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Plenary II - From Nociception to Zen Meditation: The Experiential Neurophenomenology of Pain Regulation
Pierre Rainville, PhD
Acute pain is associated with a variety of responses ranging from spinal nociceptive reflexes to autonomic arousal, a specific facial expression, as well as a unique sensory experience combined with a variety of emotional and cognitive reactions associated with the felt somatic threat. Most studies have emphasized self-report as the gold standard of pain measurement. These responses are generally associated with the activation of the cortical targets of the spino-thalamocortical system. These brain responses are also modulated by a variety of interventions that affect pain perception such as distraction, expectation and hypnosis. Motor and autonomic reflexes can also be evoked by noxious stimuli but these may be at least partly dissociated from pain reports. Brain activation associated with these separate output channels reveal complementary nociceptive responses that may not be adequately or fully captured by self-report. Similarly, the facial expression of pain may convey complementary information about spino-thalamocortical activity not fully accounted for by self-report.
In contrast, the lack of facial response to nociceptive stimuli appears to reflect an active suppression of spontaneous expression induced by prefrontal cortices. Finally, experiential descriptions should be conceived as essential and complementary means to describe pain and emotional experiences but these are not sufficiently exploited in neuroscience. The effects of hypnotic interventions targeting sensory or affective experiential dimensions of pain and the recent investigation of pain responses in Zen meditators trained to observe their experience passively and in a non-judgemental manner further provide unique insight on the brain systems involved in pain and suffering.
Pierre Rainville, PhD, is Professor at the Faculty of Dentistry of the Université de Montréal and Director of the Laboratoire de recherche en neuropsychologie de la douleur at the Research center of the Institut universitaire de gériatrie de Montréal. He is trained in clinical and experimental neuropsychology and has completed post-doctoral training in Cognitive neuroscience in the laboratory of Antonio R. Damasio. His research focuses on the neurophysiology of pain and emotions with a particular emphasis on the brain mechanisms underlying the non-pharmacological approaches to pain relief (hypnosis, placebo…). His research is funded by the CIHR, NSERC and FRSQ and has been published in high impact scientific journals including Science, Proceedings of the National Academy of Science, Journal of Neuroscience, Pain and the Journal of Cognitive Neuroscience. He is also the author or co-author or several chapters in major textbooks in the field of pain and affective neurosciences.