Brain-predicted age difference mediates the association between PROMIS sleep impairment, and self-reported pain measure in persons with knee pain

Soamy Montesino-Goicolea; Pedro Valdes-Hernandez; Chavier Laffitte Nodarse; Alisa J Johnson; James H Cole; Lisa H Antoine; Burel R Goodin; Roger B Fillingim; Yenisel Cruz-Almeida

doi:10.1016/j.nbas.2023.100088

Brain-predicted age difference mediates the association between PROMIS sleep impairment, and self-reported pain measure in persons with knee pain

Aging Brain. 2023 Jul 22:4:100088. doi: 10.1016/j.nbas.2023.100088. eCollection 2023.

Authors

Soamy Montesino-Goicolea^{1

2}, Pedro Valdes-Hernandez^{1

2}, Chavier Laffitte Nodarse^{1

2}, Alisa J Johnson^{1

2}, James H Cole^{3

4}, Lisa H Antoine⁵, Burel R Goodin⁵, Roger B Fillingim^{1

2

6}, Yenisel Cruz-Almeida^{1

2

6}

Affiliations

¹ Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States.
² Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States.
³ Centre for Medical Image Computing, Department of Computer Science, University College London, UK.
⁴ Dementia Research Centre, Institute of Neurology, University College London, UK.
⁵ Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, United States.
⁶ Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States.

Abstract

Knee pain, the most common cause of musculoskeletal pain (MSK), constitutes a severe public health burden. Its neurobiological causes, however, remain poorly understood. Among many possible causes, it has been proposed that sleep problems could lead to an increase in chronic pain symptomatology, which may be driven by central nervous system changes. In fact, we previously found that brain cortical thickness mediated the relationship between sleep qualities and pain severity in older adults with MSK. We also demonstrated a significant difference in a machine-learning-derived brain-aging biomarker between participants with low-and high-impact knee pain. Considering this, we examined whether brain aging was associated with self-reported sleep and pain measures, and whether brain aging mediated the relationship between sleep problems and knee pain. Exploratory Spearman and Pearson partial correlations, controlling for age, sex, race and study site, showed a significant association of brain aging with sleep related impairment and self-reported pain measures. Moreover, mediation analysis showed that brain aging significantly mediated the effect of sleep related impairment on clinical pain and physical symptoms. Our findings extend our prior work demonstrating advanced brain aging among individuals with chronic pain and the mediating role of brain-aging on the association between sleep and pain severity. Future longitudinal studies are needed to further understand whether the brain can be a therapeutic target to reverse the possible effect of sleep problems on chronic pain.

Keywords: Aging; Brain age; Chronic pain; DeepBrainNet; Sleep impairment.

Abstract

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