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Citation
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Bhatt RR, Haddad E, Zhu AH, Thompson PM, Gupta A, Mayer EA, Jahanshad N. Biol. Psychiatry 2023; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Chronic pain affects nearly 20% of the US population. It is a leading cause of disability globally, and associated with a heightened risk for suicide. The role of the central nervous system in the perception and maintenance of chronic pain has recently been accepted, but specific brain circuitries involved have yet to be mapped across pain types in a large-scale study.
METHODS: We use data from the UK Biobank (N = 21,968) to investigate brain structural alterations in individuals reporting chronic pain compared to pain-free controls, and their mediating effect on history of suicide attempt.
RESULTS: Chronic pain and more notably, chronic multisite pain, was associated with, on average, lower surface area throughout the cortex after adjusting for demographic, clinical and neuropsychiatric confounds. Only participants with abdominal pain showed lower subcortical volumes including the amygdala and brainstem, and lower cerebellum volumes. Participants with chronic headaches showed a widespread thicker cortex compared to controls. Mediation analyses revealed precuneus thickness mediated the relationship of chronic multisite pain and history of suicide attempt. Mediating effects were also identified specific to localized pains, with the strongest effect being amygdala volume in individuals with chronic abdominal pain.
CONCLUSIONS: Results support a widespread effect of chronic pain on brain structure, and distinct brain structures underlying chronic musculoskeletal pain, visceral pain, and headaches. Mediation effects of regions in the extended ventromedial prefrontal cortex subsystem suggest exacerbated negative internal states, negative self-referencing, and impairments in future planning may underly suicidal behaviors in chronic pain patients.
Language: en |