Pain modulates cerebral activity during cognitive performance.

The present study investigates how pain modulates brain activity during the performance of a semantic cognitive task. Based on previous observations, we hypothesized that a simultaneous painful stimulus will induce an activation increase in brain regions engaged in the cognitive task. High-field BOLD-fMRI experiments were conducted on 12 young healthy subjects, using a 2 x 2 factorial design. Painful stimuli were induced by thermal hot stimulation (46-49 degrees C) on the palmar surface of the hand, using a contact thermode. Cognitive tasks consisted of either word generation (category fluency) or word repetition. Brain activity owing to the semantic tasks in the group was highly consistent with previous neuroimaging studies. When the painful stimulus was added to the cognitive task, activity in brain regions involved in semantic cognition, such as Broca's area, was increased (P < 0.01). Pain also modulated activity in brain areas not directly engaged in cognition. A positive modulation effect was observed in the midcingulate and the dorsomedial prefrontal cortex (P < 0.05). A negative modulation effect was observed in perigenual cingulate cortex, insula, and medial thalamus (P < 0.05).