A research that analyzed the brains of war veterans with chronic painhe tracked down three unique brain subtypes that potentially indicate high, medium and low susceptibility to pain and trauma symptoms. It is an objective measurement of pain and susceptibility to trauma that could pave the way for personalized therapies for chronic pain.
The study was developed by a team of scholars from San Francisco Veterans Affairs Health Care Center and was published in the scientific journal Frontiers in Pain Research.
Why it’s important to study the brains of war veterans with chronic pain
Chronic pain and trauma often occur at the same time. However, most previous research has studied them in isolation and using subjective measures such as surveys, leading to an incomplete picture.. The new research has filled several gaps and revealed three unique signs in brain connectivity that appear to indicate the susceptibility or resilience of war veterans with chronic pain and trauma, regardless of their diagnostic or combat history. Research could open new frontiers for more objective measurements of pain and trauma, leading to targeted and personalized treatments.
“Chronic pain is a major public health concern, especially among veterans“Stated the first author, the Professor Irina Strigo of the San Francisco Veterans Affairs Health Care Center. “Furthermore, chronic pain sufferers almost never present with a single disorder, but often with multiple co-morbidities, such as trauma, post-traumatic stress and depression “.
Researchers have stated that both pain and trauma can affect connections in our brains, but no research has observed the phenomenon in the context of concomitant trauma and pain. Much pain and trauma research is also based on subjective measurements such as questionnaires, rather than objective measurements such as brain scans.
Taking a different approach, the researchers behind this new research studied a group of 57 war veterans with chronic pain and trauma: chronic pain particularly affected back pain. The group had quite varied symptoms in terms of pain and severity of the trauma.
By scanning the brains of war veterans with chronic pain and using functional MRI, the team of researchers traced the strength of connections between brain regions involved in pain and trauma. Scientists subsequently exploited a statistical technique to automatically group veterans based on their brain connection signatures, regardless of self-reported pain and trauma levels.
Based on the brain activity of the war veterans, the computer automatically divided them into three groups. The result was particularly interesting: the divisions were comparable to the severity of the veterans’ symptoms and fell into a low, medium, or high symptom group.
The researchers speculated that the brain connection pattern found in the low-symptom group enabled veterans to avoid some of the emotional fallout from pain and trauma, and also included natural pain-reducing abilities. In reverse, the group of war veterans with chronic pain with elevated symptoms demonstrated brain connection patterns that may have increased their chances of anxiety and catastrophism while experiencing pain.
Interestingly, based on self-reported pain and trauma symptoms, the medium symptom group was largely similar to the low symptom group. However, the average symptom group showed differences in certain signs of brain connectivity, which suggested they were better at focusing on other things when they were in pain, reducing its impact.
“Despite the fact that most of the subjects within each subgroup had a concomitant diagnosis of pain and trauma, their brain connections differed.“, Strigo declared.
“In other words, despite the demographic and diagnostic similarities, we found neurobiologically distinct groups with different mechanisms for pain and trauma management. Neurobiology-based subgroups can provide insight into how these individuals will respond to brain stimulation and psychopharmacological treatments“, Concluded the scientist.
To date, the team does not know whether the neural hallmarks they found represent a vulnerability to trauma and pain or a consequence of these conditions. However, the technique is interesting, as it provides an objective and unbiased hallmark of susceptibility or resilience to pain and trauma. It is not based on subjective measures such as surveys. Indeed, the subjective pain measurements in this study would not distinguish between the low and middle groups.
Techniques that use objective measures, such as brain connectivity, seem more sensitive and may provide a clearer overall picture of someone’s resilience or susceptibility to pain and trauma, specifically, war veterans with chronic pain who lend themselves to study. thus allowing to give the possibility to develop a personalized treatment and pave the way for new therapies.
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