# PRROPS:  Pathways of Risk and Resilience for Overlapping Pain and Sensitization

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $684,920

## Abstract

Chronic pain affects >100 million American adults with estimated costs of up to $1 trillion annually. Older adults
are at increased risk of having multiple painful conditions and are living longer with the negative impacts of
chronic pain. Chronic pain, regardless of anatomy or diagnosis involved (e.g., back pain, migraine), is the
leading cause of disability worldwide. Limited insights into whether common mechanisms underlie all pain
conditions, regardless of diagnosis, has contributed to inadequate pain management options, and in turn, to the
opioid epidemic. Health care providers who treat one pain condition (e.g., joint pain) typically do not manage
symptoms in other parts of the body (e.g., abdominal pain), and patients are often referred from one specialist
to another. Studying commonalities of various chronic overlapping pain conditions (COPC) in community-based
cohorts unselected for pain conditions can provide novel insights into causes of chronic pain as a disease itself,
and into shared risk factors that may be promising targets to help ameliorate chronic pain regardless of diagnosis.
Alterations in nociceptive signaling such as pain sensitization assessed by quantitative sensory testing (QST)
may commonly underlie chronic pain, but why such alterations occur is not known, and whether such nociceptive
signaling changes are heritable is also not known. Beyond nociception, there may be broader nervous system
dysfunction underlying chronic pain. Generalized heightened sensitivity to external stimuli (e.g., light, sound) and
impaired autonomic nervous system functioning, reflected by diminished heart rate variability (HRV), are
associated with chronic pain, but it is unclear if they contribute to COPC, QST-assessed abnormalities, or
development of chronic pain. Treatments targeting these potential risk factors could represent new avenues for
pain management. Another untapped potential is in understanding whether positive factors such as resilience,
sleep quality, and physical activity can be harnessed to alter risk of COPC or QST abnormalities. We propose
evaluating COPC in the upcoming study visit of a community-based middle age and older adult cohort unselected
for any pain complaints, the 3rd Generation of the Framingham Heart Study (FHS) (N~3374, mean age 60).
We aim to understand the relation of multisensory sensitivity, autonomic function, resilience, sleep, and physical
activity to COPC, QST-assessed pain processing and evolution of chronic pain over time; and to study heritability
of QST abnormalities. Understanding the relation of these novel factors to COPC and QST would spur
development of novel pain management approaches for all types of pain regardless of diagnosis involved. We
will collect data regarding common chronic pain complaints, QST (to assess pain sensitization), and proposed
risk factors, and conduct two follow-up assessments to obtain longitudinal data. We will leverage the ongoing
FHS Offspring (2nd Generation) Exa...

## Key facts

- **NIH application ID:** 10183976
- **Project number:** 1R01NS121419-01
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Emelia J. Benjamin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $684,920
- **Award type:** 1
- **Project period:** 2021-07-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10183976

## Citation

> US National Institutes of Health, RePORTER application 10183976, PRROPS:  Pathways of Risk and Resilience for Overlapping Pain and Sensitization (1R01NS121419-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10183976. Licensed CC0.

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