QST in Context With Conditioned Pain Modulation (CPM)

Quantitative Sensory Testing in Context With Conditioned Pain Modulation (CPM)

Conditioned Pain Modulation (CPM) is a phenomenon which isn't examined enough. Many factors of influence such as gender, age and psyche are already known - but the duration of such effects, their reliability and the correlation between standardized Quantitative Sensory Testing (QST) and CPM is still unknown.

In this study the investigators expect to find parameters in QST that correlate with the efficacy of Conditioned Pain Modulation. Knowing factors that indicate high or low potential CPM could help finding patients-at-risk and adapting their therapy.

Study Overview

• Status: Completed
• Conditions: Healthy
• Intervention / Treatment: Procedure: Quantitative Sensory Testing; Procedure: Conditioned Pain Modulation; Procedure: Repetition of four QST parameters

Detailed Description

Conditioned Pain Modulation was firstly found in rats by electrical stimulation of their spinal cord and called Diffuse Noxious Inhibitory Controls. In humans such experimental settings are impossible. That is why we need two noxious stimuli for provoking such an endogenous pain inhibition.

Before the CPM setting begins, we will investigate our 32 healthy probands by basic QST following the protocol of DFNS (German Research Network on Neuropathic Pain). This assessment helps us to create a sensory profile for every proband and to look for correlations between QST parameters and CPM efficacy. Then the CPM setting follows. In our experimental design we use a test stimulus (TS) on the dominant forearm by thermode (normally 45-47°C, depending on the pain rating, we need scores >NRS 60) and a conditioned stimulus (CS) on the other hand by cold water bath (10°C). Both stimuli must be rated on the numerical rating scale (NRS) 0-100 alone and in combination. A positive effect can be seen, if the difference between TS alone and TS in combination with CS is >0. To learn more about the duration of CPM effects we decided to repeat four QST parameters (cold detection threshold, warm detection threshold, mechanical detection threshold and mechanical pain threshold) within 30 minutes after finishing the CPM part to detect changes of time.

The whole study design will be repeated 24-72h hours later to increase the test-retest-reliability.

• Study Type: Observational
• Enrollment (Actual): 26

Contacts and Locations

Study Locations

• Germany
  • Nordrhein-Westfalen
    • Bochum, Nordrhein-Westfalen, Germany, 44789
      • Bergmannsheil, department for pain management

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Healthy voluntary probands

Description

Inclusion Criteria:

• healthy probands >18 years
• right-handedness
• informed consent
• no chronic pain
• no drugs (but oral contraceptives)
• no neurological diseases
• no psychiatric diseases

Exclusion Criteria:

• no informed consent
• language deficits
• left-handedness
• not enough pain intensity by thermode or cold water bath
• psychiatric disease, neurological diseases other chronic disease
• chronic pain syndromes
• pregnancy or lactation
• permanent drug use, drug use in the last 14 days

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Healthy; 26 healthy voluntary probands

Procedure: Quantitative Sensory Testing; following the standardized protocol of DFNS; Other Names: QST; Procedure: Conditioned Pain Modulation; test stimulus by hot thermode conditioned stimulus by cold water bath; Other Names: CPM; DNIC; Diffuse Noxious Inhibitory Controls; Procedure: Repetition of four QST parameters; warm detection threshold (WDT); cold detection threshold (CDT); mechanical detection threshold (MDT); mechanical pain threshold (MPT); Other Names: MDT; Quantitative Sensory Testing; WDT; CDT; MPT

Collaborators and Investigators

• Sponsor: Ruhr University of Bochum
• Investigators: Study Director: Christoph Maier, Prof. Dr. med, University hospital Bergmannsheil department of pain management

Publications and helpful links

General Publications

• Gehling J, Mainka T, Vollert J, Pogatzki-Zahn EM, Maier C, Enax-Krumova EK. Short-term test-retest-reliability of conditioned pain modulation using the cold-heat-pain method in healthy subjects and its correlation to parameters of standardized quantitative sensory testing. BMC Neurol. 2016 Aug 5;16:125. doi: 10.1186/s12883-016-0650-z.

Study record dates

Study Major Dates

• Study Start: May 1, 2012
• Primary Completion (Actual): December 1, 2012
• Study Completion (Actual): December 1, 2012

Study Registration Dates

• First Submitted: June 11, 2012
• First Submitted That Met QC Criteria: June 11, 2012
• First Posted (Estimate): June 13, 2012

Study Record Updates

• Last Update Posted (Estimate): January 3, 2013
• Last Update Submitted That Met QC Criteria: December 30, 2012
• Last Verified: December 1, 2012

More Information

Terms related to this study

• Keywords: Quantitative Sensory Testing; duration; Conditioned Pain Modulation; correlation
• Other Study ID Numbers: CPM2012