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The objective of this study was to investigate the role of blood monoamines as biomarkers of conditioned pain modulation (<jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content>) efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and five paediatric patients with chronic back pain were enrolled in this observational study. The protocol involved dosage of plasma monoamines (dopamine, <jats:styled-content style=\"fixed-case\">DOPA<\/jats:styled-content>; serotonin, 5\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>; epinephrine, Epi; norepinephrine, <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>; metanephrine, <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content>; and normetanephrine, <jats:styled-content style=\"fixed-case\">NME<\/jats:styled-content>) and clinical assessment (<jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content>, functional disability, pain, sleep quality, anxiety and depression).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>5\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DOPA<\/jats:styled-content> were positively correlated among each other and were both negatively correlated with Epi, <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> NE<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NME<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> presented a positive correlation with <jats:styled-content style=\"fixed-case\">DOPA<\/jats:styled-content> and 5\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>. On the other hand, Epi, <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> NE<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NME<\/jats:styled-content> correlated negatively with <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content>. Different correlation coefficients were observed between genders, with stronger coefficients being observed in the male subpopulation. Stepwise regression controlling for age and gender indicated that <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content> (B\u00a0=\u00a0\u22120.987, <jats:italic>SE<\/jats:italic>(B)\u00a0=\u00a00.299, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) was the only significant predictor for <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> efficacy. Higher blood <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content> was associated with poorer <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> efficacy. <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content> explained 53% of variation of <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> in males (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.536, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001) and 7% in females (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.074, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014). In males, blood <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content> &gt;15\u00a0pg\/ml predicted inefficient <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> with 88.9% sensitivity and 83.3% specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content> can be a potential biomarker for <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> efficacy in paediatrics. Future studies are needed to assess the efficacy of tailored treatments for pain according to blood <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>We were able to demonstrate an association between <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> and circulating monoamines. In the clinical setting, sampling <jats:styled-content style=\"fixed-case\">ME<\/jats:styled-content> could provide the clinician an idea of the individual's pain modulation potential. This may be particularly important for children with cognitive impairment, for whose <jats:styled-content style=\"fixed-case\">CPM<\/jats:styled-content> paradigm cannot be used.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1307","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T08:35:34Z","timestamp":1534754134000},"page":"327-340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Blood monoamines as potential biomarkers for conditioned pain modulation efficacy: An exploratory study in paediatrics"],"prefix":"10.1002","volume":"23","author":[{"given":"Catherine E.","family":"Ferland","sequence":"first","affiliation":[{"name":"McGill Scoliosis and Spine Group Montreal Qu\u00e9bec Canada"},{"name":"Shriners Hospitals for Children\u2010Canada Montreal Qu\u00e9bec Canada"},{"name":"McGill University Health Centre Montreal Qu\u00e9bec Canada"},{"name":"Alan Edwards Centre for Research 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