Perceptual discrimination impairment in chronic pain: the role of fear learning.

A growing body of evidence has identified pain-related fear as key process in the development of chronic pain, a common and disabling disorder that remains challenging to treat. Yet, how such fear amplifies pain or affects perception remains unclear. Recently, we suggested that fear learning towards bodily sensations impairs the ability to discriminate between bodily sensations. Preliminary clinical findings report of a relationship between impairments in tactile discrimination and amplified perception of pain. Yet, the precise relationship between fear learning, discrimination acuity and pain perception remains unclear. The present research project aims at further investigating the malleability of discrimination acuity by fear learning and its role in chronic pain. In a series of experimental studies we will investigate: (1) the impact of fear learning on discrimination acuity, (2) the role of avoidance within this context, (3) whether chronic pain patients are more susceptible to these perceptual alterations compared to controls, (4) and whether the effectiveness of fear reducing therapies is mediated through improvements in tactile discrimination. The outcome of this project would extend contemporary pain models through the mapping of fear learning-perception pathways, and better inform clinical practices (e.g., extension of therapy with a somatosensory discrimination training) on the behavioral and perceptual effects of fear learning.