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:
Benson S, Kattoor J, Kullmann JS, Hofmann S, Engler H, Forsting M, Gizewski ER, Elsenbruch S (2014) Towards understanding sex differences in visceral pain: enhanced reactivation of classically-conditioned fear in healthy women. Neurobiol Learn Mem. 109: 113–121.
Elsenbruch S, Rosenberger C, Bingel U, Forsting M, Schedlowski M, Gizewski ER (2010) Patients with irritable bowel syndrome have altered emotional modulation of neural responses to visceral stimuli. Gastroenterology. 139(4): 1310–1319.
Elsenbruch S, Wolf OT (2015) Could Stress Contribute to Pain-Related Fear in Chronic Pain? Front Behav Neurosci. 9: 340.
Gramsch C, Kattoor J, Icenhour A, Forsting M, Schedlowski M, Gizewski ER, Elsenbruch S (2014) Learning pain-related fear: neural mechanisms mediating rapid differential conditioning, extinction and reinstatement processes in human visceral pain. Neurobiol Learn Mem. 116: 36–45.
Icenhour A, Langhorst J, Benson S, Schlamann M, Hampel S, Engler H, Forsting M, Elsenbruch S (2015a) Neural circuitry of abdominal pain-related fear learning and reinstatement in irritable bowel syndrome. Neurogastroenterol Motil. 27(1): 114–127.
Icenhour A, Kattoor J, Benson S, Boekstegers A, Schlamann M, Merz CJ, Forsting M, Elsenbruch S (2015b) Neural circuitry underlying effects of context on human pain-related fear extinction in a renewal paradigm. Hum Brain Mapp. 36(8): 3179–3193.
Kattoor J, Gizewski ER, Kotsis V, Benson S, Gramsch C, Theysohn N, Maderwald S, Forsting M, Schedlowski M, Elsenbruch S (2013) Fear conditioning in an abdominal pain model: neural responses during associative learning and extinction in healthy subjects. PLoS One. 8(2): e51149.
Labrenz F, Icenhour A, Benson S, Elsenbruch S (2015) Contingency Awareness Shapes Acquisition and Extinction of Emotional Responses in a Conditioning Model of Pain-Related Fear. Front Behav Neurosci. 9: 318.
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.
Schmid J, Langhorst J, Gass F, Theysohn N, Benson S, Engler H, Gizewski ER, Forsting M, Elsenbruch S (2015) Placebo analgesia in patients with functional and organic abdominal pain: a fMRI study in IBS, UC and healthy volunteers. Gut. 64(3): 418–427.