Supplementary Digital Content

Transcription

1 Supplementary Digital Content Contextual modulation of pain in masochists: involvement of the parietal operculum and insula Sandra Kamping a, Jamila Andoh a, Isabelle C. Bomba a, Martin Diers a,b, Eugen Diesch a, Herta Flor a a Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany b Institute of Medical Psychology and Medical Sociology, Georg-August-University Goettingen, Goettingen, Germany Department of Psychosomatic Medicine and Psychotherapy, LWL-University, Ruhr- University Bochum, Bochum, Germany Emotional modulation of pain by IAPS pictures For the emotional modulation of pain intensity ratings during the presentation of negative, neutral and positive pictures, we found no significant interaction of EMOTION x GROUP (F(1,30) = 1.494; p = 0.231) but a significant main effect of EMOTION (F(1,30) = 765, p = 0.003). We observed significantly higher pain intensity ratings for negative versus neutral pictures (t(31) = 2.770, p = 0.009) and negative versus positive pictures (t(31) = 3.289, p = 0.003), but no significant difference between neutral and positive pictures (t(31) = 0.809, p = 0.425). For the emotional modulation of pain unpleasantness during the presentation of negative, neutral and positive pictures, we found again no significant interaction of EMOTION x GROUP (F(1,30) = 0.309, p = 0.553) but a significant main effect of EMOTION (F1,30) = , p = 0.001). Pain intensity ratings were significantly higher for negative versus neutral pictures (t(31) = 3.439, p = 0.002), and negative versus positive pictures (t(31) = 3.572, p = 0.001), but no significant difference between neutral and positive pictures (t(31) = 1.232, p = 0.227). 1

2 Functional imaging results of the picture trials of the IAPS pictures There were no significant group differences in brain activation for neutral and positive picture trials between masochists and controls. For the negative picture trials, the controls compared to masochists showed significantly greater activation in the left superior parietal lobe (x: -34, y: -36, z: 38, z- max: 3.59, 286 voxels). There were no significant differences in brain activation for neutral and negative picture-pain trials between masochists and controls. For the positive picture-pain trials, masochists showed significantly increased activation in the left inferior frontal gyrus (x: -52, y: 8, z: 4, z-max: 4.37, 705 voxels), left frontal pole (x: -30, y: 50, z: 26, z-max: 3.80, 639 voxels), right frontal operculum (x: 46, y: 24, z: 0, z-max: 2.7, 472 voxels) and right supplementary motor area (x: 2, y: -8, z: 50, z-max: 3.45, 296 voxels) compared to controls. 2

3 Table S1: Results of the ratings of valence, arousal, relevance and appeal of the masochistic pictures by 18 masochists. Masochistic subjects M (SD), range Valence ratings of masochistic pictures a 6.34 (0.87), Arousal ratings of masochistic pictures a 4.62 (1.44), Relevance ratings of the masochistic pictures b 3.68 (0.70), Appeal of the picture related to one s own practices c 3.62 (0.48), a Valence and arousal ratings were collected using the Self-Assessment Manikin (SAM) rating scale (1 = negative valence/no arousal, 9 = positive valence/high arousal). b Ratings were conducted on a 5-point scale with 1 = not relevant at all and 5 = extremely relevant. c Ratings were conducted on a 5-point scale with 1 = not appealing to one s own masochistic practices, 5 = very appealing to one s own masochistic practices. 3

4 Table S2: Mean coordinates (mm) of the brain areas activated for the pain-only trials for both masochists and controls combined. MNI coordinates in mm x y z Cluster-size (voxels) Region z-stat right insula a left insula right parietal operculum left parietal operculum right central operculum left central operculum right M1/S left M1/S right thalamus left thalamus ACC PCC left occipital pole M1: precentral gyrus, S1: postcentral gyrus, ACC: anterior cingulate cortex, PCC: posterior cingulate cortex a This large cluster listed under insula encompassed the areas mentioned below. 4

5 Table S3: Mean coordinates (mm) of the brain areas activated for the masochistic picture trials for masochists and controls. MNI coordinates in mm Cluster-size Region X y z z-stat (voxels) Masochists activations left thalamus a right thalamus left amygdala right amygdala left hippocampus right parahippocampal gyrus left parahippocampal gyrus right PAG left PAG right occipital pole left occipital pole right M left M right MFG Left SMG Masochists- deactivations right lateral occipital cortex left angular gyrus right MFG left STG left precuneus b right PCC left PCC Controls - activations right lateral occipital cortex c right thalamus left thalamus right amygdala left amygdala right hippocampus left hippocampus right parahippocampal gyrus left parahippocamapl gyrus left PAG left occipital fusiform gyrus left frontal pole right MFG d left MFG right SMG Controls - deactivations right frontal pole e right ACC right frontal operculum left planum temporale f

6 left central operculum right lateral occipital cortex left M right caudate PAG: periaqueductal gray, M1: precentral gyrus, MFG: medial frontal gyrus, SMG: supramarginal gyrus, STG: superior temporal gyrus, PCC: posterior parietal cortex, ACC: anterior cingulate cortex a This large cluster listed under thalamus encompassed the below areas. b This large cluster listed under precuneus encompassed the bilateral PCC. c This large cluster listed under lateral occipital cortex encompassed the below areas. d This large cluster extended bilaterally. e This large cluster listed under frontal pole extended into the ACC and frontal operculum. f This large cluster listed under planum temporale encompassed the central operculum. 6

7 Table S4: Mean coordinates (mm) of the areas activated for the masochistic picture-pain trials for masochists and controls. MNI coordinates in mm Cluster-size Region x y z z-stat (voxels) Masochists - activations right temporal occipital fusiform cortex a left temporal occipital fusiform cortex right lateral occipital cortex left lateral occipital cortex right thalamus left thalamus right hippocampus left hippocampus right parahippocampal gyrus left parahippocampal gyrus right amygdala left amygdala right insula left insula right parietal operculum left parietal operculum right M left M right S left S right SMG left SMG ACC ACC left IFG right frontal pole Controls - activations right temporal occipital fusiform gyrus b left occipital pole right thalamus left hippocampus right hippocampus left hippocampus right parahippocampal gyrus left parahippocampal gyrus right amygdala left amygdala right insula left insula right central operculum right M left M

8 right S left S right ACC left frontal pole c right MFG left MFG right subcallosal cortex left subcallosal cortex M1: precentral gyrus, S1: postcentral gyrus, SMG: supramarginal gyrus, ACC: anterior cingulate cortex, IFG: inferior frontal gyrus, MFG: medial frontal gyrus a This large cluster listed under temporal occipital fusiform cortex encompassed the below areas. b This large cluster listed under temporal occipital fusiform cortex encompassed the below areas. c This large cluster listed under frontal pole encompassed the below areas. 8

9 Table S5: Mean coordinates (mm) of the areas with increased functional connectivity with the parietal operculum during the masochistic picture-pain trials for masochists and controls. MNI coordinates in mm x y z Cluster-size (voxels) Region z-stat Masochists positive connectivity left lateral occipital cortex Masochists negative connectivity left M1 a left parietal operculum left central operculum left insula left lingual gyrus b left thalamus left parahippocampal gyrus right central operculum c right M left M right SMG right ACC right insula d right parietal operculum right SMG right supracalcarine cortex right parahippocampal gyrus e right thalamus left lateral occipital cortex right frontal pole Controls negative connectivity left temporal fusiform cortex f left parahippocampal gyrus M1: precentral gyrus, SMG: supramarginal gyrus, ACC: anterior cingulate cortex a This large cluster listed under M1 encompassed the below areas. b This large cluster listed under lingual gyrus encompassed the below areas. c This large cluster listed under central operculum encompassed the below areas. d This large cluster listed under insula encompassed the below areas. e This large cluster listed under parahippocampal gyrus encompassed the thalamus. f This large cluster listed under temporal fusiform cortex encompassed the parahippocampal gyrus. 9

10 Table S6: Mean coordinates (mm) of the brain areas activated for the pain-only trials for masochists and controls separately. Region Pain-only trial Controls MNI coordinates in mm x y z z-stat Middle occipital cortex Cerebellum Superior occipital cortex Middle temporal gyrus Supramarginal gyrus Supramarginal gyrus, extending into the insula Thalamus Parietal ventral operculum Insula, extending into the secondary somatosensory cortex Superior frontal gyrus Primary motor cortex, extending into the primary somatosensory cortex Inferior frontal operculum, extending into the secondary somatosensory cortex Caudate Anterior cingulate cortex Pain-only trial Masochists Inferior frontal operculum, extending into the insula and the secondary somatosensory cortex, as well as the anterior and middle cingulate cortex Inferior parietal cortex, extending into the insula and secondary somatosensory cortex Inferior frontal cortex (pars triangularis) Cerebellum Primary motor cortex extending into the primary somatosensory cortex Inferior occipital cortex Middle frontal gyrus Supramarginal gyrus Middle temporal gyrus Clustersize (voxels) 10

11 Figure S1: Imaging results of the pain-only trials. Areas activated while receiving painful stimuli for control subjects and masochists combined. Pictures were created using MRIcroN ( with the function render and the following parameters: overlay (air/skin threshold) = 10%, search depth = 8mm, search: infront/below BG surface; for the left hemisphere the azimuth was set at -120 and the elevation at +35, for the right hemisphere the azimuth was set at +120 and the elevation at