Brain activity, endogenous pain inhibition, and psychological changes in patients with endometriosis

Adverse childhood experiences are associated with an increased risk of chronic pain and gynecological complications in adulthood, including endometriosis. Alterations of central pain inhibitory and reward systems might be associated with pain chronification. Offset analgesia (OA) is a psychophysical test of endogenous pain inhibition characterized by a disproportionately large reduction in pain perception after a small decrease in temperature during noxious thermal stimulation. An attenuated OA response is consistently found in patients with chronic pain, indicating a lack of ability to modulate changes in pain perception. Still, it has not been measured in people with endometriosis-associated pain and has not been assessed using functional near-infrared spectroscopy (fNIRS). I will present my results from women with and without endometriosis-associated pain and describe if pain catastrophizing, characteristics of resilience, and adverse childhood experiences impact descending pain inhibition and brain activity.