Researchers from the Universities of California San Diego and San Francisco conducted a study of 57 veterans who each suffered from chronic back pain and the effects of trauma. They performed MRIs of each participant’s brain to reveal resting-state neurological connections between regions involved in the experience of pain and trauma: the insula, anterior cingulate cortex, thalamus, cortex posterior cingulate and nucleus accumbens. Then they used statistical analysis to sort the scans into three categories based on the strength of the connections.
They found that the strength of regional connections (called connection signatures) directly correlated with each veteran’s self-reported trauma and pain symptoms. One group, called the “low symptom” group, had the least or least impactful symptoms and shared extremely similar login signatures. This group appeared to have neurobiological patterns that predicted their ability to avoid cognitive catastrophizing, manage their pain more effectively, and maintain a sense of resilience. At the other end of the spectrum, the “high symptom” group “reported the highest scores for pain catastrophizing, pain anxiety, and depressive symptom severity.”
Treatments for chronic pain and trauma have historically relied on the patient’s subjective input. While this information is essential to ensure that treatment results in a happier and more comfortable patient, it does not give physicians direct visibility into how the patient is perceiving or mitigating the effects of either ‘other. Hard data, like the ones revealed in this study, could fill those gaps.
“Trauma and post-traumatic stress are strongly comorbid with chronic pain and are often a history of the development of chronic pain conditions,” said the study, published last month in the journal Frontiers in Pain Research, lit. “Despite the high overlap in the clinic, the neural mechanisms of pain and trauma are often studied separately.” Pairing the two has yielded information capable of changing the way doctors understand and treat the two.
Because the study was conducted with veterans who had previously experienced trauma and chronic pain, it is difficult to say whether the connection signatures already existed in each participant or whether their individual experiences led to altered connections. But whichever comes first, the findings represent a big step toward personalized trauma and pain management. For example, physicians may be able to use a patient’s connection signatures along with self-report data to determine which style of treatment would be most effective.