(359) Resilience and Pain-Related Areas in the Brain: Consideration of Sex and Ethnic/Race Differences

Abstract

In adults with osteoarthritis, clinical pain and disability have been shown to differ across sex and ethnicity/race. Recent evidence also indicates changes in pain-related brain structure across these groups. Resilience is associated with lower pain and greater functioning. However, the relationship between resilience and the brain is not well understood. We investigated if resilience was associated with pain-related brain structure in individuals with/without knee pain and if patterns differed by sex and ethnicity/race. Study participants included 171 individuals (mean age 57.97±8.50; 62 male/109 female; 72 Non-Hispanic Black (NHB)/99 Non-Hispanic White (NHW) with and without knee pain. Participants completed measures of resilience: biobehavioral (tobacco use and waist/hip ratio) and psychosocial (optimism, affect, coping, perceived stress, and social support). Responses were dichotomized based on published norms/means and summed, creating a composite resilience score. High and low resilience was defined by median split. T1-weighted MRI data were processed using FreeSurfer for a priori region analyses. Potential covariates included age, sex, race, study site, education level, body mass index, and chronic pain severity based on the FITT index (frequency, intensity, time/duration, and total pain sites). MANCOVAs were completed for analyses. The high and low resilience groups differed in amygdala volume (p=0.021) with trends for medial prefrontal cortex (MPFC; p=0.064) and thalamus (p=0.094). Males with high resilience had thicker MPFC than low resilience males (p=0.037). Females with high resilience had larger amygdala than low resilience females (p=0.005). NHB with high resilience had larger amygdala (p=0.025) and a trend for thicker somatosensory cortex (p=0.064). NHW with high resilience had a trend for thicker insula (p=0.081). Preliminary findings indicate resilience may be associated with pain-related brain structure. Sex and ethnic/race group differences were also observed. Prospective research is needed to elucidate the influence of resilience on the experience of pain, neurobiological underpinnings, and sex and ethnicity/race differences.