Brain and pain: old assumptions and new science about chronic pain

2020 ◽  
Vol 26 (3) ◽  
pp. 156-158
Author(s):  
George Ikkos ◽  
Parashar Pravin Ramanuj
Keyword(s):  
Chronic Pain ◽  
Nucleus Accumbens ◽  
Clinical Outcomes ◽  
Adverse Childhood Experiences ◽  
Gabaergic Neurons ◽  
Behavioural Inhibition ◽  
Childhood Experiences ◽  
New Science ◽  
Psychopharmacological Treatment ◽  
Adverse Childhood

SUMMARYThe authors summarise the evolving understanding of the neuropsychophysiology of chronic pain, including the relevance of adverse childhood experiences in facilitating it and similarities between the central physiology of chronic pain and opioid addiction. Emerging understanding highlights the importance of dopamine-expressing GABAergic neurons in the nucleus accumbens and suggests that D1 expression is associated with a sense of pleasure and approach behaviour and D2 with a sense of punishment and behavioural inhibition. Regulation of D1 and D2 expression may be mediated by nigrostriatal and medial frontal striatal pathways within the increasingly understood brain as a ‘predictive’ organ. The distinction between the predictive brain and personal ‘expectations’ and the importance of the latter for clinical outcomes are emphasised. The relevance of findings for possible future psychopharmacological treatment avenues is also presented.

scholarly journals Case-control study of adverse childhood experiences and multiple sclerosis risk and clinical outcomes

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262093
Author(s):  
Mary K. Horton ◽  
Shannon McCurdy ◽  
Xiaorong Shao ◽  
Kalliope Bellesis ◽  
Terrence Chinn ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Outcomes ◽  
Adverse Childhood Experiences ◽  
Multiple Testing ◽  
Multiple Testing Correction ◽  
Latent Factors ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Rich Data ◽  
Control Study

Background Adverse childhood experiences (ACEs) are linked to numerous health conditions but understudied in multiple sclerosis (MS). This study’s objective was to test for the association between ACEs and MS risk and several clinical outcomes. Methods We used a sample of adult, non-Hispanic MS cases (n = 1422) and controls (n = 1185) from Northern California. Eighteen ACEs were assessed including parent divorce, parent death, and abuse. Outcomes included MS risk, age of MS onset, Multiple Sclerosis Severity Scale score, and use of a walking aid. Logistic and linear regression estimated odds ratios (ORs) (and beta coefficients) and 95% confidence intervals (CIs) for ACEs operationalized as any/none, counts, individual events, and latent factors/patterns. Results Overall, more MS cases experienced ≥1 ACE compared to controls (54.5% and 53.8%, respectively). After adjusting for sex, birthyear, and race, this small difference was attenuated (OR = 1.01, 95% CI: 0.87, 1.18). There were no trends of increasing or decreasing odds of MS across ACE count categories. Consistent associations between individual ACEs between ages 0–10 and 11–20 years and MS risk were not detected. Factor analysis identified five latent ACE factors, but their associations with MS risk were approximately null. Age of MS onset and other clinical outcomes were not associated with ACEs after multiple testing correction. Conclusion Despite rich data and multiple approaches to operationalizing ACEs, no consistent and statistically significant effects were observed between ACEs with MS. This highlights the challenges of studying sensitive, retrospective events among adults that occurred decades before data collection.

scholarly journals Adverse childhood experiences in parents of youth with chronic pain: prevalence and comparison with a community-based sample

PAIN Reports ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. e866
Author(s):  
Jaimie K. Beveridge ◽  
Keith S. Dobson ◽  
Sheri Madigan ◽  
Keith O. Yeates ◽  
Amanda L. Stone ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Adverse Childhood Experiences ◽  
Community Based ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Pain Prevalence

Adverse childhood experiences predict autonomic indices of emotion dysregulation and negative emotional cue-elicited craving among female opioid-treated chronic pain patients

2019 ◽  
Vol 31 (3) ◽  
pp. 1101-1110 ◽  
Author(s):  
Eric L. Garland ◽  
Sarah E. Reese ◽  
Carter E. Bedford ◽  
Anne K. Baker
Keyword(s):  
Chronic Pain ◽  
Adverse Childhood Experiences ◽  
Emotion Dysregulation ◽  
Opioid Analgesic ◽  
Opioid Use ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Chronic Pain Patients ◽  
Pain Patients

AbstractThrough autonomic and affective mechanisms, adverse childhood experiences (ACEs) may disrupt the capacity to regulate negative emotions, increasing craving and exacerbating risk for opioid use disorder (OUD) among individuals with chronic pain who are receiving long-term opioid analgesic pharmacotherapy. This study examined associations between ACEs, heart rate variability (HRV) during emotion regulation, and negative emotional cue-elicited craving among a sample of female opioid-treated chronic pain patients at risk for OUD. A sample of women (N= 36, mean age = 51.2 ± 9.5) with chronic pain receiving long-term opioid analgesic pharmacotherapy (mean morphine equivalent daily dose = 87.1 ± 106.9 mg) were recruited from primary care and pain clinics to complete a randomized task in which they viewed and reappraised negative affective stimuli while HRV and craving were assessed. Both ACEs and duration of opioid use significantly predicted blunted HRV during negative emotion regulation and increased negative emotional cue-elicited craving. Analysis of study findings from a multiple-levels-of-analysis approach suggest that exposure to childhood abuse occasions later emotion dysregulation and appetitive responding toward opioids in negative affective contexts among adult women with chronic pain, and thus this vulnerable clinical population should be assessed for OUD risk when initiating a course of extended, high-dose opioids for pain management.

Reliability and validity of chronic pain scales in adults with adverse childhood experiences

2016 ◽  
Vol 5 (2) ◽  
pp. 68 ◽  
Author(s):  
Deborah Helitzer ◽  
Cristina MurrayKrezan ◽  
David Graeber ◽  
Joanna Katzman ◽  
Daniel Duhigg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Adverse Childhood Experiences ◽  
Reliability And Validity ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Pain Scales

scholarly journals Interaction between adverse childhood experiences and polygenic risk in patients with bipolar disorder

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Young-Min Park ◽  
Tatyana Shekhtman ◽  
John R. Kelsoe
Keyword(s):  
Bipolar Disorder ◽  
Clinical Outcomes ◽  
Adverse Childhood Experiences ◽  
Age At Onset ◽  
Polygenic Risk Score ◽  
Childhood Experiences ◽  
Polygenic Risk ◽  
Adverse Childhood ◽  
Genes And Environment ◽  
Genomic Study

Abstract The interaction between genes and environment often occurs when they depend on one another. We hypothesized that adverse childhood experiences (ACEs) would interact with genetic predispositions to bipolar disorder (BD), demonstrating earlier age at onset (AAO) and worse clinical outcomes. We aimed to clarify the effects of the interaction between ACEs and genetic susceptibility using polygenic risk score (PRS) on AAO and clinical outcomes. Single nucleotide polymorphisms and clinical data, including ACEs, were obtained from the Bipolar Genomic Study, which contains a large sample of BD participants. A total of 1615 subjects with BD I were obtained and divided into two groups according to the presence or absence of ACEs and an additional four groups based on the number of ACEs (none versus one versus two versus ≥ three types). ACEs was evaluated using the childhood life events scale (CLES). BD–PRS was obtained from the Psychiatric Genomics Consortium, which compared BD patients and healthy controls. The BD–PRS was higher in the group with ACEs than without ACEs at most p-value thresholds. In multivariate linear regression analyses, both groups with more ACEs and higher BD–PRS were independently and interactively associated with an earlier AAO of BD; however, only greater ACEs were associated with worsened clinical outcome. These findings highlight the clinical importance of evaluating ACEs and polygenic risk in research of the etiology of BD.

scholarly journals A Pilot Study Investigating the Role of Gender in the Intergenerational Relationships between Gene Expression, Chronic Pain, and Adverse Childhood Experiences in a Clinical Sample of Youth with Chronic Pain

Epigenomes ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 9
Author(s):  
Jennaya Christensen ◽  
Jaimie K. Beveridge ◽  
Melinda Wang ◽  
Serena L. Orr ◽  
Melanie Noel ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Adverse Childhood Experiences ◽  
Clinical Sample ◽  
Saliva Sample ◽  
Intergenerational Relationships ◽  
Ptsd Symptoms ◽  
Childhood Experiences ◽  
Epigenetic Biomarkers ◽  
Adverse Childhood ◽  
Parental Trauma

Chronic pain is a highly prevalent and costly issue that often emerges during childhood or adolescence and persists into adulthood. Adverse childhood experiences (ACEs) increase risk for several adverse health conditions, including chronic pain. Recent evidence suggests that parental trauma (ACEs, post-traumatic stress disorder (PTSD) symptoms) confers risk of poor health outcomes in their children. Intergenerational relationships between parental trauma and child chronic pain may be mediated by epigenetic mechanisms. A clinical sample of youth with chronic pain and their parents completed psychometrically sound questionnaires assessing ACEs, PTSD symptoms, and chronic pain, and provided a saliva sample. These were used to investigate the intergenerational relationships between four epigenetic biomarkers (COMT, DRD2, GR, and SERT), trauma, and chronic pain. The results indicated that the significant biomarkers were dependent upon the gender of the child, wherein parental ACEs significantly correlated with changes in DRD2 expression in female children and altered COMT expression in the parents of male children. Additionally, the nature of the ACE (maltreatment vs. household dysfunction) was associated with the specific epigenetic changes. There may be different pathways through which parental ACEs confer risk for poor outcomes for males and females, highlighting the importance of child gender in future investigations.

Sign in / Sign up

Export Citation Format

Share Document