Does being in pain change how the brain responds to winning money?
People in acute pain showed a stronger medial prefrontal response to winning money, while the nucleus accumbens response was unchanged.
Source
Pain modulates neural responses to reward in the medial prefrontal cortex
Study at a glance
- Design
- Human experiment — Between-subjects fMRI: capsaicin cream (pain) vs. ordinary hand cream (control), then a card-guessing game with rigged win/loss/neutral outcomes.
- N
- N=50 · 50 analysed healthy students (25 pain, 25 control) after excluding the remainder of 60 recruited for head motion or failed pain manipulation; the PPI connectivity test reports fewer degrees of freedom.
- Population
- Healthy Chinese college students
- Outcome
- BOLD responses to win vs. loss feedback in mPFC and nucleus accumbens, mPFC-NAcc connectivity, self-estimated accuracy and happiness ratings
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What they did
Healthy students had either capsaicin cream (which causes a sustained burning pain) or plain hand cream applied to the forearm, then played a card-guessing game in an fMRI scanner. The game was secretly fixed so everyone won and lost equally often. The researchers compared brain responses to wins and losses between groups in the medial prefrontal cortex (mPFC) and nucleus accumbens (NAcc), and tested how strongly these regions were coupled.
What they found
The pain group rated their pain far higher during scanning (7.09 vs. 0.40 on a 0-10 scale). They also overestimated their success, believing they had been correct on 56.8% of trials when the true rate was fixed at chance. Pain boosted the mPFC response to wins but not to losses, and in the pain group a larger mPFC win-minus-loss response went with feeling happier about winning. NAcc responses were not changed by pain, and task-related coupling between mPFC and NAcc was weaker in the pain group.
The limits
What it doesn't show
The whole-brain analysis found no pain effect or interaction; the key mPFC result comes from a region-of-interest test with a modest interaction (p = .034), so it needs replication. Groups were different people, so group differences could partly reflect individual variation rather than pain. The authors note the sample was too small to test sex differences properly, they did not measure how unpleasant the pain felt, and the fixed 50% win rate means reward learning and probability coding were not tested. Links to prosocial behaviour or chronic pain are speculation rather than findings of this study.
Key terms
- Medial prefrontal cortex (mPFC)
- Front midline brain region involved in judging the value and meaning of outcomes, including rewards.
- Nucleus accumbens (NAcc)
- A part of the ventral striatum central to detecting and responding to rewards.
- Capsaicin pain model
- A safe way to create steady, moderate pain by putting chilli-pepper extract cream on the skin.
- Psychophysiological interaction (PPI)
- An fMRI analysis that asks whether the coupling between two brain regions changes depending on the task condition.
- Region of interest (ROI) analysis
- Testing effects in a few pre-chosen brain areas rather than across every voxel of the brain.
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Quiz yourself
What was the main neural effect of acute pain reported in this study?
Common questions
Why rig the game so everyone won half the time?
Fixing outcomes means both groups received identical rewards, so any difference in brain response reflects how pain changes processing, not how much money people actually won.
Does this mean pain makes people happier?
No. It suggests pain may make rewards feel more valuable in the mPFC, and people in pain overrated their own performance, but overall mood was not the target and the effect was modest.
Why does it matter that the NAcc did not change?
It suggests pain affects the evaluation of a reward (an mPFC function) more than the basic detection of it, though the task could not test other NAcc roles like learning reward probabilities.
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