Kinesiophobia
Conditions
Keywords
kinesiophobia, experimental pain, corticospinal excitability, conditioned pain modulation, input output curves
Brief summary
Fear of movement (kinesiophobia) is a phenomenon commonly observed in people suffering from chronic pain. The aims of this project are to better understand the neurophysiological basis of this phenomenon, in particular 1) the effect of kinesiophobia (induced by nocebo intervention) on the excitability of corticospinal projections and 2) the association between kinesiophobia and top-down inhibitory mechanisms.
Detailed description
The study will include 44 healthy (pain-free) participants. Corticospinal measurements will be taken before and after the application of capsaicin cream (experimental pain paradigm). The investigators will manipulate kinesiophobia levels (assessed using the Tampa Kinesiophobia Scale) upward by pretending to diagnose a musculoskeletal problem in half of the participants (nocebo ultrasound), and will measure the efficacy of top-down inhibitory mechanisms using a counter-irritation paradigm (thermode and cold pressor test : the subjects will be subjected to 5 thermal stimulations, 7 mechanical stimulations and 1 water bath at 10°C of the hand) and corticospinal parameters using transcranial magnetic stimulation. Together, these results will allow a better understanding of the mechanisms associated with a predictor of pain onset (such as kinesiophobia), by studying its interactions with endogenous pain inhibition systems and the motor system, in order to develop relevant prophylactic treatments.
Interventions
BEHAVIORALNocebo
Nocebo ultrasound with diagnosis of a fake shoulder cuff injury.
BEHAVIORALPlacebo
Placebo ultrasound with no diagnosis of injury.
Sponsors
Université de Sherbrooke
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
DOUBLE (Subject, Investigator)
Masking description
The principal investigators will be blinded by anonymization of the subjects and will not be present during the ultrasound. Participants will be notified of their group allocation at the end of their experimental session (after the experiment).
Intervention model description
Participants will attend two experimental sessions at the Research Center on Aging of the Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie, Sherbrooke. During the first one, the efficacy of their excitatory and inhibitory mechanisms will be assessed (thermode and cold water bath) and during the second one, their corticospinal excitability will be assessed by transcranial magnetic stimulation (before and during induced pain + placebo or nocebo echography of shoulder). Subjects will be randomized between 2 arms, nocebo (bad fake result) or placebo echography (good fake result). Participants will be allocated using minimization with 2 factors (age and sex). The two sessions will be separated by at least 48 hours.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Aged 18 years old or older * Healthy Volunteers * Capable of understanding instructions * Abstain from tobacco and caffeine 2 hours before data collection * Abstain from short-acting analgesics 6 hours before data collection
Exclusion criteria
* A painful condition or chronic pain * Neurological disorders * Shoulder pathology * Skin diseases * Capsaicin allergy * Raynaud's syndrome * Epilepsy * Intracranial metallic foreign bodies, hearing aids and cochlear implants
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Corticospinal excitability | 1 hour | The corticospinal excitability will be assessed using motor evoked potentials at different intensity of stimulation (from motor threshold to maximal amplitude response). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| downward inhibition of pain | 1 hour | Inhibitory mechanisms will be assessed by comparing pain levels (measured using a computerized visual analog scale \[0 = no pain; 10 = worst pain imaginable\]) evoked by a test stimulus before and after a conditioning stimulus. Pain levels evoked by the test stimulus before the conditioning stimulus will be subtracted from pain levels evoked by the test stimulus after the pain stimulus, such that a positive score represents increased pain (hyperalgesia) and a negative score represents decreased pain (hypoalgesia, i.e., inhibitory mechanisms). |
Countries
Canada
Outcome results
None listed