Assessment of the Effects of Extensive Somatosensory Training on Pain Processing

Study Overview
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Brief Summary
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Persistent pain may lead to several alterations in the brain activity and sensory perception (i.e. pain). Around 80% of professional musicians experience prolonged episodes of musculoskeletal pain throughout their careers, a percentage that is four times higher than in the general population. With this background, the intended experiment aims at understanding the role of several biological factors associated to sensorimotor training that can lead to alteration of the brain activity and, consequently, pain processing.

Official Title
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Assessment of the Effects of Extensive Sensorimotor Training on Pain Processing

Conditions
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Musculoskeletal Pain

Intervention / Treatment
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* Drug: Nerve Growth Factor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy men and women Speak and understand English. General exclusion criteria are: Pregnancy Drug addiction defined as the use of cannabis, opioids or other drugs Previous neurologic or mental illnesses Presence of a history of trauma or neurologic entrapment syndromes to the arm regions. Lack of ability to cooperate Frequent computer gamer ( > 9 hours/week)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthy musicians<br>Men and women aged 18-60, who must be enrolled in a music conservatory performance program or be professionally active, and must speak and understand English. | Drug: Nerve Growth Factor<br>* Induction of experimental muscle soreness using intramuscular injections of Nerve Growth Factor.<br>|
| Healthy non-musicians<br>Men and women aged 18-60, must speak and understand English and not have any kind of musical training. | Drug: Nerve Growth Factor<br>* Induction of experimental muscle soreness using intramuscular injections of Nerve Growth Factor.<br>|
| Musicians with chronic pain<br>Men and women aged 18-60 with chronic and idiopathic musculoskeletal upper limb and/or neck pain lasting more than 6 months. They must be enrolled in a music conservatory performance program or be professionally active and must speak and understand English. | Drug: Nerve Growth Factor<br>* Induction of experimental muscle soreness using intramuscular injections of Nerve Growth Factor.<br>|
| Non-musicians with chronic pain<br>Men and women aged 18-60 with chronic and idiopathic musculoskeletal upper limb and/or neck pain lasting more than 6 months. They must not have any kind of musical training and must speak and understand English. | Drug: Nerve Growth Factor<br>* Induction of experimental muscle soreness using intramuscular injections of Nerve Growth Factor.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain rating | Pain on an 11-point numerical rating scale (0 = no pain, 10 = most intense pain imaginable) | Changes from baseline measured at day 3 and day 8 | 
| Cortical Sensory Evoked Potentials | Electrical stimulation will be elicited to record sensory evoked potentials using electroencephalography (EEG) | Changes from baseline measured at day 3 and day 8 | 
| Motor Evoked Potentials | Transcranial magnetic stimualtion will be used to evoke motor evoked potentials (MEPs) | Changes from baseline measured at day 3 and day 8 | 
| Brain connectivity | Continuous electroencephalography recording will be used to explore connectivity between brain areas | Changes from baseline measured at day 3 and day 8 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Questionnaires | Questionnaires about pain and muscle soreness (Pain catastrophization; State and Trait anxiety; Pain vigilance) | Changes from baseline measured at day 3 and day 8 | 
| Pressure pain thresholds | Pressure applied to the surface of the skin using a handheld algometer | Changes from baseline measured at day 3 and day 8 |