TY - JOUR
T1 - Sensory sensitivity and symptom severity represent unique dimensions of chronic pain
T2 - A MAPP Research Network study
AU - Schrepf, Andrew
AU - Williams, David A.
AU - Gallop, Robert
AU - Naliboff, Bruce D.
AU - Basu, Neil
AU - Kaplan, Chelsea
AU - Harper, Daniel E.
AU - Richard Landis, J.
AU - Quentin Clemens, J.
AU - Strachan, Eric
AU - Griffith, James W.
AU - Afari, Niloofar
AU - Hassett, Afton
AU - Pontari, Michel A.
AU - Clauw, Daniel J.
AU - Harte, Steven E.
N1 - Funding Information:
Funding for the MAPP Research Network was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) (DK82370, DK82342, DK82315, DK82344, DK82325, DK82345, DK82333, and DK82316). Additional support for author A. Schrepf came from Grant Number K12 DE023574 from the National Institute of Dental and Craniofacial Research.
Funding Information:
A. Schrepf reports grants from NIH, during the conduct of the study. D.A. Williams has nothing to disclose. R. Gallop has nothing to disclose. B. Naliboff has nothing to disclose. N. Basu has nothing to disclose. C. Kaplan has nothing to disclose. D.E. Harper has nothing to disclose. R. Landis has nothing to disclose. J.Q. Clemens reports grants from NIDDK, during the conduct of the study. E. Strachan has nothing to disclose. J.W. Griffith has nothing to disclose. N. Afari reports grants from NIH/NIDDK, during the conduct of the study. A. Hassett reports personal fees from AbbVie Pharmaceuticals, outside the submitted work. M.A. Pontari reports grants from NIH, during the conduct of the study; grants and personal fees from Aquinox Pharmaceuticals, outside the submitted work. D.J. Clauw reports personal fees from Abbott Pharmaceutical, grants and personal fees from Aptinyx, personal fees from Astellas Pharmaceutical, grants and personal fees from Cerephex, personal fees from Daiichi Sankyo, grants and personal fees from Pfizer, Inc, personal fees from Pierre Fabre, personal fees from Samumed, personal fees from Theravance, personal fees from Tonix, personal fees from Williams & Connolly LLP, and personal fees from Zynerba, outside the submitted work. S.E. Harte reports grants from NIH during the conduct of the study; grants from NIH, VA, Cerephex, Eli Lilly, American Cancer Society, AAOGF; grants and personal fees from Aptinyx; personal fees from SUFU, Longitudinal Capital Management; personal fees and nonfinancial support from University of North Carolina, Chapel Hill; and an affiliation with Arbor Medical Innovations, outside the submitted work. In addition, S.E. Harte has a patent US 9307906 with royalties paid outside the submitted work.
PY - 2018
Y1 - 2018
N2 - Chronic overlapping pain conditions (COPCs) are characterized by aberrant central nervous system processing of pain. This "centralized pain" phenotype has been described using a large and diverse set of symptom domains, including the spatial distribution of pain, pain intensity, fatigue, mood imbalances, cognitive dysfunction, altered somatic sensations, and hypersensitivity to external stimuli. Here, we used 3 cohorts, including patients with urologic chronic pelvic pain syndrome, a mixed pain cohort with other COPCs, and healthy individuals (total n 5 1039) from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network to explore the factor structure of symptoms of centralized pain. Using exploratory and confirmatory factor analysis, we identified 2 general factors in all 3 cohorts, one characterized by a broad increased sensitivity to internal somatic sensations,environmental stimuli, and diffuse pain, termed Generalized Sensory Sensitivity, and one characterized by constitutional symptoms-Sleep, Pain, Affect, Cognition, Energy (SPACE). Longitudinal analyses in the urologic chronic pelvic pain syndrome cohort found the same 2-factor structure at month 6 and 1 year, suggesting that the 2-factor structure is reproducible over time. In secondary analyses, we found that Generalized Sensory Sensitivity particularly is associated with the presence of comorbid COPCs, whereas SPACE shows modest associations with measures of disability and urinary symptoms. These factors may represent an important and distinct continuum of symptoms that are indicative of the centralized pain phenotype at high levels. Future research of COPCs should accommodate the measurement of each factor.
AB - Chronic overlapping pain conditions (COPCs) are characterized by aberrant central nervous system processing of pain. This "centralized pain" phenotype has been described using a large and diverse set of symptom domains, including the spatial distribution of pain, pain intensity, fatigue, mood imbalances, cognitive dysfunction, altered somatic sensations, and hypersensitivity to external stimuli. Here, we used 3 cohorts, including patients with urologic chronic pelvic pain syndrome, a mixed pain cohort with other COPCs, and healthy individuals (total n 5 1039) from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network to explore the factor structure of symptoms of centralized pain. Using exploratory and confirmatory factor analysis, we identified 2 general factors in all 3 cohorts, one characterized by a broad increased sensitivity to internal somatic sensations,environmental stimuli, and diffuse pain, termed Generalized Sensory Sensitivity, and one characterized by constitutional symptoms-Sleep, Pain, Affect, Cognition, Energy (SPACE). Longitudinal analyses in the urologic chronic pelvic pain syndrome cohort found the same 2-factor structure at month 6 and 1 year, suggesting that the 2-factor structure is reproducible over time. In secondary analyses, we found that Generalized Sensory Sensitivity particularly is associated with the presence of comorbid COPCs, whereas SPACE shows modest associations with measures of disability and urinary symptoms. These factors may represent an important and distinct continuum of symptoms that are indicative of the centralized pain phenotype at high levels. Future research of COPCs should accommodate the measurement of each factor.
KW - Central nervous system sensitization
KW - Factor analysis
KW - Fibromyalgia
KW - Interoception
KW - Interstitial cystitis/painful bladder syndrome
KW - statistical
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UR - http://www.scopus.com/inward/citedby.url?scp=85049004162&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000001299
DO - 10.1097/j.pain.0000000000001299
M3 - Article
C2 - 29863527
AN - SCOPUS:85049004162
VL - 159
SP - 2002
EP - 2011
JO - Pain
JF - Pain
SN - 0304-3959
IS - 10
ER -