Project Summary
Pain is complex and consists of three dimensions: sensory-discriminative, affective-motivational, and cognitive-
evaluative, yet the EEG profile of the cortical activity that underlies the cognitive processing of the pain
dimensions is not known. Pain questionnaires such as the widely utilized McGill Pain Questionnaire (MPQ)
contain sections that assess the sensory and affective dimensions of pain, and it is well known that these pain
dimensions are associated with activity in select cortical areas. However, the pain literature lacks a
comprehensive and methodologically robust profile of the EEG cortical activity that underlies cognitive
processing of the multidimensional pain experience, particularly in osteoarthritis. Further, recent systematic
reviews suggested that there is a need for significant advancement in methodological robustness in EEG pain
studies. The primary objective of this basic/ disease-related research, is to provide a methodologically robust,
cortex-wide, full-frequency band profile of cortical EEG activity associated with the cognitive processing of the
sensory-discriminative and affective-motivational dimensions of osteoarthritis knee pain. We will record cortical
activity using EEG in participants without and with chronic knee pain (osteoarthritis) at both baseline resting-
state and during experimentally-induced pain (cold pressor task) with simultaneous presentation of previously
validated sensory dimension and affective dimension questions from the MPQ. Aim 1 is to elucidate the
cortical EEG response that underlies the cognitive processing of the sensory-discriminative dimensions of pain
by presenting sensory stimuli during an acute pain stimulus in participants both with and without chronic
osteoarthritis knee pain. Aim 2 is to investigate the cortical EEG response that underlies the cognitive
processing of the affective-motivational dimension of pain by presenting affective stimuli during an acute pain
stimulus in participants both with and without chronic osteoarthritis knee pain. Aim 3 is to use a new approach
to overcome barriers to progress in the field that occur due to narrow reporting of EEG outcomes and lack of
rigor. We used recent systematic reviews to identify key barriers to advancement in the field due to rigor. At the
conclusion of this work we will provide a comprehensive EEG profile including full-frequency band activities
from all electrodes, with coherence, absolute, and overall power, to be conducted in a robust sample of
participants with sex-matched controls, a large number of experimental trials, and statistical adjustments for
multiple comparisons. Due to the robust methodological and statistical design that sets this study apart,
findings will be meaningful even if the hypotheses are not supported. These data will provide novel insights into
the cortical EEG profile of the cognitive processing of the multidimensional pain experience in knee
osteoarthritis. Imaging of cortical activity during pain can reveal mechanisms of pain processing which is
indispensable for knowledge of pain physiology as well as development of novel treatment targets.
