ArticleChronic stress (Thousand Oaks, Calif.)
Chronic Pain is Associated With Reduced Sympathetic Nervous System Reactivity During Simple and Complex Walking Tasks: Potential Cerebral Mechanisms.
Article in Chronic stress (Thousand Oaks, Calif.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain-Meta-analytic evidence from neuroimaging studies.Human brain mapping · 2022Pooled it
- Post-traumatic osteoarthritis in aged rodents is associated with brain changes that correlate with joint remodeling.The journal of pain · 2026Article
- Pain assessment using physiological responses/markers in different types of pain: a scoping review.NPJ digital medicine · 2026Article
- The prevalence of dysautonomia in chronic musculoskeletal pain: a systematic review and meta-analysis.Rheumatology advances in practice · 2026Review
- Dexmedetomidine for chronic pain patients with anxiety and depression: a propensity score matching cohort study.BMC anesthesiology · 2025Article
- Exploring the association of metabolic factors and chronic musculoskeletal pain over a period of 10 years - the Doetinchem Cohort Study.Clinical rheumatology · 2025Article
- Effect of neuromodulation for chronic pain on the autonomic nervous system: a systematic review.BJA open · 2024Review
- Vagotomy accelerates the onset of symptoms during early disease progression and worsens joint-level pathogenesis in a male rat model of chronic knee osteoarthritis.Osteoarthritis and cartilage open · 2024Article
- Effect Sizes for Changes in Health and Well-Being Following Treatment With the One-To-Zero Technique in Individuals With Occipito-Atlantal Joint Dysfunction: A Repeated Measures Study.Journal of chiropractic medicine · 2023Article
- Narrative Review of Pathophysiology and Endoscopic Management of Basivertebral and Sinuvertebral Neuropathy for Chronic Back Pain.Journal of Korean Neurosurgical Society · 2023Article
- Neuromodulation as a Potential Disease-Modifying Therapy for Osteoarthritis.Current rheumatology reports · 2023Review
- Autonomic Nervous System Dysregulation and Osteoarthritis Pain: Mechanisms, Measurement, and Future Outlook.Current rheumatology reports · 2022Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAutonomic dysregulation may lead to blunted sympathetic reactivity in chronic pain states. Autonomic responses are controlled by the central autonomic network (CAN). Little research has examined sympathetic reactivity and associations with brain CAN structures in the presence of chronic pain; thus, the present study aims to investigate how chronic pain influences sympathetic reactivity and associations with CAN brain region volumes.
methodsSympathetic reactivity was measured as change in skin conductance level (ΔSCL) between a resting reference period and walking periods for typical and complex walking tasks (obstacle and dual-task). Participants included 31 people with (n = 19) and without (n = 12) chronic musculoskeletal pain. Structural 3 T MRI was used to determine gray matter volume associations with ΔSCL in regions of the CAN (i.e., brainstem, amygdala, insula, and anterior cingulate cortex).
resultsΔSCL varied across walking tasks (main effect p = 0.036), with lower ΔSCL in chronic pain participants compared to controls across trials 2 and 3 under the obstacle walking condition. ΔSCL during typical walking was associated with multiple CAN gray matter volumes, including brainstem, bilateral insula, amygdala, and right caudal anterior cingulate cortex (p's < 0.05). The difference in ΔSCL from typical-to-obstacle walking were associated with volumes of the midbrain segment of the brainstem and anterior segment of the circular sulcus of the insula (p's < 0.05), with no other significant associations. The difference in ΔSCL from typical-to-dual task walking was associated with the bilateral caudal anterior cingulate cortex, and left rostral cingulate cortex (p's < 0.05).
conclusionsSympathetic reactivity is blunted during typical and complex walking tasks in persons with chronic pain. Additionally, blunted sympathetic reactivity is associated with CAN brain structure, with direction of association dependent on brain region. These results support the idea that chronic pain may negatively impact typical autonomic responses needed for walking performance via its potential impact on the brain.
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