Details:

• Alternative Title:
  J Head Trauma Rehabil
• Personal Author:
  Hoffman, Jeanne M. ; Ketchum, Jessica M. ; Agtarap, Stephanie ; Dams-O’Connor, Kristen ; Hammond, Flora M. ; ... More +

  Hoffman, Jeanne M. ; Ketchum, Jessica M. ; Agtarap, Stephanie ; Dams-O’Connor, Kristen ; Hammond, Flora M. ; Martin, Aaron M. ; Sevigny, Mitch ; Walker, William C. ; Harrison-Felix, Cynthia ; Zafonte, Ross ; Nakase-Richardson, Risa Less -
• Description:
  Objective:
  
  To define and characterize extreme phenotypes based on perceived improvement in pain for persons with chronic pain following traumatic brain injury (TBI).
  
  Setting:
  
  18 TBIMS Centers
  
  Participants:
  
  1762 TBIMS participants 1–30 years post-injury reporting chronic pain at their most recent follow-up interview.
  
  Primary Measures:
  
  Patients Global Impression of Change (PGIC) related to pain treatment. Sociodemographic, injury, functional outcome, pain, and pain treatment characteristics.
  
  Results:
  
  Participants were mostly male (73%), White (75%), middle-aged (mean 46 years), injured in motor vehicle accidents (53%) or falls (20%). Extreme phenotypes were created for an extreme improvement phenotype (N=512, 29.8%) defined as “moderately better” or above on the PGIC and an extreme no change group (N=290, 16.9%) defined as no change or worse. LASSO regression combined with logistic regression identified multivariable predictors of improvement vs. no change extreme phenotypes. Higher odds of extreme improvement phenotype were significantly associated with being female (OR=1.85), married vs. single (2.02), better motor function (OR=1.03), lower pain intensity (OR = 0.78), and less frequent pain, especially chest pain (OR=.36). Several pain treatments were associated with higher odds of being in the extreme improvement vs. no change phenotype including pain medication (OR=1.85), physical therapy (OR=1.51), yoga (OR=1.61), home exercise program (OR=1.07) and massage (OR=1.69).
  
  Conclusion:
  
  Investigation of extreme phenotypes based on perceived improvement with pain treatment highlights the ability to identify characteristics of individuals based on pain treatment responsiveness. A better understanding of the biopsychosocial characteristics of those who respond and do not respond to pain treatments received may help inform better surveillance, monitoring, and treatment. With further research, the identification of risk factors (such as pain intensity and frequency) for treatment response/non-response may provide indicators to prompt changes in care for individuals with chronic pain after TBI.
  
  
• Keywords:
  [+]

  Brain Brain Injuries, Traumatic Chronic Pain Exercise Therapy Female Humans Male Middle Aged Patient Reported Outcome Perceived Improvement Phenotype Risk Factors Traumatic Brain Injury
• Source:
  J Head Trauma Rehabil. 39(1):43-55
• Pubmed ID:
  38032837
• Pubmed Central ID:
  PMC10840786
• Document Type:
  Journal Article
• Funding:
  90DPTB0017/ACL/ACL HHSUnited States/ ; U48 DP000033/DP/NCCDPHP CDC HHSUnited States/

  90DPTB0017/ACL/ACL HHSUnited States/ ; U48 DP000033/DP/NCCDPHP CDC HHSUnited States/ Less -
• Volume:
  39
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  [+]

  urn:sha-512:c06734d3bc82f0a7dc67c7cf20c286848a236cb172d8a445279261a3eb9b4e07c63dcf9f193302a804c3d0a61efc57c434046f2485b795feafe42ce428243efd
• File Type:

• Supporting Files:
  No Additional Files