Chronic pain is defined as the experience of pain for more than three months or beyond the normal healing time after injury or illness. Approximately 20% of adults are experiencing chronic pain globally, leading to significant health (e.g. diminished quality of life) and economic burdens (e.g. reduced presence at work) to both the people living with chronic pain, their families, friends, and the society. Individuals with chronic pain often report mental health including depression, anxiety, and post-traumatic stress disorder (PTSD), as well as physical health problems, including cardiovascular problems. Chronic pain and trauma exposure are strongly related, with around 20% of people with chronic pain experiencing posttraumatic stress symptoms (PTSS), and with 20 to 80% of people with PTSD also suffering from chronic pain.
The prolonged experience of pain is associated with long-term structural and functional brain changes, particularly evident in key brain regions involved in emotion processing and regulation that impact larger cognitive processes, especially attention, social cognition, and reward processing. Similar alterations have all also been reported in separate studies of in populations exposed to trauma either in childhood or adulthood. However, studies investigating the impact of trauma exposure on brain morphology and function, including associated behaviours in people with chronic pain remains limited in the literature. This project aims to closely examine the role of trauma exposure on brain alterations, their interactions with comorbid mental and physical health problems, as well as their differences among females and males, in a large cohort of people with and without chronic pain.
This project will take approximately three years to complete. Upon completion, the project will identify the long-term effects of chronic pain, trauma exposure (adulthood or childhood or both), and their interactions with mental and physical health problems on brain morphology and function (including cognitive functions). Importantly, this project will determine the sex-specifics effects of trauma exposure and/or mental illness on indices of brain morphology and function in people who developed chronic pain. Understanding these mechanisms will inform on the best, most tailored therapeutic interventions targeting the brain regions/networks altered, to alleviate pain sensation, as well as the effects associated with comorbidities in people with chronic pain.