SEARCHMETA-ANALYSISneurology, psychiatry

meta-analysis·neurology, psychiatry, systematic review, meta-analysis, epidemiology·PMC10251130

The effect of adverse childhood experiences on chronic pain and major depression in adulthood: a systematic review and meta-analysis

BJA: British Journal of Anaesthesia · 4 authors, 2 centres

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The analysis used activation likelihood estimate meta-analysis to locate significant brain regions.

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The analysis used activation likelihood estimate meta-analysis to locate significant brain regions. Findings showed that ACE exposure is associated with functional and structural brain abnormalities in several regions, including the superior frontal gyrus, hippocampus, insula, and cingulate gyrus, in patients with MDD or chronic pain. The study suggests ACE may lead to different neural alterations in these conditions, which could help understand shared vulnerability mechanisms.

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meta-analysis

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neurology

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ORIGINAL PAPER

PMC10251130

The effect of adverse childhood experiences on chronic pain and major depression in adulthood: a systematic review and meta-analysis

BJA: British Journal of Anaesthesia

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ABSTRACT

Abstract Background Adverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often associated with mood disorders, such as major depressive disorder (MDD); both have been linked to adverse childhood experiences. It is unclear how the effect of adverse childhood experiences on neural processing impacts on vulnerability to chronic pain, MDD, or both, and whether there are shared mechanisms. We aimed to assess evidence for central neural changes associated with adverse childhood experiences in subjects with chronic pain, MDD, or both using systematic review and meta-analysis. Methods Electronic databases were systematically searched for neuroimaging studies of adverse childhood experiences, with chronic pain, MDD, or both. Two independent reviewers screened title, abstracts, and full text, and assessed quality. After extraction of neuroimaging data, activation likelihood estimate meta-analysis was performed to identify significant brain regions associated with these comorbidities. Results Forty-nine of 2414 studies were eligible, of which 43 investigated adverse childhood experiences and MDD and six investigated adverse childhood experiences and chronic pain. None investigated adverse childhood experiences, chronic pain, and MDD together. Functional and structural brain abnormalities were identified in the superior frontal, lingual gyrus, hippocampus, insula, putamen, superior temporal, inferior temporal gyrus, and anterior cerebellum in patients with MDD exposed to adverse childhood experiences. In addition, brain function abnormalities were identified for patients with MDD or chronic pain and exposure to adverse childhood experiences in the cingulate gyrus, inferior parietal lobule, and precuneus in task-based functional MRI studies. Conclusions We found that adverse childhood experiences exposure can result in different functional and structural brain alterations in adults with MDD or chronic pain compared with those without adverse childhood experiences. Systematic review protocol PROSPERO CRD42021233989. Keywords: adverse childhood experiences, chronic pain, depression, early life adversity, major depressive disorder, MRI, neuroimaging, neuropathic pain

CITATION EXPORT

Georgia Antoniou, Emilie Lambourg, J Douglas Steele et al.. The effect of adverse childhood experiences on chronic pain and major depression in adulthood: a systematic review and meta-analysis. BJA: British Journal of Anaesthesia. (2023). https://doi.org/10.1016/j.bja.2023.03.008

AUTHORS

4 · 2 CENTRES

Georgia Antoniou, Emilie Lambourg, J Douglas Steele, Lesley A Colvin

1Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK
2Division of Imaging Science and Technology, Medical School, University of Dundee, Dundee, UK