Miller Samantha, Cobos Karen L, Rasic Nivez, Long Xiangyu, Lebel Catherine, Bar Am Neta, Noel Melanie, Kopala-Sibley Daniel, Mychasiuk Richelle, Miller Jillian Vinall
Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
Eur J Pain. 2025 Jan;29(1):e4702. doi: 10.1002/ejp.4702. Epub 2024 Jul 16.
Adverse childhood experiences (ACEs) are often reported by youths with chronic pain, and both ACEs and chronic pain disrupt how information is processed. However, it is unknown whether changes to shared neural networks underlie the relationship between ACEs and the development of pain symptoms. This study explored the relationships between ACEs, brain efficiency, and pain symptomology in youth.
A community sample of youths aged 14-18 years underwent MRIs, answered trauma and pain questionnaires, and underwent pain sensory testing, twice, 3 months apart (N = 44; N = 42). Sensory testing determined thresholds for mechanical and thermal stimuli. Global and local network efficiencies were evaluated using graph theory. Generalized estimating equations were applied to examine whether brain efficiency moderated the relationships between ACEs, pain intensity, and pain sensitivity (i.e., mechanical detection, heat pain, and temperature change thresholds).
There was a significant interaction between ACEs and global brain efficiency in association with pain intensity (β = -0.31, p = 0.02) and heat pain (β = -0.29, p = 0.004). Lower global brain efficiency exacerbated the relationship between ACEs and pain intensity (θ = 0.37, p = 0.05), and heat pain sensitivity (θ = 0.44, p = 0.05). Higher global brain efficiency ameliorated the relationship between ACEs and pain intensity (θ = -0.53, p = 0.05).
The relationship between ACEs and pain symptomology was comparable to chronic pain phenotypes (i.e., higher pain intensity and pain thresholds) and may vary as a function of brain efficiency in youth. This stresses the importance of assessing for pain symptoms in trauma-exposed youth, as earlier identification and intervention are critical in preventing the chronification of pain.
This article explores the relationship between ACEs, pain symptomology, and brain efficiency in youth. ACEs may affect how the brain processes information, including pain. Youths with lower brain efficiencies that were exposed to more ACEs have pain symptomology comparable to youths with chronic pain. Understanding this relationship is important for the earlier identification of pain symptoms, particularly in vulnerable populations such as youths exposed to trauma, and is critical for preventing the chronification of pain.
童年不良经历（ACEs）常被患有慢性疼痛的青少年提及，ACEs和慢性疼痛都会扰乱信息处理方式。然而，共享神经网络的变化是否是ACEs与疼痛症状发展之间关系的基础尚不清楚。本研究探讨了青少年中ACEs、大脑效率和疼痛症状之间的关系。
对14至18岁的青少年社区样本进行了磁共振成像（MRI）检查、回答了创伤和疼痛问卷，并进行了疼痛感觉测试，间隔3个月进行两次（N = 44；N = 42）。感觉测试确定了机械和热刺激的阈值。使用图论评估全局和局部网络效率。应用广义估计方程来检验大脑效率是否调节了ACEs、疼痛强度和疼痛敏感性（即机械检测、热痛和温度变化阈值）之间的关系。
ACEs与全局大脑效率之间存在显著交互作用，与疼痛强度（β = -0.31，p = 0.02）和热痛（β = -0.29，p = 0.004）相关。较低的全局大脑效率加剧了ACEs与疼痛强度（θ = 0.37，p = 0.05）以及热痛敏感性（θ = 0.44，p = 0.05）之间的关系。较高的全局大脑效率改善了ACEs与疼痛强度之间的关系（θ = -0.53，p = 0.05）。
ACEs与疼痛症状之间的关系与慢性疼痛表型（即较高的疼痛强度和疼痛阈值）相当，并且可能因青少年的大脑效率而异。这强调了在遭受创伤的青少年中评估疼痛症状的重要性，因为早期识别和干预对于预防疼痛慢性化至关重要。
本文探讨青少年中ACEs、疼痛症状和大脑效率之间的关系。ACEs可能会影响大脑处理信息的方式，包括疼痛信息。大脑效率较低且接触更多ACEs的青少年具有与慢性疼痛青少年相当的疼痛症状。理解这种关系对于早期识别疼痛症状很重要，特别是在诸如遭受创伤的青少年等弱势群体中，并且对于预防疼痛慢性化至关重要。
