Background & Aims
Evidence suggests that the hippocampus, a brain structure that is among the most deleteriously affected by stress, plays a role in pain perception. However, minimal research has directly investigated the role that stress exposure (e.g., adverse childhood experiences) can have on neurobiological function, particularly hippocampal volume and connectivity, in youth with chronic pain. As such, aims of the current investigation include delineating brain regions of interest typically known to be impacted by stress or trauma exposure that may be important in pain maintenance in youth.
Methods
Youth (ages 11 – 17) with chronic widespread pain (CWP) and healthy controls (HCs) completed a baseline visit with fMRI and quantitative sensory testing, self-report of intervention engagement, and questionnaires on stress, ACEs exposure, and pain characteristics (e.g., frequency, intensity).
Results
Preliminary results of an ongoing investigation indicated that youth with CWP endorsed significantly higher rates of ACEs than HCs. In parallel, statistically significant resting state differences (p<0.05) were also found between CWP and HC in the following seed areas: right parahippocampal gyrus, anterior division; parahippocampal gyrus, posterior division; left hippocampus.
Conclusions
Preliminary results are consistent with the literature in that youth with CWP reported high rates of ACEs exposure when compared to non-pain youth, indicating a potential stress-imposed vulnerability at the neurological level. Further, hippocampal differences were observed in pain vs. non-pain youth, which is consistent with the hypothesis that youth with CWP evidence hippocampal changes, which may increase vulnerability to pain. Given the preliminary nature of this investigation, future research should take place in this population to fully understand the role of stress, ACEs exposure, and brain function in vulnerability to pain and pain-related impairment.
References
•Nelson, S., et al., 2016. A conceptual framework for understanding the role of adverse childhood experiences in pediatric chronic pain, Clinical Journal of Pain, 33(3), 264-270
•Nelson, S., Bento, S. and Enlow, M.B., 2021. Biomarkers of Allostatic Load as Correlates of Impairment in Youth with Chronic Pain: An Initial Investigation. Children, 8(8), p.709.
•Nelson, S., Borsook, D. and Enlow, M.B., 2021. Targeting the stress response in pediatric pain: current evidence for psychosocial intervention and avenues for future investigation. Pain reports, 6(3).
Presenting Author
Sarah Nelson
Poster Authors
Topics
- Pain Imaging