Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches

Jillian Vinall Miller*, Quinn Andre, Inge Timmers, Laura Simons, Nivez Rasic, Catherine Lebel, Melanie Noel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

BACKGROUND/AIMS: Post-traumatic stress symptoms (PTSS) and chronic pain often co-occur at high rates in youth. PTSS may alter brain structure thereby contributing to headache chronicity. This study examined whether PTSS and altered limbic circuitry were associated with headache frequency in youth.

METHODS: Thirty youth aged 10-18 years with chronic headaches and 30 age- and sex-matched controls underwent a 3T MRI scan. Volumes of the hippocampus and amygdala were obtained from T1-weighted images. Mean fractional anisotropy (FA, an index of white matter structure) axial and radial diffusivity values of the cingulum and uncinate fasciculus were extracted from diffusion-weighted images. Youth reported on their headaches daily, for one-month, and self-reported pubertal status, emotion regulation, adverse childhood experiences (ACEs) and PTSS using validated measures. Volumes of the hippocampus and amygdala and diffusivity values of the cingulum and uncinate were compared between patients and controls. Hierarchical linear regressions were used to examine the association between PTSS, subcortical volumes and/or diffusivity values and headache frequency.

RESULTS: Mean FA values of the cingulum were higher in patients compared to controls (P = 0.02, Cohen's d = 0.69). Greater PTSS (P = 0.04), smaller amygdala volumes (P = 0.01) and lower FA of the cingulum (P = 0.04) were associated with greater headache frequency, after accounting for age, puberty, pain duration, emotion regulation, and ACEs (Adjusted R2 ≥ 0.15). Headache frequency was associated with increases in radial diffusivity (P = 0.002, Adjusted R2 = 0.59), as opposed to axial diffusivity (n.s.).

CONCLUSIONS: PTSS, smaller amygdalar volume, and poorer cingulum structural connectivity were associated with headache frequency in youth, and may underlie headache chronicity.

Original languageEnglish
Article number102627
Number of pages11
JournalNeuroImage: Clinical
Volume30
Early online date13 Mar 2021
DOIs
Publication statusPublished - 2021
Externally publishedYes

Keywords

  • ADVERSE CHILDHOOD EXPERIENCES
  • Brain
  • CHILDREN
  • CHRONIC PAIN
  • DIFFUSION
  • DISORDER SYMPTOMS
  • FIBER TRACTOGRAPHY
  • FUNCTIONAL CONNECTIVITY
  • Headache
  • MIGRAINE
  • PTSD
  • Pain
  • Post-traumatic stress symptoms
  • TENSION-TYPE HEADACHE
  • Trauma
  • WHITE-MATTER INTEGRITY

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