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It is yet to be determined why family history of chronic pain is a risk factor for some chronic pain disorders such as migraine. Several biopsychosocial factors may impact this relationship. This study focuses on pain catastrophization, which is a well-established psychosocial influence on the perception of pain. We explored the relationships between pain catastrophizing scores of an adolescent and their parent and the adolescent’s pain modulation capabilities. Thirty-six healthy female adolescents (9-16 years old, mean=12.08) completed a battery of quantitative sensory testing which included mechanical temporal summation and conditioned pain modulation paradigm (test stimulus was pressure pain threshold; conditioning stimulus was foot immersion in cold water [80C]). In addition, both adolescent and their parent completed the pain catastrophizing scale (aPCS and pPCS, respectively). Interestingly, aPCS was not found to be correlated with pPCS (r2=0.010; p=0.561). Neither aPCS nor pPCS were correlated to the pain modulation responses. It is possible PCS has less influence on pain modulation than pain sensitivity in healthy female adolescents. Future studies should examine these relationships in adolescents with chronic pain. Funded by IHS and National Institutes of Health (R01ns129742).

Animal studies suggest that prolactin impacts pain and higher prolactin levels contribute to pain vulnerability in females (Chen et al., 2020). However, other studies found no sex differences in the impact of prolactin on pain (Patil et al., 2013). We hypothesized higher prolactin levels would be related to lower pain thresholds in females but not males. Adolescents (n=23, 13 females, mean age=12.7) completed heat, cold, and pressure pain thresholds (HPT, CPT, PPT) and a blood draw for prolactin levels. Regression models included the psychophysical assessments and sex, age, prolactin, and prolactin*sex interaction. HPT correlated with prolactin (p=0.036) and sex*prolactin interaction (p=0.041). Higher prolactin levels correlated with lower HPT in males (R2=0.532, p=0.016) but not in females (p=0.972). Similarly, CPT correlated with prolactin (p=0.018) and sex*prolactin interaction (p=0.032). Higher prolactin levels were correlated with higher CPT only in males (R2=0.746, p=0.001) but not in females (p=0.772), or to PPT measures in either sex. Prolactin can regulate pain via the transient receptor potential (TRP) channels. However, it is not clear why higher prolactin levels are related to greater pain sensitivity only in adolescent males. Further research is needed to examine these relationships in adults and adolescents at different pubertal stages and menstrual phases. International Headache Society (IHS). International Association for the Study of Pain (IASP).

Puberty marks the onset of pain-related differences in males and females with the latter reporting greater pain sensitivity as age advances. Much of our current knowledge of pediatric pain mechanisms is extrapolated from findings in the adult population. The objective of this study is to identify sex differences in pain sensitivity in healthy adolescents. We present initial findings from our ongoing over-arching project to investigate the effects of puberty on pain sensitivity. Twenty-two adolescents (mean age 12.8±2.0, 10 males) completed the study. Participants completed the Physical Developmental Scale (PDS) to determine their pubertal status. Using the visual analog scale (VAS), participants rated the pain intensity to noxious heat stimuli (44°C) delivered to the forearm and completed a cold pain tolerance task in which they immersed their foot in cold water (8°C). Upon reaching their respective cold-pain tolerance (max 120-seconds), participants used the VAS to rate their pain intensity. A pilot run of pre-specified regression models included heat and cold pain as the dependent variables, and sex, PDS score, age, and sex x PDS interaction as the independent variables. Only sex was significantly correlated with pain ratings of both heat (p=0.004) and cold stimuli (p=0.003). Surprisingly, males compared to females had higher pain ratings for both heat (2.90±1.24 (mean±SD, 95%CI [2.01,3.79] vs. 1.48±1.02, 95%CI [0.83,2.13]) and cold stimuli (5.19±2.04, 95%CI [3.73,6.65] vs. 2.37±2.45, 95%CI [0.89,3.85]). It is not clear why adolescent males are more sensitive to thermal stimuli. Biopsychosocial factors not included in the model might explain the results. The study is funded by the ‘International Association for the Study of Pain' and the ‘International Headache Society' (PI: Nahman-Averbuch, IRB #202109120).