# Neurobiological Mechanisms of Stress in Youth with Chronic Widespread Pain - Supplement

> **NIH NIH K23** · BOSTON CHILDREN'S HOSPITAL · 2022 · $53,022

## Abstract

Project Summary/Abstract
Pediatric chronic widespread pain (CWP) is a serious public health problem resulting in high levels of healthcare
utilization and disability. Youth with CWP also frequently report exposure to adverse childhood experiences
(ACEs; abuse/neglect, etc.) and a significant subset continue to experience impairment long-term. Certain mind-
body interventions such as mindfulness-based stress reduction (MBSR) may be particularly appropriate for
pediatric CWP as they have been shown to modulate stress-induced maladaptation of the HPA-axis, autonomic
nervous system, and brain structure (e.g., hippocampus). However, it is currently unknown if these targets are
affected in pediatric CWP. Preliminary research indicates that allostatic load (AL), or “wear and tear” on the
nervous system due to stress, may contribute to pain chronicity. Similarly, evidence suggests that the
hippocampus, a brain structure that is among the most deleteriously affected by stress, plays a role in pain
perception. However, no study to-date has examined AL and hippocampal functioning in relation to stress
exposure in pediatric CWP. Mind-body interventions such as MBSR are an important and safe therapy option
for both pain and stress reduction in pediatric CWP and may modulate the negative impact of ACEs, so there is
a critical need to know if these mechanisms are engaged in this population. The proposed research project
utilizes multifactorial physiological and neuroimaging measurement techniques to enhance our understanding of
the potential role of these mechanisms in impairment and mind-body intervention response. The aims of this
submission are to better characterize AL, assessed via a multifactorial composite, and hippocampal functioning
via fMRI in pediatric CWP as specific targets for mind-body interventions that can lead to treatment optimization.
The long-term goal of this K23 award is for the candidate to establish an independent research career aimed at
carrying out mechanistically informed mind-body interventions. CWP was selected as a model condition because
of its commonality within pediatric pain clinics and strong association with central sensitization, high stress, and
functional disability. The primary training objectives are to acquire expertise in neurobiological measurement and
interpretation and to leverage current research activities complementary to this proposal that will lay the
foundation for mechanistically driven clinical trial grant submissions as an independent investigator. The
candidate will accomplish this through: 1) mentorship in a clinical/research environment, 2) hands-on training in
the neurobiological measurement of the physiological effects of stress, complemented by didactics in
neuroendocrine and fMRI measurement, 3) mentorship and coursework in advanced data analytic techniques,
4) leveraging psychosocial practice activities and clinical trial involvement in conjunction with effort on the
proposed award, and 5) executi...

## Key facts

- **NIH application ID:** 10604412
- **Project number:** 3K23AT010643-03S1
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Sarah Mary Nelson
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $53,022
- **Award type:** 3
- **Project period:** 2020-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10604412

## Citation

> US National Institutes of Health, RePORTER application 10604412, Neurobiological Mechanisms of Stress in Youth with Chronic Widespread Pain - Supplement (3K23AT010643-03S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10604412. Licensed CC0.

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