Expertise Modulates Students' Perception of Pain From a Self-Perspective: Quasi-Experimental Study

Journal article

Publication Details

Author(s): Yekta-Michael SS, Schueppen A, Gaebler AJ, Ellrich J, Koten JW
Journal: Journal of Medical Internet Research
Publication year: 2019
Volume: 21
Journal issue: 1
Pages range: e10885-
ISSN: 1438-8871


BACKGROUND: Perception of stimuli presented in a virtual dentistry environment affects regions of the brain that are related to pain perception. OBJECTIVE: We investigated whether neural correlates of virtual pain perception are affected by education in dentistry. METHODS: In this functional magnetic resonance imaging study, a sample of 20 dental students and 20 age-matched controls viewed and listened to video clips presenting a dental treatment from the first-person perspective. An anxiety questionnaire was used to assess the level of dental anxiety. Neural correlates of pain perception were investigated through classic general linear model analysis and in-house classification methods. RESULTS: Dental students and naïve controls exhibited similar anxiety levels for invasive stimuli. Invasive dentistry scenes evoked a less affective component of pain in dental students compared with naïve controls (P<.001). Reduced affective pain perception went along with suppressed brain activity in pain matrix regions including the insula, anterior cingulate cortex, and basal ganglia. Furthermore, a substantial reduction of brain activity was observed in motor-related regions, particularly the supplementary motor area, premotor cortex, and basal ganglia. Within this context, a classifier analysis based on neural activity in the nucleus lentiformis could identify dental students and controls on the individual subject level in 85% of the cases (34 out of 40 participants, sensitivity=90%, specificity=80%). CONCLUSIONS: Virtual dental treatment activates pain-related brain regions in controls. By contrast, dental students suppress affective and motor-related aspects of pain. We speculate that dental students learn to control motoric aspects of pain perception during their education because it is a prerequisite for the professional manual treatment of patients. We discuss that a specific set of learning mechanisms might affect perceived self-efficacy of dental students, which in turn might reduce their affective component of pain perception.

FAU Authors / FAU Editors

Ellrich, Jens Prof. Dr.
Medizinische Fakultät

External institutions with authors

Karl-Franzens-Universität Graz
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen

How to cite

Yekta-Michael, S.S., Schueppen, A., Gaebler, A.J., Ellrich, J., & Koten, J.W. (2019). Expertise Modulates Students' Perception of Pain From a Self-Perspective: Quasi-Experimental Study. Journal of Medical Internet Research, 21(1), e10885-.

Yekta-Michael, Sareh Said, et al. "Expertise Modulates Students' Perception of Pain From a Self-Perspective: Quasi-Experimental Study." Journal of Medical Internet Research 21.1 (2019): e10885-.


Last updated on 2019-23-05 at 15:08