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
AU - Basu, Neil
AU - Kaplan, Chelsea
AU - Harper, Daniel E.
AU - Landis, J. Richard
AU - Clemens, J. Quentin
AU - Strachan, Eric
AU - Griffith, James W.
AU - Afari, Niloofar
AU - Hassett, Afton
AU - Pontari, Michael A.
AU - Clauw, Daniel J.
AU - Harte, Steven E.
PY - 2018/10/31
Y1 - 2018/10/31
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 three cohorts, including patients with Urologic Chronic Pelvic Pain Syndrome (UCPPS), a mixed pain cohort with other COPCs, and healthy individuals (total n = 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 two general factors in all three cohorts, one characterized by a broad increased sensitivity to internal somatic sensations and environmental stimuli, and diffuse pain, termed Generalized Sensory Sensitivity (GSS), and one characterized by constitutional symptoms – Sleep, Pain, Affect, Cognition, Energy (SPACE). Longitudinal analyses in the UCPPS cohort found the same two factor structure at month six and one year, suggesting that the two factor structure is reproducible over time. In secondary analyses we found that GSS particularly is associated with the presence of comorbid COPCs, while SPACE shows modest associations with measures of disability and urinary symptoms. These factors may represent 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 three cohorts, including patients with Urologic Chronic Pelvic Pain Syndrome (UCPPS), a mixed pain cohort with other COPCs, and healthy individuals (total n = 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 two general factors in all three cohorts, one characterized by a broad increased sensitivity to internal somatic sensations and environmental stimuli, and diffuse pain, termed Generalized Sensory Sensitivity (GSS), and one characterized by constitutional symptoms – Sleep, Pain, Affect, Cognition, Energy (SPACE). Longitudinal analyses in the UCPPS cohort found the same two factor structure at month six and one year, suggesting that the two factor structure is reproducible over time. In secondary analyses we found that GSS particularly is associated with the presence of comorbid COPCs, while SPACE shows modest associations with measures of disability and urinary symptoms. These factors may represent 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.
U2 - 10.1097/j.pain.0000000000001299
DO - 10.1097/j.pain.0000000000001299
M3 - Article
SN - 0304-3959
VL - 159
SP - 2002
EP - 2011
JO - Pain
JF - Pain
IS - 10
ER -