https://doi.org/10.1038/s41380-024-02612-7
Öhlmann H, Lanters LR, Theysohn N, Langhorst J, Engler H, Icenhour A, Elsenbruch S (2023) Distinct Alterations in Central Pain Processing of Visceral and Somatic Pain in Quiescent Ulcerative Colitis Compared to Irritable Bowel Syndrome and Health. J Crohns Colitis 17:1639–1651. https://doi.org/10.1093/ecco-jcc/jjad080