A five-year $9 million grant was awarded to an international research collaborative group from the U.S. National Institutes of Health to address the surprising and complex challenge of chronic musculoskeletal pain in adolescents. The team includes an international team of investigators from the University of Toronto, the Hospital for Sick Children, Stanford University, and Cincinnati Children’s Hospital.
This group will work towards investigating a biological signature for chronic pain, supporting those who don’t benefit from standard pain therapies. This population has actually remained a relatively unstudied population.
The study will seek to uncover a not very well understood phenomenon. As much as 5% of adolescents—representing 3.5 million in America by itself, suffer from chronic musculoskeletal pain. Stemming from anything from injuries to juvenile fibromyalgia and Ehlers-Danlos Syndrome—a rare condition that impacts connective tissues in the body.
Jennifer Stinson, professor of University of Toronto’s Lawrence S. Bloomberg Faculty of Nursing and a nurse practitioner herself reports “This is the first pediatric study of this magnitude.” And co-investigator Robert Coghill of the Center for Understanding Pediatric Pain and professor of pediatrics at Cincinnati Children’s Hospital Medical Center reports, “Children’s chronic pain is really, really underappreciated in that the incidence of it is surprisingly high, but the awareness of it is surprisingly low.”
With up to 40% to 60% of this target population being considered “treatment resistant,” the researchers, by using brain imaging, quantitative sensory testing, immunology and psychology, the researchers hope to zero in on which adolescents will or won’t respond to treatments, and what underlying elements may be at play in those outcomes.
Phase one of the project will gather these types of data from 250 adolescents aged 14 to 18 who suffer from chronic musculoskeletal pain. The idea is to accumulate enough data based on a range of elements and domains to apply unbiased machine learning along side big data to predict if patients will respond to various treatments, reports Massieh Moayedi, assistant professor of University of Toronto’s Facility of Dentistry, a co-investigator who brings expertise in pain and brain imaging to the study. He hopes, “A multimodal biomarker will allow us to classify those who are high risk for pain persistence.”
Hopefully the team can pinpoint a chronic pain signature—a sort of biomarker—and commence to a second phase of the study which involves data from a second cohort of 125 adolescent recruits who will help validate the pain signature. Laura Simons, a psychologist and associate professor at Stanford University will head the study.
Laura Simons, Psychologist, Stanford University
Massieh Moayedi, assistant professor of University of Toronto’s Facility of Dentistry,
Robert Coghill of the Center for Understanding Pediatric Pain and professor of pediatrics at Cincinnati Children’s Hospital Medical Center
Jennifer Stinson, professor of University of Toronto’s Lawrence S. Bloomberg Faculty of Nursing