The P.A.I.N.S lab is focused on research examined the impact of pain and anesthesia on the developing brain, the mechanisms of underlying the chronification of pain, the intergenerational transmission of pain and trauma, and novel strategies to manage pediatric pain, focusing on the optimization of outcomes in youth and their families.
Below are a list of just a few of the ongoing studies being led by P.A.I.N.S lab, or being conducted in partnership with the P.A.I.N.S lab at the University of Calgary:
Trajectories of Maternal Stress and Pain
Stress and pain during pregnancy is common. Symptoms often will increase with increasing gestation, and subside during the postnatal period. However, for a subset of mothers, stress and pain can persist beyond the third trimester. We are examining the maternal stress and pain trajectories and their impact on the developing brain, parent-child interaction and child neurodevelopmental outcomes.
STRess After Pediatric Pain in the Emergency Department (STRAPPED)
Venipunctures in the emergency department (ED) are stressful to children and their parents. However, pain protocols remain under-utilized. Stress and pain from venipuncture may be associated with post-traumatic stress symptoms (PTSS) and future healthcare avoidance. However, the relationship between venipuncture and PTSS following the ED has not been previously examined. We are examining post-hospital behaviour changes in the parent and child in relation to parent recollection of the ED visit.
Pain Memories and Pain Chronification Post-Surgery
Approximately 20% of youth undergoing major surgery will develop chronic post-surgical pain. Chronic post-surgical pain appears to be linked to pain memories. Pain memories can set the stage for future pain experiences, however, they also can easily become distorted. The hippocampus is a brain region known to play a role in memory formation. We will examine the role of the hippocampus in the chronification of post-surgical pain in youth undergoing spinal surgery.
Development of pain symptoms in youth exposed to trauma (PAINTED)
Adolescents with chronic pain report having more PTSD symptoms as compared to pain-free peers. Trauma might increase the risk of developing or worsening of pain symptoms due to changes in brain regions that activate in response to both traumatic and painful experiences. We are exploring whether greater PTSD symptoms are associated with alterations in brain structure/function, and whether these brain changes are related to the development of pain symptomology in youth.
Brain responses to analgesia and hyperalgesia in youth (BRAIN)
Expectation can significantly impact the efficacy of pain treatments. Both positive and negative expectations of pain treatments have mapped in the brains of adults. However, this has not been well-studied in youth. We will examine brain responses to thermal pain following the application of three creams (neutral, capsaicin, and lidocaine) to understand how expectations of pain management influence brain responses in youth.
Brain stimulation: additional therapy to interdisciplinary intensive pain treatment
Interdisciplinary intensive pain treatment (IIPT) was developed to help adolescents with chronic pain who are not progressing in traditional outpatient pain therapies. IIPT is a 3-week (8 hours/day for 15 days) program designed to help youth resume normal daily functioning. We will be adding personalized, image-guided brain stimulation to try to enhance improvements in pain, brain, and mental health outcomes following IIPT.