Somatosensory Profiles Differentiate Pain and Psychophysiological Symptoms among Young Adults with Irritable Bowel Syndrome: A Cluster Analysis

• Type of Material: Article
• Authors: Jie Chen, University of Connecticut, School of Nursing; Yiming Zhang, University of Connecticut; Zahra Amirkhanzadeh Barandouzi, University of Connecticut; Wanli Xu, University of Connecticut; Bin Feng, University of Connecticut; Ki Chon, University of Connecticut; Melissa Santos, Connecticut Children's Medical Center; Angela Starkweather, University of Connecticut; Xiaomei Cong, University of Connecticut
• Language: English
• Date: 2022-07-16
• Publisher: Emory University Libraries
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Wolters Kluwer Health
• Final Published Version (URL): http://dx.doi.org/10.1097/AJP.0000000000001046
• Title of Journal or Parent Work: Clinical Journal of Pain
• Volume: 38
• Issue: 7
• Start Page: 492
• End Page: 501
• Grant/Funding Information: This study was supported by the National Institute of Nursing Research of the National Institutes of Health (NIH-NINR) under award number: NIH-NINR P20NR016605 (PI: Starkweather)—Pilot 1 sub-award (PI: Cong). Jie Chen received research support from Virginia Stone Fund through American Nurses Foundations Research Grants Award, Eastern Nursing Research Society (ENRS)/Council for the Advancement of Nursing Science Dissertation Award, Sigma Theta Tau International Mu Chapter Research Award, and the University of Connecticut Dissertation Fellowship.
• Keywords: Depression; Sleep disturbance; Cluster Analysis; Pain Threshold; Sensory; Fatigue; Anxiety; Longitudinal data; Symptoms
• Research Categories: Engineering, Biomedical; Health Sciences, Nursing; Statistics

Abstract

Objective: The aim of this study was to investigate if somatosensory profiles can differentiate pain and psychophysiological symptoms among young adults with irritable bowel syndrome (IBS). Methods: We performed a cluster analysis of data collected from a randomized clinical trial of 80 IBS patients and 21 age-matched healthy controls (HCs) to stratify pain and symptoms among young adults with IBS by their peripheral sensory profiles. Data of quantitative sensory testing and IBS-related pain and symptoms were collected at baseline and 6-week and 12-week follow-ups. Results: Using the K-means method, IBS patients were classified into 2 clusters, the "IBS normal threshold" (IBS-NT) and the "IBS increased threshold" (IBS-IT). The IBS-NT cluster had a similar pain threshold as the HCs, and the IBS-IT cluster had an increased threshold of somatic pain perception (lower cold pain threshold, higher heat pain threshold, and higher pressure pain threshold, all P<0.001) than HCs. Compared with the IBS-NT cluster, the IBS-IT cluster reported higher levels of IBS-related pain intensity, anxiety, fatigue, and sleep disturbance over the 3 visits (all P<0.05). Discussion: Young adults with IBS fell into 2 clusters, one with a similar sensory threshold as the HCs and another with an increased pain threshold, who reported higher pain intensity and more severe symptoms. Somatic sensory profiles should be integrated into further personalized self-management intervention among patients with IBS.