Sociocultural & Biobehavioral Influences on Pain Expression and Assessment

Launched by NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH) · Aug 22, 2017

Keywords

ClinConnect Summary

This clinical trial is exploring how social and cultural factors affect the way people experience and express pain. Researchers want to understand if these factors change how we interpret pain in ourselves and in others. The study is looking for healthy adults between the ages of 18 and 60 who are fluent in English and can give their consent to participate.

Participants will have one or two visits where they may undergo various tests that involve experiencing mild pain in a safe setting. This could include small electric shocks, cold water immersion, or heat applied to the skin. During these tests, researchers will monitor physical responses like heart rate and sweating, and they will record facial expressions. Participants will also watch videos or look at pictures of others experiencing pain and be asked to respond to what they see. It’s important to know that individuals with certain medical conditions or those currently on specific medications will not be eligible for the study. This trial aims to shed light on how our backgrounds influence our pain experiences, which could lead to better pain management strategies in the future.

Gender

ALL

Eligibility criteria

• * INCLUSION CRITERIA:
• All Sub-Studies:
• • Healthy
• • Between 18 and 60 years old
• • Fluent in English
• • Able to provide written informed consent
• EXCLUSION CRITERIA:
• All Sub-Studies:
• • Unable to comply with study procedures
• • Has a major-medical condition or medical history that in a clinician's assessment could affect ability to comply with study procedures, including neurological conditions (including stroke, blindness or deafness, or a history of brain damage)
• • Has a current mood disorder, anxiety disorder, or substance use disorder, or has a history of psychosis, hospitalization for a mental health condition, or recurrent psychiatric episodes.
• • NIH staff member who is a subordinate/relative/co-worker of any investigator on the protocol
• • Prior completion of a different sub-study within this protocol.
• • Is born outside of the states or territories of the United States of America
• • Does not currently reside in a state or territory of the United States of America
• Sub-study 1:
• • Has a major-medical condition or medical history that in a clinician's assessment could affect heat sensitivity or pain thresholds. This may include cardiovascular, autonomic, or neurological conditions or a chronic systemic disease (e.g., diabetes)
• • Has a medical condition that in a clinician's assessment might affect somatosensation (e.g., Raynaud's disease, peripheral neuropathy, or circulatory disorder)
• • Has a current chronic pain condition or has had chronic pain in the past (painful condition lasting more than six months)
• • Has a dermatological condition affecting the testing region, such as scars, burns, or recent tattoos that might influence cutaneous sensibility
• • Regular use of prescription medication that has a significant effect on pain or heat perception. Excluded medications include central-acting agents such as opiates (morphine, tramadol), antidepressants (amitriptyline, duloxetine, milnacipran), anticonvulsants (gabapentin, pregabalin), anxiolytics (barbituates, benzodiazepines), hypnotics (zolpidem, sodium oxybate), antipsychotics (valproate, lithium, olanzapine), antimigraine agents (sumatriptan, ergotamine), and muscle relaxants (cyclobenzaprine, carisoprodol). Use of analgesic medications, such as non-steroidal anti-inflammatories, salicylates, and acetaminophen, taken on an "as needed" basis is acceptable as long as the last dose was not taken was within 5 half-lives of testing.
• • Is left handed
• Sub-study 4, FMRI participants:
• • Has a current chronic pain condition or has had chronic pain in the past (painful condition lasting more than six months)
• • Is left-handed
• * Any FMRI contraindications, including:
• • Ferromagnetic metal in the cranial cavity or eye, e.g. aneurysm clip, implanted neural stimulator, cochlear implant, ocular foreign body.
• • Implanted cardiac pacemaker or auto-defibrillator.
• • Insulin pump.
• • Irremovable body piercing.
• • Pregnant women (based on urine test completed within 24 hours prior to scan).
• • Those with an abnormality on a structural MRI that has functional consequences based on clinician assessment.