Jones Scott A, Cooke Holly E, Wilson Anna C, Nagel Bonnie J, Holley Amy L
Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.
School of Graduate Psychology, Pacific University, Hillsboro, OR, United States.
Front Neurol. 2020 Jan 15;10:1403. doi: 10.3389/fneur.2019.01403. eCollection 2019.
Chronic pain is common in adolescence and is associated with both pain and prevalence of mental illness later in life. While previous functional neuroimaging work has informed knowledge of neural alterations associated with chronic pain, these findings have been primarily limited to adult samples, and it is unclear if similar patterns of altered brain activation are present in the developing adolescent brain. The purpose of this study was to pilot a noxious pressure task during functional neuroimaging to assess brain response to pain in adolescents with and without chronic pain. Adolescents (ages 11-16) with ( = 9, 7 females) and without ( = 9, 7 females) chronic pain, matched on age, sex, IQ, and parental history of chronic pain, completed a noxious mechanical pressure task to assess subjective pain thresholds. This was followed by randomized presentation of subjective equivalent pressure applications (adolescents' pain 4/0-10), and two objectively equivalent pressures (0.25 and 1.5 kg/cm), during functional magnetic resonance imaging, using an event-related task design. Findings revealed that adolescents with chronic pain demonstrated significantly greater activation in the posterior cingulate compared to controls. Further, all adolescents demonstrated significant pain-related brain response in brain regions implicated in pain neurocircuitry, as well as in several regions of the default mode network. Similar patterns of neural response were also noted during pain anticipation. These findings are important for not only understanding the neurocircuitry involved in adolescent chronic pain, but may prove beneficial to future pain treatment efforts that seek to alter pain neurocircuitry.
慢性疼痛在青少年中很常见，并且与日后生活中的疼痛和精神疾病患病率都有关联。虽然先前的功能神经影像学研究已经为我们提供了与慢性疼痛相关的神经改变的知识，但这些发现主要局限于成人样本，尚不清楚在发育中的青少年大脑中是否存在类似的大脑激活改变模式。本研究的目的是在功能神经影像学检查期间开展一项有害压力任务，以评估有和没有慢性疼痛的青少年对疼痛的大脑反应。患有（n = 9，7名女性）和未患有（n = 9，7名女性）慢性疼痛的青少年（年龄11 - 16岁），在年龄、性别、智商和慢性疼痛家族史方面进行匹配，完成一项有害机械压力任务以评估主观疼痛阈值。随后，在功能磁共振成像期间，采用事件相关任务设计，随机呈现主观等效压力应用（青少年疼痛程度4/0 - 10）以及两种客观等效压力（0.25和1.5 kg/cm）。研究结果显示，与对照组相比，患有慢性疼痛的青少年在后扣带回中的激活明显更强。此外，所有青少年在与疼痛神经回路相关的脑区以及默认模式网络的几个区域都表现出与疼痛相关的显著大脑反应。在疼痛预期期间也观察到了类似的神经反应模式。这些发现不仅对于理解青少年慢性疼痛所涉及的神经回路很重要，而且可能对未来旨在改变疼痛神经回路的疼痛治疗努力有益。
