Mahya Faghih1, Anna E Phillips2, Louise Kuhlmann3, Elham Afghani4, Asbjørn M Drewes3, Dhiraj Yadav2, Vikesh K Singh5, Søren S Olesen3. 1. Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland. 2. University of Pittsburgh School of Medicine, Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Pittsburgh, Pennsylvania. 3. Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 4. Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland; Pancreatitis Center, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland. 5. Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland; Pancreatitis Center, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland. Electronic address: vsingh1@jhmi.edu.
Abstract
BACKGROUND & AIMS: Quantitative sensory testing (QST) has been previously used to study pain in chronic pancreatitis (CP) but included methods that are not suitable for clinical purposes. The aims of this study were to determine if pancreatic QST (P-QST) can differentiate patients into distinct pain phenotypes and to determine the association of these with their clinical pain and psychiatric comorbidities. METHODS: A multicenter cross-sectional study was conducted where patients completed validated questionnaires assessing quality of life (QoL), depression and anxiety scores as well as clinical pain symptoms followed by P-QST which included a cold pressor test, repetitive pinprick stimuli and pressure stimulation of the upper abdominal (T10) and control dermatomes. P-QST categorized patients into pain phenotypes based on a previously established nomogram. QoL, clinical pain and psychiatric assessment scores were compared across these groups. RESULTS: A total of 179 patients were enrolled with a mean age of 54.1±13.6 years among whom 59% were males and 42% had an alcoholic etiology. P-QST showed no hyperalgesia in 91 (51%), segmental hyperalgesia in 50 (28%) and widespread hyperalgesia in 38 (21%) patients. Patients with widespread hyperalgesia had significantly higher pain intensity scores (P = .03) and rates of constant pain (P = .002) as well as decreased QoL (P < .001) and physical functioning (P =.03) in comparison with the other two pain phenotypes. In contrast, psychiatric comorbidities were similar across all groups. CONCLUSIONS: P-QST may serve as a novel unbiased pain assessment tool in CP as it categorizes patients into distinct pain phenotypes independent of their psychiatric comorbidities.
BACKGROUND & AIMS: Quantitative sensory testing (QST) has been previously used to study pain in chronic pancreatitis (CP) but included methods that are not suitable for clinical purposes. The aims of this study were to determine if pancreatic QST (P-QST) can differentiate patients into distinct pain phenotypes and to determine the association of these with their clinical pain and psychiatric comorbidities. METHODS: A multicenter cross-sectional study was conducted where patients completed validated questionnaires assessing quality of life (QoL), depression and anxiety scores as well as clinical pain symptoms followed by P-QST which included a cold pressor test, repetitive pinprick stimuli and pressure stimulation of the upper abdominal (T10) and control dermatomes. P-QST categorized patients into pain phenotypes based on a previously established nomogram. QoL, clinical pain and psychiatric assessment scores were compared across these groups. RESULTS: A total of 179 patients were enrolled with a mean age of 54.1±13.6 years among whom 59% were males and 42% had an alcoholic etiology. P-QST showed no hyperalgesia in 91 (51%), segmental hyperalgesia in 50 (28%) and widespread hyperalgesia in 38 (21%) patients. Patients with widespread hyperalgesia had significantly higher pain intensity scores (P = .03) and rates of constant pain (P = .002) as well as decreased QoL (P < .001) and physical functioning (P =.03) in comparison with the other two pain phenotypes. In contrast, psychiatric comorbidities were similar across all groups. CONCLUSIONS: P-QST may serve as a novel unbiased pain assessment tool in CP as it categorizes patients into distinct pain phenotypes independent of their psychiatric comorbidities.
Authors: Jens Brøndum Frøkjær; Søren Schou Olesen; Mikkel Gram; Yousef Yavarian; Stefan A W Bouwense; Oliver H G Wilder-Smith; Asbjørn Mohr Drewes Journal: Gut Date: 2011-05-24 Impact factor: 23.059
Authors: Samantha D Outcalt; Kurt Kroenke; Erin E Krebs; Neale R Chumbler; Jingwei Wu; Zhangsheng Yu; Matthew J Bair Journal: J Behav Med Date: 2015-03-19
Authors: Jan Pedersen; Chunwen Gao; Henrik Egekvist; Peter Bjerring; Lars Arendt-Nielsen; Hans Gregersen; Asbjørn Mohr Drewes Journal: Gastroenterology Date: 2003-05 Impact factor: 22.682
Authors: Laurie Keefer; Douglas A Drossman; Elspeth Guthrie; Magnus Simrén; Kirsten Tillisch; Kevin Olden; Peter J Whorwell Journal: Gastroenterology Date: 2016-02-19 Impact factor: 22.682
Authors: Furqan A Bhullar; Mahya Faghih; Venkata S Akshintala; Ahmed I Ahmed; Katie Lobner; Elham Afghani; Anna E Phillips; Phil A Hart; Mitchell L Ramsey; Benjamin L Bick; Louise Kuhlmann; Asbjørn M Drewes; Dhiraj Yadav; Søren S Olesen; Vikesh K Singh Journal: Pancreatology Date: 2021-11-18 Impact factor: 3.996
Authors: Dhiraj Yadav; Tonya M Palermo; Anna E Phillips; Melena D Bellin; Darwin L Conwell Journal: Curr Opin Gastroenterol Date: 2021-09-01 Impact factor: 2.741