A prognostic risk score for development and spread of chronic pain.

Humans Chronic Pain / epidemiology Prognosis Chronic Disease Risk Factors Pain Management / methods

Journal

Nature medicine
ISSN: 1546-170X
Titre abrégé: Nat Med
Pays: United States
ID NLM: 9502015

Informations de publication

Date de publication:
07 2023
Historique:
received: 16 08 2022
accepted: 31 05 2023
medline: 21 7 2023
pubmed: 7 7 2023
entrez: 6 7 2023
Statut: ppublish

Résumé

Chronic pain is a complex condition influenced by a combination of biological, psychological and social factors. Using data from the UK Biobank (n = 493,211), we showed that pain spreads from proximal to distal sites and developed a biopsychosocial model that predicted the number of coexisting pain sites. This data-driven model was used to identify a risk score that classified various chronic pain conditions (area under the curve (AUC) 0.70-0.88) and pain-related medical conditions (AUC 0.67-0.86). In longitudinal analyses, the risk score predicted the development of widespread chronic pain, the spreading of chronic pain across body sites and high-impact pain about 9 years later (AUC 0.68-0.78). Key risk factors included sleeplessness, feeling 'fed-up', tiredness, stressful life events and a body mass index >30. A simplified version of this score, named the risk of pain spreading, obtained similar predictive performance based on six simple questions with binarized answers. The risk of pain spreading was then validated in the Northern Finland Birth Cohort (n = 5,525) and the PREVENT-AD cohort (n = 178), obtaining comparable predictive performance. Our findings show that chronic pain conditions can be predicted from a common set of biopsychosocial factors, which can aid in tailoring research protocols, optimizing patient randomization in clinical trials and improving pain management.

Identifiants

DOI: 10.1038/s41591-023-02430-4 PMID: 37414898 PMC: PMC10353938
pubmed: 37414898
doi: 10.1038/s41591-023-02430-4
pii: 10.1038/s41591-023-02430-4
pmc: PMC10353938
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1821-1831

Subventions

Organisme : NIDA NIH HHS
ID : U54 DA049110
Pays : United States

Investigateurs

John C S Breitner (JCS)
Julien Menes (J)
Judes Poirier (J)
Jennifer Tremblay-Mercier (J)

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2023. The Author(s).

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Auteurs

Christophe Tanguay-Sabourin (C)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada. christophe.tanguaysabourin@mcgill.ca.
Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. christophe.tanguaysabourin@mcgill.ca.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada. christophe.tanguaysabourin@mcgill.ca.
ORCID: 0000-0003-0426-8322

Matt Fillingim (M)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.

Gianluca V Guglietti (GV)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.

Azin Zare (A)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.
ORCID: 0000-0002-7476-9897

Marc Parisien (M)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.
ORCID: 0000-0003-2924-5960

Jax Norman (J)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.

Hilary Sweatman (H)

Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
ORCID: 0000-0003-1802-2702

Ronrick Da-Ano (R)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.

Eveliina Heikkala (E)

Research Unit of Population Health, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.

Jordi Perez (J)

Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Quebec, Canada.

Jaro Karppinen (J)

Research Unit of Population Health, University of Oulu, Oulu, Finland.
Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
Rehabilitation Services of Southern Karelia Social and Health Care District, Lappeenranta, Finland.

Sylvia Villeneuve (S)

Douglas Mental Health Institute Research Centre, McGill University, Montreal, Quebec, Canada.
McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.

Scott J Thompson (SJ)

Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA.

Marc O Martel (MO)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.

Mathieu Roy (M)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Department of Psychology, McGill University, Montreal, Quebec, Canada.

Luda Diatchenko (L)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.
ORCID: 0000-0002-1350-6727

Etienne Vachon-Presseau (E)

Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada. etienne.vachon-presseau@mcgill.ca.
Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada. etienne.vachon-presseau@mcgill.ca.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada. etienne.vachon-presseau@mcgill.ca.
ORCID: 0000-0002-8681-3154

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A prognostic risk score for development and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur chronique › A prognostic risk score for development and...
questionsmedicales.fr › Diagnostic › Pronostic › A prognostic risk score for development and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › A prognostic risk score for development and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › A prognostic risk score for development and...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Prise en charge de la maladie › Gestion de la douleur › A prognostic risk score for development and...