Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling
Trauma and posttraumatic stress are highly comorbid with chronic pain and are often antecedents to developing chronic pain conditions. Pain and trauma are associated with greater utilization of medical services, greater use of psychiatric medication, and increased total cost of treatment. Despite th...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Pain Research |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2022.871961/full |
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| author | Irina A. Strigo Irina A. Strigo Andrea D. Spadoni Andrea D. Spadoni Andrea D. Spadoni Alan N. Simmons Alan N. Simmons Alan N. Simmons |
| author_facet | Irina A. Strigo Irina A. Strigo Andrea D. Spadoni Andrea D. Spadoni Andrea D. Spadoni Alan N. Simmons Alan N. Simmons Alan N. Simmons |
| author_sort | Irina A. Strigo |
| collection | DOAJ |
| description | Trauma and posttraumatic stress are highly comorbid with chronic pain and are often antecedents to developing chronic pain conditions. Pain and trauma are associated with greater utilization of medical services, greater use of psychiatric medication, and increased total cost of treatment. Despite the high overlap in the clinic, the neural mechanisms of pain and trauma are often studied separately. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) scans were completed among a diagnostically heterogeneous sample of veterans with a range of back pain and trauma symptoms. Using Group Iterative Multiple Model Estimation (GIMME), an effective functional connectivity analysis, we explored an unsupervised model deriving subgroups based on path similarity in a priori defined regions of interest (ROIs) from brain regions implicated in the experience of pain and trauma. Three subgroups were identified by patterns in functional connection and differed significantly on several psychological measures despite similar demographic and diagnostic characteristics. The first subgroup was highly connected overall, was characterized by functional connectivity from the nucleus accumbens (NAc), the anterior cingulate cortex (ACC), and the posterior cingulate cortex (PCC) to the insula and scored low on pain and trauma symptoms. The second subgroup did not significantly differ from the first subgroup on pain and trauma measures but was characterized by functional connectivity from the ACC and NAc to the thalamus and from ACC to PCC. The third subgroup was characterized by functional connectivity from the thalamus and PCC to NAc and scored high on pain and trauma symptoms. Our results suggest that, despite demographic and diagnostic similarities, there may be neurobiologically dissociable biotypes with different mechanisms for managing pain and trauma. These findings may have implications for the determination of appropriate biotype-specific interventions that target these neurological systems. |
| first_indexed | 2024-04-14T00:07:02Z |
| format | Article |
| id | doaj.art-ab9102dfd0684d9d8c5b8bd010757232 |
| institution | Directory Open Access Journal |
| issn | 2673-561X |
| language | English |
| last_indexed | 2024-04-14T00:07:02Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj.art-ab9102dfd0684d9d8c5b8bd0107572322022-12-22T02:23:29ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2022-05-01310.3389/fpain.2022.871961871961Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised ModelingIrina A. Strigo0Irina A. Strigo1Andrea D. Spadoni2Andrea D. Spadoni3Andrea D. Spadoni4Alan N. Simmons5Alan N. Simmons6Alan N. Simmons7Emotion and Pain Laboratory, San Francisco Veterans Affairs Health Care Center, San Francisco, CA, United StatesDepartment of Psychiatry, University of California, San Francisco, San Francisco, CA, United StatesStress and Neuroimaging Laboratory, San Diego Veterans Affairs Health Care Center, San Francisco, CA, United StatesCenter of Excellence in Stress and Mental Health, San Diego Veterans Affairs Health Care Center, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesStress and Neuroimaging Laboratory, San Diego Veterans Affairs Health Care Center, San Francisco, CA, United StatesCenter of Excellence in Stress and Mental Health, San Diego Veterans Affairs Health Care Center, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesTrauma and posttraumatic stress are highly comorbid with chronic pain and are often antecedents to developing chronic pain conditions. Pain and trauma are associated with greater utilization of medical services, greater use of psychiatric medication, and increased total cost of treatment. Despite the high overlap in the clinic, the neural mechanisms of pain and trauma are often studied separately. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) scans were completed among a diagnostically heterogeneous sample of veterans with a range of back pain and trauma symptoms. Using Group Iterative Multiple Model Estimation (GIMME), an effective functional connectivity analysis, we explored an unsupervised model deriving subgroups based on path similarity in a priori defined regions of interest (ROIs) from brain regions implicated in the experience of pain and trauma. Three subgroups were identified by patterns in functional connection and differed significantly on several psychological measures despite similar demographic and diagnostic characteristics. The first subgroup was highly connected overall, was characterized by functional connectivity from the nucleus accumbens (NAc), the anterior cingulate cortex (ACC), and the posterior cingulate cortex (PCC) to the insula and scored low on pain and trauma symptoms. The second subgroup did not significantly differ from the first subgroup on pain and trauma measures but was characterized by functional connectivity from the ACC and NAc to the thalamus and from ACC to PCC. The third subgroup was characterized by functional connectivity from the thalamus and PCC to NAc and scored high on pain and trauma symptoms. Our results suggest that, despite demographic and diagnostic similarities, there may be neurobiologically dissociable biotypes with different mechanisms for managing pain and trauma. These findings may have implications for the determination of appropriate biotype-specific interventions that target these neurological systems.https://www.frontiersin.org/articles/10.3389/fpain.2022.871961/fullinsulanucleus accumbenseffective connectivityneuroimagingveteranscatastrophizing |
| spellingShingle | Irina A. Strigo Irina A. Strigo Andrea D. Spadoni Andrea D. Spadoni Andrea D. Spadoni Alan N. Simmons Alan N. Simmons Alan N. Simmons Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling Frontiers in Pain Research insula nucleus accumbens effective connectivity neuroimaging veterans catastrophizing |
| title | Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling |
| title_full | Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling |
| title_fullStr | Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling |
| title_full_unstemmed | Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling |
| title_short | Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling |
| title_sort | understanding pain and trauma symptoms in veterans from resting state connectivity unsupervised modeling |
| topic | insula nucleus accumbens effective connectivity neuroimaging veterans catastrophizing |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2022.871961/full |
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