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Measuring and Modulating Changes in EEG Resting State Functional Connectivity During Short-term and Long-term Pain

Not Applicable
Completed
Conditions
Prolonged Pain, EEG, Resting State Functional Connectivity
Interventions
Other: placebo patch
Other: 8% Capsaicin patch
Registration Number
NCT05158309
Lead Sponsor
Aalborg University
Brief Summary

Background and aims: Experimental prolonged pain models can shed more light on the cortical mechanisms involved in the transition from acute to chronic pain including changes in resting state functional connectivity (rsFC). This experiment aimed at examining the effect of 24-hour-capsaicin application on the rsFC of the default mode network (DMN), a prominent network in the dynamic pain connectome.

Methods: Electroencephalographic (EEG) rsFC measured by Granger causality was acquired at baseline, 1-hour, and 24-hour following the initial patch application (placebo or capsaicin). After 24 hours, the patch was cooled down then heated up to assess rsFC changes in response to pain relief and facilitation. Pain was induced using a topical capsaicin patch (or placebo as control) on the right forearm and assessed on a 0-10 numerical rating scale (NRS).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria

Healthy men and women, age 19-44, right-handed (assessed using the Edinburgh Handedness Inventory, speak and understand English.

Exclusion Criteria
  1. Chili allergies
  2. History of chronic pain or current acute pain
  3. Present or previous neurologic such as epilepsy, Alzheimer disease, dementia, stroke, migraine and other headache disorders, multiple sclerosis, Parkinson's disease, neuroinfections, brain tumours and head trauma.
  4. Present or previous musculoskeletal disorders such muscle/tendon strain, ligament sprain tension,tendonitis, degenerative disc disease, mechanical back syndrome, and ruptured/herniated disc.
  5. Present or previous mental illnesses such as depression, bipolar disorder, and schizophrenia.
  6. Pregnancy
  7. Current use of medications that may affect the trial (e.g. pain relieving medication and anti-inflammatory medication)
  8. Using hair products that may interfere with EEG conductance such as gel, except for shampoo, prior to the trial.
  9. Drug addiction defined as the use of cannabis, opioids or other drugs
  10. Consumption of alcohol, caffeine, or tobacco 6 hours before the experimental onset
  11. Lack of ability to cooperate -

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Placeboplacebo patchPlacebo condition: participants received no pain.
Capsaicin8% Capsaicin patchCapsaicin condition: in this condition participants received pain using a (5x10 cm) 8% topical capsaicin patch on the volar part of the dominant right forearm.
Primary Outcome Measures
NameTimeMethod
Change in resting state functional connectivityGranger causality is assessed at 5 time points for each condition (capsaicin or placebo): baseline, 1 hour, 24 hours, 24 hours, cooling at 24hours, and heating at 24 hours.

resting state functional connectivity is assessed using Granger causality. It can take on any value starting with "0" representing no connectivity. Higher granger causality scores indicate higher connectivity.

Change in Subjective pain intensityIntensity is assessed at 5 time points for each condition (capsaicin or placebo): baseline, 1 hour, 24 hours, cooling at 24hours, and heating at 24 hours.

Intensity rated by the participants on a numerical rating scale anchoring from 0 "no pain" to 10 "the worst imaginable pain" . Higher numerical rating scores indicate higher pain intensity.

Secondary Outcome Measures
NameTimeMethod
Change in Pain sensitivity (Warmth detection threshold)Warmth detection threshold is assessed at 3 time points for each condition (capsaicin or placebo): baseline, 1 hour, and 24 hours.

Warmth detection threshold is assessed using a thermal stimulator probe (3 × 3 cm, Pathway Medoc Ltd, Israel). Higher threshold scores indicate less sensitivity.

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Change in Pain sensitivity ( Cold detection threshold).Warmth detection threshold is assessed at 3 time points for each condition (capsaicin or placebo): baseline, 1 hour, and 24 hours.

Cold detection threshold is assessed using a thermal stimulator probe (3 × 3 cm, Pathway Medoc Ltd, Israel). Higher threshold scores indicate less sensitivity.

Change in Pain sensitivity ( Heat pain threshold).Heat pain threshold is assessed at 3 time points for each condition (capsaicin or placebo): baseline, 1 hour, and 24 hours.

Heat detection threshold is assessed using a thermal stimulator probe (3 × 3 cm, Pathway Medoc Ltd, Israel). Higher threshold scores indicate less sensitivity.

Change in Pain sensitivity ( Cold pain thresholds).Cold pain threshold is assessed at 3 time points for each condition (capsaicin or placebo): baseline, 1 hour, and 24 hours.

Cold pain threshold is assessed using a thermal stimulator probe (3 × 3 cm, Pathway Medoc Ltd, Israel). Higher threshold scores indicate less sensitivity.

Change in Pain sensitivity ( Mechanical pain thresholds).Mechanical pain threshold is assessed at 3 time points for each condition (capsaicin or placebo): baseline, 1 hour, and 24 hours.

Mechanical pain thresholds was assessed using a set of seven weighted pinprick stimulators consisting of steel tubes ending with a tip contact area of 0.25 mm diameter and excreting forces of 0.8, 1.6, 3.2, 6.4, 12.8, 25.6, and 51.2 g. Higher threshold scores indicate less sensitivity.

Pain vigilanceIt is assessed at baseline and after 24 hours for each condition (capsaicin or placebo).

Pain Vigilance and Awareness Questionnaire (PVAQ). This questionnaire consists of 16 items evaluating preoccupation and attention to one's pain over the past two weeks, rated between 0 = "never" and 5 = "always", with a maximum score of 80. The higher the scores, the higher the preoccupation with pain.

Pain CatastrophizingIt is assessed at baseline and after 24 hours for each condition (capsaicin or placebo).

Scale (PCS). This questionnaire comprises 13 items assessed on a 5-point scale ranging from 0 = "not at all" to 4 = "all the time", with a maximum score of 52. It evaluates three scales of catastrophizing: rumination, magnification, and helplessness. Ratings reflect the degree to which specific thoughts and feelings are present when experiencing pain over the last three months. Higher scores indicate a higher degree of pain catastrophizing.

Sleep quality assessmentIt is assessed at baseline and after 24 hours for each condition (capsaicin or placebo).

Pittsburgh Sleep Quality Index (PSQI). This questionnaire determines sleep quality and sleep patterns across seven areas: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction over the last month. These areas are evaluated on a scale ranging from 0 = "no difficulty" to 3 = "severe difficulty," with a maximum score of 21. Higher scores reflect poor sleep quality.

Fatigue assessmentIt is assessed at baseline and after 24 hours for each condition (capsaicin or placebo).

Modified Fatigue Impact Scale (MFIS). The MFIS evaluates the degree to which fatigue influences overall perceived function over the last 4 weeks. It assesses three subscales: cognitive (9 items), physical (10 items), and psychosocial (2 items) functioning. Items are measured on a scale from 0 = "no problem" to 4 = "extreme problem", with a maximum score of 120. Higher scores indicate higher levels of fatigue.

Positive and negative affectThey are assessed at baseline and after 24 hours for each condition (capsaicin or placebo).

Positive and Negative Affect Scale (PANAS). This scale consists of 20 items assessing two groups of emotions: negative and positive (10 items each). Subjects rate the intensity of a specific emotion they are experiencing at the moment on a scale (1 = "very slightly or not at all" to 5 = "Extremely"). for each emotion group with a maximum of 50. Higher scores indicate more intense emotions. The positive affect items were "interested," "excited," "strong," "enthusiastic," "proud," "alert," "inspired," "determined," "attentive," and "active." The negative affect items were "distressed," "upset," "guilty," "scared," "hostile," "irritable," "ashamed," "nervous," "jittery," and "afraid."

Depression scoresThey are assessed at baseline and after 24 hours for each condition (capsaicin or placebo).

Beck Depression Inventory (BDI-II). The BDI determines the severity of depressive mood states and consists of 21 questions assessing hopelessness, guilt, fatigue, and other physical symptoms, rated between 0 = "no symptom impact" and 3 = "maximum symptom impact" with a maximum score of 63. Higher scores indicate severe depressive symptoms. To obtain measures of trait depression, subjects in this study are instructed to rate the items in relation to how they generally feel.

Trial Locations

Locations (1)

Aalborg University, Department of Health Sciences and technology

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Aalborg, Denmark

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