Journal
FRONTIERS IN PAIN RESEARCH
Volume 3, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fpain.2022.871961
Keywords
insula; nucleus accumbens; effective connectivity; neuroimaging; veterans; catastrophizing; chronic back pain; PTSD
Categories
Funding
- United States Department of Veterans Affairs [I01-CX-000816, I01-CX-001652, I01-CX001542, I01-CX-001762]
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health [U19AR076737]
- Painless Research Foundation
Ask authors/readers for more resources
Our study identified three subgroups with different functional connectivity patterns, despite similar demographic and diagnostic characteristics. These findings suggest the existence of neurobiologically dissociable biotypes with different mechanisms for managing pain and trauma, which may have implications for tailored interventions targeting specific neurological systems.
Trauma and posttraumatic stress are highly comorbid with chronic pain and are often antecedents to developing chronic pain conditions. Pain and trauma are associated with greater utilization of medical services, greater use of psychiatric medication, and increased total cost of treatment. Despite the high overlap in the clinic, the neural mechanisms of pain and trauma are often studied separately. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) scans were completed among a diagnostically heterogeneous sample of veterans with a range of back pain and trauma symptoms. Using Group Iterative Multiple Model Estimation (GIMME), an effective functional connectivity analysis, we explored an unsupervised model deriving subgroups based on path similarity in a priori defined regions of interest (ROIs) from brain regions implicated in the experience of pain and trauma. Three subgroups were identified by patterns in functional connection and differed significantly on several psychological measures despite similar demographic and diagnostic characteristics. The first subgroup was highly connected overall, was characterized by functional connectivity from the nucleus accumbens (NAc), the anterior cingulate cortex (ACC), and the posterior cingulate cortex (PCC) to the insula and scored low on pain and trauma symptoms. The second subgroup did not significantly differ from the first subgroup on pain and trauma measures but was characterized by functional connectivity from the ACC and NAc to the thalamus and from ACC to PCC. The third subgroup was characterized by functional connectivity from the thalamus and PCC to NAc and scored high on pain and trauma symptoms. Our results suggest that, despite demographic and diagnostic similarities, there may be neurobiologically dissociable biotypes with different mechanisms for managing pain and trauma. These findings may have implications for the determination of appropriate biotype-specific interventions that target these neurological systems.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available