Associations of pain catastrophizing with pain-related brain structure in individuals with or at risk for knee osteoarthritis: Sociodemographic considerations

Abstract

Compelling evidence exists that non-Hispanic blacks (NHB) engage in pain catastrophizing (negatively evaluate one’s ability to cope with pain) more often than non-Hispanic whites (NHW). Functional neuroimaging studies revealed that individuals with high levels of trait pain catastrophizing show increased cerebral responses to pain in several pain-related brain regions (e.g., insula, primary somatosensory cortex [S1]), but associations between brain structure and catastrophizing remain largely unexplored. The current investigation was conducted at the University of Florida and the University of Alabama at Birmingham. Participants were 129 community-dwelling adults with or at risk of knee osteoarthritis (OA). Participants completed the pain catastrophizing subscale of the Coping Strategies Questionnaire-Revised and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain intensity subscale. Magnetic Resonance Imaging data were obtained. MANOVA and Chi-Square analyses assessed sociodemographic/clinical differences stratified by ethnicity/race. Multivariate regression analyses with insula and somatosensory cortical thickness entered as dependent variables with catastrophizing and the interaction between catastrophizing and ethnicity/race as the independent variables. Covariates include education, body mass index, study site, and WOMAC pain (ethnicity/race was an additional covariate in non-stratified analyses). There were significant interactions between ethnicity/race, pain catastrophizing, and brain structure. Higher pain catastrophizing was associated with thinner S1 bilaterally (ps < .05) in NHW, but not NHB participants with or at risk for knee OA. These results suggest that pain catastrophizing might have differing effects on pain-related central pathways and may contribute to ethnic/race group differences in individuals with or at risk for knee OA.

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Acknowledgements

The authors would like to thank the research team that made this work possible: Ralisa Pop and Eric Weber.

Funding

This study was funded and supported by NIH Grants R37AG033906 (R.B.F.), T32AG049673 and K22NS102334 (E.L.T.), R01AG054370 (K.T.S.), CTSA Grants UL1TR001427 (UF) and UL1TR001417 (UAB) from the NIH Center for Advancing Translational Sciences. Support was also provided by UF McKnight Brain Institute Career Enhancement Award (E.L.T.).

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Correspondence to Ellen L. Terry.

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Terry, E.L., Tanner, J.J., Cardoso, J.S. et al. Associations of pain catastrophizing with pain-related brain structure in individuals with or at risk for knee osteoarthritis: Sociodemographic considerations. Brain Imaging and Behavior (2020). https://doi.org/10.1007/s11682-020-00372-w

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Keywords

  • Pain Catastrophizing
  • Ethnic
  • Race
  • Knee osteoarthritis
  • Knee pain
  • Cortical thickness