Pain Processing Mechanisms in Patients With Juvenile Arthritis
Washington University School of Medicine
Summary
Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disease in children. The main symptoms of JIA, which are often the primary focus of treatment, include joint swelling, stiffness, and tenderness. Additional symptoms can include malaise, fatigue, and pain. However, the exact mechanisms contributing to pain are not yet fully understood. Participants will complete a 2.5-hours study session. In the study session, psychophysical assessments of thermal and pressure stimuli will be performed. In addition, demographic, social, pubertal maturation, and behavioral and psychological factors will be collected via questionnaires. A saliva sample and/or blood draw may occur for the analysis of various immune factors and sex hormones. If a joint aspiration is done as part of their standard of care, we will request a sample of the synovial fluid for analyses of immune, hormonal and/or genetic factors. Participants will have the option to participate in additional optional follow-up study visits (every 3 months, up to 1 year) and to complete monthly surveys asking about their juvenile arthritis.
Eligibility
- Age range
- 9–17 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: 1. Age between 9-17 2. Males and females 3. English speakers 4. Able to complete surveys and understand study instructions 5. Juvenile arthritis group: diagnosed or suspected of juvenile arthritis 6. Control group: healthy Exclusion Criteria: 1. Pregnancy or breastfeeding 2. (Control Group) Diagnosed with a chronic pain condition 3. (Control Group) Diagnosed with psychiatric condition including ADHD, anxiety, depression, etc.
Interventions
- BehavioralPressure pain thresholds (measured in kilopascal)
Pressure will be increased continually and participants will be instructed to press a button the first moment they feel pain from the pressure stimulus. The first threshold measurement will be used as a familiarization. The average threshold is calculated from three measurements. Higher value indicates lower experimental pain sensitivity
- BehavioralCold pain tolerance (duration in seconds)
Cold pain tolerance will be assessed by having participants immerse their hand or foot in a cold (4-12°C) water bath. Tolerance will be defined by the time of hand withdrawal. Pain ratings of cold pain intensity might be obtained periodically, and both pain intensity and pain unpleasantness will be recorded upon hand/foot withdrawal. Higher value indicates lower experimental pain sensitivity
Location
- Washington University School of MedicineSt Louis, Missouri