Papers of the Week

Multisensory sensitivity (MSS) to non-painful stimuli has been identified as a risk factor for the presence of coexisting chronic pain conditions (COPCs). However, it remains unclear whether MSS can differentiate pain phenotypes involving different levels of central sensitivity. Both pain-free and those with chronic pain, particularly fibromyalgia (FM), migraine or low back pain (LBP) were recruited, with pain co-morbidities assessed. MSS was highest in FM, followed by migraine, then LBP, and lowest in pain-free individuals (adjusted between condition Cohen's d = 0.32 – 1.2, p ≤ 0.0007). However, when secondly grouping patients by total number of pain comorbidities reported, those with a single pain condition (but not FM) did not have significantly elevated MSS versus pain-free individuals (adj d= 0.17, p = 0.18). Elevated MSS scores produced increased odds of having 2 or more pain comorbidities; OR [95%CI] =2.0 [1.15, 3.42] without, and 5.6 [2.74, 11.28], with FM (p ≤ 0.0001). Further, those with low MSS levels were 55% – 87% less likely to have ≥ 2 pain comorbidities with or without FM (OR 0.45 [0.22, 0.88] to 0.13 [0.05, 0.39]; p ≤ 0.0001). Our findings support that MSS can differentiate between pain phenotypes with different degrees of expected central mechanism involvement, and also serves as a risk and resilience marker for total COPCs. This supports the use of MSS as a marker of heightened central nervous system processing, and thus may serve as a clinically feasible assessment to better profile pain phenotypes with the goal of improving personalized treatment.