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Randomized Controlled Trial
. 2021 Sep 1;37(9):648-656.
doi: 10.1097/AJP.0000000000000956.

Does Quantitative Sensory Testing Improve Prediction of Chronic Pain Trajectories? A Longitudinal Study of Youth With Functional Abdominal Pain Participating in a Randomized Controlled Trial of Cognitive Behavioral Treatment

Matthew C Morris  1 , Stephen Bruehl  2 , Amanda L Stone  2 , Judy Garber  3 , Craig Smith  3 , Tonya M Palermo  4 , Lynn S Walker  5
Affiliations
Randomized Controlled Trial

Does Quantitative Sensory Testing Improve Prediction of Chronic Pain Trajectories? A Longitudinal Study of Youth With Functional Abdominal Pain Participating in a Randomized Controlled Trial of Cognitive Behavioral Treatment

Matthew C Morris et al. Clin J Pain. .

Abstract

Objectives: Youth with functional abdominal pain (FAP) experience significant pain-related distress and functional impairment. Although quantitative sensory testing protocols have identified alterations in pain modulatory systems that distinguish youth with FAP from healthy controls, the extent to which evoked pain responses predict subsequent trajectories of pain symptoms and disability over and above established psychosocial risk factors is unclear.

Methods: The present study included 183 adolescents with FAP who were enrolled in a randomized controlled trial comparing an 8-week, internet-delivered program of cognitive behavior therapy (n=90) or pain education (n=93). Participants completed a quantitative sensory testing protocol before the intervention and were followed for 12-month posttreatment.

Results: Whereas adolescents with FAP who exhibited stronger baseline conditioned pain modulation (CPM) reported decreases in pain-related interference over follow-up (b=-0.858, SE=0.396, P=0.032), those with weaker CPM exhibited high, relatively stable levels of pain-related interference over time (b=-0.642, SE=0.400, P=0.110). CPM status predicted changes in pain-related interference after controlling for the effects of treatment condition and psychosocial risk factors. Static measures of pain sensitivity (ie, pain threshold, pain tolerance) and temporal summation of second pain were not associated with changes in measures of abdominal pain, gastrointestinal symptom severity, or pain-related interference over follow-up.

Discussion: The present findings contribute to a growing literature on the predictive utility of quantitative sensory testing indices and suggest that CPM may complement existing psychosocial risk measures in determining individualized pain-related risk profiles.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
CONSORT chart.
Figure 2.
Figure 2.
Multilevel model of the association between CPM and pain interference in youth with FAP over follow-up. *p < .05.
See this image and copyright information in PMC

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References

    1. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A and Walker LS. Childhood functional gastrointestinal disorders: Child/adolescent. Gastroenterology 2006;130:1527–1537. - PMC - PubMed
    1. Korterink JJ, Diederen K, Benninga MA and Tabbers MM. Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis. PloS one 2015. - PMC - PubMed
    1. Shelby GD, Shirkey KC, Sherman AL, Beck JE, Haman K, Shears AR, Horst SN, Smith CA, Garber J and Walker LS. Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders. Pediatrics 2013;132:475–482. - PMC - PubMed
    1. Gieteling MJ, Bierma-Zeinstra SM, Passchier J and Berger MY. Prognosis of chronic or recurrent abdominal pain in children. Journal of pediatric gastroenterology and nutrition 2008;47:316–326. - PubMed
    1. Walker LS, Sherman AL, Bruehl S, Garber J and Smith CA. Functional abdominal pain patient subtypes in childhood predict functional gastrointestinal disorders with chronic pain and psychiatric comorbidities in adolescence and adulthood. Pain 2012;153:1798–1806. - PMC - PubMed

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