Researchers at the Universities of California at San Diego and San Francisco conducted a study involving 57 veterans who each experienced chronic back pain and the effects of trauma. They conducted MRI scans of each participant’s brain to reveal the resting-state neurological connections between regions involved in the experience of pain and trauma: the insula, anterior cingulate cortex, thalamus, posterior cingulate cortex, 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 the regional connections (called connection signatures) directly correlated with each veteran’s self-reported trauma and pain symptoms. One group—called the “low-symptom” group—experienced the fewest or least impactful symptoms and shared extremely similar connection signatures. This group appeared to have neurobiological patterns that predicated their ability to avoid cognitive catastrophizing, manage their pain more effectively, and to maintain a sense of resilience. On the other end of the spectrum, the “high-symptom” group “reported the highest pain catastrophizing, pain anxiety, and depressive symptom severity scores.”
Chronic pain and trauma treatments have historically relied on subjective input from the patient. While this information is key to ensuring treatment results in a happier and more comfortable patient, it doesn’t give doctors direct visibility into how the patient is perceiving or mitigating the effects of either. Objective data, like that revealed in this study, might fill in those blanks.
“Trauma and posttraumatic stress are highly comorbid with chronic pain and are often antecedents to developing chronic pain conditions,” the study, published last month in the journal Frontiers in Pain Research, reads. “Despite the high overlap in the clinic, the neural mechanisms of pain and trauma are often studied separately.” The pairing of the two has yielded insights capable of changing how doctors understand and treat both.
Because the study was conducted with veterans who had each already experienced trauma and chronic pain, it’s hard to tell whether the connection signatures already existed in each participant or if their individual experiences resulted in altered connections. But regardless of which came first, the findings represent a big step toward personalized trauma and pain management. For example, doctors may be able to use a patient’s connection signatures alongside self-report data to determine which style of treatment would be most effective.