- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04308044
Clinical Assessment of Pain Processes in Pediatric Patients With Chronic Musculoskeletal Pain (MSK)
Study Overview
Status
Conditions
Detailed Description
Enabling better pain management in children with musculoskeletal (MSK) pathologies by improving assessment techniques is a cornerstone of this research program.
This research project will elucidate the regulation of specific physiological mechanisms related to pain in children reporting presence of chronic MSK pain. As molecular events of pathophysiological processes are quantifiable, the investigators will test for associations between the expression of pain-related molecular markers in blood and the patient's experience of pain assessed with semi-objective sensory testing. The identification of specific alterations in the nociceptive process will provide a deeper understanding of a patient's pain perception alongside self-report or observers' report subjective measurements. Pain experience variability may originate in the lack of rigor in the clinical pain assessment tools. A personalized mechanism-based approach may be the key to better identify a patient's pain outcome and how this assessment could lead to personalized pain management. By testing temporal summation (TS), conditioned pain modulation (CPM), electroencephalography (EEG) patterns and balance in relation to biomarkers, the investigators will be able to determine the phenotype of the patients who presents higher risk of central sensitization related to increased hyperactivity and decreased endogenous inhibition. The ultimate goal is to use this information to offer the highest quality of pain control in children with MSK conditions.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
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Quebec
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Montréal, Quebec, Canada, H4A0A9
- Shriners Hospital for Children-Canada
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Aged between 10 and 18 years old
- Report of MSK pain lasting 3 months or longer, including orthopaedic diagnoses such as those involving the spine, knees, hips, ankles, shoulders.
- Ability to adequately understand and respond to outcome measures
- Female or male
- Any ethnic background
Exclusion Criteria:
- Inability of the child to speak English or French
- Pain due to an acute trauma occurring in the last 3 months (e.g. fracture)
- Diagnosed with developmental delay that would interfere with understanding questions being asked (autism, mental retardation)
- Children with major chronic medical conditions (ASA status III or higher)
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Cross-Sectional
Cohorts and Interventions
Group / Cohort |
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Chronic MSK Pain
Participants who have chronic musculoskeletal pain.The pain profile of the patient will be assessed, including biological sample analysis (blood), quantitative sensory testing, electroencephalogram (EEG), and psychological state via the completion of questionnaires by the patient.
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Healthy Control
Participants who do not have chronic musculoskeletal pain.The pain profile of the patient will be assessed, including biological sample analysis (blood), quantitative sensory testing, electroencephalogram (EEG), insole assessment (40 healthy control participants), and psychological state via the completion of questionnaires by the patient.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Mechanical detection threshold (grams) as measured with von Frey filaments
Time Frame: Completed during study visit (5 minutes).
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Completed during study visit (5 minutes).
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Dynamic mechanical allodynia (numerical pain intensity using Faces Pain Scale -Revised scores 0-10) as measured with a standardized brush (Somedic SENSELab - Brush-05)
Time Frame: Completed during study visit (5 minutes).
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Completed during study visit (5 minutes).
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Vibration detection threshold (Hertz) as measured with a Rydel-Seiffer graded tuning fork (64 Hz)
Time Frame: Completed during study visit (5 minutes).
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Completed during study visit (5 minutes).
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Temporal mechanical summation (numerical pain intensity using Faces Pain Scale -Revised scores 0-10) as measured with the Neuropen (Owen Mumford) with disposable Neurotips
Time Frame: Completed during study visit (15 minutes).
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Completed during study visit (15 minutes).
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Pain pressure threshold (Newtons) as measured with an algometer.
Time Frame: Completed during study visit (5 minutes).
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Completed during study visit (5 minutes).
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Conditioned pain modulation (CPM) efficiency, a physiological parameter calculated as the percentage difference between the average pain intensity (0-10) reported during a thermode (heat) test before and after a cold water submersion bath test.
Time Frame: Completed during study visit (20 minutes).
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Completed during study visit (20 minutes).
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Electroencephalography (EEG) (μV) as measured with a 24-electrode wireless EEG headset (DSI-24, Wearable Sensing)
Time Frame: Completed during study visit (5 minutes).
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Completed during study visit (5 minutes).
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Biochemical assessment and genomic analysis of blood sample (10ml), drawn by research nurse.
Time Frame: The blood samples will be analyzed within 1 year of the study visit.
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A molecular assessment of monoamines involved in the dopaminergic and adrenergic pain (pathways related to the endogenous pain inhibitory system (dopamine, serotonin, epinephrine,norepinephrine) will be performed. Genomics analyses will be done to analyze specific single-nucleotide polymorphisms (SNPs). This process involves amplification of specific DNA fragments by polymerase chain reaction (PCR) followed by analysis on an optical plate for specific genetic polymorphisms, to identify which patients carry such polymorphisms. |
The blood samples will be analyzed within 1 year of the study visit.
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Insole assessment (N; N/cm2; mm/s; mm) as measured with Moticon© sensor insoles
Time Frame: Completed during study visit (5 minutes).
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Forty participants who agree to participate in the insole assessment will be asked to stand on sensory insoles for a duration of fifteen seconds to measure the forces, pressures and center of pressure in their feet.
The measurement data obtained using the Moticon© insoles will be aggregated for analysis of plantar pressure distribution, which will be performed using the Moticon© software.
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Completed during study visit (5 minutes).
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Total score on Neuropathic Pain Questionnaire (DN4) (0-10) assessing the probability of neuropathic pain (score greater than 4 indicates neuropathic pain).
Time Frame: Completed during study visit (5 minutes).
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2 domains (Interview (0-7) and Examination (0-3) of the Patient) Completed by MSK chronic pain participants.
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Completed during study visit (5 minutes).
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Total Score of the Functional Disability Inquiry (0-60). Higher scores indicate greater activity limitations during the past 2 weeks.
Time Frame: Completed during study visit (5 minutes).
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Completed by MSK chronic pain participants.
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Completed during study visit (5 minutes).
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Total Subscale Score of the Adolescent Pediatric Pain Tool (APPT), which evaluates the intensity, location, and quality (including affective, evaluative, sensory, and temporal) dimensions of pain.
Time Frame: Completed during study visit (5 minutes).
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The APPT provides five subscale scores: 1) the number of pain sites (alternatively, the number of pain segments) as a measure of pain location from marks on a body outline; 2) a pain intensity score measured by a 10-centimeter line known as the Word Graphic Rating Scale (WGRS) and anchored by words no pain, little, medium, large, worst possible pain; 3) the number of pain quality descriptors, which yields percent scores for the sensory, affective, evaluative subscales; 4) the number of temporal descriptors, which yields a percent temporal subscale; and (5) the percent of total pain quality and temporal descriptors as a total subscale. Completed by MSK chronic pain participants. |
Completed during study visit (5 minutes).
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Global Score of the Pittsburgh Sleep Quality Index (0-21). Higher scores indicate a worse sleep quality (>5 indicates "poor sleeper").
Time Frame: Completed during study visit (5 minutes).
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Completed by all participants
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Completed during study visit (5 minutes).
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Total Anxiety Score and Total Internalizing Scale on the Revised Children Anxiety and Depression Scale (RCADS) (0-47) (t-score of 65 = borderline clinical threshold, t-score 70 = above clinical threshold)
Time Frame: Completed during study visit (5 minutes).
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The RCADS is intended to assess children's report of symptoms corresponding to selected DSM-IV anxiety disorders and depression. . Scale yields Total Anxiety Score (5 anxiety subscales: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder), which gives an overall index of anxiety levels, and Total Internalizing Scale (sum of all 6 subscales, including major depression subscale), which provides an estimate of the total level of internalising symptoms. Completed by all participants. |
Completed during study visit (5 minutes).
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Total Score of the Pain Catastrophizing Scale (0-52). Higher scores indicate higher levels of pain-related anxiety.
Time Frame: Completed during study visit (5 minutes).
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Completed by all participants.
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Completed during study visit (5 minutes).
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Score of Trait Anxiety of the State-Trait Anxiety Scale (20-60). Higher scores indicate greater trait anxiety.
Time Frame: Completed during study visit (5 minutes).
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Completed by healthy control participant only.
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Completed during study visit (5 minutes).
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Catherine Ferland, PhD, Shriners Hospitals for Children,Canada
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- A09-M17-17B
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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