Diffuse Noxious Inhibitory Controls (DNIC): Nociceptive Modulation and Interaction With Neurocognitive Performance in Chronic Pain

NCT ID: NCT01172795

Last Updated: 2010-07-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-07-31

Study Completion Date

2011-08-31

Brief Summary

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Diffuse noxious inhibitory control In order to quantify central sensitization in chronic pain patients, the Diffuse Noxious Inhibitory Control (DNIC) model has been used frequently. DNIC relies on painful conditioning stimulation of one part of the body to inhibit pain in another part, to remove the "noise" and to focus on relevant stimuli.

Earlier studies provided evidence for malfunctioning of DNIC in Fibromyalgia (FM) patients. However, the cause of this impairment is not yet elucidated, and further study is required to unravel the pathophysiology of DNIC in FM.

Hypothalamus-Pituitary-Adrenal (HPA) axis Besides neural mechanisms, also hormonal abnormalities could cause altered pain processing. Cortisol is released in answer to pain to suppress the pain. Given the evidence for hypofunction of the hypothalamic-pituitary-adrenal axis and the lower cortisol release in response to stressors in a proportion of FM patients and in chronic whiplash associated disorders (WAD) patients, the relation between pain and cortisol in these patients may be an interesting topic to consider.

Neurocognitive performance Besides chronic pain, people with chronic WAD and FM suffer from severe concentration difficulties and decreased neurocognitive capabilities (reduced reaction time, short term memory deficits etc. The decreased neurocognitive performance is known to be related to pain severity in various chronic pain populations. It is hypothesized that malfunctioning of descending inhibitory pathways and subsequent chronic pain experience precludes optimal neurocognitive performance.

Objectives The present investigation addresses the (patho)physiological mechanisms of DNIC in chronic pain populations.

1. Firstly, patients with FM, chronic WAD and healthy controls are compared regarding functioning of DNIC, cortisol levels and response and neurocognitive performance (case-control).
2. Secondly, the possible interaction between the functioning of DNIC, cortisol and neurocognitive performance is studied in patients with FM, WAD and healthy control subjects (cross-sectional).
3. Thirdly, to examine whether a fatiguing neurocognitive stressor changes DNIC and cortisol levels in patients with FM, chronic WAD or healthy sedentary control subjects.

Detailed Description

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Conditions

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Fibromyalgia Whiplash Chronic Pain

Keywords

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Whiplash associated disorder chronic pain neural inhibition neuropsychological tests

Study Design

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Observational Model Type

CASE_CROSSOVER

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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healthy controls

Relaxation session

Intervention Type BEHAVIORAL

30 minutes relaxation session (audiotape)

Neurocognitive test battery

Intervention Type BEHAVIORAL

the psychomotor vigilance task, span task and the stroop task on computer

chronic whiplash patients

Relaxation session

Intervention Type BEHAVIORAL

30 minutes relaxation session (audiotape)

Neurocognitive test battery

Intervention Type BEHAVIORAL

the psychomotor vigilance task, span task and the stroop task on computer

Fibromyalgia patients

Relaxation session

Intervention Type BEHAVIORAL

30 minutes relaxation session (audiotape)

Neurocognitive test battery

Intervention Type BEHAVIORAL

the psychomotor vigilance task, span task and the stroop task on computer

Interventions

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Relaxation session

30 minutes relaxation session (audiotape)

Intervention Type BEHAVIORAL

Neurocognitive test battery

the psychomotor vigilance task, span task and the stroop task on computer

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 30 FM group: comply with the diagnostic criteria for FM as defined by the American College of Rheumatology.
* 30 WAD group: comply with the criteria of the Quebec Task Force (grade I to III)
* 40 healthy pain-free control subjects
* Dutch speaking
* aged between 18 and 65 years.

Exclusion Criteria

* FM patients reporting a history of a whiplash trauma
* WAD patients fulfilling the diagnostic criteria for FM
* healthy control subjects cannot suffer any pain complaints
* cannot be pregnant or until 1 year postnatal
* asked to stop analgesics 48 hours prior to study participation, not to undertake physical exertion, and to refrain from consuming caffeine, alcohol or nicotine on the day of the experiment.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Research Foundation Flanders

OTHER

Sponsor Role collaborator

Vrije Universiteit Brussel

OTHER

Sponsor Role lead

Locations

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Vrije Universiteit Brussel

Brussels, Brussels Capital, Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Mira Meeus, PhD

Role: CONTACT

Phone: 0032 485 58 21 14

Email: [email protected]

Facility Contacts

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Mira Meeus, PhD

Role: primary

Other Identifiers

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B-Cognitive tests

Identifier Type: -

Identifier Source: org_study_id