Early life adversity in Pain and Depression (E-PaiD)

Approximately 50% of individuals, especially those in advanced age, experience chronic pain, while nearly 25% of the global population encounter intermittent but long-term episodes of depression. The relationship between pain and depression is intricate, and there is a limited understanding of the underlying mechanisms. The presence of long-lasting pain and depression in a substantial number of individuals results in a considerable level of burden. It is hypothesized that the occurrence of adverse events during childhood, commonly referred to as Adverse Childhood Experiences (ACEs), increases the probability of developing chronic pain and depression later in life. Such events can cause prolonged elevation of stress responses, leading to inflammatory effects, activation of microglia, alterations in hypothalamic-pituitary axis, long-term impacts on the endogenous opioid system, and changes in brain areas associated with pain and mood regulation, persisting throughout one's lifetime.

We are investigating the effects of ACEs on chronic pain and depression by utilising the Generation Scotland: Scottish Family Health Survey (GS:SFHS) and the Stratifying Resilience and Depression Longitudinally (STRADL) study. This STRADL data includes more than 1000 patients' neuroimaging data (structural and functional MRI images), clinical assessments related to diagnosis and mood ratings, the childhood trauma questionnaire, as well as details about prescribed medications. The GS:SFHS includes chronic pain scores, linked with the STRADL study data, which allows for an investigation into the association between chronic pain, depression, and ACEs. Furthermore, the STRADL data has been linked to the Dundee Walker birth cohort, which contains detailed birth-related records such as pregnancy, birth, and birth weight. We analyse this data to explore the neural correlates of chronic pain and/or depression with potential causative factors such as ACEs scores, for example sexual abuse, emotional abuse, physical abuse, physical and emotional neglect, and the birth weight in the reward system of the brain as well as the emotional processing and salience network.