Distraction produces an increase in pain-evoked anterior cingulate activity

This study examined the effects of distraction on pain-evoked activity in the anterior cingulate cortex (ACC). Twenty-eight healthy adults were given painful electrical stimulation of the sural nerve during an attend condition, where they rated the subjective magnitude of each electrical stimulus, and during a distraction condition, where they performed an arithmetic distraction task. The magnitude of the pain-evoked ACC activity was estimated from the dipole source localization analysis of the somatosensory evoked potential. Subjective pain ratings were smaller and pain-evoked ACC activity was larger during the distraction condition than during the attend condition. Recent regional cerebral blood flow studies have also reported a distraction-related increase in pain-evoked ACC activity. Our results confirm these reports, and verify that the distraction effect specifically involves pain-evoked ACC activity. The cognitive demands of the distraction task present the possibility that the pain-evoked ACC activity might be involved, at least in part, in response competition and/or orienting attention toward painful stimuli.