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Doctor trustworthiness influences pain and its neural correlates in virtual medical interactions.

ABSTRACT: Trust is an important component of the doctor-patient relationship and is associated with improved patient satisfaction and health outcomes. Previously, we reported that patient feelings of trust and similarity toward their clinician predicted reductions in evoked pain in response to painful heat stimulations. In the present study, we investigated the brain mechanisms underlying this effect. We used face stimuli previously developed using a data-driven computational modeling approach that differ in perceived trustworthiness and superimposed them on bodies dressed in doctors' attire. During functional magnetic resonance imaging, participants (n = 42) underwent a series of virtual medical interactions with these doctors during which they received painful heat stimulation as an analogue of a painful diagnostic procedure. Participants reported increased pain when receiving painful heat stimulations from low-trust doctors, which was accompanied by increased activity in pain-related brain regions and a multivariate pain-predictive neuromarker. Findings suggest that patient trust in their doctor may have tangible impacts on pain and point to a potential brain basis for trust-related reductions in pain through the modulation of brain circuitry associated with the sensory-discriminative and affective-motivational dimensions of pain.

SUBMITTER: Anderson SR

PROVIDER: S-EPMC10068271 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Doctor trustworthiness influences pain and its neural correlates in virtual medical interactions.

Anderson Steven R SR Gianola Morgan M Medina Natalia A NA Perry Jenna M JM Wager Tor D TD Losin Elizabeth A Reynolds EAR

Cerebral cortex (New York, N.Y. : 1991) 20230301 7

Trust is an important component of the doctor-patient relationship and is associated with improved patient satisfaction and health outcomes. Previously, we reported that patient feelings of trust and similarity toward their clinician predicted reductions in evoked pain in response to painful heat stimulations. In the present study, we investigated the brain mechanisms underlying this effect. We used face stimuli previously developed using a data-driven computational modeling approach that differ ...[more]

PMID: 36001114

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Project description:Abstract Persons with Tourette syndrome show altered social behaviours, such as echophenomena and increased personal distress in emotional situations. These symptoms may reflect an overactive mirror neuron system, causing both increased automatic imitation and a stronger tendency to share others’ emotions. To test this, we measured the individual level of echophenomena with a video protocol and experimentally induced empathy for pain in 21 participants with Tourette syndrome and 25 matched controls. In the empathy for pain paradigm, pictures of hands and feet in painful or neutral situations were presented, while we measured participants’ EEG and skin conductance response. Changes in somatosensory mu suppression during the observation of the pictures and pain ratings were compared between groups, and correlations were calculated with the occurrence of echophenomena, self-reported empathy and clinical measures. Our Tourette syndrome sample showed significantly more echophenomena than controls, but the groups showed no behavioural differences in empathic abilities. However, controls, but not patients with Tourette syndrome, showed the predicted increased mu suppression when watching painful compared to neutral actions. While echophenomena were present in all persons with Tourette syndrome, the hypothesis of an overactive mirror neuron system in Tourette syndrome could not be substantiated. On the contrary, the Tourette syndrome group showed a noticeable lack of mu attenuation in response to pain stimuli. In conclusion, we found a first hint of altered processing of others’ emotional states in a brain region associated with the mirror neuron system. Weiblen et al. report intact behavioural empathy for pain in Tourette syndrome, accompanied by reduced neural differentiation between painful and neutral stimuli. They find no evidence for the hypothesis of an overactive mirror neuron system as the cause of echophenomena and altered social behaviours in Tourette syndrome. Graphical Abstract Graphical Abstract

Dataset Information

Doctor trustworthiness influences pain and its neural correlates in virtual medical interactions.

Publications

Doctor trustworthiness influences pain and its neural correlates in virtual medical interactions.

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