Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study.
Document Type
Article
Publication Date
11-1-2024
Identifier
DOI: 10.1097/AJP.0000000000001237
Abstract
OBJECTIVE: Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth.
METHODS: This study examined changes in brain activation associated with experiencing physical pain and observing physical and emotional pain in others by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youths (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain.
RESULTS: Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes may suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests potentially better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus).
DISCUSSION: These changes could indicate that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.
Journal Title
The Clinical journal of pain
Volume
40
Issue
11
First Page
665
Last Page
672
MeSH Keywords
Humans; Pilot Projects; Male; Female; Adolescent; Magnetic Resonance Imaging; Brain; Catastrophization; Chronic Pain; Emotions; Pain Management; Pain Measurement; Treatment Outcome; Brain Mapping
Keywords
Pilot Projects; Magnetic Resonance Imaging; Brain; Catastrophization; Chronic Pain; Emotions; Pain Management; Pain Measurement; Treatment Outcome; Brain Mapping
Recommended Citation
Lepping RJ, Hoffart CM, Bruce AS, et al. Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study. Clin J Pain. 2024;40(11):665-672. Published 2024 Nov 1. doi:10.1097/AJP.0000000000001237
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