Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
- University of Geneva, Switzerland
- Univeristy of Geneva, Switzerland
Abstract
Healthcare providers often underestimate patients' pain, sometimes even when aware of their reports. This could be the effect of experience reducing sensitivity to others pain, or distrust towards patients' self-evaluations. Across multiple experiments (375 participants), we tested whether senior medical students differed from younger colleagues and lay controls in the way they assess people's pain and take into consideration their feedback. We found that medical training affected the sensitivity to pain faces, an effect shown by the lower ratings and highlighted by a decrease in neural response of the insula and cingulate cortex. Instead, distrust towards the expressions' authenticity affected the processing of feedbacks, by decreasing activity in the ventral striatum whenever patients' self-reports matched participants' evaluations, and by promoting strong reliance on the opinion of other doctors. Overall, our study underscores the multiple processes which might influence the evaluation of others' pain at the early stages of medical career.
Data availability
The behavioral data and script are stored and available at the following link: https://osf.io/qnp6m/The UPDATED (revision1) brain imaging data are stored and available at the following link: https://neurovault.org/collections/9006/
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Brain networks for pain diagnosis. Differential contribution of medical education and distrust in the appraisal of others' pain.https://identifiers.org/neurovault.collection:9006.
Article and author information
Author details
Corrado Corradi-Dell'Acqua
Funding
SNSF (PP00O1_157424/1)
- Corrado Corradi-Dell'Acqua
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: all subjects read and signed an informed consent prior to taking part to the experiement, thus agreeing that their data could be published under anonimity. They had the time to read and ask for clarification/ information the the researcher conductiong the experiment in case they wanted to.This research was conducted in accordance with the Declaration of Helsinki and was approved by the local ethical committee (Commission Cantonale d'Éthique e de la Recherce [CCER] of Geneva, protocol code: CCER N. 2016-01862).
Copyright
© 2021, Dirupo et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
eLife 10:e63272.
https://doi.org/10.7554/eLife.63272
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