Mun Chung Jung, Youngstedt Shawn D, Petrov Megan E, Pituch Keenan A, Elliott Jeffrey A, George Steven Z, LoVecchio Frank, Mardian Aram S, Elam Kit K, Winsick Nina, Eckert Ryan, Sajith Surabhi, Alperin Kate, Lakhotia Ananya, Kohler Kaylee, Reid Matthew J, Davis Mary C, Fillingim Roger B
Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Pain Rep. 2024 Oct 24;9(6):e1194. doi: 10.1097/PR9.0000000000001194. eCollection 2024 Dec.
Chronic overlapping pain conditions (COPCs), such as chronic low back pain (cLBP) and fibromyalgia, frequently cooccur and incur substantial healthcare costs. However, to date, much focus has been placed on individual anatomically based chronic pain conditions, whereas little is known about the mechanisms underlying progression to multiple (more than 1) COPCs. This study aims to address the gap by investigating the role of common and modifiable risk factors, specifically sleep and circadian rhythm disturbances, in the development of multiple COPCs.
The study will enroll 300 participants with cLBP, including 200 with cLBP only and 100 with cLBP plus other COPCs (ie, fibromyalgia, temporomandibular disorders, irritable bowel syndrome, and chronic headaches) and follow them up for 12 months. Sleep and circadian rhythms will be assessed using wireless sleep electroencephalography, 24-hour evaluation of the rhythm of urinary 6-sulfatoxymelatonin, actigraphy, and sleep diaries. Pain amplification using quantitative sensory testing, psychological distress using validated self-report measures, and the number of pain sites using a pain body map will also be assessed.
This research aims to (1) comprehensively characterize sleep/circadian disturbances in individuals with single and multiple COPCs using multimodal in-home assessments; (2) examine the associations between sleep/circadian disturbances, changes in pain amplification, and psychological distress; and (3) investigate the relationship among these factors and the progression in the number of pain sites, a proxy for multiple COPCs. The findings will provide insights into the mechanisms leading to multiple COPCs, potentially informing treatment and prevention strategies for these complex conditions.
慢性重叠疼痛病症（COPCs），如慢性下腰痛（cLBP）和纤维肌痛，经常同时出现并产生大量医疗费用。然而，迄今为止，人们主要关注基于个体解剖结构的慢性疼痛病症，而对于发展为多种（超过一种）COPCs的潜在机制知之甚少。本研究旨在通过调查常见且可改变的风险因素，特别是睡眠和昼夜节律紊乱，在多种COPCs发展过程中的作用来填补这一空白。
该研究将招募300名患有cLBP的参与者，其中包括200名仅患有cLBP的参与者和100名患有cLBP并伴有其他COPCs（即纤维肌痛、颞下颌关节紊乱、肠易激综合征和慢性头痛）的参与者，并对他们进行为期12个月的随访。睡眠和昼夜节律将通过无线睡眠脑电图、尿6-硫酸氧褪黑素节律的24小时评估、活动记录仪和睡眠日记进行评估。还将使用定量感觉测试评估疼痛放大、使用经过验证的自我报告测量方法评估心理困扰，并使用疼痛身体图评估疼痛部位数量。
本研究旨在（1）使用多模式居家评估全面描述单一和多种COPCs个体的睡眠/昼夜节律紊乱情况；（2）研究睡眠/昼夜节律紊乱、疼痛放大变化和心理困扰之间的关联；（3）调查这些因素与疼痛部位数量的进展之间的关系，疼痛部位数量是多种COPCs的一个替代指标。这些发现将为导致多种COPCs的机制提供见解，可能为这些复杂病症的治疗和预防策略提供依据。
