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, Siebert C, Koenen LR, Engler H, Kleine-Borgmann J, Bingel U, Icenhour A, Elsenbruch S (2019) Cortisol affects pain sensitivity and pain-related emotional learning in experimental visceral but not somatic pain: a randomized controlled study in healthy men and women. Pain. 160(8): 1719–1728.
Elsenbruch S, Benson S, Ricarda Koenen L, Labrenz F, Icenhour A (2020) From gut feelings to memories of visceral pain. Neuroforum. 26(3): 118.
Icenhour A, Labrenz F, Ritter C, Theysohn N, Forsting M, Bingel U, Elsenbruch S (2017) Learning by experience? Visceral pain-related neural and behavioral responses in a classical conditioning paradigm. Neurogastroenterol Motil. 29(6):
Icenhour A, Kattoor J, Benson S, Boekstegers A, Schlamann M, Merz CJ, Forsting M, Elsenbruch S (2015) Neural circuitry underlying effects of context on human pain-related fear extinction in a renewal paradigm. Hum Brain Mapp. 36(8): 3179–3193.
Icenhour A, Labrenz F, Roderigo T, Benson S, Elsenbruch S (2020) The Role of Chronic Stress in Normal Visceroception: Insights From an Experimental Visceral Pain Study in Healthy Volunteers. Front Psychiatry. 11: 107.
Icenhour A, Tapper S, Bednarska O, Witt ST, Tisell A, Lundberg P, Elsenbruch S, Walter S (2019) Elucidating the putative link between prefrontal neurotransmission, functional connectivity, and affective symptoms in irritable bowel syndrome. Sci Rep. 9(1): 1–11.
Koenen LR, Icenhour A, Forkmann K, Pasler A, Theysohn N, Forsting M, Bingel U, Elsenbruch S (2017) Greater fear of visceral pain contributes to differences between visceral and somatic pain in healthy women. Pain. 158(8): 1599–1608.
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(9): 826–835.
Labanski A, Langhorst J, Engler H, Elsenbruch S (2020) Stress and the brain-gut axis in functional and chronic-inflammatory gastrointestinal diseases: A transdisciplinary challenge. Psychoneuroendocrinology. 111: 104501.
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.