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Front. Behav. Neurosci. | doi: 10.3389/fnbeh.2018.00323

Pain expressions and inhibitory control in patients with fibromyalgia: behavioral and neural correlates

  • 1Department of Clinical Psychology and Psychobiology, Facultad de Psicologia, Universidad de Santiago de Compostela, Spain

Fibromyalgia (FM) is a generalized chronic pain condition associated with a variety of symptoms, including altered cognitive and emotional processing. It has been proposed that FM patients show a preferential allocation of attention to information related to the symptoms of the disease, particularly to pain cues. However, the existing literature does not provide conclusive evidence on the presence of this attentional bias, and its effect on cognitive functions such as inhibitory control.
To clarify this issue, we recorded the electroencephalographic activity of 31 women diagnosed with FM and 28 healthy women, while performing an emotional Go/NoGo task with micro-videos of pain, happiness, and neutral facial expressions. We analyzed behavioral data, performed EEG time-frequency analyses, and obtained the event-related potentials (ERPs) N2 and P3 components in NoGo trials. A series of self-reports was also administered to evaluate catastrophic thinking and the main symptoms of fibromyalgia.
Pain expressions were associated with longer reaction times and more errors, as well as with higher theta and delta power, and P3 amplitude to NoGo stimuli. Thus, behavioral and psychophysiological data suggest that increased attention to pain expressions impairs the performance of an inhibitory task, although this effect was similar in FM patients and healthy controls. N2 amplitude was modulated by type of facial expression (larger to pain faces), but only for the control group. This finding suggests that the presentation of pain faces might represent a smaller conflict for the patients, more used to encounter pain stimuli. No main group effects were found significant for N2 or P3 amplitudes, nor for time-frequency data. Using stimuli with greater ecological validity than in previous studies, we could not confirm a greater effect of attentional bias towards negative stimuli over inhibitory performance in patients with FM. Studying these effects allow us to better understand the mechanisms that maintain pain and develop intervention strategies to modify them.
Keywords: Chronic pain; cognitive dysfunction; emotion; attention; pain; inhibitory control; EEG; ERPs.

Keywords: Chronic Pain, Fibromyaglia, cognitive dysfunction, attentional bias, Attention, emotion, Pain empathy, EEG & ERP, Inhibitory Control

Received: 05 Jul 2018; Accepted: 07 Dec 2018.

Edited by:

Elia Valentini, University of Essex, United Kingdom

Reviewed by:

Giuseppe Di Pellegrino, University of Bologna, Italy
Daniela M. Pfabigan, Faculty of Medicine, University of Oslo, Norway  

Copyright: © 2018 Pidal-Miranda, González-Villar and Carrillo-de-la-Peña. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ms. M Pidal-Miranda, Facultad de Psicologia, Universidad de Santiago de Compostela, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, 15782, Galicia, Spain,