Lecture 9: Pain and Brain Development

Stress and Trauma:

T/F: Stress and Trauma can be POSITIVE and NEGATIVE

True

What is the downstream consequences?

• Adverse Childhood Experience (ACE) has been associated with nearly how much of psychiatric disorders?

• Adults w more that what ACE score have higher likelihood of dying 20 years earlier than anticipated?

• 1/3 of psych disorders

• 6 ACE

Childhood Brain Development:

• The newborn’s brain weight about how much of the adult brain?

• Adult’s brain are relativley ____, BUT children’s brains are developing and evolving rapidly and thus always _____.

• 25%

• Adult: Set, Child: Changing

Are there times in a child’s development when trauma and injuty have larger impacts on brain development and pain?

• Children who were sexually abused AFTER the age of 12 were 10x more likley to develop PTSD then those BEFORE 12.

• Pain chronicity increases w age in children peaking in adolescents at 16 yo. F > M.

Network Changes w Chronic Pain:

• Increase or Decrease:

  • Salience Network

  • Central Autonomic Network

  • Emotion Regulation Network

  • Default Mode

• Salience Network

  • Increase

• Central Autonomic Network

  • Increase

• Emotion Regulation Network

  • Increase

• Default Mode

  • Decrease

Changes in Cortical and Subcortical Regions:

Key Point:

• Pain is about what?

• Chronic Pain and Trauma Response are what?

• Pain = Memory

• CP and TR = Memory Disorder

Changes in Cortical and Subcortical Regions:

• Knowing the function of the areas of the brain helps understanding of what?

• What is common function of the Cortical and Subcortical Regions? (3)

• What are the 2 Levels of Processing?

• Nature of Pain

• Function

  • Memory and Learning

  • Emotions

  • Autonomic Response

• Level of Processing

  • Subconsious and Unconsious

Childhood Brain Development:

• Towards which direction does the brain DEVELOP?

• Towards which direction does the brain MATURE?

• What gender does the brain develop faster?

• People w ADHD, their brains develop how many years slower?

• Dev: Inside Out

• Mature: Back to Front

• Female

• 3-4 years slower

Childhood Brain Development:

• Myelination proceeds from what directions?

• Back to Front of Brain

• From Center to Sides

Trauma and Pain in Child’s Brain: AMYGDALA

• L or R Amygdala develops quicker?

• L Amygdala has been associated with what?

• R Amygdala is associated with what?

• L development is impacted by trauma at what age?

• R development is most impacted by trauma at what age?

• L quicker than R

• L = Positive Experiences

• R = Avoidance

• L development impacted at:

  • Early Childhood (0-3 yrs)

• R Development impacted at:

  • Middle Childhood (10-11 yrs)

Trauma and Pain in the Child’s Brain: HIPPOCAMPUS

• What months are the KEY milestone of hippocampal development and continues to adolescence?

• Spikes seen when?

• 18-24 mo

• Spike at Early Adolescence

Trauma and Pain in the Child’s Brain: PREFRONTAL CORTEX

• Activity may correspond to what?

  • Ages?

• Intense periods of growth

  • 7-9 yo

  • 11 - Adult (greatest impact)

Subconscious: Amygdala

• When does Amygdala develop?

• Assesses threat by assessing what?

• (0-10 yrs)

• Importance of incoming information w memory

Subconscious: Hippocampus

• When does Hippocampus develop?

• Influences new what?

• Storage of what before it moves to Long Term Memory?

• Informs ____ and stores information about what?

• (2-7 yrs)

• Influences new memory formation and consolidation

• Short Term Memeoru

• Behavior; space and time of events

Subconscious: Insular Cortex

• When does Insular Cortex develop?

• The Insula filters and interprets what type of information taken by what?

• Insular Cortex function:

  • Example:

• (7 yrs to Teens)

• Filters and Interprets Interceptive Info taken by senses

  • Sound, Smell, Taste, Sight, Touch (Autonomic Reg)

• Fx:

  • Threat Decision Making

    • Emotion and Empathy

    • Craving, Addiction, Desires

Subconscious: Insular Cortex

• L Posterior Insula develops when?

• R Posterior Insula develops when?

• L: 7-9 yrs

• R: Teens

Subconscious: Anterior Cingulate Cortex

• When does ACC develop?

• Critical role in what?

• Involved in interpreting what?

  • Recieved from where?

• (7 yrs to Teens)

• Delegating areas of the brain to perform specific tasks

• Interp: Sensory, Social, Contextual Info

  • Received from Physical Env

Subconscious: Anterior Cingulate Cortex

• ACC is involved in what of emotion?

• Wave of activity at what age?

• Active when?

• Perception, Eval, and Experience of Emotion

• 7-9 yrs

• Adolescence

Conscious: Prefrontal Cortex

• When does PFC develop?

• Main function:

• Teens

• Fx:

  • Problem Solving

  • Integ of Emotion

  • Interp and Integ Info

• Predicting and Adjusting Behavior

Conscious: Prefrontal Cortex

• ____ and ____ behavior

• Helps determine social relevance of what?

• Predicting and Adjusting Behavior

• Social Relevance of:

  • Info

  • Integrating Affect

  • Controlling Impulses

Subconscious: Corpus Callosum

• When does Corpus Callosum develop?

• Allows for communication between what structures and is involved in what?

• Neuroimaging research has identified reduces overall size and reduced gray and white matter of the CC in what?

• 3-12 years

• Communication btwn L and R brain; Lateral Processing

• Traumatized Children

Subconscious: Corpus Callosum

• CC undergoes significant development in children of what age?

  • This dev relates to what?

• In children from 6-12 yrs, the CC develops significantly in relation to what?

• 3-6 years

  • Attention and Behavioral Planning

• Language and Memory

Other: Cerebellum

• When does Cerebellum develop?

• Cerebellum is involved in diverse processes such as:

• There is consistent evidence of ____ Cerebellum Volume in children w histories of trauma exposure

• Adulthood

• Diverse Processes such as:

  • Classical Conditioned

    • Motor Control

    • Language

    • Working Memory

    • Cognition

    • Emotion

  • Decreased

Other: Cerebellum

• _____ related circuitry found in Cerebellum w CP

• Inverse relationship between what?

• Cerebellum also has prolonged what?

  • Potentially making it vulnerable to what?

• Aversion

• Limbic Activity and Cerebellar Activity

• Prolonged Dev Period

  • Vulnerable to Env Stress

Childhood Pain and Trauma Related Brain Dev:

• What brain structures develop during ages:

  • Infancy (0 - 2 yrs)

  • Early Childhood (2 - 7 yrs)

  • Grade School (7 - 12 yrs)

  • Teenage (13 - Adult)

• Infancy (0 - 2 yrs)

  • L Amygdala

• Early Childhood (2 - 7 yrs)

  • Bilat Hippocampus

• Grade School (7 - 12 yrs)

  • R Amygdala

• Teenage (13 - Adult)

  • R Insular Cortex

  • R ACC

  • R mPFC

Childhood Pain and Trauma Related Brain Dev:

When does the Corpus Callosum develop?

• Early Childhood to Teenage

• What type of response is Pain?

• Pain is a response that can be _____ and ____ learned

• Protective threat response

• Subconsciously and Associatively

Mind Shapes the Body:

• 90-95% of our responses and behaviors occur at:

  • What level?

  • Regulated how?

• Subconscious Level

• Autonomically

Using the Body to Shape the Mind