Expectation effects on repetition suppression in nociception

Repetition suppression, the reduced neural response upon repeated presentation of a stimulus, can be explained by models focussing on bottom-up (i.e. adaptation) or top-down (i.e. expectation) mechanisms. Predictive coding models fall into the latter category and propose that repetitions are expected and therefore elicit smaller prediction error responses. While studies in the visual and auditory domain provide some support for such models, in nociception evidence remains inconclusive, despite the substantial influence expectations exert on pain perception. To assess expectation effects on repetition suppression in nociception, we developed a paradigm in which healthy volunteers received brief CO2 laser stimuli, while we acquired electroencephalographic (EEG) and peripheral physiological data. Importantly, laser stimuli could be either repeated after one second or not be repeated, with the probability of repetitions manipulated in a block-wise fashion, such that repetitions were either expected or unexpected. We observed repetition suppression in laser-evoked potentials as well as laser-induced gamma band oscillations, but not in laser-induced desynchronisations in the alpha and beta band. Critically, neither these EEG responses, nor the peripheral physiological data showed significant differences between the expectation conditions, with Bayesian analyses mostly providing evidence for an absence of effects. This indicates that repetition suppression to brief nociceptive laser stimuli is not driven by top-down factors, but rather mediated by other adaptation processes. While this does not preclude an influence of predictive coding models in nociception, it suggests that when the nervous system receives highly precise input, its responses are less susceptible to influence from expectations.