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Terry EL, Tanner JJ, Cardoso JS, Sibille KT, Lai S, Deshpande H, Deutsch G, Price CC, Staud R, Goodin BR, Redden DT, Fillingim RB. Associations between pain catastrophizing and resting-state functional brain connectivity: Ethnic/race group differences in persons with chronic knee pain. J Neurosci Res 2022; 100:1047-1062. [PMID: 35187703 PMCID: PMC8940639 DOI: 10.1002/jnr.25018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 02/01/2023]
Abstract
Chronic pain is a significant public health problem, and the prevalence and societal impact continues to worsen annually. Multiple cognitive and emotional factors are known to modulate pain, including pain catastrophizing, which contributes to pain facilitation and is associated with altered resting-state functional connectivity in pain-related cortical and subcortical circuitry. Pain and catastrophizing levels are reported to be higher in non-Hispanic black (NHB) compared with non-Hispanic White (NHW) individuals. The current study, a substudy of a larger ongoing observational cohort investigation, investigated the pathways by which ethnicity/race influences the relationship between pain catastrophizing, clinical pain, and resting-state functional connectivity between anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (dlPFC), insula, and primary somatosensory cortex (S1). Participants included 136 (66 NHBs and 70 NHWs) community-dwelling adults with knee osteoarthritis. Participants completed the Coping Strategies Questionnaire-Revised Pain Catastrophizing subscale and Western Ontario and McMaster Universities Osteoarthritis Index. Magnetic resonance imaging data were obtained, and resting-state functional connectivity was analyzed. Relative to NHW, the NHB participants were younger, reported lower income, were less likely to be married, and self-reported greater clinical pain and pain catastrophizing (ps < 0.05). Ethnicity/race moderated the mediation effects of catastrophizing on the relationship between clinical pain and resting-state functional connectivity between the ACC, dlPFC, insula, and S1. These results indicate the NHB and NHW groups demonstrated different relationships between pain, catastrophizing, and functional connectivity. These results provide evidence for a potentially important role of ethnicity/race in the interrelationships among pain, catastrophizing, and resting-state functional connectivity.
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Affiliation(s)
- Ellen L. Terry
- College of Nursing, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida, USA,Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida, USA
| | - Jared J. Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Josue S. Cardoso
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida, USA
| | - Kimberly T. Sibille
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida, USA
| | - Song Lai
- Department of Radiation Oncology, University of Florida, Gainesville, Florida, USA,CTSI Human Imaging Core, University of Florida, Gainesville, Florida, USA
| | - Hrishikesh Deshpande
- Division of Molecular Imaging and Therapeutics, University of Alabama at Birmingham, Birmingham, Alabama, USA,Division of Advanced Medical Imaging Research, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Georg Deutsch
- Division of Molecular Imaging and Therapeutics, University of Alabama at Birmingham, Birmingham, Alabama, USA,Division of Advanced Medical Imaging Research, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Catherine C. Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Burel R. Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David T. Redden
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida, USA
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Pain-Related Worrying and Goal Preferences Determine Walking Persistence in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031513. [PMID: 35162534 PMCID: PMC8835050 DOI: 10.3390/ijerph19031513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
Abstract
Physical activity and exercise are relevant behaviors for fibromyalgia health outcomes; however, patients have difficulties undertaking and maintaining an active lifestyle. With a cross-sectional design, this study explored the role of pain-related worrying and goal preferences in the walking persistence of women with fibromyalgia. The sample included 111 women who attended a tertiary health setting. We adapted the Six-Minute Walk Test where participants decided either to stop or continue walking in five voluntary 6 min bouts. Women who were categorized higher in pain-related worrying reported higher preference for pain avoidance goals (t = -2.44, p = 0.02) and performed worse in the walking task (LongRank = 4.21; p = 0.04). Pain avoidance goal preference increased the likelihood of stopping after the first (OR = 1.443), second (OR = 1.493), and third (OR = 1.540) 6 min walking bout, and the risk of ending the walking activity during the 30 min task (HR = 1.02, [1.0-1.03]). Influence of pain-related worrying on total walking distance was mediated by goal preferences (ab = -3.25). In interventions targeting adherence in physical activity and exercise, special attention is needed for women who are particularly worried about pain to help decrease their preference for short-term pain avoidance goals relative to long-term goals such as being active through walking.
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Brouwer B, Waardenburg S, Jacobs C, Overdijk M, Leue C, Köke A, Kuijk SV, van Kleef M, Van Zundert J, de Meij N. Biopsychosocial baseline values of 15 000 patients suffering from chronic pain: Dutch DataPain study. Reg Anesth Pain Med 2020; 45:774-782. [DOI: 10.1136/rapm-2020-101476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 01/23/2023]
Abstract
Background and objectivesChronic pain affects many adults. To improve our daily practice, we need to understand multidisciplinary approaches, integrated treatment plans and the biopsychosocial context of these patients. To date, almost 15 000 chronic pain patients have been referred to the Maastricht University Pain Center in the Netherlands.MethodsThis study describes 11 214 of these patients suffering from chronic pain. Chronic pain was analyzed using relevant Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials instruments.ResultsMost patients were female (59.3%). The prevalence of low education was 59%, and unemployment/disability was 35.9%. The mean age was 55.6 years. Severe pain (Numerical Rating Sale score 7–10) was reported by 71.9% of the patients; psychological and quality of life values deteriorated when pain severity increased. Approximately 36% of patients showed severe signs of depression or anxiety, and 39% displayed high pain catastrophizing. Of all patients, 17.8% reported high values for pain severity, catastrophizing and anxiety or depression.ConclusionsBased on baseline biopsychosocial values, this study shows the complexity of patients referred to pain centers. Pain management with a biopsychosocial approach in an integrated multidisciplinary setting is indispensable. Above all, adjusted education on chronic pain and attention to its biopsychosocial aspects are deemed necessary.
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