Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol

<p>Abstract</p> <p>Background</p> <p>Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently...

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Main Authors: Gerhardt Andreas, Hartmann Mechthild, Tesarz Jonas, Janke Susanne, Leisner Sabine, Seidler Günter, Eich Wolfgang
Format: Article
Language:English
Published: BMC 2012-08-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://www.biomedcentral.com/1471-2474/13/136
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author Gerhardt Andreas
Hartmann Mechthild
Tesarz Jonas
Janke Susanne
Leisner Sabine
Seidler Günter
Eich Wolfgang
author_facet Gerhardt Andreas
Hartmann Mechthild
Tesarz Jonas
Janke Susanne
Leisner Sabine
Seidler Günter
Eich Wolfgang
author_sort Gerhardt Andreas
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated.</p> <p>The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1) identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity) and 2) investigate whether distinct sensory profiles or 3) distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients.</p> <p>Methods/Design</p> <p>We will examine a population-based chronic pain sample (n = 100), a clinical tertiary care sample (n = 100) and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively). The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma), perceptual and central sensitisation (quantitative sensory testing), descending inhibition (conditioned pain modulation, the diffuse noxious inhibitory control-like effect), as well as measurement of the plasma levels of nerve growth factor and endocannabinoids.</p> <p>Discussion</p> <p>The identification of the underlying pathophysiologic mechanisms in different subgroups of chronic musculoskeletal pain patients will contribute to a mechanism-based subgroup classification. This will foster the development of mechanism-based treatments and holds promise to treat patients more sufficient.</p>
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spelling doaj.art-fa224a1aabea48e38284f3e1881b93872022-12-22T02:50:11ZengBMCBMC Musculoskeletal Disorders1471-24742012-08-0113113610.1186/1471-2474-13-136Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocolGerhardt AndreasHartmann MechthildTesarz JonasJanke SusanneLeisner SabineSeidler GünterEich Wolfgang<p>Abstract</p> <p>Background</p> <p>Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated.</p> <p>The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1) identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity) and 2) investigate whether distinct sensory profiles or 3) distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients.</p> <p>Methods/Design</p> <p>We will examine a population-based chronic pain sample (n = 100), a clinical tertiary care sample (n = 100) and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively). The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma), perceptual and central sensitisation (quantitative sensory testing), descending inhibition (conditioned pain modulation, the diffuse noxious inhibitory control-like effect), as well as measurement of the plasma levels of nerve growth factor and endocannabinoids.</p> <p>Discussion</p> <p>The identification of the underlying pathophysiologic mechanisms in different subgroups of chronic musculoskeletal pain patients will contribute to a mechanism-based subgroup classification. This will foster the development of mechanism-based treatments and holds promise to treat patients more sufficient.</p>http://www.biomedcentral.com/1471-2474/13/136Chronic non-specific musculoskeletal painEndocannabinoidsMental comorbidityPain drawingPain extentQuantitative sensory testingMechanism-basedSubgroup classificationNerve growth factorTrauma
spellingShingle Gerhardt Andreas
Hartmann Mechthild
Tesarz Jonas
Janke Susanne
Leisner Sabine
Seidler Günter
Eich Wolfgang
Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol
BMC Musculoskeletal Disorders
Chronic non-specific musculoskeletal pain
Endocannabinoids
Mental comorbidity
Pain drawing
Pain extent
Quantitative sensory testing
Mechanism-based
Subgroup classification
Nerve growth factor
Trauma
title Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol
title_full Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol
title_fullStr Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol
title_full_unstemmed Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol
title_short Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol
title_sort subgroups of musculoskeletal pain patients and their psychobiological patterns the login study protocol
topic Chronic non-specific musculoskeletal pain
Endocannabinoids
Mental comorbidity
Pain drawing
Pain extent
Quantitative sensory testing
Mechanism-based
Subgroup classification
Nerve growth factor
Trauma
url http://www.biomedcentral.com/1471-2474/13/136
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