Session-Order Sensitivity of TS and OA in a Capsaicin Crossover Model (TS-OA-Cap)
2026年6月3日 更新者:John Srbely、University of Guelph
Session-order Sensitivity of Temporal Summation and Offset Analgesia in a Randomised Crossover Capsaicin Model of Secondary Hyperalgesia
Temporal summation (TS) and offset analgesia (OA) are widely used psychophysical endpoints in pain research that index different components of central nociceptive processing.
While crossover designs are commonly used in experimental pain studies to reduce between-participant variability, the design-stability of these endpoints under repeated testing during experimental sensitisation is not well characterised.
This study compared the design-stability of mechanical TS (Sumscore) and offset analgesia magnitude (OffA) in a two-period, vehicle-controlled crossover trial of capsaicin-evoked secondary hyperalgesia in healthy adults.
The primary aim was methodological: to determine whether session-order effects differ between TS and OffA when these are used as outcome measures in two-period crossover designs of capsaicin-induced central sensitisation.
Topical capsaicin was used as a reversible experimental intervention to create a controlled, transient state of secondary hyperalgesia rather than as a therapeutic intervention.
The study informs endpoint selection in future quantitative sensory testing (QST) crossover trials.
研究概览
地位
完全的
详细说明
This was a single-site, two-period, vehicle-controlled, allocation- and formulation-blinded, randomised crossover study conducted at the Department of Human Health Science, University of Guelph, Canada.
Sixteen healthy adult volunteers (10 female, 6 male; mean age 21.9 years) were recruited between May 2024 and April 2025.
Participants were randomised in a 1:1 intended allocation to one of two sequences: capsaicin-first then vehicle (Sequence A-to-B) or vehicle-first then capsaicin (Sequence B-to-A); actual allocation was 6:10.
The allocation sequence was computer-generated by a research assistant not involved in outcome collection.
Sessions were separated by a minimum 1-week washout.
Topical 0.075% capsaicin cream (Zostrix; Hi-Tech Pharmacal) was applied as a 5 mL dose to a 5 x 10 cm target area on the lateral elbow and to bilateral C5-C6 cervicothoracic dermatomes.
The comparator was an equivalent 5 mL volume of inert vehicle lotion (Lubriderm; Johnson & Johnson) applied identically; creams were matched for colour and texture and prepared by a research assistant in unlabelled containers.
Mechanical temporal summation (Sumscore; 256 mN pinprick, 16 stimuli at 1 Hz) and thermal offset analgesia (OA; 32-46°C stepped-stimulus protocol with three thermal hold durations of 5, 10, and 15 s) were assessed at baseline and at 10, 20, 30, and 40 min post-intervention.
Continuous pain ratings during thermal stimulation were captured via CoVAS.
Primary outcomes (Sumscore and the duration-averaged baseline-normalised OffA) were analysed using REML linear mixed-effects models with fixed effects for Intervention, Time, Intervention x Time, Period, and Sequence, with random intercepts for Participant; sex was included as a pre-specified covariate.
Within-session temporal stability was assessed using ICC(2,1).
A combined Measure x Intervention x Period model tested for differential design-sensitivity between TS and OffA.
The study was approved by the University of Guelph Research Ethics Board (REB #19-06-003).
研究类型
介入性
注册 (实际的)
16
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
-
-
Ontario
-
Guelph、Ontario、加拿大、N1G2W1
- Human Health Sciences, University of Guelph
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参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
是的
描述
Inclusion Criteria:
- Healthy adult volunteers (≥18 years of age)
- Able to provide written informed consent in English
Exclusion Criteria:
- Current or chronic pain
- Neurological disease
- Skin conditions or sensitivity over the test sites to capsaicin
- Contraindications to thermal stimulation of the skin
- Musculoskeletal conditions that could alter somatosensory processing
- Use of analgesic medications within 24 hours prior to each session
- Use of caffeine within 24 hours prior to each session
- Use of alcohol within 24 hours prior to each session
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:基础科学
- 分配:随机化
- 介入模型:交叉作业
- 屏蔽:三倍
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:Arm 1: Sequence A-to-B (Capsaicin first)
Participants received topical 0.075% capsaicin (Zostrix) cream (5 mL) in Period 1, followed by topical inert (Lubriderm) vehicle (5 mL) in Period 2. Periods were separated by a minimum 1-week washout.
n = 6.
|
5 mL of 0.075% capsaicin cream (Zostrix; Hi-Tech Pharmacal, Amityville, NY, USA) applied to a 5 x 10 cm target region on the lateral elbow and to bilateral C5-C6 cervicothoracic dermatomes (total 15 mL).
The cream was massaged into the skin by a gloved investigator until no residue was visible.
Used as an experimental probe to evoke transient, reversible secondary hyperalgesia; not under therapeutic evaluation.
5 mL of inert vehicle lotion (Lubriderm; Johnson & Johnson, Montgomery, NJ, USA) applied to the same dermatomes as the capsaicin condition (total 15 mL), using the identical preparation and massage technique.
Matched to the capsaicin cream for colour and texture.
|
|
有源比较器:Arm 2: Sequence B-to-A (Vehicle first)
Participants received topical inert (Lubriderm) vehicle (5 mL) in Period 1, followed by topical 0.075% capsaicin (Zostrix) cream (5 mL) in Period 2. Periods were separated by a minimum 1-week washout.
n = 10.
|
5 mL of 0.075% capsaicin cream (Zostrix; Hi-Tech Pharmacal, Amityville, NY, USA) applied to a 5 x 10 cm target region on the lateral elbow and to bilateral C5-C6 cervicothoracic dermatomes (total 15 mL).
The cream was massaged into the skin by a gloved investigator until no residue was visible.
Used as an experimental probe to evoke transient, reversible secondary hyperalgesia; not under therapeutic evaluation.
5 mL of inert vehicle lotion (Lubriderm; Johnson & Johnson, Montgomery, NJ, USA) applied to the same dermatomes as the capsaicin condition (total 15 mL), using the identical preparation and massage technique.
Matched to the capsaicin cream for colour and texture.
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Mechanical temporal summation (Sumscore)
大体时间:Baseline and 10, 20, 30, and 40 min post-intervention (within each of two sessions, separated by a minimum 1-week washout)
|
Sumscore is a summed pinprick temporal-summation response computed from a train of 16 repeated 256 mN pinprick stimuli delivered perpendicularly to the skin at 1 Hz, paced by a metronome.
Pain ratings (NPRS 0-10) immediately after each stimulus were summed (Clouse et al., 2021).
The primary Sumscore endpoint was pre-specified as the average of the lateral and inferior testing sites at the lateral elbow, expressed as a baseline-normalised ratio.
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Baseline and 10, 20, 30, and 40 min post-intervention (within each of two sessions, separated by a minimum 1-week washout)
|
|
Offset analgesia magnitude (OffA)
大体时间:Baseline and 10, 20, 30, and 40 min post-intervention (within each of two sessions, separated by a minimum 1-week washout)
|
OffA was measured during a three-phase stepped-stimulus thermal protocol (32-45-46-45-32°C; T1/T2/T3 phases) using a 32 x 32 mm Peltier contact thermode (TSA-II NeuroSensory Analyzer, Medoc AMS).
Continuous pain ratings were collected via CoVAS (0-100) at 10 Hz.
OA magnitude was quantified as peak minus nadir CoVAS during the 46°C hold and the subsequent 45°C phase.
The primary OffA endpoint was pre-specified as the duration-averaged value across three thermal hold durations (5, 10, and 15 s at 46°C), expressed as a baseline-normalised ratio.
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Baseline and 10, 20, 30, and 40 min post-intervention (within each of two sessions, separated by a minimum 1-week washout)
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Within-session temporal stability (ICC(2,1)) of Sumscore and OffA
大体时间:10, 20, 30, and 40 minutes post-intervention
|
Intraclass correlation coefficient (ICC(2,1); Shrout and Fleiss, 1979) computed across the four post-intervention time points (10, 20, 30, 40 min) within each intervention condition, separately for Sumscore and OffA.
Reported with bias-corrected bootstrap 95% confidence intervals.
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10, 20, 30, and 40 minutes post-intervention
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Differential design-sensitivity (Measure × Intervention × Period interaction)
大体时间:10, 20, 30, and 40 minutes post-intervention, across two crossover periods separated by a minimum 1-week washout.
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A combined linear mixed-effects model using within-measure z-scored outcomes tested whether the period-adjusted intervention estimate differed between TS and OffA.
Three-way Measure x Intervention x Period interaction tested via Wald F-tests with residual degrees of freedom.
|
10, 20, 30, and 40 minutes post-intervention, across two crossover periods separated by a minimum 1-week washout.
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Grill JD, Coghill RC. Transient analgesia evoked by noxious stimulus offset. J Neurophysiol. 2002 Apr;87(4):2205-8. doi: 10.1152/jn.00730.2001.
- Dwan K, Li T, Altman DG, Elbourne D. CONSORT 2010 statement: extension to randomised crossover trials. BMJ. 2019 Jul 31;366:l4378. doi: 10.1136/bmj.l4378.
- Clouse JA, et al. The reliability of a temporal summation Sumscore. (2021)
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2024年5月1日
初级完成 (实际的)
2025年4月30日
研究完成 (实际的)
2025年4月30日
研究注册日期
首次提交
2026年5月22日
首先提交符合 QC 标准的
2026年6月3日
首次发布 (实际的)
2026年6月4日
研究记录更新
最后更新发布 (实际的)
2026年6月4日
上次提交的符合 QC 标准的更新
2026年6月3日
最后验证
2026年6月1日
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- GUELPH-REB-19-06-003
- REB #19-06-003 (其他标识符:University of Guelph)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
是的
IPD 计划说明
De-identified individual participant data (IPD) and statistical analysis code will be available from the corresponding author on reasonable request, subject to a data-use agreement and institutional ethics/data-sharing requirements.
Materials required to reproduce the intervention and assessment protocol are described in the published Methods and Supplementary Materials.
IPD 共享时间框架
On request following publication of the primary manuscript.
IPD 共享访问标准
Reasonable request to the corresponding author for non-commercial research use, subject to a data-use agreement consistent with University of Guelph data-sharing policy.
IPD 共享支持信息类型
- 研究方案
- 树液
- 国际碳纤维联合会
- 分析代码
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
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