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Eur J Pain. 2012 Mar;16(3):349-58. doi: 10.1002/j.1532-2149.2011.00027.x. Epub 2011 Dec 19.

Behavioural and neural correlates of visceral pain sensitivity in healthy men and women: does sex matter?

Author information

1
Institute of Medical Psychology & Behavioral Immunobiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.

Abstract

INTRODUCTION:

We assessed sex differences in behavioural and neural responses to rectal pain stimuli in healthy subjects.

METHODS:

In age- and body mass index-matched healthy subjects (n = 15 men, 15 women), rectal sensory and pain thresholds were assessed with a pressure-controlled barostat device. The blood oxygen level-dependent response during cued anticipation and painful stimulation was measured using functional magnetic resonance imaging (fMRI). Retrospective pain evaluations were accomplished with visual analogue scales. For fMRI data, region-of-interest (ROI) analyses and additional whole-brain analyses were carried out.

RESULTS:

There were no sex differences in rectal thresholds or pain ratings. ROI analyses revealed comparable distension-induced activation of the thalamus, somatosensory cortex, insula and dorsolateral prefrontal cortex (DLPFC). Only in additional whole-brain analyses did we find increased activation in women in DLPFC and middle temporal gyrus during pain anticipation and in the cerebellum and medial frontal gyrus during pain. A significant inverse association between rectal pain threshold and distension-induced activation in virtually all ROIs was found in women. In men, pain thresholds and insula activation were positively correlated, as were pain ratings and anterior cingulate cortex activation.

CONCLUSIONS:

Healthy men and women do not differ in behavioural measures of visceral pain sensitivity. The pattern of neural activation is comparable in the majority of pain-processing brain regions, although women may differ in the activation of DLPFC which could reflect sex differences in cognitive-emotional pain regulation. Women with lower pain thresholds showed greater neural responses, which may be relevant in the pathophysiology of visceral hyperalgesia.

[Indexed for MEDLINE]

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