The goal of this observational study is to learn about spatial and temporal nociceptive filtering in adolescents with chronic overlapping pain conditions (COPCs). The main questions it aims to answer are:
1. If spatial and temporal filtering of nociceptive information is disrupted in youth with COPCs compared with youth with localized pain conditions and healthy controls. 2. If disrupted nociceptive processing at baseline is associated with the transition from a single localized pain condition to COPCs in youth.
Participation includes:
* quantitative sensory testing * blood draw * sleep assessment * questionnaires
General Criteria
Access to the internet either by laptop, tablet, or phone (for REDCap Surveys)
English-speaking
Parent or guardian willing to comply with protocol, complete study assessments, and provide written informed consent
General Criteria
Skin conditions (e.g., eczema) or past skin damage on the arms and legs in or near sites of sensory testing
Any comorbid rheumatic disease (e.g., arthritis, lupus), neurological (e.g., epilepsy, traumatic brain injury) or medical condition (e.g., cancer, diabetes)
Control Specific Criteria
Adolescents with localized and overlapping pain conditions
Case-control
Prospective
Conditioned Pain Modulation
Other interventionConditioned pain modulation (CPM) procedure evaluates the change in mechanical and heat pain sensitivity by a contralateral conditioning stimulus (cold immersion). This psychophysical paradigm investigates inhibitory pain modulation processes.
Offset Analgesia
Other interventionOffset analgesia (OFA) procedure evaluates the disproportionate change in heat pain sensitivity after a slight decrease in stimulus intensity. This psychophysical paradigm investigates inhibitory pain modulation processes.
Spatial Summation
Other interventionSpatial summation (SS) procedure evaluates the change in heat pain sensitivity when applying two painful stimuli simultaneously compared to one stimulus alone. This psychophysical paradigm investigates facilitatory pain modulation processes.
Temporal Summation
Other interventionTemporal summation (TS) procedure evaluates the change in mechanical pain sensitivity after exposure to a series of noxious stimuli of the same intensity. This psychophysical paradigm investigates facilitatory pain modulation processes.
Conditioned Pain Modulation (CPM) Profile (Pressure)
-CPM is defined by the change in pressure thresholds (increase) before and during cold immersion. Pressure thresholds will be measured using an algometer.
Conditioned Pain Modulation (CPM) Profile (Heat)
-CPM is defined by the change in heat pain intensity (decrease) before and during cold immersion. Heat stimuli will be delivered by a thermode and pain intensity measured by participant self report on the visual analog scale.
Offset Analgesia (OA) Profile
OFA is defined by the change in heat pain intensity (decrease) after a slight reduction in stimulus intensity (1 Deg C). Heat stimuli will be delivered by a thermode and pain intensity measured continuously during stimuli by participant self report on the computerized visual analog scale.
Temporal Summation (TS) Profile
TS is defined by the change in mechanical pain intensity (increase) after exposure to a series of pinprick stimuli. Pain intensity will be measured by participant self report on the visual analog scale.
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