Senaratne Dhaneesha N S, Smith Blair H, Hales Timothy G, Marryat Louise, Colvin Lesley A
Chronic Pain Research Group, School of Medicine, University of Dundee, Dundee, UK
Chronic Pain Research Group, School of Medicine, University of Dundee, Dundee, UK.
BMJ Open. 2025 Jan 7;15(1):e091053. doi: 10.1136/bmjopen-2024-091053.
Exposure to adverse childhood experiences (ACEs) is associated with a range of poor long-term health outcomes, including multimorbidity and chronic pain. Epidemiological evidence underpins much of this relationship; however, psychophysical testing methods, such as quantitative sensory testing (QST), may provide valuable insights into potential mechanisms. Previous studies have shown inconsistent links between ACEs and QST, but the QST profiles of people with multimorbidity have not been reported. We hypothesise that exposure to ACEs is associated with lowered QST thresholds (ie, experience of pain with milder stimuli) and that this association is stronger in adults with multimorbidity and/or chronic pain. The ACE-MAP study is a cross-sectional feasibility study with the primary aim of assessing the feasibility and acceptability of the proposed study procedures. The secondary aim is to generate preliminary data to understand the impact of ACEs on QST thresholds.
We plan to recruit 40 participants, with 10 in each of the following groups: (1) chronic pain with multimorbidity; (2) chronic pain without multimorbidity; (3) multimorbidity without chronic pain; and (4) controls. Participants will complete a series of questionnaires (including on ACEs, chronic pain and long-term conditions) and will then take part in QST assessments. The primary study outcomes will include measures of feasibility and acceptability of the proposed study design. The secondary study outcomes will include exploratory analysis on the relationship between ACEs and QST thresholds.
The study was approved by the Scotland B Research Ethics Committee (reference: 24/SS/0031). Results from the study will be presented at scientific conferences, published in a peer-reviewed journal and shared with patients and members of the public through other media streams.
ISRCTN10049430.
童年不良经历（ACEs）与一系列长期健康不良后果相关，包括多种疾病并存和慢性疼痛。流行病学证据支撑了这种关系的大部分内容；然而，心理物理学测试方法，如定量感觉测试（QST），可能会为潜在机制提供有价值的见解。先前的研究表明，ACEs与QST之间的联系并不一致，但尚未报道多种疾病并存患者的QST特征。我们假设，接触ACEs与较低的QST阈值相关（即对较轻刺激有疼痛体验），并且这种关联在患有多种疾病和/或慢性疼痛的成年人中更强。ACE-MAP研究是一项横断面可行性研究，其主要目的是评估所提议研究程序的可行性和可接受性。次要目的是生成初步数据，以了解ACEs对QST阈值的影响。
我们计划招募40名参与者，分为以下四组，每组10人：（1）患有多种疾病的慢性疼痛患者；（2）无多种疾病的慢性疼痛患者；（3）无慢性疼痛的多种疾病患者；（4）对照组。参与者将完成一系列问卷（包括关于ACEs、慢性疼痛和长期疾病的问卷），然后参加QST评估。主要研究结果将包括所提议研究设计的可行性和可接受性的测量。次要研究结果将包括对ACEs与QST阈值之间关系的探索性分析。
该研究已获得苏格兰B研究伦理委员会批准（参考编号：24/SS/0031）。研究结果将在科学会议上展示，发表在同行评审期刊上，并通过其他媒体渠道与患者和公众分享。
ISRCTN10049430。
