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Akin-Akinyosoye K, Sarmanova A, Fernandes GS, Frowd N, Swaithes L, Stocks J, Valdes A, McWilliams DF, Zhang W, Doherty M, Ferguson E, Walsh DA. Baseline self-report 'central mechanisms' trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort. Osteoarthritis Cartilage 2020; 28:173-181. [PMID: 31830591 DOI: 10.1016/j.joca.2019.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/13/2019] [Accepted: 11/18/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES We investigated whether baseline scores for a self-report trait linked to central mechanisms predict 1 year pain outcomes in the Knee Pain in the Community cohort. METHOD 1471 participants reported knee pain at baseline and responded to a 1-year follow-up questionnaire, of whom 204 underwent pressure pain detection thresholds (PPTs) and radiographic assessment at baseline. Logistic and linear regression models estimated the relative risks (RRs) and associations (β) between self-report traits, PPTs and pain outcomes. Discriminative performance for each predictor was compared using receiver-operator characteristics (ROC) curves. RESULTS Baseline Central Mechanisms trait scores predicted pain persistence (Relative Risk, RR = 2.10, P = 0.001) and persistent pain severity (β = 0.47, P < 0.001), even after adjustment for age, sex, BMI, radiographic scores and symptom duration. Baseline joint-line PPTs also associated with pain persistence (RR range = 0.65 to 0.68, P < 0.02), but only in univariate models. Lower baseline medial joint-line PPT was associated with persistent pain severity (β = -0.29, P = 0.013) in a fully adjusted model. The Central Mechanisms trait model showed good discrimination of pain persistence cases from resolved pain cases (Area Under the Curve, AUC = 0.70). The discrimination power of other predictors (PPTs (AUC range = 0.51 to 0.59), radiographic OA (AUC = 0.62), age, sex and BMI (AUC range = 0.51 to 0.64), improved significantly (P < 0.05) when the central mechanisms trait was included in each logistic regression model (AUC range = 0.69 to 0.74). CONCLUSION A simple summary self-report Central Mechanisms trait score may indicate a contribution of central mechanisms to poor knee pain prognosis.
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Affiliation(s)
- K Akin-Akinyosoye
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - A Sarmanova
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - G S Fernandes
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK; Centre for Sports, Exercise, and Osteoarthritis Versus Arthritis, UK.
| | - N Frowd
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - L Swaithes
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - J Stocks
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - A Valdes
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - D F McWilliams
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - W Zhang
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - M Doherty
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - E Ferguson
- Pain Centre Versus Arthritis, UK; School of Psychology, University of Nottingham, UK.
| | - D A Walsh
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
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