Evidence map›Paper›PMID 40668023›Full record

ArticlePain2025

Neurophysiological encoding of aversive prediction errors.

Raghavan Gopalakrishnan, Claire Sonneborn, Sylvain Baillet, Andre G Machado, Tor D Wager, Mathieu Roy

Registry-linked trialAbstract read
In one paragraph

Article in Pain, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07791966 (Alpha tACS and Pain Avoidance Behavior in Chronic Pain Patients), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07791966 narecruitingnot on this mapstarted 2026, after this paper: background citation

Alpha tACS and Pain Avoidance Behavior in Chronic Pain Patients

TypeinterventionalSponsorThe Cleveland ClinicRan2026 to 2028Enrolled30ConditionsComplex Regional Pain Syndrome (CRPS)Armstranscranial alternating current stimulation (tACS)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Mechanisms Underlying Pain Avoidance in Complex Regional Pain Syndrome.European journal of pain (London, England) · 2026
    Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Raghavan GopalakrishnanCenter for Neurological Restoration, Cleveland Clinic, Cleveland, OH, United States.ORCID 0000-0002-9038-9392
Claire SonnebornDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States.
Sylvain BailletMcConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Cananda.
Andre G MachadoCenter for Neurological Restoration, Cleveland Clinic, Cleveland, OH, United States.
Tor D WagerDepartment of Psychological and Brain Sciences, Dartmouth University, Hanover, NH, United States.
Mathieu RoyDept. of Psychology, McGill University, Montreal, QC, Canada.

Funding

The neural bases of placebo effects and their relation to regulatory processesR37MH076136 · NIMH · DARTMOUTH COLLEGE · PI TOR D. WAGER · 2024 to 2026
$2.4M
Pain avoidance behavior and its relation to risk for opioid use in chronic pain patientsK01DA050804 · NIDA · CLEVELAND CLINIC LERNER COM-CWRU · PI GOPALAKRISHNAN, RAGHAVAN · 2020 to 2024
$790k
NIDA NIH HHS K01 DA050804NIH HHS K01DA050804NIMH NIH HHS R37 MH076136
6 · The paper itself

Abstract

abstractAversive prediction error (PE) brain signals generated by unexpected pain or pain absence are crucial for learning to avoid future pain. Yet, the detailed neurophysiological origins of PE signaling remain unclear. In this study, we combined an instrumental pain avoidance task with computational modeling and magnetoencephalography to detect time-resolved activations underlying pain expectations and aversive PE signals in the human brain. The task entailed learning probabilistically changing cue-pain associations to avoid receiving a pain stimulus. We used an axiomatic approach to identify general aversive PE signals that encode the degree to which the outcome deviated from expectations. Our findings indicate that aversive PE signals are generated in the alpha band (8-12 Hz) by the midbrain/diencephalon, lateral orbitofrontal cortex, and ventrolateral prefrontal cortex approximately 150 milliseconds after outcome delivery. Moreover, alpha oscillations in these regions also encoded pain expectations before the outcome. We speculate that this may facilitate the rapid generation of PEs by allowing outcome-related nociceptive activity to be integrated with ongoing predictive signals. Finally, decisions to avoid pain recruited alpha oscillations in the anterior cingulate and dorsomedial prefrontal cortices, suggesting their active engagement in comparing predicted action values. Overall, our data reveal the rapid neurophysiological mechanisms underlying the generation of aversive PEs and subsequent decision-making.

Indexed as

Anticipation, PsychologicalAvoidance LearningBrainPainAdultBrain MappingCuesFemaleHumansMagnetoencephalographyMaleYoung AdultAversive prediction errorBrain oscillationsMagnetoencephalographyPain-related learning

Identifiers

PMID40668023
PMCPMC12270284

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.