Assessing Central Aspects of Pain (AsCent)
Research type
Research Study
Full title
Assessing Central Nervous System Contributions to Accelerate Musculoskeletal Pain Diagnosis and Treatment
IRAS ID
343021
Contact name
Stephanie Smith
Contact email
Sponsor organisation
University of Nottingham
Clinicaltrials.gov Identifier
1016807, Funders Reference Number
Duration of Study in the UK
2 years, 1 months, 31 days
Research summary
Background: Chronic pain is the primary symptom of musculoskeletal (MSK) conditions, rarely adequately explained by muscle and joint damage. Activity in the central nervous system (CNS; spinal cord, brain) pathways governs our response to pain. Clinically useful tools to diagnose, measure and reveal CNS pathway abnormalities are needed to improve clinical decisions and accelerate treatment development. Simpler pain sensitivity tests are being developed, which assess CNS contributions to pain, whilst questionnaires (e.g., Central Aspects of Pain (CAP)) evaluate CNS pain processing. These two dimensions should be better than either alone.
Objectives:
1. Assess the ease, ability, and performance of combining the CAP questionnaire and simple pain sensitivity assessment to identify CNS as the predominant contributor to chronic pain across MSK conditions.
2. Use the CAP questionnaire alone or with substitute CNS pathway measures, demographics, and clinical variables to indicate pain levels at 6 and 12 weeks.
3. Understand the relationship between CAP and simple pain sensitivity assessments with laboratory pain sensitivity assessments to inform current CNS activity contributing to pain.
4. Evaluate the associations between the CAP questionnaire and simple sensitivity assessment with patient-centred outcomes.
Experimental plan: 250 people with MSK pain (osteoarthritis, inflammatory arthritis, fibromyalgia, low back pain) will be recruited from existing research cohorts (consented to be contacted for future research), primary or secondary care. Participants will complete CAP and other patient-centred outcome questionnaires, and undergo laboratory and simplified pain sensitivity and clinical assessments. Interviews will evaluate the combined tool (questionnaire and simple pain sensitivity).
Impact: Understanding what we are treating and how well it responds to treatment is crucial for effective, timely, targeted treatment. This project will result in a clinical tool to identify CNS as a predominant contributor to pain, enabling proactive screening, early detection, and classification to improve outcomes for people with MSK pain.REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
24/YH/0162
Date of REC Opinion
1 Aug 2024
REC opinion
Favourable Opinion