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bioRxiv · 10.1101/2021.11.12.468345

Structural brain connectivity predicts acute pain after mild traumatic brain injury

Branco, P.·Bosak, N.·Bielefeld, J.·Cong, O.·Granovsky, Y.·Kahn, I.·Yarnitsky, D.·Apkarian, A. V.
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Abstract

Mild traumatic brain injury, mTBI, is a leading cause of disability worldwide, with acute pain manifesting as one of its most debilitating symptoms. Understanding acute post-injury pain is important since it is a strong predictor of long-term outcomes. In this study, we imaged the brains of 172 patients with mTBI, following a motorized vehicle collision and used a machine learning approach to extract white matter structural and resting state fMRI functional connectivity measures to predict acute pain. Stronger white matter tracts within the sensorimotor, thalamic-cortical, and default-mode systems predicted 20% of the variance in pain severity within 72 hours of the injury. This result generalized in two independent groups: 39 mTBI patients and 13 mTBI patients without whiplash symptoms. White matter measures collected at 6-months after the collision still predicted mTBI pain at that timepoint (n = 36). These white-matter connections were associated with two nociceptive psychophysical outcomes tested at a remote body site - namely conditioned pain modulation and magnitude of suprathreshold pain-, and with pain sensitivity questionnaire scores. Our validated findings demonstrate a stable white-matter network, the properties of which determine a significant amount of pain experienced after acute injury, pinpointing a circuitry engaged in the transformation and amplification of nociceptive inputs to pain perception.

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Branco, P., Bosak, N., Bielefeld, J., Cong, O., Granovsky, Y., Kahn, I., Yarnitsky, D., Apkarian, A. V.. 2021-11-13. Structural brain connectivity predicts acute pain after mild traumatic brain injury. https://doi.org/10.1101/2021.11.12.468345

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