Institute of Medical Psychology and Behavioral Immunobiology
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Pain-related learning, memory and attentional processes

Learning and memory processes likely play a crucial role in the transition from acute to chronic pain as well as in the maintenance of chronic pain symptoms. In addition, therapeutic approaches such as exposure therapy that are based on the principles of extinction learning are reportedly efficacious for patients with chronic pain, supporting that research into pain-related learning and memory processes also has treatment implications. Finally, growing interest in mechanistic research on learning is based on brain imaging data showing that patients with chronic pain reveal altered neural activation already during the phase of pain anticipation. Anticipatory responses to pain-predictive cues are shaped by complex learning processes, in which selective attention and hypervigilance play key roles.

Classically conditioned pain-related fear is a central component of fear-avoidance models of chronic pain. The neurobiological mechanisms underlying pain-related fear are only beginning to be unraveled in the context of visceral pain. Therefore, an important research objective is to analyze neural mechanisms involved in associative learning and extinction in healthy individuals and patients with chronic visceral pain. We are particularly interested in elucidating how stress or stress mediators impact the acquisition and extinction of pain-related fear, and to understand how the extinction context leads to renewal of previously extinguished pain-related fear memories. Finally, we strive to analyze how pain-related conditioning involves changes in selective attention and engages the fear and reward systems. Together, these translational research approaches can expand mechanistic knowledge about learning and memory processes at the interface of neurogastroenterology, the neurosciences and the pain field.

Principle investigator

Elsenbruch Sigrid

Research team

Benson Sven, Clinc of Neurology
Icenhour Adriane
Koenen Laura Ricarda
Labrenz Franziska
Pawlik Robert Jan


Prof. Dr. M. Forsting, Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital
Prof. Dr. D. Timmann-Braun, Neurology, Essen University Hospital
Prof. Dr. U. Bingel, Dr. K. Forkmann,Neurology, Essen University Hospital
Prof. Dr. J. Langhorst, Integrative Gastroenterology, Kliniken Essen-Mitte
Prof. O.T. Wolf, Cognitive Psychology, Ruhr University Bochum


German Research Foundation (DFG): Project 7 within the research unit FOR 1581 “Extinction learning: Neuronal mechanisms, behavioral manifestations and clinical implications”

Selected publications

Koenen LR, Icenhour A, Forkmann K, Theysohn N, Forsting M, Bingel U, Elsenbruch S.
From Anticipation to the Experience of Pain: The Importance of Visceral Versus Somatic Pain Modality in Neural and Behavioral Responses to Pain-Predictive Cues.
Psychosom Med. 2018;80:826-835.

Koenen LR, Icenhour A, Forkmann K, Pasler A, Theysohn N, Forsting M, Bingel U, Elsenbruch S.
Greater fear of visceral pain contributes to differences between visceral and somatic pain in healthy women.
Pain. 2017;158:1599-1608.

Icenhour A, Labrenz F, Ritter C, Theysohn N, Forsting M, Bingel U, Elsenbruch S.

Learning by experience? Visceral pain-related neural and behavioral responses in a classical conditioning paradigm.
Neurogastroenterol Motil 2017;29(6).

Labrenz F, Icenhour A, Benson S, Elsenbruch S (2015)
Contingency awareness shapes acquisition and extinction of emotional responses in a conditioning model of pain-related fear.
Front Behav Neurosci 2016;9:318   

Labrenz F, Icenhour A, Schlamann M, Forsting M, Bingel U, Elsenbruch S.
From Pavlov to pain: How predictability affects the anticipation and processing of visceral pain in a fear conditioning paradigm.
Neuroimage. 2016;130:104-14.

Icenhour A, Kattoor J, Benson S, Boekstegers A, Schlamann M, Merz CJ, Forsting M, Elsenbruch S.
Neural circuitry underlying effects of context on human pain-related fear extinction in a renewal paradigm.
Hum Brain Mapp 2015;36:3179-93.

Labrenz F, Icenhour A, Thürling M, Schlamann M, Forsting M, Timmann D, Elsenbruch S.
Sex differences in cerebellar mechanisms involved in pain-related safety learning.
Neurobiol Lern Mem 2015;123:92-99.

Icenhour A, Langhorst J, Benson S, Schlamann M, Hampel S, Engler H, Forsting M, Elsenbruch S.
Neural circuitry of abdominal pain-related fear learning and reinstatement in irritable bowel syndrome.
Neurogastroenterol Motil 2015;27:114-27.

Gramsch C, Kattoor J, Icenhour A, Forsting M, Schedlowski M, Gizewski ER, Elsenbruch S.
Learning pain-related fear: Neural mechanisms mediating rapid differential conditioning, extinction and reinstatement processes in human visceral pain.
Neurobiol Learn Mem 2014;116C:36-45.

Benson S, Kattoor J, Kullmann JS, Hofmann S, Engler H, Forsting M, Gizewski ER, Elsenbruch S.
Towards understanding sex differences in visceral pain: enhanced reactivation of classically-conditioned fear in healthy women.
Neurobiol Learn Mem 2014;109:113-21.

Kattoor J, Thürling M, Gizewski ER, Forsting M, Timmann D, Elsenbruch S.
Cerebellar contributions to different phases of visceral aversive extinction learning.
Cerebellum 2014;13(1):1-8.

Kattoor J, Gizewski ER, Kotsis V, Benson S, Gramsch C, Theysohn N, Maderwald S, Forsting M, Schedlowski M, Elsenbruch S.
Fear conditioning in an abdominal pain model: neural responses during associative learning and extinction in healthy subjects.
PLoS One 2013;8(2):e51149.