Study comparing pain intensity and discomfort in patients with Parkinson´s disease and healthy controls during inducement of mechanical, thermal, and chemical experimental pain
Project: Inducing experimental muscle pain in healthy volunteers, patients with Parkinson's disease in levodopa treatment, and patients with Parkinson's disease with deep brain stimulation treatment Research team: * Andrea S. Poulsen (PI), PhD-student, AU * Sophie Rosenkjær, PhD-student, AU * Lene Vase, Professor, AU * Nanna B. Finnerup, Professor, AUH * Mette Møller, Leading doctor, AUH * Erisela Qerama Montvilas, Clinical lector, AUH * Jan Rosner, Post-doc, AUH Objective: Comparing induced pain levels in (1) healthy volunteers, (2) patients with Parkinson's disease in levodopa treatment, and (3) patients with Parkinson's disease with deep brain stimulation treatment Participants: 21 healthy volunteers, 21 patients with Parkinson's disease in levodopa treatment, and 21 patients with Parkinson's disease with deep brain stimulation treatment will be recruited from the Department of Neurology at Aarhus University Hospital. Furthermore, recruitment sheets will be posted at Aarhus University Hospital, at Parkinsonforeningen's webpage (https://www.parkinson.dk/) and newsletter and in local newspapers. A power calculation for a Wilcoxcon-Mann-Whitney rank sum test (Three groups) determine 21 in three test groups is adequate (effect size= 0.8; 1-β=.80; α=.05). Design:Between-subject randomized study where each participant will complete a ≈1 ½ hour test session at the Department of Neurophysiology, Aarhus University Hospital, Denmark. Each test session will include assessment of ongoing pain, experimental pain (thermal, mechanical, and chemical), and motor response latencies. Procedure: Each test session proceeds as follow: First, participant is greeted in the entry hall at AUH and escorted to the examination room. Investigator goes through test procedures and introduce to assessments. Participant complete measures of ongoing pain followed by assessment of motor response latencies. Then, assessments of thermal heat detection, pain thresholds and pain-autonomic interactions on volar forearm. Next, sites of inducement of mechanical and chemical pain (randomized gluteus medius muscle, tibialis anterior muscle, and infraspinatus muscle) will be identified by use of manual palpation and defined by distinct anatomical landmarks marked with a pen. For each site: assessment of mechanical pain threshold followed by evaluation of intensity and discomfort during pain suprathreshold. Then, inducement of chemical pain by use of hypertonic saline injections. Immediately after injection, evaluation of pain intensity and discomfort followed by assessment of sensory and affective verbal descriptions of pain and patient drawings of pain size and distribution. Finally, measures of pain intensity and discomfort during mechanical suprathreshold pressure on site of injection. There will be a 15 minutes interval between inducement of experimental pain in the three sites for the pain to cease. Investigator escorts participant to the entry hall and thank participant for taking part in the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
63
Inducement of experimental pain
aarhus university Hospital
Aarhus, Denmark
RECRUITINGThermal induced heat pain
Thermal heat detection and pain thresholds will be measured following the standardized "Quantitative Sensory Testing" protocol
Time frame: Immediately after assessment of ongoing pain (15 minutes)
Mechanical induced pain
Mechanical pain thresholds and suprathresholds will be measured by use of a handhold pressor algometer (Somedic, Hörby, Sweden) with a 1-cm2 probe placed on test muscle (gluteus medius muscle, tibialis anterior muscle, and infraspinatus muscle in a randomized order)
Time frame: Immediately after assessment of thermal induced heat pain (15 minutes)
Chemical induced pain
Chemical pain will be induced by an injection of hypertonic saline (HS, 5,8% in 1 ml)
Time frame: Immediately after assessment of mechanical pain (15 minutes)
Ongoing pain (Clinical pain in daily life)
Intensity and discomfort of ongoing pain in gluteus medius muscle, tibialis anterior muscle, and infraspinatus muscle will be assessed by use of 11- point Numeric Rating Scale (NRS)
Time frame: After assessment of motor response latencies measure (15 minutes)
Ongoing pain (Sensory and affective verbal descriptions of pain and patient drawings)
Sensory and affective verbal descriptions of pain and patient drawings of pain size and distribution will be measured by use of the short-form McGill Pain Questionnaire (SF-MPQ).
Time frame: After assessment of motor response latencies measures (15 minutes)
Ongoing pain (Pain in PD)
Pain in PD will be assessed by King´s Parkinson´s disease pain scale (KPPS)
Time frame: After assessment of motor response latencies measures (15 minutes)
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Motor response latencies measure
To control for bias due to reaction time in measures which include participant stop buttons, motor response latencies will be assessed by use of a response box
Time frame: Prior to assessment of ongoing pain (3 minutes)