Pain Science Podcast Episode 102 | Dr. Tor Wager, PhD: Pain And The Neuroscience Of Nociception
Sep 13, 2018
Dr. Tor Wager, Professor of Psychology and Neuroscience and director of the Cognitive and Affective Control Laboratory, studies brain mechanisms of pain and placebo. He discusses brain models that track pain, the neurologic pain signature, differences between evoked and chronic pain, fibromyalgia hypersensitivity, pain as learned neuroplasticity, and how exposure and emotion-shaping treatments can reverse sensitization.
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Pain Comes From Multiple Brain Pathways
- Pain arises from multiple brain pathways rather than a single universal pain center.
- Tor Wager's neurologic pain signature tracks nociceptive-evoked pain robustly across individuals but doesn't capture top-down expectation effects.
Neurologic Pain Signature Predicts Evoked Pain
- The neurologic pain signature (NPS) is a reproducible brain pattern that predicts pain intensity in ~90–95% of healthy individuals.
- Wager validated the NPS across 600 people and 20 placebo studies showing consistent responses to evoked painful stimuli.
Placebo Changes Experience But Not Nociceptive Signature
- Placebo and expectation reduce reported pain but produce minimal change in the NPS, implying distinct neural ingredients for subjective pain.
- Top-down influences alter experience and autonomic responses without strongly shifting nociceptive brain patterns.