Gray matter volume differences between lower, average, and higher pain resilience subgroups

Abstract

Resilience refers to the capacity to function well despite adversity and facilitates adaptation to various stressors, including pain. Previous studies have operationalized resilience via questionnaires or task performance behaviors that do not always correlate with one another and tested extreme (lower vs. higher) resilience subgroup differences that do not permit the assessment of nonlinear associations between resilience and brain matter volume. To address these limitations, we identified high (HPR, N = 21), moderate (MPR, N = 20), and low (LPR, N = 16) pain resilience subgroups from a trait resilience questionnaire as well as behavioral performance on a laboratory pain task. Subsequently, resilience subgroup differences in gray matter volume (GMV) and behavior responses to a novel numerical interference task (NIT) were assessed. Behavioral results indicated the LPR subgroup was slower in responding to NIT trials accompanied by pain compared to MPR, and especially, HPR subgroups. Voxel‐based morphology analyses indicated the LPR subgroup had more GMV in the left postcentral gyrus than did MPR and HPR subgroups. LPR and MPR subgroups displayed larger GMV in the right inferior temporal gyrus than did the HPR subgroup. Nonlinear relations reflecting less regional GMV in the right inferior frontal gyrus (IFG)/putamen, orbitofrontal cortex and left IFG/insula were also observed for the MPR subgroup compared to LPR and HPR subgroups. In sum, lower pain resilience is characterized, in part, by comparatively greater GMV in pain processing regions and reduced GMV in “resilience” regions, though regional GMV also has several nonlinear associations with resilience.

Identifying resting state differences salient for resilience to chronic pain based on machine learning multivariate pattern analysis

“…To date, little is known about neural substrates underlying more and less resilient responses to pain. Recent brain imaging studies have identified brain structure correlates of resilience to laboratory pain (Erpelding & Davis, 2013;Li & Jackson, 2020;You & Jackson, 2021) but researchers have not assessed the presence or nature of resting state (Rs) brain activity differences between more versus less resilient subgroups with ongoing pain. We begin to address this gap with the current study.…”

Multimodal neural correlates of dispositional resilience among healthy individuals

“…A previous resting-state fMRI study of healthy individuals showed that the resilient group had significantly greater IFG activation 45 . Voxel-based morphology analyses revealed that GMVs in the IFG and insula significantly increased in the relatively high resilience group compared to the middle-level resilience group 46 . These studies underscore the IFG and insula as regions directly or indirectly related to pain resilience processing and are indirectly linked to ongoing adversity.…”

Psychophysiological correlates of pain resilience in anticipating, experiencing, and recovering from pain

“…Although operationalizations have varied, resilience reflects capacities to maintain a positive outlook, persevere, and function adaptively despite adversity or ongoing stressors including pain (Connor & Davidson, 2003;Slepian et al, 2016;Sturgeon & Zautra, 2013). Behavior studies of laboratory pain have found elevations in pain resilience are related to lower pain intensity levels (Ankawi et al, 2020;Slepian et al, 2016), increases in pain tolerance (Slepian et al, 2016;Slepian & France, 2017), an enhanced capacity to disengage visual attention from painful cues (Jackson et al, 2019;Ling et al, 2019), and superior performance on cognitive tasks accompanied by painful stimulation (Li & Jackson, 2020). Furthermore, brain-imaging research has begun to reveal brain structure correlates of pain resilience.…”

“…Furthermore, brain-imaging research has begun to reveal brain structure correlates of pain resilience. For example, lower pain resilience is related to increased gray matter volume (GMV) and higher resting state activity in regions implicated in pain processing and salience (Erpelding & Davis, 2013;, albeit some resilience-GMV associations being non-linear (Li & Jackson, 2020).…”

“…This study was designed to assess psychophysiological correlates of pain resilience during exposure to laboratory pain stimuli. Based on conceptually related research (Anderson et al, 1989;Li & Jackson, 2020), we assessed high, moderate, and low pain resilience subgroup differences on subjective perceptions of arousal and pain as well as objective indexes of autonomic arousal response during anticipation, experiencing and recovery from exposure to less versus more intense pain stimulation. In relation to autonomic response, three physiological indicators were assessed in tandem.…”