Interactive interdisciplinary pain research in adolescent and young adult females: a pilot investigation of brain, physiological, and emotional functioning following orthopedic surgery.

OBJECTIVE

In this pilot investigation, we aimed to explore the neurological and biobehavioral mechanisms underlying pain outcomes in adolescent and young adult (AYA) females following orthopedic surgery, an area largely unexplored.

METHODS

Functional near-infrared spectroscopy was used to investigate brain responses in the primary sensory cortex (sensory pain processing) and the prefrontal regions (emotional processing) in 24 AYA females who underwent orthopedic surgery within the previous 2 years compared to 20 group-matched controls without a surgical or chronic pain history. A battery of self-reported pain-related and emotional functioning measures (PROMIS; pain catastrophizing) were also administered. Cortical activations and functional connectivity (FC), involving the prefrontal (PFC) and somatosensory cortices (SMC), were assessed during resting state and a descending pain modulation task (conditioned pain modulation).

RESULTS

In the control group, PFC-SMC FC in response to pain was significantly linked to anxiety, whereas this correlation was absent in the post-surgical cohort.

CONCLUSION

These results highlight distinct altered responses in sensory and emotional brain functioning in AYA females following orthopedic surgery. We suggest that such changes may be related to the involvement of the PFC-SMC communication in the maintenance of chronic pain.