Thesis Format
Monograph
Degree
Master of Science
Program
Neuroscience
Supervisor
Schabrun, Siobhan M.
2nd Supervisor
Allison, David J.
Co-Supervisor
Abstract
Systemic inflammation plays a key role in chronic pain. Treatment success is linked to a downregulation of pro-inflammatory, and an upregulation of anti-inflammatory, cytokines. Chronic axial pain (CAP), often managed with temporary methods like intra-articular injections (IAI), may find a long-term solution with repetitive transcranial magnetic stimulation (rTMS), though its efficacy with IAI remains unclear. This study explores the relationship between plasma IL-6, IL-10, and TNF-a with treatment response in combined rTMS + IAI versus sham rTMS + IAI. Understanding this relationship could deepen our insight into chronic pain and its recovery. The study found no significant links between these cytokines and treatment response, nor did systemic cytokine levels correlate with pain intensity in either group. These results suggest that the relationship between systemic inflammation and pain response in CAP is complex. Our research contributes to the chronic pain management field and highlights the need for continued research and innovation.
Summary for Lay Audience
Chronic pain is a debilitating condition that affects many people worldwide. One of the key factors in the development and maintenance of chronic pain is systemic inflammation, or inflammation throughout the body. Successful treatment of chronic pain often involves reducing proteins that promote inflammation (pro-inflammatory cytokines) and increasing those that fight it (anti-inflammatory cytokines). Chronic axial pain (CAP) is a type of chronic pain that affects the neck to low back. It is often treated with temporary methods like intra-articular injections (IAI), where corticosteroids are injected into the joints to relieve pain. Repetitive transcranial magnetic stimulation (rTMS) is a newer technique being studied for its potential to provide long-term pain relief. This non-invasive technique involves using magnetic fields to stimulate nerve cells in the brain, which may help reduce pain. Combining rTMS with traditional treatments like IAI may improve outcomes for patients with CAP, but this has yet to be thoroughly explored. In this study, we examined the levels of specific proteins in the blood, IL-6, IL-10, and TNF-a, to see if they could predict how well patients responded to combined rTMS and IAI treatments. By understanding how these markers changed with treatment, we hoped to gain insights into how chronic pain can be better managed. The study compared two groups of patients: one received active rTMS (actual magnetic field stimulation of the brain’s nerve cells) combined with IAI, and the other received a sham rTMS (placebo stimulation, with no magnetic field stimulation affecting the brain’s nerve cells) combined with IAI. The results showed no significant relationship between the levels of these inflammatory markers and the patients' responses to the treatment. Additionally, there was no correlation between the levels of these markers and the patients' reported pain intensity throughout the study. These findings suggest that the relationship between systemic inflammation and pain response in CAP is more complex than previously thought, indicating other factors may significantly influence pain and treatment response. Although this study didn't provide clear answers, it highlights the complexity of chronic pain and the need for ongoing research to find better long-term solutions for patients.
Recommended Citation
Sivarajan, Thivya, "Understanding the Foundations: Systemic Inflammation’s Role in Chronic Axial Pain and Treatment Response" (2024). Electronic Thesis and Dissertation Repository. 10158.
https://ir.lib.uwo.ca/etd/10158