Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2002-2011 |
| Number of pages | 10 |
| Journal | Pain |
| Volume | 159 |
| Issue number | 10 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- Central nervous system sensitization
- Factor analysis
- Fibromyalgia
- Interoception
- Interstitial cystitis/painful bladder syndrome
- statistical
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Anesthesiology and Pain Medicine
Cite this
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Sensory sensitivity and symptom severity represent unique dimensions of chronic pain : A MAPP Research Network study. / Schrepf, Andrew; Williams, David A.; Gallop, Robert; Naliboff, Bruce D.; Basu, Neil; Kaplan, Chelsea; Harper, Daniel E.; Richard Landis, J.; Quentin Clemens, J.; Strachan, Eric; Griffith, James W; Afari, Niloofar; Hassett, Afton; Pontari, Michel A.; Clauw, Daniel J.; Harte, Steven E.
In: Pain, Vol. 159, No. 10, 01.01.2018, p. 2002-2011.Research output: Contribution to journal › Article
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.
PY - 2018/1/1
Y1 - 2018/1/1
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
UR - http://www.scopus.com/inward/record.url?scp=85049004162&partnerID=8YFLogxK
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
VL - 159
SP - 2002
EP - 2011
JO - Pain
JF - Pain
SN - 0304-3959
IS - 10
ER -