Reward
Does being in pain change how the brain responds to winning money?
Open access · cc by · source: Europe PMC
People in acute pain showed a stronger medial prefrontal response to winning money, while the nucleus accumbens response was unchanged.
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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Key findings
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.
Methodology
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.
Limitations
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.
How this study connects
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