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Cumulative impacts of early life adversity and persistent/recurrent pain in children: A longitudinal normative
Tong-En Lim1,2, Peter Humburg3, William R Reay4
1NeuroRecovery Research Hub, School of Psychology, The University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia.
Insights
Children with persistent/recurrent pain (PRP) and early life adversity (ELA) show unique brain changes, including reduced hippocampal volume. Understanding these combined effects is crucial for developing effective treatments for children.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Health
Background:
- Children with persistent/recurrent pain (PRP) often experience early life adversity (ELA).
- Both PRP and ELA are linked to similar brain morphology alterations in children.
- The combined impact of PRP and ELA on pediatric brain development is not well understood.
Purpose of the Study:
- To investigate the combined effects of persistent/recurrent pain (PRP) and early life adversity (ELA) on brain development in children.
- To identify unique brain signatures associated with co-occurring PRP and ELA.
Main Methods:
- Utilized structural magnetic resonance imaging data from the Adolescent Brain Cognitive Development cohort (N=1,671).
- Employed linear mixed models to analyze changes in subcortical volume, cortical thickness, and surface area over two years.
- Applied support vector machine for group classification based on brain measures.
Main Results:
- The PRP+ELA group exhibited greater reductions in left hippocampal volume and sensorimotor surface area over time compared to other groups.
- Significant differences in brain structure were observed between ELA-exposed children and control/PRP-only groups.
- Machine learning models achieved 66.8% accuracy in classifying group status based on brain metrics.
Conclusions:
- Findings reveal distinct brain alterations in children experiencing both PRP and ELA.
- These unique brain signatures highlight the complex interplay between pain and adversity during development.
- Understanding these effects can guide therapeutic strategies for pediatric pain and psychological well-being.
Background:
Compared to typically developing children, those experiencing persistent/recurrent pain (PRP) often report increased exposure to early life adversity (ELA). Separate studies of children experiencing PRP or exposed to ELA show similar alterations in brain morphology. Despite the close relationship between ELA and PRP experiences, their combined effect on the brain remains poorly understood.
Methods:
Structural magnetic resonance imaging data at baseline and 2-year follow-up was accessed from the Adolescent Brain Cognitive Development cohort (N = 1,671). Linear mixed models were used to determine the main effects of group (control, PRP only, ELA only and PRP+ELA) and group-by-time interaction on measures of subcortical volume, cortical thickness and surface area. Support vector machine was applied to perform group classification based on brain measures.
Results:
The PRP+ELA group showed more pronounced reduction in left hippocampal volume and sensorimotor surface area and increase in left precuneus and right frontal pole surface area over time compared to all other groups. In addition, independently of time, the ELA only group showed overall smaller accumbens, thicker right prefrontal and thinner left postcentral gyrus compared to the control and PRP only groups Using all brain measures, support vector machine models could not identify group status better than 66.8% accuracy.
Conclusions:
Our findings provide evidence for unique brain signatures representing the combined effects of PRP and ELA in children during development. Understanding effects of PRP and ELA on the brain of children can inform on treatment options to reduce pain symptoms and improve psychological outcomes.
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