Abstract
Adverse life experiences (ALEs) are associated with hyperalgesia and chronic pain,
but the underlying mechanisms are poorly understood. One potential mechanism is hyperexcitability
of spinal neurons (ie, central sensitization). Given that Native Americans (NAs) are
more likely to have ALEs and to have a higher prevalence of chronic pain, the relationship
between ALEs and spinal hyperexcitability might contribute to their pain risk. The
present study assessed temporal summation of the nociceptive flexion reflex (TS-NFR;
a correlate of spinal hyperexcitability) and pain (TS-Pain) in 246 healthy, pain-free
non-Hispanic whites and NAs. The Life Events Checklist was used to assess the number
of ALEs. Multilevel growth models were used to predict TS-NFR and TS-Pain, after controlling
for age, perceived stress, psychological problems, negative and positive affect, and
painful stimulus intensity. ALEs and negative affect were significantly associated
with greater pain, but not enhanced TS-Pain. By contrast, ALEs were associated with
enhanced TS-NFR. Race did not moderate these relationships. This finding implies that
ALEs promote hyperalgesia as a result of increased spinal neuron excitability. Although
relationships between ALEs and the nociceptive flexion reflex/pain were not stronger
in NAs, given prior evidence that NAs experience more ALEs, this factor might contribute
to the higher prevalence of chronic pain in NAs.
Perspective
This study found a dose-dependent relationship between ALEs and spinal neuron excitability.
Although the relationship was not stronger in NAs than non-Hispanic whites, given
prior evidence that NAs experience more ALEs, this could contribute to the higher
prevalence of chronic pain in NAs.
Key words
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Article info
Publication history
Published online: February 15, 2019
Accepted:
February 11,
2019
Received in revised form:
February 11,
2019
Received:
August 7,
2018
Footnotes
Research reported was supported by the National Institute On Minority Health and Health Disparities of the National Institute of Health under Award Number R01MD007807. Edward Lannon, Shreela Palit, and Yvette Güereca were supported by a National Science Foundation Graduate Research Fellowship Program. The content is solely the responsibility of the authors and does not necessarily reflect the views of the National Institutes of Health, National Science Foundation, Indian Health Service, or the Cherokee Nation.
The authors have no conflicts of interest to declare.
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