DNA Methylation Levels in Hypothalamic-pituitary-adrenal Axis Genes Predict Chronic Pain Outcomes Following Trauma Exposure

Traumatic stress exposure often precedes the development of chronic posttraumatic musculoskeletal pain (CPTP). Biological factors that influence the development of CPTP are poorly understood, though current evidence indicates that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis plays a critical role in its development, as well as in related and frequently comorbid posttraumatic neuropsychiatric outcomes. Little is known about molecular mechanisms underlying this association, including epigenetic mechanisms.