Explaining very early acute mild traumatic brain injury after motor vehicle collision pain variability: Additive value of pain sensitivity questionnaire

Pora Kuperman, Yelena Granovsky, Hany Bahouth, Shiri Fadel, Hen Ben Lulu, Noam Bosak, Chen Buxbaum, Elliot Sprecher, Shoshana Crystal, Michal Granot

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and Objectives: Chronic pain is a common postcollision consequence. Wherein, a clearer understanding of acute pain can help stem the acute-to-chronic pain transition. However, the variability of acute pain is only partially explained by psychophysical pain characteristics as measured by quantitative sensory testing. The Pain Sensitivity Questionnaire (PSQ) may reflect inherent psychocognitive representations of patient's sensitivity and thus may reveal less-explored pain dimensions. In the vein of the biopsychosocial approach, this study aimed to explore whether PSQ holds additive value in explaining head and neck pain reports in very early acute-stage mild traumatic brain injury (mTBI) after collision, above the use of psychophysical assessment. Methods: Study cohort (n 5 130) consisted of mTBI patients (age range 19-66, 57 F) after accident with area-of-injury pain of at least 20 on the day of testing (mean pain 58.4 6 21.6, range 20-100 Numerical Pain Scale) who underwent clinical, psychophysical, and pain-related psychological assessment within 72-hour after injury. Results: Pain Sensitivity Questionnaire scores were significantly correlated with acute clinical, psychophysical, and pain-related psychological measures. Regression model (R2 5 0.241, P, 0.001) showed that, together, age, sex, high PSQ, enhanced temporal summation, and less-efficient conditioned pain modulation explained head and neck pain variance. This model demonstrated that the strongest contribution to degree of postinjury pain was independently explained by PSQ (ß 5 0.32) and then pressure pain threshold-conditioned pain modulation (ß 5 20.25). Conclusion: Appraisal of cognitive daily-pain representations, by way of memory and imagination, provides an additional important dispositional facet to explain the variability in the acute mTBI postcollision clinical pain experience, above assessing nociceptive responsiveness to experimentally induced pain.

Original languageEnglish
Article numbere821
JournalPain Reports
Volume5
Issue number3
DOIs
StatePublished - 2020

Bibliographical note

Publisher Copyright:
Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0 (CC BY-ND) which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.

Keywords

  • Mild traumatic brain injury
  • Motor vehicle collision
  • Pain
  • Pain sensitivity questionnaire
  • Quantitative sensory testing

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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