A01 A02 A03 A04 A05 A06 A07 A09 A10 A11 A12 A13 A14 A18 A19 A21 F01 F02 INF Ö

A11 – Appetitive and aversive pain-related learning in health and chronic back pain

Ulrike Bingel, Katharina Schmidt

Project A11 will investigate neural and behavioral mechanisms underlying the acquisition, extinction and reinstatement of pain-related fear in the context of somatic pain. We will compare patients suffering from chronic low back pain to healthy controls using a differential fear conditioning paradigm with painful heat as unconditioned stimuli (US) while collecting behavioral, physiological, neuroendocrine and neural data (MRI). The planned studies will examine (1) pain-specific aspects of fear conditioning, (2) the effects of pharmacologically induced stress on extinction recall and reinstatement and (3) neural common and distinct neural mechanisms underlying appetitive and aversive conditioning in the context of somatic pain.

Guiding questions of A11:

  • Do behavioral and neural mechanisms of acquisition, extinction and reinstatement of CS-US associations differ between somatic pain stimuli and equally aversive auditory stimuli? Are these pain-specific effects enhanced in chronic low back pain patients?
  • Does the systemic application of the glucocorticoid hydrocortisone impair the memory for extinguished fear of pain? Is this effect augmented in patients suffering from chronic low back pain?
  • Do learning and extinction mechanisms differ between cues predicting pain relief and cues predicting pain exacerbation? What are the commonalities and distinctions between aversive and appetitive learning in the context of pain?
Back to overview

Ulrike Bingel

Projektleiterin A11

Universität Duisburg-Essen

Katharina Schmidt

Projektleiterin A11

Universität Duisburg-Essen

Katja Wiech

Beraterin A11

University of Oxford

Lea Busch

Doktorandin A11

Universität Duisburg-Essen

Jialin Li

Doktorandin A11

Universität Duisburg-Essen

Bálint Kincses

Postdoc A11

Universität Duisburg-Essen

10 project-relevant publications

Busch L, Wiech K, Gamer M, Kincses B, Spisák T, Schmidt K*, Bingel U* (2023) Modulatory effects of instructions on extinction efficacy in appetitive and aversive learning: A registered report.https://osf.io/cj75p

Forkmann K, Wiech K, Schmidt K, Schmid-Köhler J, Bingel U (2023) Neural underpinnings of preferential pain learning and the modulatory role of fear. Cerebral Cortex 33:9664–9676. https://doi.org/10.1093/cercor/bhad236 

Kincses B, Forkmann K, Schlitt F, Jan Pawlik R, Schmidt K, Timmann D, Elsenbruch S, Wiech K, Bingel U, Spisák T (2024) An externally validated resting-state brain connectivity signature of pain-related learning. Commun Biol 7:875. https://doi.org/10.1038/s42003-024-06574-y 

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. Psychosomatic Medicine 80:826–835. https://doi.org/10.1097/PSY.0000000000000612

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 

Li J*, Schmidt K*, Busch L, Forkmann K, Spisák T, Kaur J, Schlitt-Nguyen F, Wiech K, Bingel U (2025) Common and distinct neural mechanisms of aversive and appetitive pain-related learning. bioRxiv:2025.04.02.646781. https://doi.org/10.1101/2025.04.02.646781 #OA

Schlitt F, Schmidt K, Merz CJ, Wolf OT, Kleine-Borgmann J, Elsenbruch S, Wiech K, Forkmann K, Bingel U (2022) Impaired pain-related threat and safety learning in patients with chronic back pain. Pain 163:1560–1570. https://doi.org/10.1097/j.pain.0000000000002544 

Schmidt K, Forkmann K, Elsenbruch S, Bingel U (2020) Enhanced pain-related conditioning for face compared to hand pain. PLoS ONE 15:e0234160. https://doi.org/10.1371/journal.pone.0234160 

Schmidt K*, Schlitt F*, Wiech K, Merz CJ, Kleine-Borgmann J, Wolf OT, Engler H, Forkmann K, Elsenbruch S*, Bingel U* (2024) Hydrocortisone Differentially Affects Reinstatement of Pain-related Responses in Patients With Chronic Back Pain and Healthy Volunteers. The Journal of Pain 25:1082–1093. doi: 10.1016/j.jpain.2023.10.028 

van der Schaaf ME*, Schmidt K*, Kaur J, Gamer M, Wiech K, Forkmann K, Bingel U (2022) Acquisition learning is stronger for aversive than appetitive events. Commun Biol 5:302. https://doi.org/10.1038/s42003-022-03234-x