Impact of Kinesiophobia on Descending Corticospinal and Bulbospinal Projections

Kinesiophobia Clinical Trial

— EchoKinésio  

Official title:

Impact of Kinesiophobia on Descending Corticospinal and Bulbospinal Projections During Experimental Pain : A Randomised Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05161832
• Other study ID #: 2022-4356
• Status: Completed
• Phase: N/A
• Start date: January 15, 2022
• Est. completion date: January 29, 2024

Study information

• Verified date: June 2024
• Source: Université de Sherbrooke
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 24
• Est. completion date: January 29, 2024
• Est. primary completion date: July 29, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Kinesiophobia

Intervention

Behavioral:
• Nocebo
Nocebo ultrasound with diagnosis of a fake shoulder cuff injury.
• Placebo
Placebo ultrasound with no diagnosis of injury.

Locations

Country	Name	City	State
Canada	Centre de Recherche sur le Vieillissement	Sherbrooke	Quebec

Sponsors (1)

Lead Sponsor	Collaborator
Université de Sherbrooke

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Corticospinal excitability	The corticospinal excitability will be assessed using motor evoked potentials at different intensity of stimulation (from motor threshold to maximal amplitude response).	1 hour
Secondary	downward inhibition of pain	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).	1 hour