Exploring Risk Factors and Neurophysiological Mechanisms Underlying the Development of Chronic Postsurgical Pain After Thoracic Surgery: Protocol for an Observational Feasibility Study
Notice bibliographique
Résumé
BACKGROUND: Chronic postsurgical pain (CPSP) is a debilitating chronic pain condition that particularly impacts patients undergoing thoracic surgery, with incidence rates of up to 50%. The current understanding of risk factors is limited, and preoperative neurophysiological risk factors that may predict the development of CPSP have not yet been explored. Additionally, the specific neural mechanisms underlying the transition to CPSP are not well characterized. As a novel approach, we propose the use of transcranial magnetic stimulation and electroencephalography, along with other patient and surgical factors, to understand the neurophysiological mechanisms underlying the onset of CPSP after thoracic surgery. OBJECTIVE: The primary objective of this study is to evaluate the feasibility of our study design to inform a larger observational cohort study. Secondary objectives include exploring preoperative neurophysiological markers along with clinical characteristics associated with a higher risk of developing CPSP, as well as exploring postoperative differences in cortical function between patients who undergo thoracic surgery and develop CPSP compared with those who do not develop CPSP. METHODS: A total of 30 participants undergoing video-assisted thoracic surgery or a robotic-assisted thoracic lobectomy, wedge resection, segmental section, or minimally invasive esophagectomy, will be recruited to take part in 2 assessment sessions. The first assessment will take place 2 to 3 weeks before surgery, and the second assessment will take place 3 months after surgery, during which the CPSP diagnosis of each participant will be assessed by the experimenter using a validated definition. Feasibility outcomes include recruitment and retention rates of study participants. The secondary objectives include exploring factors associated with the development of CPSP, as well as examining postoperative differences in neurophysiological measures between patients with and without CPSP. We will consider the following neurophysiological measures for these objectives: transcranial magnetic stimulation measures of short-latency intracortical inhibition, cortical silent period, and motor evoked potentials; electroencephalography measures of resting band activity, event-related desynchronization, and corticomuscular coherence; and quantitative sensory testing of mechanical detection threshold and pressure pain threshold. RESULTS: This is an ethics-approved, ongoing study. Initial funding for this study was provided in March 2023. Recruitment for the study began in January 2025. A total of 22 participants have been recruited for the study. We anticipate completing data collection for this study by April 2026, with data analysis to follow. CONCLUSIONS: This protocol details our study design for a feasibility study exploring the neurophysiological markers and patient characteristics associated with the development of CPSP. Demonstration of feasibility is expected to lead to a larger study. Improved understanding of the risk factors and mechanisms underlying CPSP may inform the delivery of targeted therapies and preventive measures to reduce the incidence of CPSP after thoracic surgery. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/81042.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,027 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,005 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,004 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,028 | 0,007 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».