Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 1;40(11):665-672.
doi: 10.1097/AJP.0000000000001237.

Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study

Rebecca J Lepping  1   2 , Cara M Hoffart  3   4   5 , Amanda S Bruce  5   6 , Jasmine M Taylor  1   2 , Neil J Mardis  7 , Seung-Lark Lim  8 , Dustin P Wallace  3   4   5
Affiliations

Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study

Rebecca J Lepping et al. Clin J Pain. .

Abstract

Objective: Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth.

Methods: This study examined changes in brain activation associated with experiencing physical pain and observing physical and emotional pain in others by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youths (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain.

Results: Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes may suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests potentially better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus).

Discussion: These changes could indicate that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.

PubMed Disclaimer

Conflict of interest statement

Funding awarded to A.S.B. from the Cystic Fibrosis Foundation and Multiple Sclerosis Society. The remaining authors declare no conflict of interest.

Update of

References

    1. Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160:19–27.
    1. Low Kapalu CM, Hall JJ, Wallace DP. Neuropsychological functioning of youth receiving intensive interdisciplinary pain treatment. J Pediatr Psychol. 2018;43:870–881.
    1. Long RD, Walker A, Pan SC, et al. Baseline factors associated with pain intensity, pain catastrophizing, and pain interference in intensive interdisciplinary pain treatment for youth. Children (Basel). 2023;10:1229.
    1. Martin AL, McGrath PA, Brown SC, et al. Anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain. Pain Res Manag. 2007;12:267–272.
    1. Simons LE, Kaczynski KJ, Conroy C, et al. Fear of pain in the context of intensive pain rehabilitation among children and adolescents with neuropathic pain: associations with treatment response. J Pain. 2012;13:1151–1161.

LinkOut - more resources