Adriane Icenhour

Ruhr-Universität Bochum | RUB · Department of Affective Neuroscience

The role of psychological factors in the pathophysiology and treatment of chronic visceral pain in disorders of gut-brain interactions (DGBI) is increasingly appreciated. Placebo research has underscored that expectations arising from the psychosocial treatment context and from prior experiences shape treatment responses. However, effects of negati...

Visceral pain and stress are tightly intertwined bodily and emotional phenomena, which enable a flexible adaptation to environmental challenges by activating a response repertoire to restore homeostasis along the gut-brain axis. However, visceral pain and stress can persist widely independent of the initial cause, acquiring independent disease valu...

Background and aims: Despite relevance to pain chronicity, disease burden, and treatment, mechanisms of pain perception for different types of acute pain remain incompletely understood in patients with inflammatory bowel disease (IBD). Building on experimental research across pain modalities, we herein addressed behavioral and neural correlates of...

Objective Irritable bowel syndrome (IBS) is a chronic pain disorder characterized by disturbed interactions between the gut and the brain with depression as a common comorbidity. In both IBS and depression, structural brain alterations of the insular cortices, key structures for pain processing and interoception, have been demonstrated but the spec...

Placebo research has established the pivotal role of treatment expectations in shaping symptom experience and patient-reported treatment outcomes. Perceived treatment efficacy constitutes a relevant yet understudied aspect, especially in the context of the gut-brain axis with visceral pain as key symptom. Using a clinically relevant experimental mo...

Avoidance behaviors are shaped by associative learning processes in response to fear of impending threats, particularly physical harm. As part of a defensive repertoire, avoidance is highly adaptive in case of acute danger, serving a potent protective function. However, persistent or excessive fear and maladaptive avoidance are considered key facto...

Disturbances of the gut-brain axis are characterized by complex dysfunctions on peripheral and central nervous system levels, which can contribute to visceral hypervigilance and hyperalgesia and imprint visceral pain. Numerous cognitive, emotional and psychoneurobiological factors are involved in visceral pain modulation, which in the psychosocial...

The relevance of contextual factors in shaping neural mechanisms underlying visceral pain-related fear learning remains elusive. However, benign interoceptive sensations, which shape patients’ clinical reality, may context-dependently become conditioned predictors of impending visceral pain. In a novel context-dependent interoceptive conditioning p...

The formation and persistence of negative pain-related expectations by classical conditioning remain incompletely understood. We elucidated behavioural and neural correlates involved in the acquisition and extinction of negative expectations towards different threats across sensory modalities. In two complementary functional magnetic resonance imag...

Vasoactive intestinal polypeptide (VIP) is a neuroendocrine peptide distributed throughout the human body, including the CNS, where it is particularly abundant in brain regions associated with anxiety and depression. Based on earlier studies indicating that peripheral VIP may cross through the blood–brain barrier, we hypothesized plasma VIP levels...

Irritable bowel syndrome (IBS) is a symptom-based disorder of gut-brain interactions generating abdominal pain. It is also associated with a vulnerability to develop extraintestinal symptoms, with fatigue often reported as one of the most disturbing. Fatigue is related to brain function and inflammation in several disorders, however, the mechanisms...

The role of pain-related fear learning and memory processes, conceptually embedded within the fear-avoidance model of chronic pain, is increasingly recognized. The unique biological salience of interoceptive, visceral pain with its cognitive, emotional, and motivational facets fosters associative learning. Conditioned fear is in principle adaptive...

Background Although early adverse life events (EALs) are prevalent among patients with irritable bowel syndrome (IBS), the impact of fear or dissociation experienced during the trauma has not been evaluated. We investigated the prevalence of fear at the time of trauma and its association with IBS status among individuals with early‐life trauma befo...

Visceroception is a complex phenomenon comprising the sensation, interpretation, and integration of sensations along the gut-brain axis, including pain or defecatory urgency. Stress is considered a crucial risk factor for the development and maintenance of disorders of gut-brain signaling, which are characterized by altered visceroception. Although...

Altered neural mechanisms are well-acknowledged in irritable bowel syndrome (IBS), a disorder of brain-gut-communication highly comorbid with anxiety and depression. As a key hub in corticolimbic inhibition, medial prefrontal cortex (mPFC) may be involved in disturbed emotion regulation in IBS. However, aberrant mPFC excitatory and inhibitory neuro...

Background Visceral hypersensitivity plays a key role in the pathophysiology of chronic visceral pain like irritable bowel syndrome (IBS), which is significantly more prevalent in women. Possible sex differences in visceral sensitivity remain poorly studied. We assessed sex differences in visceral sensitivity and their association with subclinical...

Despite growing interest in the role of stress mediators in pain chronicity, the effects of the stress hormone cortisol on acute pain remain incompletely understood. In a randomized, double-blind, placebo-controlled study with N = 100 healthy volunteers, we tested the effects of oral hydrocortisone (20 mg) in 2 widely used pain models for the visce...

Irritable bowel syndrome (IBS) is a visceral pain condition with psychological comorbidity. Brain imaging studies in IBS demonstrate altered function in anterior insula (aINS), a key hub for integration of interoceptive, affective, and cognitive processes. However, alterations in aINS excitatory and inhibitory neurotransmission as putative biochemi...

Changes in brain-gut interactions have been implicated in the pathophysiology of chronic visceral pain in irritable bowel syndrome (IBS). Different mechanisms of sensitization of visceral afferent pathways may contribute to the chronic visceral pain reports and associated brain changes that characterize IBS. They include increased gut permeability...

Objective: The aim of this study was to compare behavioral and neural anticipatory responses to cues predicting either somatic or visceral pain in an associative learning paradigm. Methods: Healthy women (N=22) underwent functional magnetic resonance imaging. During an acquisition phase, two different visual cues repeatedly signaled either exper...

Increased perception of visceral stimuli is a key feature of Irritable Bowel Syndrome (IBS). While altered resting-state functional connectivity (rsFC) has been also reported in IBS, the relationship between visceral hypersensitivity and aberrant rsFC is unknown. We therefore assessed rsFC within the salience, sensorimotor and default mode networks...

There is evidence to support a role of the cerebellum in emotional learning processes, which are demonstrably altered in patients with chronic pain. We tested if cerebellar activation is altered during visceral pain-related fear conditioning and extinction in irritable bowel syndrome (IBS). Cerebellar blood oxygenation level-dependent (BOLD) data f...

This functional magnetic resonance imaging (fMRI) study addressed similarities and differences in behavioral and neural responses to experimental visceral compared to somatic pain stimuli and explored the contribution of fear of pain to differences between pain modalities. In N=22 healthy women, blood oxygen level-dependent (BOLD) responses to rect...

Background: Studies investigating mechanisms underlying nocebo responses in pain have mainly focused on negative expectations induced by verbal suggestions. Herein, we addressed neural and behavioral correlates of nocebo responses induced by classical conditioning in a visceral pain model. Methods: In two independent studies, a total of 40 healt...

Zusammenfassung Der von inneren Organen ausgehende, viszerale Schmerz unterscheidet sich in entscheidenden Aspekten von somatischen Schmerzen, sodass sich aus der somatischen Schmerzforschung gewonnene Erkenntnisse nur begrenzt übertragen lassen. Zugleich sind insbesondere zentralnervöse Mechanismen der bidirektionalen Kommunikation zwischen Darm u...

Visceral pain arising from inner organs differs from somatic pain in crucial aspects, limiting the possibility to transfer knowledge derived from somatic pain research. The neurobiological mechanisms involved in the bidirectional communication between the brain and the gut along the brain-gut axis remain incompletely understood. This review address...

Die Beteiligung spezifischer Großhirnareale an assoziativen Lern- und Gedächtnisprozessen bei chronischen Schmerzen ist durch eine Vielzahl experimenteller Studien gut belegt. Jedoch gibt es erste Hinweise, dass das Kleinhirn ebenfalls kognitiv-emotionale Lernvorgänge vermittelt. Insbesondere funktionelle chronische Schmerzen wie beim Reizdarmsyndr...

Conditioned pain-related fear may contribute to hyperalgesia and central sensitization, but this has not been tested for interoceptive, visceral pain. The underlying ability to accurately predict pain is based on predictive cue properties and may alter the sensory processing and cognitive-emotional modulation of pain thus exacerbating the subjectiv...

As a fundamental learning process, fear conditioning promotes the formation of associations between predictive cues and biologically significant signals. In its application to pain, conditioning may provide important insight into mechanisms underlying pain-related fear, although knowledge especially in interoceptive pain paradigms remains scarce. F...

Hyperalgesie ist ein Schlüsselkonzept in der Pathophysiologie chronischer Schmerzen. Es wird angenommen, dass klassisch-konditionierte, Schmerz-assoziierte Furcht zur Entstehung einer Hyperalgesie unter Beteiligung zentralnervöser Sensibilisierung beiträgt. Jedoch beruhen bisherige Ergebnisse auf somatischen Schmerzmodellen und gelten somit nicht u...

The role of context in pain-related extinction learning remains poorly understood. We analyzed the neural mechanisms underlying context-dependent extinction and renewal in a clinically relevant model of conditioned abdominal pain-related fear. In this functional magnetic resonance imaging study, two groups of healthy volunteers underwent differenti...

Zusammenfassung Epidemiologische Studien dokumentieren, dass Frauen deutlich haufiger von chronischen Schmerzen betroffen sind als Manner. Die Ursachen und Mechanismen, die diesen Geschlechtsunterschieden zugrunde liegen, werden jedoch erst seit einigen Jahren systematisch untersucht. Aktuell geht man von einem multifaktoriellen Schmerzmodell aus,...

Background Altered pain anticipation likely contributes to disturbed central pain processing in chronic pain conditions like irritable bowel syndrome (IBS), but the learning processes shaping the expectation of pain remain poorly understood. We assessed the neural circuitry mediating the formation, extinction, and reactivation of abdominal pain-rel...

Background We explored sex differences in the neural mechanisms mediating placebo analgesia in an established visceral pain model involving painful rectal distensions in healthy volunteers.MethodsN = 15 men and N = 15 women underwent three consecutive functional magnetic resonance imaging sessions during which cued painful rectal distensions were d...

Tier- und humanexperimentelle Studien zeigen, dass das Kleinhirn an der klassischen Furchtkonditionierung beteiligt ist. Furchtkonditionierung ist für die Pathophysiologie chronischer Schmerzsyndrome relevant, da diese häufig mit Angsterkrankungen überlappen. Vor dem Hintergrund der deutlich höheren Prävalenz chronischer Schmerzsyndrome bei Frauen...

Background and aims: There exists converging evidence to support a role of pain-related fear in the pathophysiology and treatment of chronic pain conditions. Pain-related fear is shaped by associative learning and memory processes, which remain poorly characterized especially in the context of abdominal pain such as in irritable bowel syndrome (IB...