The Human Chronic Pain Phenome

Seltzer, Zeʼev; Diehl, Scott R.; Clarke, Hance; Katz, Joel

doi:10.1002/9781118398890.ch11

Cited by 3 publications

(2 citation statements)

References 116 publications

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“…He is also the lead investigator on a project with several of our collaborators to study the phenomics and genomics of chronic postsurgical pain. In one of our most ambitious studies of patients undergoing cardiothoracic surgeries, we have already collected 4,000 blood samples with a target of 10,000 (Clarke, Katz, et al, 2015; Seltzer, Diehl, Clarke, & Katz, 2014). In our psychophysiology lab, we assess patients before and after surgery using a variety of psychosocial and psychophysiological measures, including pressure algometry, heat and cold thresholds, the cold pressor task, thermal grill, and inspirational gasp.…”

Section: The Future Of Pain Psychology—trainee Researchmentioning

confidence: 99%

This won’t hurt a bit: Reflections on a career in chronic pain.

Katz

2017

Canadian Psychology / Psychologie canadienne

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This article is based on my address to the Canadian Psychological Association at the annual convention in Victoria, British Columbia, June 11, 2016 on the occasion of receiving the Donald O. Hebb Award for Distinguished Contributions to Psychology as a Science. In the article, I present a very brief introduction to the problem of chronic postsurgical pain, including a working definition, some basic epidemiology, and its course in children and adults. I then describe some of my early work in identifying the risk factors for chronic postsurgical pain using phantom limb pain memories as an example and go on to show how these tied into what was then the newly developing field of preemptive analgesia. Next, on the basis of 25 years of research, I outline an innovative Transitional Pain Service that we recently developed, which is a multidisciplinary program designed to transform the way pain is managed after surgery by proactively identifying and treating people at high risk of developing chronic postsurgical pain. I conclude the article with an overview of my lab’s present research and our future directions by highlighting some of my current and former graduate students, whose hard work and productivity have contributed in important ways to my own success, especially over the last 14 years since I joined the Psychology Department at York University.

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Section: The Future Of Pain Psychology—trainee Researchmentioning

confidence: 99%

This won’t hurt a bit: Reflections on a career in chronic pain.

Katz

2017

Canadian Psychology / Psychologie canadienne

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“…Genetic factors interacting with the environment have been proposed as well. 14,15,38,58 Presurgical psychosocial factors that may predict the occurrence of CPSP after cardiothoracic surgery include high levels of depression, 13,41 anxiety, 13 catastrophic thinking about pain, 13 and low levels of optimism. 33,56 Other studies have not found evidence for these effects 3,10,33,41 nor for posttraumatic stress disorder (PTSD).…”

Section: Introductionmentioning

confidence: 99%

Presurgical distress about bodily sensations predicts chronic postsurgical pain intensity and disability 6 months after cardiothoracic surgery

Aternali

Slepian

Clarke

et al. 2021

Pain

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Chronic postsurgical pain (CPSP) and disability after cardiothoracic surgery are highly prevalent and difficult to treat. Researchers have explored a variety of presurgical risk factors for CPSP and disability after cardiothoracic surgery, including one study that examined distress from bodily sensations. The current prospective, longitudinal study sought to extend previous research by investigating presurgical distress about bodily sensations as a risk factor for CPSP and disability after cardiothoracic surgery while controlling for several other potential psychosocial predictors. Participants included 543 adults undergoing nonemergency cardiac or thoracic surgery who were followed over 6 months postsurgically. Before surgery, participants completed demographic, clinical, and psychological questionnaires. Six months after surgery, participants reported the intensity of CPSP on a 0 to 10 numeric rating scale and pain disability, measured by the Pain Disability Index. Multinomial logistic regression analyses were conducted to evaluate the degree to which presurgical measures predicted pain outcomes 6 months after surgery. The results showed that CPSP intensity was significantly predicted by age and presurgical scores on the Symptom Checklist-90-Revised Somatization subscale (Nagelkerke R 2 5 0.27, P , 0.001), whereas chronic pain disability was only predicted by presurgical Symptom Checklist-90-Revised Somatization scores (Nagelkerke R 2 5 0.29, P , 0.001). These findings demonstrate that presurgical distress over bodily sensations predicts greater chronic pain intensity and disability 6 months after cardiothoracic surgery and suggest that presurgical treatment to diminish such distress may prevent or minimize CPSP intensity and disability.

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Genetics of chronic post-surgical pain: a crucial step toward personal pain medicine

Clarke

Katz

Flor

et al. 2014

Can J Anesth/J Can Anesth

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Purpose Most patients who undergo surgery or experience a traumatic injury suffer from acute pain that subsides once tissues heal. Nevertheless, the pain remains in 15-30% of patients, sometimes for life, and this chronic post-surgical pain (CPSP) can result in suffering, depression, anxiety, sleep disturbance, physical incapacitation, and an economic burden. The incorporation of genetic knowledge is expected to lead to the development of more effective means to prevent and manage CPSP using tools of personalized pain medicine. The purpose of this review article is to provide an update on the current state of CPSP genetics and its future potential.Principle findings The large variability in CPSP amongst patients undergoing similar surgery suggests that individual factors are significant contributors to CPSP, raising the possibility that CPSP is influenced by genetic determinants. Heritability estimates suggest that about half of the variance in CPSP levels is attributable to genetic variation. These estimates suggest that identifying the genetic underpinnings of CPSP may lead to significant improvements in treatment. Analyzing patients' DNA sequences, blood and salivary pain biomarkers, as well as their analgesic responses to medications will facilitate developing insights into CPSP pathophysiology and inform predictive algorithms to determine a patient's likelihood of developing CPSP even prior to surgery. These algorithms could facilitate effective treatment regimens that will protect against the transition to chronicity in traumatically injured patients or those scheduled for surgery and lead to better therapy for patients who have already developed CPSP.Author contributions Hance Clarke, Joel Katz, Herta Flor, Marcella Rietschel, and Scott Diehl are co-authors of the manuscript and are responsible for revising some of the manuscript. Ze'ev Seltzer is the lead author responsible for revising the manuscript.

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The Human Chronic Pain Phenome

Cited by 3 publications

References 116 publications

This won’t hurt a bit: Reflections on a career in chronic pain.

This won’t hurt a bit: Reflections on a career in chronic pain.

Presurgical distress about bodily sensations predicts chronic postsurgical pain intensity and disability 6 months after cardiothoracic surgery

Genetics of chronic post-surgical pain: a crucial step toward personal pain medicine

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