Clinical trial NCT05161832: Impact of Kinesiophobia on Descending Corticospinal and Bulbospinal Projections
Official title: Impact of Kinesiophobia on Descending Corticospinal and Bulbospinal Projections During Experimental Pain : A Randomised Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Kinesiophobia
Keywords: kinesiophobia
experimental pain
corticospinal excitability
conditioned pain modulation
input output curves
Lead sponsor: Université de Sherbrooke
Sponsor class: OTHER
First posted: 2021-12-17
Enrollment: 24
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
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.
Primary purpose: BASIC_SCIENCE

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.

Eligibility criteria: 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

Primary outcomes:
measure: Corticospinal excitability
timeFrame: 1 hour
Secondary outcomes:
measure: downward inhibition of pain
timeFrame: 1 hour
Other outcomes:
Locations:
city: Sherbrooke
country: Canada
facility: Centre de Recherche sur le Vieillissement
state: Quebec
Study officials:
affiliation: Université de Sherbrooke
name: Guillaume Leonard, Pr
role: STUDY_DIRECTOR
References: