Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches
Background/aims: Post-traumatic stress symptoms (PTSS) and chronic pain often co-occur at high rates in youth. PTSS may alter brain structure thereby contributing to headache chronicity. This study examined whether PTSS and altered limbic circuitry were associated with headache frequency in youth. M...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158221000711 |
| _version_ | 1819100763251539968 |
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| author | Jillian Vinall Miller Quinn Andre Inge Timmers Laura Simons Nivez Rasic Catherine Lebel Melanie Noel |
| author_facet | Jillian Vinall Miller Quinn Andre Inge Timmers Laura Simons Nivez Rasic Catherine Lebel Melanie Noel |
| author_sort | Jillian Vinall Miller |
| collection | DOAJ |
| description | Background/aims: Post-traumatic stress symptoms (PTSS) and chronic pain often co-occur at high rates in youth. PTSS may alter brain structure thereby contributing to headache chronicity. This study examined whether PTSS and altered limbic circuitry were associated with headache frequency in youth. Methods: Thirty youth aged 10–18 years with chronic headaches and 30 age- and sex-matched controls underwent a 3T MRI scan. Volumes of the hippocampus and amygdala were obtained from T1-weighted images. Mean fractional anisotropy (FA, an index of white matter structure) axial and radial diffusivity values of the cingulum and uncinate fasciculus were extracted from diffusion-weighted images. Youth reported on their headaches daily, for one-month, and self-reported pubertal status, emotion regulation, adverse childhood experiences (ACEs) and PTSS using validated measures. Volumes of the hippocampus and amygdala and diffusivity values of the cingulum and uncinate were compared between patients and controls. Hierarchical linear regressions were used to examine the association between PTSS, subcortical volumes and/or diffusivity values and headache frequency. Results: Mean FA values of the cingulum were higher in patients compared to controls (P = 0.02, Cohen’s d = 0.69). Greater PTSS (P = 0.04), smaller amygdala volumes (P = 0.01) and lower FA of the cingulum (P = 0.04) were associated with greater headache frequency, after accounting for age, puberty, pain duration, emotion regulation, and ACEs (Adjusted R2 ≥ 0.15). Headache frequency was associated with increases in radial diffusivity (P = 0.002, Adjusted R2 = 0.59), as opposed to axial diffusivity (n.s.). Conclusions: PTSS, smaller amygdalar volume, and poorer cingulum structural connectivity were associated with headache frequency in youth, and may underlie headache chronicity. |
| first_indexed | 2024-12-22T01:07:56Z |
| format | Article |
| id | doaj.art-abe26b5f00274694a0b3e21f707df303 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-22T01:07:56Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-abe26b5f00274694a0b3e21f707df3032022-12-21T18:44:03ZengElsevierNeuroImage: Clinical2213-15822021-01-0130102627Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headachesJillian Vinall Miller0Quinn Andre1Inge Timmers2Laura Simons3Nivez Rasic4Catherine Lebel5Melanie Noel6Anesthesiology, Perioperative & Pain Medicine, University of Calgary, Calgary, AB, Canada; Vi Riddell Children’s Pain & Rehabilitation Centre, Alberta Children’s Hospital, Calgary, AB, Canada; Behaviour & The Developing Brain, Alberta Children’s Hospital Research Institute, Calgary, AB, Canada; Corresponding author at: Department of Anesthesia, University of Calgary, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada.Medicine, University of Alberta, Edmonton, AB, CanadaDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United StatesDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United StatesAnesthesiology, Perioperative & Pain Medicine, University of Calgary, Calgary, AB, Canada; Vi Riddell Children’s Pain & Rehabilitation Centre, Alberta Children’s Hospital, Calgary, AB, Canada; Behaviour & The Developing Brain, Alberta Children’s Hospital Research Institute, Calgary, AB, CanadaBehaviour & The Developing Brain, Alberta Children’s Hospital Research Institute, Calgary, AB, Canada; Radiology, University of Calgary, Calgary, AB, CanadaVi Riddell Children’s Pain & Rehabilitation Centre, Alberta Children’s Hospital, Calgary, AB, Canada; Behaviour & The Developing Brain, Alberta Children’s Hospital Research Institute, Calgary, AB, Canada; Psychology, University of Calgary, Calgary, AB, CanadaBackground/aims: Post-traumatic stress symptoms (PTSS) and chronic pain often co-occur at high rates in youth. PTSS may alter brain structure thereby contributing to headache chronicity. This study examined whether PTSS and altered limbic circuitry were associated with headache frequency in youth. Methods: Thirty youth aged 10–18 years with chronic headaches and 30 age- and sex-matched controls underwent a 3T MRI scan. Volumes of the hippocampus and amygdala were obtained from T1-weighted images. Mean fractional anisotropy (FA, an index of white matter structure) axial and radial diffusivity values of the cingulum and uncinate fasciculus were extracted from diffusion-weighted images. Youth reported on their headaches daily, for one-month, and self-reported pubertal status, emotion regulation, adverse childhood experiences (ACEs) and PTSS using validated measures. Volumes of the hippocampus and amygdala and diffusivity values of the cingulum and uncinate were compared between patients and controls. Hierarchical linear regressions were used to examine the association between PTSS, subcortical volumes and/or diffusivity values and headache frequency. Results: Mean FA values of the cingulum were higher in patients compared to controls (P = 0.02, Cohen’s d = 0.69). Greater PTSS (P = 0.04), smaller amygdala volumes (P = 0.01) and lower FA of the cingulum (P = 0.04) were associated with greater headache frequency, after accounting for age, puberty, pain duration, emotion regulation, and ACEs (Adjusted R2 ≥ 0.15). Headache frequency was associated with increases in radial diffusivity (P = 0.002, Adjusted R2 = 0.59), as opposed to axial diffusivity (n.s.). Conclusions: PTSS, smaller amygdalar volume, and poorer cingulum structural connectivity were associated with headache frequency in youth, and may underlie headache chronicity.http://www.sciencedirect.com/science/article/pii/S2213158221000711BrainHeadachePainPTSDPost-traumatic stress symptomsTrauma |
| spellingShingle | Jillian Vinall Miller Quinn Andre Inge Timmers Laura Simons Nivez Rasic Catherine Lebel Melanie Noel Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches NeuroImage: Clinical Brain Headache Pain PTSD Post-traumatic stress symptoms Trauma |
| title | Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches |
| title_full | Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches |
| title_fullStr | Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches |
| title_full_unstemmed | Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches |
| title_short | Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches |
| title_sort | subclinical post traumatic stress symptomology and brain structure in youth with chronic headaches |
| topic | Brain Headache Pain PTSD Post-traumatic stress symptoms Trauma |
| url | http://www.sciencedirect.com/science/article/pii/S2213158221000711 |
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