Dataset Information

Individual endogenous pain modulation profiles within a multidimensional context of people with cervicogenic headache - A retrospective exploratory study.

ABSTRACT:

Background

One in four individuals with cervicogenic headache (CeH) are unresponsive to therapy. Such therapy involves predominantly biomedical interventions targeting the upper-cervical spine. A recurring theme within musculoskeletal practice is the multidimensional nature and substantial heterogeneity of the condition. Such heterogeneity might be a reason for failure of a biomedical approach. Therefore, future studies investigating efficacy of managing CeH should ideally be based on identification, and better understanding of the heterogeneity of this population based on a comprehensive evaluation of clinically relevant contributing factors.

Objectives

The objective was to map profiles of individuals with CeH based on pain modulation within a multidimensional context.

Design

Pain Modulation Profiles (PMPs) of 18 adults (29-51 years) with CeH were mapped retrospectively.

Method

The PMPs consisted of a Pain-Profile (bilateral suboccipital, erector spinae, anterior tibialis pressure pain thresholds), a Psycho-Social-Lifestyle-Profile (Depression, Anxiety, Stress Scale, Headache Impact test, Pittsburgh Sleep Quality Index), or a combination of both. Individual results were compared to normative data. Two Pain-Profiles were defined: normal or altered. Psycho-Social-Lifestyle-Profiles were categorized based on the number of altered psycho-social-lifestyle factors (range 0-5).

Results

Mapping PMPs in individuals with CeH resulted in 50% presenting with a dominant altered Pain-Profile, 16.7% with a dominant altered Psycho-Social-Lifestyle-Profile, and 5.6% with dominant alterations in both Pain-Profile and Psycho-Social-Lifestyle-Profile.

Conclusion

Our results indicate heterogeneity of PMPs within the CeH population. Replication of these results is needed through dynamic assessment of the Pain-Profile before evaluating if these profiles can help patient-stratification.

SUBMITTER: Mingels S

PROVIDER: S-EPMC10560891 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Individual endogenous pain modulation profiles within a multidimensional context of people with cervicogenic headache - A retrospective exploratory study.

Mingels Sarah S Granitzer Marita M Schmid Annina B AB Dankaerts Wim W

Musculoskeletal science & practice 20230902

<h4>Background</h4>One in four individuals with cervicogenic headache (CeH) are unresponsive to therapy. Such therapy involves predominantly biomedical interventions targeting the upper-cervical spine. A recurring theme within musculoskeletal practice is the multidimensional nature and substantial heterogeneity of the condition. Such heterogeneity might be a reason for failure of a biomedical approach. Therefore, future studies investigating efficacy of managing CeH should ideally be based on id ...[more]

PMID: 37683308

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Project description:ObjectiveAlthough multidimensional interventions including physiotherapy, psychology, and education are generally recommended in managing headache, and to prevent chronification, such approach is lacking in cervicogenic headache (CeH). Therefore, exploring CeH within a biopsychosocial framework is deemed an essential first step.MethodsNon-randomized cross-sectional design to compare pain processing, lifestyle, and psychosocial characteristics between 18 participants with CeH (CeH group) (40.2 ± 10.9 years) and 18 matched controls (control group) (39.2 ± 13.1 years). Pain processing characteristics included degree of central sensitization (Central Sensitization Inventory), and (extra)-cephalic pressure pain thresholds (kPa/cm²/s). Lifestyle characteristics included sleep quality (Pittsburgh Sleep Quality Index), physical activity, screen time, and sedentary time (hours a week). Psychosocial characteristics included degree of depression, anxiety and stress (Depression Anxiety Stress Scale-21), and quality of life (Headache Impact Test-6).ResultsPain processing characteristics: More (p = .04) participants in the CeH group showed higher degrees of central sensitization compared to the control group. Lower (p < .05) (extra)-cephalic pressure pain thresholds were revealed in the CeH group compared to the control group for each muscle. Lifestyle and psychosocial characteristics: Compared to the control group, sleep quality and headache-related quality of life were worse (p < .0001) in the CeH group. Severe to extreme stress was experienced by more participants in the CeH group (p = .02). Further, significant relations between pain processing and (1) lifestyle characteristics and (2) psychosocial characteristics were seen in the CeH group.ConclusionExploring multidimensional characteristics in CeH exposed relations between pain processing, lifestyle, and psychosocial characteristics. These novel findings fill a gap in the current scientific literature, and highlight the need for outcome research targeting lifestyle and psychosocial factors.

Project description:Currently, evidence for effective physiotherapy interventions in patients with cervicogenic headache (CeH) is inconsistent. Although inter-individual variability in pain response is predictive for successful physiotherapy interventions, it was never explored in patients with CeH. Therefore the objective of the current study was to explore inter-individual variability in mechanical pain sensation, and its association with biopsychosocial-lifestyle (BPSL) characteristics in patients with CeH. A cross-sectional explorative analysis of inter-individual variability in mechanical pain sensation in 18 participants with CeH (29-51 years) was conducted. Inter-individual variability in mechanical pain sensation (standard deviations (SDs), F-statistics, Measurement System Analysis) was deducted from bilateral pressure pain thresholds of the suboccipitals, erector spine, tibialis anterior. BPSL-characteristics depression, anxiety, stress (Depression Anxiety Stress Scale-21), quality of life (Headache Impact Test-6), sleep-quality (Pittsburgh Sleep Quality Index), and sedentary time (hours/week) were questioned. Inter-individual variability in mechanical pain sensation explained 69.2% (suboccipital left), 86.8% (suboccipital right), 94.6% (erector spine left), 93.2% (erector spine right), 91.7% (tibialis anterior left), and 82% (tibialis anterior right) of the total variability in patients with CeH. The significant p-values and large F-statistic values indicate inter-individual differences in SDs. Significant associations between (1) lower quality of life and lower SDs of the suboccipital left PPT (p .005), and (2) longer sedentary time and higher SDs of the suboccipital left PPT (p .001) were observed. Results from our explorative study could suggest inter-individual variability in mechanical pain sensation at the left suboccipitals which associates with quality of life and sedentary time. These novel findings should be considered when phenotyping patients and 'individually' match interventions.

Project description:BackgroundVariability is a hallmark of animal behavior. It contributes to survival by endowing individuals and populations with the capacity to adapt to ever-changing environmental conditions. Intra-individual variability is thought to reflect both endogenous and exogenous modulations of the neural dynamics of the central nervous system. However, how variability is internally regulated and modulated by external cues remains elusive. Here, we address this question by analyzing the statistics of spontaneous exploration of freely swimming zebrafish larvae and by probing how these locomotor patterns are impacted when changing the water temperatures within an ethologically relevant range.ResultsWe show that, for this simple animal model, five short-term kinematic parameters - interbout interval, turn amplitude, travelled distance, turn probability, and orientational flipping rate - together control the long-term exploratory dynamics. We establish that the bath temperature consistently impacts the means of these parameters, but leave their pairwise covariance unchanged. These results indicate that the temperature merely controls the sampling statistics within a well-defined kinematic space delineated by this robust statistical structure. At a given temperature, individual animals explore the behavioral space over a timescale of tens of minutes, suggestive of a slow internal state modulation that could be externally biased through the bath temperature. By combining these various observations into a minimal stochastic model of navigation, we show that this thermal modulation of locomotor kinematics results in a thermophobic behavior, complementing direct gradient-sensing mechanisms.ConclusionsThis study establishes the existence of a well-defined locomotor space accessible to zebrafish larvae during spontaneous exploration, and quantifies self-generated modulation of locomotor patterns. Intra-individual variability reflects a slow diffusive-like probing of this space by the animal. The bath temperature in turn restricts the sampling statistics to sub-regions, endowing the animal with basic thermophobicity. This study suggests that in zebrafish, as well as in other ectothermic animals, ambient temperature could be used to efficiently manipulate internal states in a simple and ethological way.

Dataset Information

Individual endogenous pain modulation profiles within a multidimensional context of people with cervicogenic headache - A retrospective exploratory study.

Background

Objectives

Design

Method

Results

Conclusion

Publications

Individual endogenous pain modulation profiles within a multidimensional context of people with cervicogenic headache - A retrospective exploratory study.

Similar Datasets

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