Jones Scott A, Bango Carmen I, Shao Sara, Del Rubin Dani Y, Flores Arturo Lopez, Nagel Bonnie J, Holley Amy L, Wilson Anna C
Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States.
Center for Mental Health Innovation, Oregon Health and Science University, Portland, OR, United States.
Pain. 2025 May 2. doi: 10.1097/j.pain.0000000000003580.
Pain experiences in adolescence are increasing and represent a major public health concern. However, little is known about the neurobiological phenotype of pain experiences in adolescents, particularly outside of a clinical setting. A better neurobiological understanding of pain experiences in community youth may shed light on potential vulnerabilities present before clinical diagnoses of chronic pain. This study utilized an exploratory region-of-interest approach, in a large community sample (n = 7332) of youth (ages 11-12), to examine the association between white matter microstructure, fractional anisotropy (FA) and mean diffusivity (MD), and pain experiences. Bayesian multilevel modeling was used to explore group differences (between those reporting past-month pain and those who did not), and continuous associations between pain experiences (average pain intensity, worst pain intensity, and pain-related limitations) and FA and MD. Sex differences in these effects were also explored. Analyses revealed widespread associations between pain-related limitations and lower FA and greater MD in male but not female youth. Furthermore, average pain intensity was associated with greater superior corticostriate and superior longitudinal fasciculus MD in all youth, and worst pain intensity was associated with lower inferior fronto-occipital fasciculus FA in male youth. There were no group differences in FA or MD between those with or without past-month pain. These findings suggest that white matter microstructural alterations in youth may be more related to the severity of the pain experience than to the presence or absence of pain itself, with male youth showing stronger neurobiological associations with pain-related outcomes.
青少年的疼痛经历正在增加,这是一个重大的公共卫生问题。然而,对于青少年疼痛经历的神经生物学表型,我们知之甚少,尤其是在临床环境之外。更好地从神经生物学角度理解社区青少年的疼痛经历,可能有助于揭示慢性疼痛临床诊断之前存在的潜在易感性。本研究采用探索性感兴趣区域方法,在一个大型社区青少年样本(n = 7332,年龄11 - 12岁)中,研究白质微观结构、分数各向异性(FA)和平均扩散率(MD)与疼痛经历之间的关联。采用贝叶斯多级模型来探索组间差异(报告过去一个月有疼痛的青少年与无疼痛的青少年之间),以及疼痛经历(平均疼痛强度、最严重疼痛强度和与疼痛相关的功能受限)与FA和MD之间的连续关联。还探讨了这些效应中的性别差异。分析显示,在男性而非女性青少年中,与疼痛相关的功能受限与较低的FA和较高的MD之间存在广泛关联。此外,在所有青少年中,平均疼痛强度与上皮质纹状体和上纵束的MD增加有关,而在男性青少年中,最严重疼痛强度与下额枕束的FA降低有关。过去一个月有疼痛和无疼痛的青少年在FA或MD上没有组间差异。这些发现表明,青少年白质微观结构改变可能与疼痛经历的严重程度更相关,而非与疼痛本身的有无相关,男性青少年在疼痛相关结果方面表现出更强的神经生物学关联。
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