Grant: Project Grant

How children remember pain sets the stage for future pain experiences. These memories can easily become distorted. Negatively-biased pain memories (remembering pain as being worse than an earlier pain report) are associated with the development of pediatric chronic pain. Pediatric chronic pain is a growing epidemic, affecting 1 in 4 Canadian youth, and costing $19 billion/year. Treatments for pediatric chronic pain are largely ineffective, in part because we do not understand why acute pain transitions to chronic pain in the first place. We believe that children's pain memories are a key risk factor for the development of this growing child health problem. Children's memories of post-surgical pain can lead to chronic pain; however, it is not known how the brain is involved in pain memory biases or the development of chronic pain after surgery in youth. In adults, the hippocampus - a brain region critically involved in memory - underlies the development of negatively-biased pain memories and chronic pain. Our brain imaging data show abnormal hippocampal structure and function in youth with chronic pain versus healthy controls, suggesting that the hippocampus may undergo changes as pain transitions from an acute to chronic state. Therefore, it is likely that the hippocampus is involved in pain memory biases and the development of chronic pain in youth. In the proposed study, 160 youth undergoing spinal fusion surgery will be assessed at baseline, the acute recovery phase, and at the time that pain can transition to a chronic state. Pain memories will be assessed 2 months after surgery. Brain scans will be performed before and 4 months after surgery, when pain can transition to a chronic state. Given the key role of children's pain memories in the development of chronic pain, and the urgent need for prevention and treatment targets for these at-risk youth, this research will be critical in helping to understand and prevent this widespread child health issue.