State vs. Trait Alterations in Low Back Pain

NCT ID: NCT06412484

Last Updated: 2024-05-14

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

RECRUITING

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-10-01

Study Completion Date

2027-12-31

Brief Summary

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The primary goal of this study is to investigate whether different alterations observed in patients with non-specific episodic low back pain (compared to healthy volunteers), detected using several assessments: psychophysical and neurophysiological testing, imaging, and blood sampling, are dependent or independent of the presence and type of pain experienced at the time of investigation.

Detailed Description

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The study consists of three visits (healthy volunteers will only have one pain-free visit), in which patients will be tested in a different "pain state" at each visit:

1. Pain-free visit: will be carried out when the patients have no or little (Numerical Pain Rating Scale (NPRS) \</= 2/10) clinical pain.
2. Clinically relevant Low Back Pain visit: will be carried out with patients experiencing a low back pain episode with an intensity of 3/10 or more on the NPRS.
3. Experimental pain / Clinically irrelevant pain visit: will be carried out with the application of a high concentration (8%) Qutenza® capsaicin patch at the arm.

Each of the visits will consist of psychophysical testing, neurophysiological assessement of sweat activity in response to pain, brain resting state magnetic resonance imaging and magnetic resonance spectroscopy. Additionally, and depending on the type of session, a lumbar spine magnetic resonance image (only pain-free session, as characterization) and a blood sample (only pain free and low back pain visit) will be performed.

Conditions

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Low Back Pain

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Low Back Pain (LBP) Patients

LBP patients will undergo three study visits, at moments at which their pain status is different: a) "pain-free", b) low back pain (clinically relevant), c) experimental pain (clinically irrelevant). Measures will be repeated in each visit, to understand the influence / relationship of pain state on possible mechanistic alterations observed in LBP compared to HCs.

Pain Free Session

Intervention Type BEHAVIORAL

On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail): clinical exam, QST, SSRs, CPM, rsMRI, lumbar MRI, MRS, and blood sample.

Low Back Pain Session (= clinically relevant pain)

Intervention Type BEHAVIORAL

On a day in which patients have an ongoing typical low back pain episode of an intensity of 3 or more (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail), except the lumbar MRI: clinical exam, QST, SSRs, CPM, rsMRI, MRS, and blood sample.

Experimental Pain Session (= clinically irrelevant pain)

Intervention Type BEHAVIORAL

On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), an experimental pain state will be induced using a high concentration (8%) Qutenza patch, containing capsaicin. All the study measures will be performed (see primary outcome measures for detail), except the lumbar MRI and blood sample: clinical exam, QST, SSRs, CPM, rsMRI, MRS.

Healthy Controls (HCs)

HCs will undergo one single visit, equivalent to patients' "pain-free" visit.

Pain Free Session

Intervention Type BEHAVIORAL

On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail): clinical exam, QST, SSRs, CPM, rsMRI, lumbar MRI, MRS, and blood sample.

Interventions

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Pain Free Session

On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail): clinical exam, QST, SSRs, CPM, rsMRI, lumbar MRI, MRS, and blood sample.

Intervention Type BEHAVIORAL

Low Back Pain Session (= clinically relevant pain)

On a day in which patients have an ongoing typical low back pain episode of an intensity of 3 or more (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail), except the lumbar MRI: clinical exam, QST, SSRs, CPM, rsMRI, MRS, and blood sample.

Intervention Type BEHAVIORAL

Experimental Pain Session (= clinically irrelevant pain)

On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), an experimental pain state will be induced using a high concentration (8%) Qutenza patch, containing capsaicin. All the study measures will be performed (see primary outcome measures for detail), except the lumbar MRI and blood sample: clinical exam, QST, SSRs, CPM, rsMRI, MRS.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* German or English proficiency
* Informed consent
* Low back pain for more than 3 months
* Low back pain clinically not attributable to "red flags" (e.g. infection, fractures, inflammation)
* Fluctuating course of pain (with on and off pain periods).

Exclusion Criteria

* Inability to give informed consent / follow study instructions (e.g. due to language problems)
* Major medical or psychiatric condition. E.g. severe heart disease, diabetes, autoimmune disorders, rheumatic disorders, major depressive disorder, etc.
* Symptomatic radiculopathy, manifested through motor and/or sensory deficits / or signs of nerve root involvement on lumbar MRI.
* Back operation
* BMI \> 30
* Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Schweinhardt Petra

OTHER

Sponsor Role lead

Responsible Party

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Schweinhardt Petra

Prof. Dr. Med. PhD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Petra Schweinhardt

Role: PRINCIPAL_INVESTIGATOR

University of Zurich

Locations

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Balgrist Campus

Zurich, , Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Petra Schweinhardt

Role: CONTACT

+41 44 386 57 24

Beatriz Chozas Barrientos

Role: CONTACT

+41 77 809 72 12

Facility Contacts

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Petra Schweinhardt, MD, PhD

Role: primary

+41445107381

Other Identifiers

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CRPP Renewal

Identifier Type: -

Identifier Source: org_study_id

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