The innate motivation to avoid pain can be disrupted when individuals experience uncontrollable stress, such as pain. This can lead to maladaptive behaviors, including passivity, and negative affect. Despite its importance, motivational aspects of pain avoidance are understudied in humans and their neural mechanisms vastly unknown. Rodent models suggest an important role of the periaqueductal gray, but it is unknown whether it subserves a similar role in humans. Furthermore, it is unclear whether pain avoidance is associated with individual differences in pain coping. Using functional magnetic resonance imaging, networks underlying pain avoidance behavior were examined in 32 participants with and without episodic migraine. Pain avoidance behavior was assessed using an adaptation of the incentive delay task. In each trial of the task, participants tried to avoid a painful stimulus and receive a nonpainful one instead while the difficulty to succeed varied across trials (3 difficulty levels: safe, easy, and difficult). After unsuccessful pain avoidance on the preceding trial, participants showed reduced pain avoidance behavior, especially in the difficult condition. This reduction in behavior was associated with higher helplessness scores only in participants with migraine. Higher helplessness in participants with migraine was further correlated with a stronger decrease in activation of cortical areas associated with motor behavior, attention, and memory after unsuccessful pain avoidance. Of these areas, specifically posterior parietal cortex activation predicted individual's pain avoidance behavior on the next trial. The results link individual pain coping capacity to patterns of neural activation associated with altered pain avoidance in patients with migraine.

当个体经历无法控制的压力（例如疼痛）时，避免疼痛的先天动机可能会被破坏。这可能导致适应不良的行为，包括被动和负面影响。尽管它很重要，但人类对避免疼痛的动机方面的研究不足，而且它们的神经机制也非常未知。啮齿动物模型表明导水管周围灰质的重要作用，但尚不清楚它是否在人类中发挥类似作用。此外，尚不清楚疼痛回避是否与疼痛应对的个体差异有关。使用功能性磁共振成像，对 32 名患有和不患有发作性偏头痛的参与者进行了潜在的疼痛回避行为网络检查。使用激励延迟任务的适应来评估疼痛回避行为。在任务的每次试验中，参与者试图避免痛苦的刺激而接受无痛的刺激，而成功的难度因试验而异（3个难度级别：安全、简单和困难）。在先前的试验中避免疼痛不成功后，参与者的疼痛避免行为减少，尤其是在困难的情况下。仅在偏头痛参与者中，这种行为减少与更高的无助评分相关。偏头痛参与者的无助程度越高，在疼痛回避失败后，与运动行为、注意力和记忆相关的皮层区域的激活就越强烈减少相关。在这些区域中，特别是后顶叶皮层激活可以预测个体在下一次试验中的疼痛回避行为。