Background & Aims

Chronic pain is a complex phenomenon that varies widely among individuals with similar conditions. While chronic pain has effectively been identified as secondary to other medical conditions, understanding what separates individuals with higher or lower pain severity still poses a challenge. This study strives for identifying the key dimensions that influence pain severity. The aim of this study is to find out whether questionnaires evaluating different psychosocial and psychophysical factors can be predictors for the electrical stimulation threshold in healthy people as incremental step in the development of predictive pain models.

Methods

Throughout four randomized controlled trials (RCTs) patient-reported outcome measures (PROMs) have been collected during screening (145 subjects) and one visit day (115 subjects). During the visit day, high frequency stimulation (HFS) was applied to subjects to induce central sensitization as a model of chronic pain. The intensity of the high frequency stimulation was directly correlated to the individual electrical threshold of each subject. Factorial analysis on PROMs capturing psychosocial, psychophysical dimensions and pain sensitivity of subjects was performed. Successively, estimated structural models were run.

Results

This study performs a meta-analysis on shared endpoints of the four BioPain RCTs facilitated through their common study protocol structure. (Leone et al., 2022; Mouraux et al., 2021; Nochi et al., 2022). The factorial analysis, performed on full screening and first study visit PROMs (n = 115), suggests two latent variables that predict individual pain sensitivity: a) anxiety/depression/catastrophizing, b) self-efficacy/general-health.
Estimated structural equation models (SEM) further showed the influence of the factors anxiety/ depression / catastrophizing and negative state emotions on HFS intensities as proxy in pain sensitivity models.

Conclusions

Psychosocial dimensions as anxiety/depression/catastrophizing, general health/self-efficacy and negative state emotions influence the sensitivity to electrical stimuli.

References

Leone, C., Di Stefano, G., Di Pietro, G., Bloms-Funke, P., Boesl, I., Caspani, O., Chapman, S. C., Finnerup, N. B., Garcia-Larrea, L., Li, T., Goetz, M., Mouraux, A., Pelz, B., Pogatzki-Zahn, E., Schilder, A., Schnetter, E., Schubart, K., Tracey, I., Troconiz, I. F., … Treede, R. D. (2022). IMI2-PainCare-BioPain-RCT2 protocol: a randomized, double-blind, placebo-controlled, crossover, multicenter trial in healthy subjects to investigate the effects of lacosamide, pregabalin, and tapentadol on biomarkers of pain processing observed by non-invasive neurophysiological measurements of human spinal cord and brainstem activity. Trials, 23(1). https://doi.org/10.1186/S13063-022-06431-5

Mouraux, A., Bloms-Funke, P., Boesl, I., Caspani, O., Chapman, S. C., Di Stefano, G., Finnerup, N. B., Garcia-Larrea, L., Goetz, M., Kostenko, A., Pelz, B., Pogatzki-Zahn, E., Schubart, K., Stouffs, A., Truini, A., Tracey, I., Troconiz, I. F., Van Niel, J., Vela, J. M., … Treede, R. D. (2021). IMI2-PainCare-BioPain-RCT3: a randomized, double-blind, placebo-controlled, crossover, multi-center trial in healthy subjects to investigate the effects of lacosamide, pregabalin, and tapentadol on biomarkers of pain processing observed by electroencephalography (EEG). Trials, 22(1). https://doi.org/10.1186/S13063-021-05272-Y

Nochi, Z., Pia, H., Bloms-Funke, P., Boesl, I., Caspani, O., Chapman, S. C., Fardo, F., Genser, B., Goetz, M., Kostenko, A. V., Leone, C., Li, T., Mouraux, A., Pelz, B., Pogatzki-Zahn, E., Schilder, A., Schnetter, E., Schubart, K., Stouffs, A., … Treede, R. D. (2022). IMI2-PainCare-BioPain-RCT1: study protocol for a randomized, double-blind, placebo-controlled, crossover, multi-center trial in healthy subjects to investigate the effects of lacosamide, pregabalin, and tapentadol on biomarkers of pain processing observed by peripheral nerve excitability testing (NET). Trials, 23(1). https://doi.org/10.1186/S13063-022-06087-1

Presenting Author

Niko Möller-Grell

Poster Authors

Niko Möller-Grell

Heidelberg University

Lead Author

Niko Möller-Grell

Heidelberg University

Lead Author

Ombretta Caspani

Dr.

Mannheim Center for Translational Neuroscience, Heidelberg University

Lead Author

Bernd Genser

Dr.

Heidelberg University

Lead Author

Jan Vollert

Pain Research, Department of Surgery and Cancer, Imperial College London

Lead Author

Nanna Finnerup

The Danish Pain Research Center - Department of Clinical Medicine, Aarhus University

Lead Author

Zahra Nochi

Danish Pain Research Center, Aarhus University, Denmark

Lead Author

Hatice Tankisi

MD

Department of Clinical Medicine, Aarhus University and Department of Clinical Neurophysiology, Aarhu

Lead Author

Andrea Truini

University Sapienza

Lead Author

Caterina Leone

MD

Department of Human Neuroscience, Sapienza University

Lead Author

André Mouraux

Institute of Neuroscience (IoNS), UCLouvain

Lead Author

Lieve Filbrich

Institute of Neuroscience (IoNS), UCLouvain

Lead Author

Louisien Lebrun

Institute of Neuroscience (IoNS), UCLouvain

Lead Author

Vishvarani Wanigasekera

MRCP

Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosci

Lead Author

Sophie Clarke

Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosci

Lead Author

Irene Tracey

MA (Oxon)

Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosci

Lead Author

Luis Garcia-Larrea

INSERM U1028 / CRNL

Lead Author

Rolf-Detlef Treede

Heidelberg University

Lead Author

Topics

  • Mechanisms: Psychosocial and Biopsychosocial