The Centre for Pain Research
Annual Research Day
14 March 2016
School of Psychology, room G065
11.00a.m.-3.30p.m
Light lunch will be provided.
Keynote lectures by
Prof Jennifer Stinson (Hospital for Sick Children, Toronto, Canada)
Dr Siobhain O’Mahony (UCC, Cork, Ireland)
Supported by Mundipharma Pharmaceuticals Ltd
Event Schedule
11:00 – 11:15 a.m.: Introductions & Welcome
11:15 a.m. – 12:15 p.m.: Keynote Speaker
Title: The Microbiota-Gut-Brain axis: Relevance to Pain.
Dr Siobhain O’Mahony, Department of Neuroscience & Anatomy at University College Cork and the
Alimentary Pharmabiotic Centre (APC) Microbiome Institute, Cork, Ireland
12.15- 12.45 p.m.: Short Oral Presentations
12.1512.30 p.m.
Not Seeing Eye-To-Eye: Differential reporting of chronic pain by children and their
parents (PRIME-C).
Presented by Ms Hannah Durand, Centre for Pain Research & School of Psychology,
National University of Ireland Galway, Galway, Ireland.
12.3012.45 p.m.
Differential roles for TRPV1 In sub-columns of the periaqueductal grey in regulation
of formalin-evoked nociceptive behaviour in Sprague-Dawley versus Wistar-Kyoto
rats.
Presented by Dr Manish K. Madasu, Pharmacology and Therapeutics, Physiology,
School of Medicine, Galway Neuroscience Centre and Centre for Pain Research,
NCBES, National University of Ireland Galway, Galway, Ireland.
12.45- 14.00 p.m.: Lunch and Poster Presentation/Judging
14.00 – 15.00 p.m.: Keynote Speaker
Title: Improving Pediatric Pain Outcomes: Harnessing Electronic and Mobile Health Technologies.
Prof Jennifer Stinson, Hospital for Sick Children and Lawrence S. Bloomberg Faculty of Nursing,
Institute of Medical Science and Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, Canada.
15.00- 15.30 p.m.: Short Oral Presentations
15.0015.15 p.m.
Development and characterisation of a novel rat model of pain associated with
intervertebral disc injury.
Presented by Ms Isma Lisa Mohd Isa, Centre for Research in Medical Devices
(CÚRAM), Anatomy, Glycoscience Group, Centre for Microscopy and Imaging,
Pharmacology and Therapeutics, and Centre for Pain Research, National University
of Ireland Galway, Galway, Ireland.
15.1515:30 p.m.
The efficacy of a biopsychosocial e-learning intervention on the clinical judgment
of medical students and GP trainees regarding future risk of disability in patients
with chronic lower back pain.
Presented by Dr Brian W. Slattery, Centre for Pain Research and School of
Psychology, National University of Ireland Galway, Galway, Ireland.
15.30 p.m.: Prizegiving and Meeting Ends
15:45 – 17:00 p.m.: Optional tour of the Psychology Department
Poster Presentations
1. An Examination of the Efficacy of a Brief Cognitive-Restructuring or Acceptance Intervention to
Decrease Catastrophising and Reduce Pain in a Sample of Female University Students. Francis K, Keane
AM.
Presented by Kady Francis.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
2. Genotype-dependent exacerbation of nerve injury-induced pain, anxiety and depressive behaviour in
rats. Jennings EM, Burke NN, Roche M, Finn DP.
Presented by Elaine Jennings.
 Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland,
Galway, Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National
University of Ireland, Galway, Ireland.
3. Participatory methods inform the design of an Internet-based pain management programme for
children with chronic pain and their parents. Traynor A, Egan J, O’Higgins S, Durand H, McGuire BE.
Presented by Angeline Traynor.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
4. Investigating the effects of pharmacological blockade of PPAR-α and PPAR-β/δ on formalin-evoked
nociceptive behaviour, fear-conditioned analgesia and conditioned fear in the presence of nociceptive
tone in rats. Gaspar JC, Okine B, Llorente-Berzal A, Burke O, Roche M, Finn DP.
Presented by Jessica Gaspar.
 Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland,
Galway, Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National
University of Ireland, Galway, Ireland.
5. The prevalence, impact, and cost of multimorbidity in a cohort of people with chronic pain in Ireland.
O’Connor L, Slattery BW, Haugh S, Dwyer CP, O'Higgins S, Caes L, Egan J, McGuire BE
Presented by Laura O’Connor.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
6. Comparing the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT)
intervention with a waiting list control on health related quality of life among adults with
multimorbidity: Study protocol for a randomized controlled trial. Barrett K, Slattery BW, O’Connor L,
Haugh S, Francis K, Dwyer C, O’Higgins S, Egan J, Caes L, McGuire, BE.
Presented by Katie Barret.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
7. Protocol for a systematic review with network meta-analysis of the modalities used to deliver eHealth
interventions for chronic pain. Haugh S, Slattery BW, Francis K, O’Connor L, Barret K, O'Higgins S, Dwyer
CP, Caes L, Egan J, McGuire BE
Presented by Stephanie Haugh.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
8. Impaired expression of fear-conditioned analgesia in the stress- and pain-hyper responsive WistarKyoto rat strain. Corcoran L, Rea K, Campbell A, Roche M, Finn DP.
Presented by Louise Corcoran.
 Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland,
Galway, Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National
University of Ireland, Galway, Ireland.
9.
State versus Trait: Validation of state versions of Pain Catastrophizing Scales for Parents and
Children. Durand H, Birnie KA, Noel M, Vervoort T, Goubert L, Boerner KE, Chambers CT, Caes L.
Presented by Hannah Durand.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
10. Can processes that promote better coping and resilience in families of children with chronic pain be
instrumental in improving quality of life?. Saetes S, McGuire BE, Caes L.
Presented by Sophia Saetes.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
11. Intra-mPFC administration of the endogenous PPAR agonist N-palmitoylethanolamide reduces
formalin-evoked nociceptive behavior in rats via a CB1 receptor-mediated mechanism. Okine BN,
Madasu MK, McGowan F, Harhen B, Roche M, Finn D.
Presented by Bright Okine.
 Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland,
Galway, Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National
University of Ireland, Galway, Ireland.
12. Parent-child mutual interactions during pre-schoolers’ everyday pain experiences: A pilot study.
O’Sullivan G, Gormley E, McGuire BE, Roche M, Caes L.
Presented by Grace O’Sullivan.
 School of Psychology, Pharmacology and Therapeutics and Physiology, School of Medicine, and
Centre for Pain Research, University Road, National University of Ireland, Galway, Ireland.
13. Using Interactive Management to model factors influencing the application of biopsychosocial
perspectives in clinical judgment of chronic pain cases. Dwyer C, McKenna-Plumley PE, Gormley E,
Durand H, Slattery BW, Harney OM, MacNeela P, McGuire BE.
Presented by Emer Gormley.
 School of Psychology and Centre for Pain Research, University Road, National University of Ireland
Galway, Ireland.
14. Prevalence, impact and costs of chornic pain in Irish schoolchilren: results form a longitudinal study
(PRIME-C). O’Higgins S, Durand H, Taheny D, Doherty E, Nic Gabhainn S, Murphy AW, Hogan M, O'Neill
C, McGuire BE.
Presented by Siobhan O’Higgins.
 School of Psychology and Centre for Pain Research, Discipline of Economics, Discipline of Health
Promotion, Discipline of General Practice, University Road, National University of Ireland Galway,
Ireland.
Abstracts Short Oral Presentations
Not Seeing Eye-To-Eye: Differential reporting of chronic pain by children and their parents (PRIME-C).
Hannah Durand, Siobhán O’Higgins, Line Caes, Christopher P. Dwyer, Brian W. Slattery, Saoirse Nic Gabhainn, Andrew W.
Murphy, Michael J. Hogan, Ciaran O’Neill, & Brian E. McGuire.
Affiliations: Centre for Pain Research & School of Psychology, National University of Ireland, Galway, Ireland.
Abstract:
The research literature suggests that parents may underestimate and under-report the extent and impact of chronic
pain for their children. This can have detrimental developmental implications and result in increased child disability,
isolation and distress. The PRIME-C study investigated the prevalence, impact and cost of chronic pain amongst
children aged 5 – 12 in Ireland using child self-report and parental report. Participants completed a quantitative
survey to assess quality of life and location, quality and intensity of pain. Demographic information and indicators of
socioeconomic status were also recorded. Parents and children then completed an open-ended question to provide
qualitative insights into their experiences of child pain. Data were collected from 1648 parent-child dyads (55.6%
girls, 88.4% mothers). Among parents, 4% (n = 64) reported that one or more of their children had chronic pain
compared to 10% of children reporting pain. Only 21% of children who self-reported chronic pain had a confirmatory
parental report. Similarly, when parents stated that their child had chronic pain this was not reported by the child
themselves in 20% of cases. Qualitative data suggested that communication between parents and children was a
major issue, and that fear and maladaptive coping strategies were common for children with chronic pain. These
findings indicated that there are significant inconsistencies between children’s self-report and parental reports of
pain, indicating a need to further explore and understand this mismatch of views.
Differential roles for TRPV1 In sub-columns of the periaqueductal grey in regulation of formalin-evoked
nociceptive behaviour in Sprague-Dawley versus Wistar-Kyoto rats.
Manish K. Madasu
1, 3, 4
, Bright N. Okine
1, 3, 4
, Weredeselam M. Olango
1, 3, 4
1
, Róisín Lenihan , Michelle Roche
2, 3, 4
and David P. Finn
1,
3, 4
1
2
3
4
Affiliations: Pharmacology and Therapeutics, Physiology, School of Medicine, Galway Neuroscience Centre and Centre for
Pain Research, NCBES, National University of Ireland Galway, University Road, Galway, Ireland
Abstract:
Introduction: The Wistar-Kyoto (WKY) rat exhibits a hyperalgesic phenotype, compared with the Sprague-Dawley
(SD) strain. TRPV1 within the midbrain periaqueductal grey (PAG) plays a key role in regulating nociceptive
behaviour. We investigated the role of TRPV1 in the sub-columns of PAG in formalin-evoked nociceptive behaviour
in SD versus WKY rats.
Methods: Adult male WKY and SD rats (n=5-7) received intra-DLPAG(Dorsolateral PAG)/ intra-VLPAG(Ventrolateral
PAG)/ intra-LPAG(Lateral PAG) injections of vehicle, TRPV1 agonist capsaicin (6nmoles/0.2µL), TRPV1 antagonist 5’IRTX (0.5nmoles/0.2µL) or capsaicin+5’-IRTX 10 minutes prior to intra-plantar formalin injection (2.5%). Nociceptive
behaviour was assessed for 60 minutes. We used qRT-PCR to compare levels of TRPV1 mRNA in the DLPAG, LPAG
and VLPAG of SD and WKY rats. Data were analysed by two-way ANOVA followed by Fisher’s LSD post-hoc test.
Results: Intra-DLPAG administration of 5’-IRTX or capsaicin significantly increased formalin-evoked nociceptive
behaviour in SD rats, but not WKY rats. Intra-VLPAG administration of 5’-IRTX or capsaicin significantly decreased the
formalin-evoked nociceptive behaviour in SD rats, but not WKY rats. Intra-LPAG administration of 5’-IRTX or
capsaicin had no effect on formalin-evoked nociception in either strain. TRPV1 mRNA levels were significantly higher
in the DLPAG and lower in the LPAG of SD rats compared with WKY counterparts. There were no significant
differences in TRPV1 mRNA expression in the VLPAG between the two strains. TRPV1 mRNA expression significantly
decreased in DLPAG and increased in VLPAG of SD rats upon formalin administration.
Conclusions: TRPV1 in the DLPAG and VLPAG regulates formalin-evoked nociceptive behaviour in SD rats and may
contribute to the hyperalgesic phenotype of WKY rats.
Acknowledgements: PhD Fellowship from the College of Science at NUI Galway and research grant from Science
Foundation Ireland (10/IN.1/B2976).
Development and characterisation of a novel rat model of pain associated with intervertebral disc injury
1, 2
1
3,1
1
1
1
2,4
Isma Liza Mohd Isa , Sunny A. Abbah , Michelle Kilcoyne , Oliver Caroll , Peadar Rooney , Akshay Srivastava , Peter Owens ,
3,1
2,4,1
5,1
1
Lokesh Joshi , Peter Dockery , David P. Finn , Abhay Pandit
:1
2
3
4
Affiliations Centre for Research in Medical Devices (CÚRAM), Anatomy, Glycoscience Group, Centre for Microscopy and
5
Imaging, Pharmacology and Therapeutics, and Centre for Pain Research, National University of Ireland Galway
Abstract:
INTRODUCTION: Intervertebral disc (IVD) injury in rodents has been shown histologically to resemble the painful
degenerated disc in humans1, however, to date no studies have investigated pain-related behaviour or changes in
glycosylation in response to IVD injury. We hypothesized that surgical puncture-induced IVD injury elicits robust pain
behaviour and induces molecular markers of pain in rats. Moreover we investigated the effects of IVD injury on
glycan expression and micro-structural degeneration in both nucleus pulposus (NP) and annulus fibrosus (AF).
METHODS: Twenty (20) male Sprague-Dawley rats were randomized into four groups: sham (n=5), sham incison
(n=5), injury IVD Co4-Co5 (n=5), and injury IVD Co4-Co5 and Co5-Co6 (n=5). The injury was created through AF into
NP in the coccygeal (Co) disc. Tail flick, Hargreaves and von Frey tests of thermal and mechanical
allodynia/hyperalgesia were performed at baseline and post-operative days 1, 7, 14 and 28. The rats were then
euthanised to harvest the spinal cord and discs for analyses c-Fos gene expression and histological changes in IVD
cell distribution, collagen orientation, glycosaminoglycan content and innervation. Lectin histochemistry and HPLC
analysis were used to analyse expression of sialic acid, mannose, fucose, galactose motifs and chondroitin sulfate in
the disc.
RESULTS: The Hargreaves’s test revealed thermal hyperalgesia at in injury groups at post-operative days 2, 7, 14 and
28 . The tail flick test indicated hypoalgesia at a lower level of rat-tail. The microstructure of normal disc showed
predominantly proteoglycan in NP and highly organized collagen fibres in AF. Con A lectin was bound to high
mannose in AF and NP cells and significantly up-regulated in injured disc (Figure 1).
CONCLUSION: These data support the development and characterisation of a novel rat model of pain associated with
IVD injury.
REFERENCES: 1. Lai, A. et al. Spine J. 1–12 (2015). doi:10.1016/j.spinee.2015.11.019
ACKNOWLEDGEMENTS: Majlis Amanah Rakyat (MARA) Malaysia for providing financial support to this project. This
publication has emanated from research supported in part by a research grant from Science Foundation Ireland (SFI)
and is co-funded under the European Regional Development Fund under Grant Number 13/RC/2073.
The efficacy of a biopsychosocial e-learning intervention on the clinical judgment of medical students and GP
trainees regarding future risk of disability in patients with chronic lower back pain
Christopher P. Dwyer, Laura L. O’Connor, Hannah Durand , Padraig MacNeela, Chris J. Main, Phoebe McKenna-Plumley, Bronagh
Reynolds, Robert M. Hamm, Sinead Conneely, Darragh Taheny, Ciaran O'Neill, Saoirse NicGabhainn, Andrew W Murphy, Thomas
Kropmans, Brian E. McGuire.
Affiliations: Centre for Pain Research and School of Psychology, National University of Ireland, Galway
Abstract:
Chronic lower back pain (CLBP) is a major healthcare burden and often results in workplace absenteeism. It is a
priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions
informed by the flags approach, which integrates cognitive and behavioural approaches via the identification of
biopsychosocial barriers to recovery, have been observed to lead to successfully reduced pain-related work absences
and increased return to work for individuals with CLBP. However, research indicates that physicians’ adherence to
biopsychosocial guidelines is low. Though GP trainees and medical students may provide a diverse sample to assess
with respect to judgment-making, as a result of potentially being more open to considering biopsychosocial
perspectives, their treatment strategies may overlook these features depending on the nature of their education.
Thus, the current study examined the effects of a flags approach -based e-learning intervention on the clinical
judgments of medical students and GP trainees regarding the risk of future disability of CLBP patients. Using 40
fictional CLBP cases, differences in clinical judgment accuracy, weighting and speed were examined pre- and postintervention, as were: flags approach knowledge; pain attitudes and beliefs; and empathy, in comparison with a nointervention control group. Results revealed positive effects of the e-learning intervention on flags approach
knowledge, pain related attitudes and beliefs and judgement weighting of psychologically-based cues; and are
discussed in light of existing theory and research.
Abstracts Poster Presentations
1. An Examination of the Efficacy of a Brief Cognitive-Restructuring or Acceptance Intervention to
Decrease Catastrophising and Reduce Pain in a Sample of Female University Students.
Francis K, Keane AM.
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Objectives: In light of the lack of research on cognitive restructuring in the context of acute pain and the
reported differences between CBT- and ACT-based interventions on acute pain outcomes, this study aimed
to design and assess the efficacy of a brief cognitive-restructuring and a brief acceptance intervention in
comparison with a control condition to decrease catastrophising and reduce pain during a Cold-Pressor Test.
Design: A 3x2x2 mixed subjects’ design was employed; Intervention condition (cognitive
restructuring/acceptance/control) and level of dispositional catastrophising (high/low) were the betweensubjects factors, while time (pre-intervention/ post-intervention) was the within-subjects factor. The
dependent variables were pain tolerance and self-reported pain-intensity.
Methods: One hundred and ten female university students completed a baseline Cold-Pressor Test to attain
pre-intervention pain tolerance and self-reported pain intensity ratings. Participants were then randomly
assigned to either the cognitive-restructuring, acceptance or control condition. After the intervention,
participants once again completed a CPT and measures of pain tolerance and self-reported pain intensity.
Results: After controlling for pre-intervention pain scores, participants in both the acceptance and cognitiverestructuring condition displayed significantly increased pain tolerance and reported decreased pain
catastrophising compared to those in the control condition. Participants in the cognitive-restructuring
condition displayed significantly greater decreases in self-reported pain intensity compared to those in the
acceptance and control condition.
Conclusion: The results emphasize the value of Cognitive-Behavioural Therapy and Acceptance and
Commitment Therapy in providing a framework for the design of effective brief interventions aimed at
decreasing catastrophising and reducing acute pain outcomes.
2. Genotype-dependent exacerbation of nerve injury-induced pain, anxiety and depressive behaviour in
rats.
Jennings, EM, Burke, NN, Roche M, Finn, DP.
Affiliations: Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland, Galway,
Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National University of Ireland, Galway,
Ireland.
Abstract:
The bidirectional interplay between affective disorders and chronic pain is poorly understood. Wistar-Kyoto
(WKY) rats are an inbred rat strain that demonstrate hyper-responsivity to stress, a depressive and
anxiogenic phenotype, as well as enhanced nociceptive responding to visceral (1), mechanical and
inflammatory (2-3) stimuli, compared with Sprague-Dawley (SD) rats. The aim of this study was to investigate
if WKY rats, as a model of trait negative affect, exhibit altered nociceptive behaviour and depressive- or
anxiety-like behaviour following peripheral nerve injury, compared with SD counterparts. L5 spinal nerve
ligation (SNL) resulted in prolonged (up to 30 days) mechanical and cold allodynia in adult male SD and WKY
rats as measured by the von Frey and acetone drop tests, respectively. Prolonged SNL-induced heat
hyperalgesia in the Hargreaves test was only observed in WKY, but not SD rats. Baseline testing showed that
WKY rats displayed increased anxiety-like behaviour (reduced time in centre zone of the open field)
compared to the SD rats. Post-SNL, both SD and WKY rats displayed increased anxiety-like behaviour
compared to sham counterparts, but levels of anxiety-like behaviour were higher in WKY rats than in SD rats.
WKY-sham rats spent more time immobile in the forced swim test versus SD-sham rats, indicating increased
depressive-like behaviour. Immobility was greater in the WKY-SNL group versus the WKY-sham group, while
no difference in immobility was observed between SD-sham and SD-SNL groups. In conclusion, these data
suggest increased sensitivity to noxious heat, and increased anxiety- and depressive-like behaviour following
peripheral nerve injury in a genotype (WKY) predisposed to negative affect.
3. Participatory methods inform the design of an Internet-based pain management programme for
children with chronic pain and their parents.
Traynor A, Egan J, O’Higgins S, Durand H, McGuire BE.
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Background: Research in the area of pediatric pain management and online intervention development has
largely focused on adolescents with chronic pain. Little is known about the acceptability of technologybased psychological treatment for early school-age children with chronic pain.
Aim: To explore the support needs and coping preferences of children with chronic pain and their parents
and to elicit participants’ perceptions of technology-delivered treatment using a web-based prototype pain
management programme.
Methods: Children (<12 years) with chronic or recurrent pain for a period of three months or more and their
parents were invited to share their experiences of coping with pain. A series of group-based participative
workshops were used to examine participants coping preferences, support needs and perceptions of
technology-delivered treatment. A participative research process approach was used to involve separate
groups of children (n= 11) and parents (n = 21) in the process of generating, categorising and analysing data
in order of importance for successful coping. All participants (n- 32) gave feedback on a prototype webbased pain management programme.
Results: Preliminary findings reveal similarities between parents and children’s understanding of what
constitutes successful coping. Differences emerged between parents and children’s perspectives on the
value of specific coping strategies. Coping strategies addressing pain-related disability and enhancing a
sense of belonging were identified as most important to children, while parents viewed coping strategies
that facilitate emotional equilibrium and independence as the most necessary elements in children’s coping
repertoire.
Conclusions: This research highlights the support needs of children with chronic pain and their parents and
elicits participant’s perceptions on the ability of technology-delivered treatment programmes to meet those
needs. The implications of findings for the development of remotely-delivered pain management
programmes are discussed.
4. Investigating the effects of pharmacological blockade of PPAR-α and PPAR-β/δ on formalin-evoked
nociceptive behaviour, fear-conditioned analgesia and conditioned fear in the presence of nociceptive
tone in rats.
Gaspar JC, Okine B, Llorente-Berzal A, Burke O, Roche M, Finn DP.
Affiliations: Pharmacology and Therapeutics and Physiology, School of Medicine, National University
of Ireland, Galway, Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National University of
Ireland, Galway, Ireland.
Abstract:
Background: Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptor
family and occur in three isoforms: PPAR-α, PPAR-β/δ and PPAR-γ 1. There is evidence for their involvement
in pain2, cognition3 and mood disorders 4. However, their role in pain-fear interactions is not well
understood. Fear-conditioned analgesia (FCA) is pain suppression upon re-exposure to a context previously
paired with an aversive stimulus 5.
Aim: To investigate the effects of systemic administration of PPAR-α and PPAR-β/δ antagonists on formalinevoked nociceptive behaviour, FCA, and conditioned fear in the presence of nociceptive tone in rats.
Methods: Male Sprague-Dawley rats received footshock (10x1s, 0.4mA) or no footshock in a conditioning
arena; 23.5 hours later, rats received intraplantar injection of formalin (2.5%) into the right hindpaw and
systemic administration (i.p.) of vehicle, PPAR-α (GW6471; 2mg/kg) or PPAR-β/δ (GSK0660; 1mg/kg)
antagonists. Thirty minutes after the injections, rats were re-exposed to the conditioning arena for 15
minutes where nociceptive and fear-related behaviours (freezing and 22KHz ultrasonic vocalisation) were
assessed. Data were analysed using repeated measures or two way ANOVA with Fisher’s LSD post-hoc test.
P<0.05 was considered statistically significant. Results: Fear-conditioned rats expressed robust FCA and
context-induced freezing. Systemic administration of the PPAR-α and PPAR-β/δ antagonists prolonged
context-induced freezing and increased the duration of 22KHz ultrasonic vocalisation without altering
nociceptive behaviour. Conclusion: PPAR-α and PPAR-β/δ may play a role in the extinction of conditioned
fear in the presence of nociceptive tone.
Acknowledgements:
The present study was carried out with financial support from CNPq, Conselho Nacional de Desenvolvimento
Cientifico e Tecnologico – Brazil (207530/2014-9).
References
1. Blanquart, C., Barbier, O., Fruchart, J.C., Staels, B., and Glineur, C. (2003). Peroxisome proliferatoractivated receptors: regulation of transcriptional activities and roles in inflammation. The Journal of Steroid
Biochemistry and Molecular Biology 85: 267–73.
2. Maeda, T., and Kishioka, S. (2009). PPAR and Pain. International Review of Neurobiology 85: 165–77.
3. Panlilio, L. V, Justinova, Z., and Goldberg, S.R. (2013). Inhibition of FAAH and activation of PPAR: new
approaches to the treatment of cognitive dysfunction and drug addiction. Pharmacology & Therapeutics 138:
84–102.
4. Kemp, D.E., Schinagle, M., Gao, K., Conroy, C., Ganocy, S.J., Ismail-Beigi, F., et al. (2014). PPAR-γ agonism
as a modulator of mood: proof-of-concept for pioglitazone in bipolar depression. CNS Drugs 28: 571–81.
5. Butler, R.K., Nilsson-Todd, L., Cleren, C., Lena, I., Garcia, R., and Finn, D.P. (2011). Molecular and
electrophysiological changes in the prefrontal cortex-amygdala-dorsal periaqueductal grey pathway during
persistent pain state and fear-conditioned analgesia. Physiol Behav 104: 1075–1081.
5. The prevalence, impact, and cost of multimorbidity in a cohort of people with chronic pain in Ireland.
O’Connor L, Slattery BW, Haugh S, Dwyer CP, O'Higgins S, Caes L, Egan J, McGuire BE
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Introduction: Multimorbidity (MM) is the coexistence of two or more conditions within one person, where
no one condition is considered primary. MM is becoming more common, and is a challenge for the single
morbidity approach usually adopted by healthcare systems. This study aims to assess the extent, profile,
impact, and cost of MM among Irish adults with chronic pain.
Methods and analysis: Using cluster sampling, participants aged 18 and over will be recruited from Irish pain
clinics and sent an information package and questionnaire asking them to participate in our study at three
time points, 6 months apart. The questionnaire will include our specially developed checklist to assess the
prevalence and impact of MM, along with validated measures of quality of life, pain, depression and anxiety,
and illness perception. Economic data will also be collected, including direct and indirect costs.
Ethics and dissemination: Ethical approval has been granted by the Research Ethics Committee of the
National University of Ireland, Galway. Dissemination of results will be via journal articles and conference
presentations.
6. Comparing the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT)
intervention with a waiting list control on health related quality of life among adults with
multimorbidity: Study protocol for a randomized controlled trial.
Barrett K, Slattery BW, O’Connor L, Haugh S, Francis K, Dwyer C, O’Higgins S, Egan J, Caes L, McGuire, BE.
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Introduction: Multimorbidity is defined as the coexistence of two or more conditions within one person,
where no one condition is primary. MM can have significant debilitating effects on a persons’ Health Related
Quality of Life (HRQoL). There is a dearth of research however, using online psychotherapy targeting and
improving HRQoL for people living with MM.
Aim of Investigation: This study will compare the clinical- effectiveness of an online ACT intervention with a
waitlist control condition in terms of increasing health related quality of life among people with
multimorbidity.
Methods: Adult participants with two or more chronic conditions as diagnosed by a doctor will be
randomised to one of two study conditions. The experimental group will undergo an 8-session internetdelivered ACT-programme over an 8-week period. A wait-list group will be offered the ACT intervention after
the 3-month follow-up period.
Results: Participants will be assessed pre-intervention, post-intervention and at a 3-month follow-up. HRQoL
will be the primary outcome. Secondary outcomes will include: depression; acceptance; symptoms of other
morbidities.
Conclusions: At present, we are in the early stages of participant recruitment. As a result, the focus of this
poster will be on describing the methodological and recruitment processes for the current study.
7. Protocol for a systematic review with network meta-analysis of the modalities used to deliver eHealth
interventions for chronic pain.
Haugh S, Slattery BW, Francis K, O’Connor L, Barret K, O'Higgins S, Dwyer CP, Caes L, Egan J, McGuire BE
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Background: Traditional approaches to interventions for chronic pain are subject to numerous constraints,
including, direct and indirect costs, highly labour intensive, long waiting lists, mobility and accessibility
issues, and shortages in appropriately trained health care professionals. To negate these limitations,
researchers have begun to administer psychological interventions via various technologies. A recent
systematic review examined the various treatment modalities for chronic pain (Heapy 2015). The objective
of the current systematic review and network-meta-analysis is to evaluate the various treatment modalities
(Internet, IVR, telephone, mobile apps, virtual reality, microcomputer, mobile operated system technologies)
used to deliver self-management interventions for chronic pain and to extend Heapy’s review by including a
quantitative analysis.
Methods/design: A recent Cochrane review of internet delivered interventions for adults with chronic pain
forms the basis of the search terms and databases that will be in this review (Eccleston 2014). We will search
MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library) and
PsycINFO. Randomised controlled trials that investigate technologically delivered interventions for adults
with chronic pain will be included. Exclusion categories will be as follows: 1) Non RCT in Peer Reviewed
Journal, 2) Less than 20 participants in each arm at each time point, 3) Non self-management with noncancer chronic pain, 4) intervention not delivered via one of the investigated modalities. Two reviewers will
independently assess relevant studies to determine whether they satisfy eligibility criteria, extract data from
the selected studies and assess the risk of bias using the Cochrane Method. The primary outcome measures
are pain intensity and pain severity. Given that we anticipate the scales used to measure participant
responses will be related but varied across studies, standardized mean differences will be used to compare
effect sizes between treatment modalities. Given the possibility of little or no head-to-head evidence
comparing modalities, we will use a network meta-analysis, allowing us to develop indirect comparisons
between all modalities and to rank the modalities in order of effectiveness at delivering eHealth
interventions. We anticipate substantial heterogeneity, which we will reduce through the introduction of
study level covariates (e.g. the site of pain).
Discussion: The findings from this study will assist patients and researchers to make informed decisions
regarding which modalities deliver more effective interventions for chronic pain, which require further
investigation and whether any modality should be avoided when researching eHealth interventions for
chronic pain.
8. Impaired expression of fear-conditioned analgesia in the stress- and pain-hyper responsive WistarKyoto rat strain.
Corcoran L, Rea K, Campbell A, Roche M, Finn DP.
Affiliations: Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland, Galway,
Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National University of Ireland, Galway,
Ireland.
Abstract:
Background: Fear-conditioned analgesia (FCA) is pain suppression upon re-exposure to a context previously
paired with an aversive stimulus. The endocannabinoid system (ECS) mediates FCA.
Aim: To compare formalin-evoked nociceptive behaviour and FCA in two rat strains, Sprague-Dawley (SD)
and Wistar-Kyoto (WKY), that differ in their stress and pain responsivity, and determine associated
alterations in the ECS.
Methods: Male SD and WKY rats received footshock (10x1s, 0.4mA) or no footshock (controls) in a
conditioning arena. 23.5 hours later, rats received intraplantar injection of formalin (2.5%) into the right
hindpaw. 30 minutes post-formalin, rats were re-exposed to the conditioning arena for 30 minutes, during
which time nociceptive and fear-related behaviour were assessed. Animals were euthanised post
behavioural testing, the brain removed and liquid-chromatography-mass-spectrometry used to determine
endocannabinoid levels in the infralimbic cortex. Data were analysed using ANOVA with Fisher’s LSD posthoc test.
Results: Significant expression of FCA was observed in SD rats, but not WKY rats. Formalin-evoked
nociceptive behaviour was significantly higher and the duration of freezing significantly lower in WKY rats,
compared with SD rats. There was a significant main effect of strain on levels of the endocannabinoid
anandamide in the infralimbic cortex, with levels lower in WKY rats compared with SD counterparts.
Conclusions: These data provide evidence for hyperalgesia in WKY rats and suggest dysfunction of the
endogenous analgesic system in this strain, as evidenced by impaired expression of FCA. The extent to which
decreased levels of anandamide in the infralimbic cortex may underlie these behavioural alterations
warrants further investigation.
Acknowledgements:
Science Foundation Ireland (10/IN.1/B2976) and a PhD fellowship from the National University of Ireland
Galway and from the Irish Research Council.
9.
State versus Trait: Validation of state versions of Pain Catastrophizing Scales for Parents and
Children.
Durand H, Birnie KA, Noel M, Vervoort T, Goubert L, Boerner KE, Chambers CT, Caes L.
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Pain catastrophizing has emerged as one of the most robust predictors of child pain outcomes. Although
assessments of state pain catastrophizing in children and parents are often used, their psychometric
properties are unknown. This study aimed to validate state versions of the Pain Catastrophizing Scale for
parents (PCS-P State) and children (PCS-C State); and examine the relative influence of state and trait
catastrophizing on child and parent pain-related outcomes. Data were pooled from 9 acute pain studies
wherein child and/or parent state catastrophizing (measured immediately before application of noxious
stimulation) and trait catastrophizing were assessed for community-based and clinical samples of children
aged 6 months – 18 years (N = 771) and their parents (N = 970) in Dutch or English. Exploratory factor
analyses were conducted to examine the underlying factor structure of the PCS-P/PCS-C State version,
revealing a single factor solution that explained 71.76% of variance for children and 68.55% for parents.
Hierarchical linear regression analyses were used to examine the relative influence of state versus trait
catastrophizing on child and parent pain-related outcomes. Parent and child state catastrophizing was
significantly associated with child pain intensity, child state anxiety, parental distress and parental sympathy.
State catastrophizing scores showed stronger associations than trait scores for most outcomes. Findings
underscore the importance of assessing state pain catastrophizing of acute pain experiences in parents and
children and provide a basis for robust and valid measurement of state pain catastrophizing about child pain
for these groups.
10. Can processes that promote better coping and resilience in families of children with chronic pain be
instrumental in improving quality of life?
Saetes S, McGuire BE, Caes L.
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Research Question: Can processes that promote better coping and resilience in families of children with
chronic pain be instrumental in improving quality of life?
Background: The International Association for the Study of Pain has indicated that 20% of adults suffer from
chronic pain globally, and 10% are newly diagnosed annually. In Ireland, chronic pain affects 35% of adults
(Raftery, Ryan, & McGuire, 2012). Chronic pain is also present in the paediatric population and it is
conservatively estimated to affect 11% to 38% of children and adolescents worldwide (King, Chambers, et
al., 2011). In Ireland, 9% of children aged 5-12 years have reported chronic pain (O’Higgins, Hayes, Doherty,
et al., 2014); the majority of children with chronic pain suffer from Juvenile Idiopathic Arthritis (JIA).
This research will evaluate the effectiveness of processes that promote better coping and resilience in
families of children with chronic pain. The testing and application of this research in the context of chronic
pain and JIA will advance and authenticate potential resilience resources and resilience mechanisms to
improve the quality of life for children with chronic pain. Additionally, we will study both the child and the
family in an effort to expand the field by furthering our understanding of how paediatric chronic pain
impacts resilience processes in parents and siblings. Method: A systematic literature review will be
conducted to evaluate and synthesize previous studies involving family resiliency within paediatric chronic
pain. Subsequently, we will utilize the Growing Up In Ireland (GUI) data to study the children reporting
chronic illness and how resiliency affects the family dyad. Finally, we will observe the comparison of
resiliency mechanisms and resources in children who are recently diagnosed with JIA and those who have
been diagnosed for some time. Participants for the final study will be recruited from the collaboration my
supervisors have with the paediatric hospital rheumatology departments (i.e., in Our Lady's Children's
Hospital, Crumlin, Temple Street Children’s University Hospital and University Hospital Galway).
11. Intra-mPFC administration of the endogenous PPAR agonist N-palmitoylethanolamide reduces
formalin-evoked nociceptive behavior in rats via a CB1 receptor-mediated mechanism.
Okine BN, Madasu MK, McGowan F, Harhen B, Roche M, Finn D.
Affiliations: Pharmacology and Therapeutics and Physiology, School of Medicine, National University of Ireland, Galway,
Ireland and NCBES Centre for Pain Research and Galway Neuroscience Centre, National University of Ireland, Galway,
Ireland.
Abstract:
Background: N-Palmitoylethanolamide (PEA), an endogenous peroxisome- proliferator- activated-receptor
(PPAR) agonist, has antinociceptive effects in animal models of inflammatory and neuropathic pain.
Aim: To determine the effects of intra-mPFC administration of PEA on formalin-evoked nociceptive
behaviour and the receptor mechanisms involved
Methods: Adult male SD rats (n=7-10) received intra-mPFC injections of PEA (6nmoles/0.5µL) and/or
antagonists for the cannabinoid1 (CB1) receptor [AM251 (1.25nmoles/0.5 µL)], TRPV1 receptor [5iodoresiniferatoxin (5-IRTX; 1nmoles/0.5 µL)], PPAR-α [GW6471 (3nmoles/0.5 µL)] or PPAR-γ [GW9662
(36nmoles/0.5 µL)], 10 minutes prior to intraplantar formalin (2.5%) injection. Nociceptive behaviour was
assessed for 60 minutes using EthovisionXT. Post-mortem levels of AEA, 2-AG, N-oleoylethanolamide (OEA)
and PEA in the mPFC were measured by LC/MS/MS.
Results: Intra-mPFC administration of PEA significantly attenuated the first and early second phases of
formalin-evoked nociceptive behaviour, effects partially reversed by CB1 but not by PPAR or TRPV1
antagonists. Administration of CB1, TRPV1 and the PPAR antagonists alone, tended to reduce formalinevoked nociceptive behaviour compared with vehicle-treated rats. There was a significant increase in PEA
levels, a strong trend for increased AEA levels, but no change in OEA or 2-AG levels, in the mPFC of rats that
received PEA microinjections compared with vehicle-treated controls.
Conclusions: The elevation in local AEA levels and consequent CB1 receptor activation may account, at least
in part, for the rapid antinociceptive effects of PEA injected into the mPFC. The antinociceptive effects of
pharmacological blockade of CB1¬, TRPV1 or PPAR antagonists may indicate a facilitatory role for these
receptors in the mPFC in tonic, inflammatory pain.
Acknowledgments:
This work was funded by Science Foundation Ireland (10/IN.1/B2976) and approved by the Animal Care and
Research Ethics Committee at NUI Galway.
12. Parent-child mutual interactions during pre-schoolers everyday pain experiences: a pilot study’.
O’Sullivan G, Gormley E, McGuire BE, Roche M, Caes L.
Affiliations: School of Psychology, Pharmacology and Therapeutics and Physiology, School of Medicine, and Centre for
Pain Research, University Road, National University of Ireland, Galway, Ireland.
Abstract:
Pain is an integral part of children's everyday experience, with parents providing the main source of comfort.
However, the association between parental responses and child behaviour is poorly understood. The
majority of research has focused on either parental or child responses, but failed to examine
interdependence between parents and children. Furthermore, research efforts have mainly studied pain in
medical contexts. ‘Everyday’ pains (bumps, scratches, etc.) are more frequent pain experiences for preschoolers; however, research targeting the unique parent-child responses during these pain experiences is
limited.
This project will evaluate parent-child interactions during ‘everyday’ pain events in pre-school children, by
applying the 'Actor-Partner Interdependence Model’ (APIM)6, to examine bidirectional social influences
between pre-school children and parents’ behavioural and emotional responses to everyday pain. It is
expected that parental responses will influence development of their child’s pain sensitivity and painmanagement skills over time.
Participants will be 24 children (3-5years) and one of their parents. Similar to previously-used methodologies
in other settings1,2, parent-child interactions during a typical family afternoon or morning at home will be
videotaped with the goal of capturing at least one painful experience by the child. Each time a pain event
occurs, the child will rate their experienced level of pain using the Faces Pain Scale-Revised (FPS-R3) as soon
as they are soothed and relaxed. At the same time, parents will provide a proxy rating for the child’s pain
using the FPS-R and report on their own distress using a numeric rating scale4. The videotapes of the
observations will later be used to code parental protective and coping-promoting behaviour, as well as child
distress and coping behaviour in response to each painful event, by means of the validated observation
scale, the CAMPIS-R5. The data will be analysed in accordance with the APIM using multilevel modelling
procedures6.
References
1 Gilbert-MacLeod, C.A., Craig, K.D., Rocha, E.M., & Mathias, M.D. (2000). Everyday pain responses in
children with and without developmental delays. Journal of Pediatric Psychology, 25 (5), 301–308.
2 Campos, B., Graesch, A.P., Repetti, R., Bradburry, I.T., & Ochs, EL. (2009). Opportunity for interaction? a
naturalistic observation study of dual-earner families after work and school. Journal of Family Psychology, 23
(6), 798–807.
3 Hicks, C.L., von Baeyer, C.L., Spafford, P.A., van Korlaar, I., & Goodenough, B. (2001). The faces pain scalerevised: Toward a common metric in pediatric pain measurement. Pain, 93, 173-183.
4 Caes, L., Vervoort, T., Eccleston, C., Vandenhende, M, & Goubert, L. (2011). Parental catastrophizing about
child’s pain and its relationship with activity restriction: The mediating role of parental distress. Pain, 152,
212-222.
5 Blount, R.L., Cohen, L., Frank, N.C., Bachanas, P.J., Smith, A.J., Manimala, M.R., & Pate, J.T. (1997). The
Child-Adult Medical Procedure Interaction Scale-Revised: an assessment of validity. Journal of Pediatric
Psychology, 22, 73-88.
6 Cook, W.L., & Kenny, D.A. (2005). The Actor-Partner Interdependence Model: a model of bidirectional
effects in developmental studies. International Journal of Behavioral Development, 29, 101-109.
13. Using Interactive Management to model factors influencing the application of biopsychosocial
perspectives in clinical judgment of chronic pain cases.
Dwyer C, McKenna-Plumley PE, Gormley E, Durand H, Slattery BW, Harney OM, MacNeela P, McGuire BE.
Affiliations: School of Psychology and Centre for Pain Research, University Road, National University of Ireland Galway,
Ireland.
Abstract:
Though there is wide support for the application of biopsychosocial perspectives in clinical judgment of
chronic pain cases, such perspectives are often overlooked, for example, due to inadequate training,
attitudes favouring a biomedical approach or time available with patients. A greater understanding of clinical
judgment-making processes and the factors that affect the application of these processes is required,
particularly those regarding chronic pain. The current study investigated medical students’
conceptualisations of the factors that influence the application of a biopsychosocial approach to clinical
judgment-making in cases of chronic pain using interactive management (IM). IM is a computer-assisted
process that allows a group to build a structural model describing relations between elements in a system.
Results of IM group work revealed five core biopsychosocial approach application categories: GP attitudes,
cost, GP knowledge, time, patient-doctor relationship, biomedical factors and patient perception. GP
attitude was the most critical driver of all other competencies in the system, with cost and GP knowledge
revealed as secondary drivers.Results of IM group work are discussed in light of extant research and theory.
15. Prevalence, impact and costs of chornic pain in Irish schoolchilren: results form a longitudinal study
(PRIME-C).
O’Higgins S, Durand H, Taheny D, Doherty E, Nic Gabhainn S, Murphy AW, Hogan M, O'Neill C, McGuire BE.
Affiliations: School of Psychology and Centre for Pain Research, Discipline of Economics, Discipline of Health
Promotion, Discipline of General Practice, University Road, National University of Ireland Galway, Ireland.
Abstract:
Introduction: Chronic pain is acknowledged as a significant health problem for children; however there is
limited data on the prevalence of chronic pain in children. PRIME-C is a three-year longitudinal study that
explored this issue among 5–12-year-olds living in Ireland.
Aim of Investigation: PRIME-C aimed to determine the prevalence, impact and cost of child chronic pain in
an Irish context.
Methods: Data were collected from 3,116 children at baseline, 2,034 at one-year follow-up, and 1,605 at
two-year follow-up. Series of t-tests and χ2 tests were undertaken to determine differences between
children with and without pain. Binary logistic regression models estimated odds ratios to highlight factors
associated with child chronic pain.
Results: Approximately 10% of children reported chronic pain, 85 of whom reported persistent pain over a
year. Chronic pain increased with age from 2% of five-year-olds to 24% of 12-year-olds. A larger proportion
of 12-year-old boys reported pain compared to girls; many boys reported accidents related to sport as the
reason for pain. Only 20.7% of children with pain had a confirmatory report of chronic pain from a primary
caregiver. Children with chronic pain were more likely to have a parent who also suffered from chronic pain.
The annual cost to parents of their child suffering with chronic pain was estimated to be between €400-500.
Conclusions: This study established that chronic pain in primary school children is a significant health
problem in Ireland, and is associated with their having a lower quality of life.
Acknowledgements:
This study is funded by the Health Research Board’s Interdisciplinary Capacity Enhancement Award (Ref:
ICE/2011/19).