Tor D Wager

University of Colorado Boulder | CUB · Department of Psychology and Neuroscience

The processing of reinforcers and punishers is crucial to adapt to an ever changing environment and its dysregulation is prevalent in mental health and substance use disorders. While many human brain measures related to reward have been based on activity in individual brain regions, recent studies indicate that many affective and motivational proce...

Mental imagery has been proposed to play a critical role in the amplification of cravings. Here we tested whether olfactory imagery drives food cue reactivity strength to promote adiposity in 45 healthy individuals. We measured odor perception, odor imagery ability, and food cue reactivity using self-report, perceptual testing, and neuroimaging. Ad...

Periaqueductal gray (PAG) columns mediate affective experience, physiological regulation, and survival-related behavior; yet, only 7T imaging can resolve these small structures in humans. In a social stress task, participants prepared a speech, and we observed (a) bilateral ventrolateral PAG activity, relative to baseline, and (b) distinct spatial...

The periaqueductal grey (PAG) is a small midbrain structure that surrounds the cerebral aqueduct, regulates brain–body communication, and is often studied for its role in "fight–or–flight" defense responses. We used ultra–high field 7–Tesla fMRI to resolve the PAG in humans and distinguish it from the cerebral aqueduct, examining its in vivo functi...

Craving is a core feature of substance use disorders. It is a strong predictor of substance use and relapse and is linked to overeating, gambling, and other maladaptive behaviors. Craving is measured via self-report, which is limited by introspective access and sociocultural contexts. Neurobiological markers of craving are both needed and lacking,...

Muscle weakness is common in many neurological, neuromuscular, and musculoskeletal conditions. Muscle size only partially explains muscle strength as adaptions within the nervous system also contribute to strength. Brain-based biomarkers of neuromuscular function could provide diagnostic, prognostic, and predictive value in treating these disorders...

The superior colliculus is often studied for its role in visually guided behaviors, but research in non-human animals indicates it is a midbrain hub for processing sensory information from multiple domains, including interoception (which is associated with affect). We used ultra-high field 7-Tesla fMRI to extend this work to humans, modeling superi...

We examined the superior colliculus (SC) with ultra-high resolution 7-Tesla fMRI during an N-back working memory task. We observed both increased BOLD signal intensity and functional connectivity that followed a layer-dependent pattern predicted from anatomical connections between SC and other brain structures important for visual processing, motor...

Introduction: Genetic correlations between brain and behavioral phenotypes in analyses from major genetic consortia have been weak and mostly nonsignificant. fMRI models of systems-level brain patterns may help improve our ability to link genes, brains, and behavior by identifying reliable and reproducible endophenotypes. Work using connectivity-ba...

Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances and other symptoms, and has a substantial socioeconomic impact. Current biomedical and psychosocial treatments are unsatisfactory for many patients, and treatment progress has been hindered by the lack of a clear understanding of the pathogenesis of fibromyalgia. We prese...

Recent years have marked a renaissance in efforts to increase research reproducibility in psychology, neuroscience, and related fields. Reproducibility is the cornerstone of a solid foundation of fundamental research-one that will support new theories built on valid findings and technological innovation that works. The increased focus on reproducib...

Mediation analysis is used to investigate the role of intermediate variables (mediators) that lie in the path between an exposure and outcome variable. While significant research has focused on developing methods for assessing the influence of mediators on the exposure-outcome relationship, current approaches do not easily extend to settings where...

Unlabelled: A fundamental challenge in emotion research is measuring feeling states with high granularity and temporal precision without disrupting the emotion generation process. Here we introduce and validate a new approach in which responses are sparsely sampled and the missing data are recovered using a computational technique known as collabo...

Mediation analysis is used to investigate the role of intermediate variables (mediators) that lie in the path between an exposure and an outcome variable. While significant research has focused on developing methods for assessing the influence of mediators on the exposure-outcome relationship, current approaches do not easily extend to settings whe...

Sharing imaging data and comparing them across different psychological tasks is becoming increasingly possible as the open science movement advances. Such cross-paradigm integration has the potential to identify commonalities in findings that neighboring areas of study thought to be paradigm-specific. However, even the integration of research from...

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...

This paper responds to a recent critique by Bissett and colleagues of the fMRI Stop task used in the Adolescent Brain Cognitive Development℠ Study (ABCD Study®). The critique focuses primarily on a task design feature related to race model assumptions (i.e., that the Go and Stop processes are fully independent). In response, we note that the race m...

Objective: Mindfulness-based interventions are widely used to target pain, yet their neural mechanisms of action are insufficiently understood. The authors studied neural and subjective pain response in a randomized active-control trial of mindfulness-based stress reduction (MBSR) alongside long-term meditation practitioners. Methods: Healthy pa...

Chronic pain is attributable to both local and systemic pathology. To investigate the latter, we focused on genetic risk shared among 24 chronic pain conditions in the UK Biobank. We conducted genome-wide association studies (GWAS) on all conditions and estimated genetic correlations among them, using these to model a factor structure in Genomic SE...

Brain-Wide Association Studies (BWAS) have become a dominant method for linking mind and brain over the past 30 years. Univariate models test tens to hundreds of thousands of brain voxels individually, whereas multivariate models (‘multivariate BWAS’) integrate signals across brain regions into a predictive model. Numerous problems have been raised...

The processing of rewards and losses are crucial for learning to adapt to an ever changing environment. Dysregulated reward processes are prevalent in mental health and substance use disorders. While many human brain measures related to reward have been based on activity in individual brain regions, recent studies indicate that many affective and m...

Significance We often willingly experience pain to reach a goal. However, potential pain can also prevent reckless action. How do we consider future pain when deciding on the best course of action? To date, the precise neural mechanisms underlying the valuation of future pain remain unknown. Using functional MRI, we derive a whole-brain signature o...

The brain contains both generalized and stimulus-type-specific representations of aversive events, but models of how these are integrated and related to subjective experience are lacking. We combined functional magnetic resonance imaging with predictive modeling to identify representations of generalized (common) and stimulus-type-specific negative...

Characterizing cerebral contributions to individual variability in pain processing is crucial for personalized pain medicine, but has yet to be done. In the present study, we address this problem by identifying brain regions with high versus low interindividual variability in their relationship with pain. We trained idiographic pain-predictive mode...

Information is coded in the brain at multiple anatomical scales: locally, distributed across regions and networks, and globally. For pain, the scale of representation has not been formally tested, and quantitative comparisons of pain representations across regions and networks are lacking. In this multistudy analysis of 376 participants across 11 s...

Chronic pain produces the largest non-fatal burden of disease, yet our understanding of factors that contribute to the transition from acute chronic pain are poorly understood. The Acute to Chronic Pain Signatures Program (A2CPS) is a longitudinal, multi-site observational study to identify biomarkers (individual or biosignature combinations) that...

Chronic pain has become a global health problem contributing to years lived with disability and reduced quality of life. Advances in the clinical management of chronic pain have been limited due to incomplete understanding of the multiple risk factors and molecular mechanisms that contribute to the development of chronic pain. The Acute to Chronic...

Introduction: Many drug trials for chronic pain fail because of high placebo response rates in primary endpoints. Neurophysiological measures can help identify pain-linked pathophysiology and treatment mechanisms. They can also help guide early stop/go decisions, particularly if they respond to verum treatment but not placebo. The neurologic pain...

Quantitative sensory testing (QST) allows researchers to evaluate associations between noxious stimuli and acute pain in clinical populations and healthy participants. Despite its widespread use, our understanding of QST's reliability is limited, as reliability studies have used small samples and restricted time windows. We examined the reliability...

Objective: A pre/post pilot study was designed to investigate neurobiological mechanisms and plasma metabolites in an 8-week Tai-Chi (TC) group intervention in subjects with knee osteoarthritis. Methods: Twelve postmenopausal women underwent Tai-Chi group exercise for 8 weeks (60 min/session, three times/week). Outcomes were measured before and aft...

Previous studies suggest there is a complex relationship between sexual and general affective stimulus processing, which varies across individuals and situations. We examined whether sexual and general affective processing can be distinguished at the brain level. In addition, we explored to what degree possible distinctions are generalizable across...

Identifying biomarkers that predict mental states with large effect sizes and high test-retest reliability is a growing priority for fMRI research. We examined a well-established multivariate brain measure that tracks pain induced by nociceptive input, the Neurologic Pain Signature (NPS). In N = 295 participants across eight studies, NPS responses...

Common executive functioning (cEF) is a domain-general factor that captures shared variance in performance across diverse executive function tasks. To investigate the neural mechanisms of individual differences in cEF (e.g., goal maintenance, biasing), we conducted the largest fMRI study of multiple executive tasks to date (N=546). Group average ac...

The specific neural systems underlying the subjective feeling of fear are debated in affective neuroscience. Here, we combine functional MRI with machine learning to identify and evaluate a sensitive and generalizable neural signature predictive of the momentary self-reported subjective fear experience across discovery (n = 67), validation (n = 20)...

For the last several decades, emotion research has attempted to identify a "biomarker" or consistent pattern of brain activity to characterize a single category of emotion (e.g., fear) that will remain consistent across all instances of that category, regardless of individual and context. In this study, we investigated variation rather than consist...

For the last several decades, emotion research has attempted to identify a "biomarker" or consistent pattern of brain activity to characterize a single category of emotion (e.g., fear) that will remain consistent across all instances of that category, regardless of individual and context. In this study, we investigated variation rather than consist...

Threat learning elicits robust changes across multiple affective domains, including changes in autonomic indices and subjective reports of fear and anxiety. It has been argued that the underlying causes of such changes may be dissociable at a neural level, but there is currently limited evidence to support this notion. To address this, we examined...

Importance Chronic back pain (CBP) is a leading cause of disability, and treatment is often ineffective. Approximately 85% of cases are primary CBP, for which peripheral etiology cannot be identified, and maintenance factors include fear, avoidance, and beliefs that pain indicates injury. Objective To test whether a psychological treatment (pain r...

A fundamental challenge in emotion research is measuring feeling states with high granularity and temporal precision without disrupting the emotion generation process. Here we introduce and validate a new approach in which responses are sparsely sampled and the missing data are recovered using a computational technique known as collaborative filter...

How do thoughts arise, unfold, and change over time? Are the contents and dynamics of everyday thought rooted in conceptual associations within one's semantic networks? To address these questions, we developed the Free Association Semantic task (FAST), whereby participants generate dynamic chains of conceptual associations in response to seed words...

Escape from threats has paramount importance for survival. However, it is unknown if a single circuit controls escape vigor from innate and conditioned threats. Cholecystokinin (cck)-expressing cells in the hypothalamic dorsal premammillary nucleus (PMd) are necessary for initiating escape from innate threats via a projection to the dorsolateral pe...

A growing number of studies have examined alterations in white matter organization in people with posttraumatic stress disorder (PTSD) using diffusion MRI (dMRI), but the results have been mixed which may be partially due to relatively small sample sizes among studies. Altered structural connectivity may be both a neurobiological vulnerability for,...

Craving is a core feature of substance use disorders and a strong predictor of relapse. It is linked to polysubstance use, overeating, pathological gambling, and other maladaptive behaviors. Despite its utility, craving measures are based on self-report, with associated limitations related to introspective access and variability across sociocultura...

Animals must rapidly respond to threats to survive. In rodents, threat-related signals are processed through a subcortical pathway from the superior colliculus to the amygdala, a putative “low road” to affective behavior. This pathway has not been well characterized in humans. We developed a novel pathway identification framework that uses pattern...

Identifying biomarkers that predict mental states with large effect sizes and high test-retest reliability is a growing priority for fMRI research. We examined a well-established multivariate brain measure that tracks pain induced by nociceptive input, the Neurologic Pain Signature (NPS). In N = 295 participants across eight studies, NPS responses...

Brain biomarkers of pain, including pain-predictive 'signatures' based on brain activity, can provide measures of neurophysiological processes and potential targets for interventions. A central issue relates to the specificity of such measures, and understanding their current limits will both advance their development and explore potentially genera...

Compassion meditation (CM) is a promising intervention for enhancing compassion, though its active ingredients and neurobiological mechanisms are not well understood. To investigate these, we conducted a three-armed placebo-controlled randomized trial (N = 57) with longitudinal functional MRI (fMRI). We compared a four-week CM program delivered by...

Escape from threats has paramount importance for survival. However, it is unknown if a single circuit controls escape from innate and conditioned threats. The hypothalamic dorsal premammillary nucleus (PMd) may control escape, as it is activated by escape-inducing threats and projects to the region most implicated in flight, the dorsolateral periaq...

Predictive brain markers promise a number of important scientific, clinical, and societal applications. Over 600 predictive brain markers have been described in published reports, but very few have been tested in independent replication attempts. Here, we conducted an independent replication of a previously published marker predicting treatment res...

The United States faces a crisis due to the high prevalence of chronic pain and associated opioid use disorder and overdose deaths. While the majority of acute pain resolves within weeks, 20-50% of people with acute pain persists well beyond the initial insult. The mechanisms driving the transition from acute to chronic pain states are poorly under...

Increasing evidence suggests that mental health and physical health are linked by neural systems that jointly regulate somatic physiology and high-level cognition. Key systems include the ventromedial prefrontal cortex and the related default-mode network. These systems help to construct models of the 'self-in-context', compressing information acro...

Introduction Cortical thickness (CT) and surface area (SA) are established biomarkers of brain pathology in posttraumatic stress disorder (PTSD). Structural covariance networks (SCN) constructed from CT and SA may represent developmental associations, or unique interactions between brain regions, possibly influenced by a common causal antecedent. T...

The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We f...

Caregiving and other interpersonal interactions often require accurate perception of others’ pain from nonverbal cues, but perceivers may be subject to systematic biases based on gender, race, and other contextual factors. Such biases could contribute to systematic under-recognition and under-treatment of pain. In two experiments, we studied the im...

Compared to our understanding of positive prediction error signals occurring due to unexpected reward outcomes, less is known about the neural circuitry in humans that drives negative prediction errors during omission of expected rewards. While classical learning theories such as Rescorla–Wagner or temporal difference learning suggest that both typ...

Sustained pain is a major characteristic of clinical pain disorders, but it is difficult to assess in isolation from co-occurring cognitive and emotional features in patients. In this study, we developed a functional magnetic resonance imaging signature based on whole-brain functional connectivity that tracks experimentally induced tonic pain inten...

Different pain types may be encoded in different brain circuits. Here, we examine similarities and differences in brain processing of visceral and somatic pain. We analyze data from seven fMRI studies (N = 165) and five types of pain and discomfort (esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure) to e...

The specific neural systems underlying the subjective feeling of fear remain vigorously debated in affective neuroscience. Here, we combined functional MRI with machine learning to identify and evaluate a sensitive and generalizable neural signature predictive of the momentary self-reported subjective fear experience across discovery (n=67), valida...

Sexual stimuli processing is a key element in the repertoire of human affective and motivational states. Previous neuroimaging studies of sexual stimulus processing have revealed a complicated mosaic of activated regions, leaving unresolved questions about their sensitivity and specificity to sexual stimuli per se, generalizability across individua...

Introduction: Clinical and laboratory studies demonstrate that placebo and nocebo effects influence various symptoms and conditions after