Prof. Dr. Sigrid Elsenbruch, Department of Medical Psychology and Medical Sociology, Faculty of Medicine
Research Programme:
Our research concept with the overarching research focus “Interoception & Pain” is interdisciplinary and translational, and builds on long-standing scientific and clinical expertise in the field of pain and the gut-brain axis.
The motivation for our research comes from clinical reality and scientific advances: At least 25% of the adult population in Germany is affected by chronic pain. The neural mechanisms relevant to the transition from acute to chronic pain remain incompletely understood, especially for conditions involving pain from within the body (interoceptive, visceral pain), such as in patients with chronic abdominal pain. We are fascinated by recent advances regarding the gut-brain axis, particularly about the role of the brain in the perception and response to aversive signals from the gastrointestinal tract. More knowledge about the role of stress, cognitions, and memory processes in shaping the response to different types of pain can further improve basic knowledge about how the brain and body interact, relevant to chronic pain prevention and treatment. Within our research projects, we integrate methods from different research fields, including pain, stress, and memory research, interlinking experimental studies in healthy volunteers and patient populations with clinically-oriented work on new treatment approaches.
Current Research Projects
Neural mechanisms of interoception and visceral pain
Using brain imaging techniques in combination with behavioural pain testing, this line of research elucidates the neural mechanisms underlying the perception of sensations arising from the gastrointestinal tract, ranging from non-painful sensations over acute to chronic visceral pain. The focus is on the neural correlates underlying hypersensitivity and interoceptive hypervigilance, and on the role of sensory, cognitive and emotional factors in shaping central pain processing.
Pain-related learning and memory processes
Learning and memory processes play an important role in the pathophysiology and treatment of chronic pain. Inspired by the fear-avoidance model of chronic pain and the success of cognitive-behavioural treatment approaches that are based on extinction learning, brain imaging studies are beginning to elucidate the brain mechanisms underlying associative learning and memory processes in the context of pain. Within the Collaborative Research Centre SFB1280 ‘Extinction Learning’, funded by the German Research Foundation, we conduct experimental studies assessing the behavioural and neural mechanisms of conditioned pain-related fear and safety learning and extinction processes. Our particular interest is to elucidate learned fear of different types of pain, comparing modality-specific conditioning in response to visceral and somatic pain stimuli in healthy volunteers and patients with chronic abdominal pain. In addition, we are developing novel experimental approaches to assess context-dependent interoceptive fear learning and extinction, as a basis to unravel learned fear based on what is commonly referred to as “gut feelings”.
Stress and cognitions in acute pain modulation
Emotions and cognitions have a great impact on how we perceive, respond to and remember pain. This is relevant to understanding the mechanisms underlying pain modulation, with implications for the treatment of patients. We study the role of stress, negative emotions and maladaptive coping in healthy volunteers and patients using brain imaging approaches in combination with behavioural experimental studies. Some of our translational work on cognitive pain modulation in the context of visceral pain and the gut-brain axis focusses on the role of treatment expectations, carried out within the Collaborative Research Centre TRR/SFB289 ‘Treatment Expectation’, complemented by patient-oriented studies with different collaborating clinics at RUB and other national and international groups.
Pain and inflammation
Acute and chronic inflammatory processes play a key role in chronic-inflammatory bowel disease, and may also contribute to altered gut-brain interactions in conditions like irritable bowel syndrome. In this line of research at the interface of pain and psychoneuroimmunology, we elucidate the role of inflammatory mediators in pain-related emotional learning and memory processes. The focus is to unravel extinction learning in the context of the gut-brain axis. Experimental studies in healthy volunteers and in patients with chronic-inflammatory bowel disease are carried out within the Collaborative Research Centre SFB1280 ‘Extinction Learning’, funded by the German Research Foundation, and accomplished in close collaboration with behavioural immunology and gastroenterology.