Abstract Details

Title Brain Functional Connectivity Correlates of Pain Catastrophizing in Post-traumatic Headache

Topic Headache

Presentation(s) S23 - Hot Topics in Headache Medicine (1:12 PM-1:24 PM)

Poster/Presentation
Number 002

Objective To investigate whether individuals’ pain experience, as measured by the Pain Catastrophizing Scale (PCS), is associated with magnetic resonance imaging resting-state functional connectivity (rs-FC) patterns in individuals with PTH.

Background Post-traumatic headache (PTH) is a common and debilitating sequela following mild traumatic brain injury (mTBI). Cognitive–affective factors, such as heightened attention or negative expectations about pain, have been linked to greater pain intensity and increased risk of pain persistence. Nevertheless, brain functional connectivity patterns associated with these cognitive-affective factors in PTH are poorly understood.

Design/Methods Rs-FC and PCS data were collected from 112 individuals with acute PTH (mean age: 40.5 ± 15.5; 75 females/ 37 males) within 1- 60 days post-mTBI. FC across 38 predefined regions-of-interest involved in pain, attention, and emotional processing was assessed using a seed-based correlation approach, controlling for age and sex. Correlations between FC and PCS total scores and subscores (rumination, helplessness, magnification) were investigated using linear regression corrected for multiple testing using Benjamini and Hochberg (FDR) with significance levels set as p < 0.05.

Results

The mean PCS total score of the study population was 12.9 ± 10.6. Higher PCS scores were associated with hyperconnectivity between left amygdala and right cerebellum (raw p-value 0.0002; FDR p-value 0.0484; beta 0.0073). There were not significant associations between FC with PCS subscores.

Conclusions

This finding suggests that cognitive-affective components of pain assessed using the PCS is associated with stronger FC among regions primarily involved in emotional (amygdala) and sensory–motor processing (cerebellum) in individuals with acute PTH. The identified strengthening of connectivity may amplify pain perception through heightened integration of affective and sensory signals. Overall, this study provides a novel insight into the neurobiological mechanisms contributing to maladaptive pain processing in individuals with PTH and suggests possible neural pathways involved in pain persistence.

Authors/Disclosures
Catherine D. Chong, PhD, FAAN PRESENTER	Dr. Chong has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for HCOP.
Simona Nikolova, PhD (FSU)	Dr. Nikolova has nothing to disclose.
Gina Dumkrieger, PhD (Mayo Clinic)	Gina Dumkrieger has received personal compensation for serving as an employee of Mayo Clinic. The institution of Gina Dumkrieger has received research support from NIH. The institution of Gina Dumkrieger has received research support from DOD. The institution of Gina Dumkrieger has received research support from AMGEN.
Michael R. Leonard, CCRP	Mr. Leonard has nothing to disclose.
Dani Smith, MS	Miss Smith has nothing to disclose.
Todd J. Schwedt, MD, FAAN (Mayo Clinic)	Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. The institution of Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Salvia. Dr. Schwedt has or had stock in Nocira.Dr. Schwedt has or had stock in Allevalux. The institution of Dr. Schwedt has received research support from National Institutes of Health. The institution of Dr. Schwedt has received research support from United States Department of Defense. The institution of Dr. Schwedt has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Schwedt has received research support from Henry Jackson Foundation. The institution of Dr. Schwedt has received research support from Pfizer. The institution of Dr. Schwedt has received research support from National Headache Foundation. The institution of Dr. Schwedt has received research support from American Heart Association. The institution of Dr. Schwedt has received research support from AbbVie. The institution of Dr. Schwedt has received research support from Flinn Foundation. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received publishing royalties from a publication relating to health care.
Federico Bighiani, MD	Dr. Bighiani has nothing to disclose.