Category: Biomedical Sciences
Distinguishing widespread (WSP) from non-widespread (nWSP) pain is challenging in patients with myofascial pain syndrome (MPS). Comparison of self-reports, biomarkers and operator determined measurements between these two groups may help distinguish them. This study compares self-reports of pain and physiological measures in patients presenting with/without WSP.
Eight patients of 38 (21%) had WSP, 36 were analyzable (2 were out of measurement range). WSP and nWSP had significantly different microanalytic profiles. Those with WSP showed mean IGF1 concentrations of 183.12 ng/ml (SD +/-44.83) compared with nWSP 140.54(SD+/-40.04) (Mann-Whitney: p-exact 0.006). The WSP group showed significant increases in DHEA of 2.38+/-mg/ml (SD+/-1.29)versus 1.33(SD+/-.77)in nWSP (p-exact 0.014), dopamine of 0.97(SD+/- 336) in nWSP cohort and1.53(SD+/-695) in WSP (p-exact 0.021). WSP cohort had a mean concentration of nor-epinephrine (NE) of 23.27(SD +/-7.29) while nWSP had 16.15(SD+/- 6.82)(p-exact 0.006).
Participants with WSP had a lower PPT threshold, higher BPI pain scores than nWSP (p=ns). QST ratings did not correlate with WSP.
Our findings distinguish patients with WSP from nWSP on the basis of micro-analytic profiles including NE, DHEA, dopamine and IGF1. A higher NE concentration suggests WSP is associated with pain facilitation. These findings offer promise for future applications of biomarker profiles the diagnostic workup of patients presenting with MPS. Future studies are needed to assess mechanisms contributing to the unique biomarker profiles characteristic for each condition.
Naomi Lynn Gerber– Director of Research, Department of Medicine, Inova Fairfax Hospital
Vy Phan– Post-Baccalaureate Research Fellow, NIH
Jay Shah– Senior Staff Physiatrist, Rehabilitation Medicine Dept/National Institutes of Health
Hannah Tandon– Medical student, University of Nebraska Medical Center
Secili DeStefano– Owner, Optimal Motion Physical Therapy
Matthew Bird– Graduate Research Assistant, George Mason University
Siddhartha Sikdar– Professor, George MAson University
John Srbely– Associate Professor, University of Guelph
Dinesh Kumbhare– Dr., University of Toronto
Katherine Mireles– Graduate student, George Mason University
Sasha Stoddard– graduate student, George Mason University
Aybike Birerdinc– Research Assistant Professor, George Mason University