Brain Function and Pain Interference After Pediatric Intensive Interdisciplinary Pain Treatment.

Autor:	Epp S; Department of Anesthesiology, Perioperative and Pain Medicine., Walker A; Department of Anesthesiology, Perioperative and Pain Medicine., Boudes E; Department of Pediatrics., Bray S; Department of Radiology, Cumming School of Medicine.; Hotchkiss Brain Institute.; Owerko Centre, Alberta Children's Hospital Research Institute.; Alberta Children's Hospital Research Institute., Noel M; Department of Radiology, Psychology.; Hotchkiss Brain Institute.; Owerko Centre, Alberta Children's Hospital Research Institute.; Alberta Children's Hospital Research Institute.; Vi Riddell Children's Pain and Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada., Rayner L; Department of Anesthesiology, Perioperative and Pain Medicine., Rasic N; Department of Anesthesiology, Perioperative and Pain Medicine.; Alberta Children's Hospital Research Institute.; Vi Riddell Children's Pain and Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada., Miller JV; Department of Anesthesiology, Perioperative and Pain Medicine.; Department of Radiology, Psychology.; O'Brien Institute for Public Health, University of Calgary.; Hotchkiss Brain Institute.; Owerko Centre, Alberta Children's Hospital Research Institute.; Alberta Children's Hospital Research Institute.; Vi Riddell Children's Pain and Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada.
Jazyk:	angličtina
Zdroj:	The Clinical journal of pain [Clin J Pain] 2024 Jul 01; Vol. 40 (7), pp. 393-399. Date of Electronic Publication: 2024 Jul 01.
DOI:	10.1097/AJP.0000000000001216
Abstrakt:	Objectives: Intensive interdisciplinary pain treatments (IIPTs) are programs that aim to improve functioning in youth with severe chronic pain. Little is known about how the brain changes after IIPT; however, decreased brain responses to emotional stimuli have been identified previously in pediatric chronic pain relative to healthy controls. We examined whether IIPT increased brain responses to emotional stimuli, and whether this change was associated with a reduction in pain interference. Patients and Methods: Twenty youths with chronic pain aged 14 to 18 years were scanned using functional magnetic resonance imaging, pre and post-IIPT. During the functional magnetic resonance imaging, patients were presented with emotional stimuli (ie, faces expressing happiness/fear), neutral expressions, and control (ie, scrambled) images. Patients completed a measure of pain interference pre and post-IIPT. Paired t tests were used to examine differences in brain activation in response to emotional versus neutral stimuli, pre to post-IIPT. Data from significant brain clusters were entered into linear mixed models to examine the relationships between brain activation and impairment pre and post-IIPT. Results: Patients demonstrated a decrease in middle frontal gyrus (MFG) activation in response to emotional stimuli (happy + fear) relative to scrambled images, between pre and post-IIPT ( P < 0.05). Lower MFG activation was associated with lower pain interference, pre and post-IIPT ( P < 0.05). Conclusion: Contrary to our hypothesis, IIPT was associated with a reduction in MFG activation to emotional stimuli, and this change was associated with reduced pain interference. The MFG is a highly interconnected brain area involved in both pain chronification and antinociception. With further validation of these results, the MFG may represent an important biomarker for evaluating patient treatment response and target for future pain interventions. Competing Interests: Financial assistance was provided by generous community donations to the Vi Riddell Pain and Rehabilitation Centre through the Alberta Children’s Hospital Foundation (10016199). The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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