Trends in physical health complaints among adolescents from 2014 - 2019: Considering screen time, social media use, and physical activity

White matter microstructural associations with pain experiences in a large community sample of youth

ABSTRACT

Pain experiences in adolescence are increasing and represent a major public health concern. However, little is known about the neurobiological phenotype of pain experiences in adolescents, particularly outside of a clinical setting. A better neurobiological understanding of pain experiences in community youth may shed light on potential vulnerabilities present before clinical diagnoses of chronic pain. This study utilized an exploratory region-of-interest approach, in a large community sample (n = 7332) of youth (ages 11-12), to examine the association between white matter microstructure, fractional anisotropy (FA) and mean diffusivity (MD), and pain experiences. Bayesian multilevel modeling was used to explore group differences (between those reporting past-month pain and those who did not), and continuous associations between pain experiences (average pain intensity, worst pain intensity, and pain-related limitations) and FA and MD. Sex differences in these effects were also explored. Analyses revealed widespread associations between pain-related limitations and lower FA and greater MD in male but not female youth. Furthermore, average pain intensity was associated with greater superior corticostriate and superior longitudinal fasciculus MD in all youth, and worst pain intensity was associated with lower inferior fronto-occipital fasciculus FA in male youth. There were no group differences in FA or MD between those with or without past-month pain. These findings suggest that white matter microstructural alterations in youth may be more related to the severity of the pain experience than to the presence or absence of pain itself, with male youth showing stronger neurobiological associations with pain-related outcomes.

Level and correlates of physical activity among children and adolescents with juvenile idiopathic arthritis compared to controls: results from a German nationwide prospective observational cohort study

BACKGROUND

Physical active lifestyles are essential throughout growth and maturation and may offer potential preventive and therapeutic benefit in patients with juvenile idiopathic arthritis (JIA). Insufficient physical activity (PA), in contrast, can lead to aggravation of disease-related symptoms. This study aimed to i) examine PA levels in children and adolescents with JIA compared to general population controls and ii) investigate correlates of pronounced physical inactivity in order to identify risk groups for sedentary behaviour.

METHODS

Data from children and adolescents with JIA and population controls aged 3 to 17 years documented in the National Pediatric Rheumatologic Database (NPRD) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were used. Self-reported PA was collected from parents/guardians of children up to 11 years of age or adolescents 12 years of age and older. To compare PA-related data, age- and sex-specific pairwise analyses were conducted considering NPRD/KiGGS participants' data from 2017. Correlates of physical inactivity among patients were identified using a linear regression model.

RESULTS

Data of 6,297 matched-pairs (mean age 11.2 ± 4.2 years, female 67%, patients' disease duration 4.5 ± 3.7 years, persistent oligoarthritis 43%) were available for evaluation. Almost 36% of patients aged 3-17 years (vs. 20% of controls) achieved the WHO recommended amount of PA, while PA steadily decreased with age (18% of patients aged ≥ 12 years) and varied between JIA categories. Female adolescents and patients with enthesitis-related arthritis were least likely to achieve the minimum recommended level of PA. Physical inactivity was associated with female sex, higher age at disease onset, longer disease duration, more functional disability (C-HAQ) and higher disease activity (cJADAS-10).

CONCLUSIONS

Depending on JIA category, children and adolescents with JIA were similarly or even more likely to achieve the WHO recommended minimum level of PA compared to general population controls. However, since a large proportion of young JIA patients appear to be insufficiently physically active, engagement in targeted efforts to promote PA is urgently needed.