Can we characterize A-P/IAP behavioural phenotypes in people with chronic pain?

Vaidhehi Veena Sanmugananthan; Joshua C Cheng; Kasey S Hemington; Anton Rogachov; Natalie Rae Osborne; Rachael L Bosma; Junseok Andrew Kim; Robert D Inman; Karen Deborah Davis

doi:10.3389/fpain.2023.1057659

Can we characterize A-P/IAP behavioural phenotypes in people with chronic pain?

Front Pain Res (Lausanne). 2023 Feb 15:4:1057659. doi: 10.3389/fpain.2023.1057659. eCollection 2023.

Authors

Vaidhehi Veena Sanmugananthan^{1

2}, Joshua C Cheng^{1

2}, Kasey S Hemington^{1

2}, Anton Rogachov^{1

2}, Natalie Rae Osborne^{1

2}, Rachael L Bosma^{1

2}, Junseok Andrew Kim^{1

2}, Robert D Inman^{1

3}, Karen Deborah Davis^{1

2

4}

Affiliations

¹ Division of Brain, Imaging and Behaviour, Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
² Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
³ Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁴ Department of Surgery, University of Toronto, Toronto, ON, Canada.

Abstract

Two behavioural phenotypes in healthy people have been delineated based on their intrinsic attention to pain (IAP) and whether their reaction times (RT) during a cognitively-demanding task are slower (P-type) or faster (A-type) during experimental pain. These behavioural phenotypes were not previously studied in chronic pain populations to avoid using experimental pain in a chronic pain context. Since pain rumination (PR) may serve as a supplement to IAP without needing noxious stimuli, we attempted to delineate A-P/IAP behavioural phenotypes in people with chronic pain and determined if PR can supplement IAP. Behavioural data acquired in 43 healthy controls (HCs) and 43 age-/sex-matched people with chronic pain associated with ankylosing spondylitis (AS) was retrospectively analyzed. A-P behavioural phenotypes were based on RT differences between pain and no-pain trials of a numeric interference task. IAP was quantified based on scores representing reported attention towards or mind-wandering away from experimental pain. PR was quantified using the pain catastrophizing scale, rumination subscale. The variability in RT was higher during no-pain trials in the AS group than HCs but was not significantly different in pain trials. There were no group differences in task RTs in no-pain and pain trials, IAP or PR scores. IAP and PR scores were marginally significantly positively correlated in the AS group. RT differences and variability were not significantly correlated with IAP or PR scores. Thus, we propose that experimental pain in the A-P/IAP protocols can confound testing in chronic pain populations, but that PR could be a supplement to IAP to quantify attention to pain.

Keywords: attention; behavioural phenotype; chronic pain; reaction time; rumination.

Grants and funding

This research was supported by the Mayday Fund, and by the Canadian Institute of Health Research (operating grant PJT-156409 to KD).