Impact of Kinesiophobia on Descending Corticospinal and Bulbospinal Projections

Not Applicable

Completed

• Conditions: Kinesiophobia
• Interventions: Behavioral: Nocebo; Behavioral: Placebo

• Registration Number: NCT05161832
• Lead Sponsor: Université de Sherbrooke

Brief Summary

Fear of movement (kinesiophobia) is a phenomenon commonly observed in people suffering from chronic pain. The aims of this project are to better understand the neurophysiological basis of this phenomenon, in particular 1) the effect of kinesiophobia (induced by nocebo intervention) on the excitability of corticospinal projections and 2) the association between kinesiophobia and top-down inhibitory mechanisms.

Detailed Description

The study will include 44 healthy (pain-free) participants. Corticospinal measurements will be taken before and after the application of capsaicin cream (experimental pain paradigm). The investigators will manipulate kinesiophobia levels (assessed using the Tampa Kinesiophobia Scale) upward by pretending to diagnose a musculoskeletal problem in half of the participants (nocebo ultrasound), and will measure the efficacy of top-down inhibitory mechanisms using a counter-irritation paradigm (thermode and cold pressor test : the subjects will be subjected to 5 thermal stimulations, 7 mechanical stimulations and 1 water bath at 10°C of the hand) and corticospinal parameters using transcranial magnetic stimulation.

Together, these results will allow a better understanding of the mechanisms associated with a predictor of pain onset (such as kinesiophobia), by studying its interactions with endogenous pain inhibition systems and the motor system, in order to develop relevant prophylactic treatments.

Study Timeline

• Study First Submitted: 2021-11-26
• Study First Submitted QC: 2021-12-10
• Study First Posted: 2021-12-17
• Study Start: 2022-01-15
• Primary Completion: 2023-07-29
• Study Completion: 2024-01-29
• Status Verified: 2024-06
• Last Update Submitted: 2024-06-04
• Last Update Posted: 2024-06-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 24

Inclusion Criteria

• Aged 18 years old or older
• Healthy Volunteers
• Capable of understanding instructions
• Abstain from tobacco and caffeine 2 hours before data collection
• Abstain from short-acting analgesics 6 hours before data collection

Exclusion Criteria

• A painful condition or chronic pain
• Neurological disorders
• Shoulder pathology
• Skin diseases
• Capsaicin allergy
• Raynaud's syndrome
• Epilepsy
• Intracranial metallic foreign bodies, hearing aids and cochlear implants

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
nocebo	Nocebo	Ultrasound with fake results of rotator cuff injury.
placebo	Placebo	Ultrasound with fake results of the healthy rotator cuff.

Primary Outcome Measures

Name	Time	Method
Corticospinal excitability	1 hour	The corticospinal excitability will be assessed using motor evoked potentials at different intensity of stimulation (from motor threshold to maximal amplitude response).

Secondary Outcome Measures

Name	Time	Method
downward inhibition of pain	1 hour	Inhibitory mechanisms will be assessed by comparing pain levels (measured using a computerized visual analog scale \[0 = no pain; 10 = worst pain imaginable\]) evoked by a test stimulus before and after a conditioning stimulus.; Pain levels evoked by the test stimulus before the conditioning stimulus will be subtracted from pain levels evoked by the test stimulus after the pain stimulus, such that a positive score represents increased pain (hyperalgesia) and a negative score represents decreased pain (hypoalgesia, i.e., inhibitory mechanisms).

Trial Locations

Locations (1)

Centre de Recherche sur le Vieillissement; 🇨🇦 Sherbrooke, Quebec, Canada