Neural and sociocultural mediators of ethnic differences in pain

Elizabeth A.Reynolds Losin, Choong Wan Woo, Natalia A. Medina, Jessica R. Andrews-Hanna, Hedwig Eisenbarth, Tor D. Wager

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities.

Original languageEnglish (US)
Pages (from-to)517-530
Number of pages14
JournalNature Human Behaviour
Issue number5
StatePublished - May 1 2020

All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Experimental and Cognitive Psychology
  • Behavioral Neuroscience

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