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: