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

BMC Musculoskeletal Disorders

Study Protocol

Mechthild Hartmann¹  Wolfgang Eich¹  Susanne Janke¹  Günter Seidler¹  Andreas Gerhardt¹  Sabine Leisner¹  Jonas Tesarz¹ 

[1]Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120, Heidelberg, Germany

关键词: Chronic non-specific musculoskeletal pain;    Endocannabinoids;    Mental comorbidity;    Pain drawing;    Pain extent;    Quantitative sensory testing;    Mechanism-based;    Subgroup classification;    Nerve growth factor;    Trauma;   

DOI  :  10.1186/1471-2474-13-136

 received in 2012-06-01, accepted in 2012-07-23,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundPain 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.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.Methods/DesignWe 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.DiscussionThe 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.

【 授权许可】

CC BY   
© Gerhardt et al.; licensee BioMed Central Ltd. 2012