INDIVIDUAL PHENOTYPES OF CHRONIC PAIN: THE DYNAMIC PAIN CONNECTOME TOWARDS PAINOMETER DEVELOPMENT AND NEUROETHICS

Leader(s): Karen D. Davis, PhD; Cyril Schneider, PhD
Institution(s): University Health NetworkUniversite Laval & CHU of Quebec
Other Members: Dwight Moulin, Petra Schweinhardt, McGill Research Group



Why was the study done?

A one-size-fits-all approach to pain management does not work for all people with chronic pain because of differences in the brain that can cause individual differences in pain sensitivities and coping, and determine whether we respond to various treatments.
This study was done to investigate individual brain differences related to pain and how they may predict treatment response. An understanding of these linkages will help to develop a personalized and more effective approach to pain management. A second part of the study sought to understand the opinions of people with pain regarding the use of new brain imaging technologies to diagnose and guide pain treatment. This neuroethics study examined issues of data privacy, objective vs self report measures of pain, to establish a framework for neuroethics, legal and societal challenges related to brain imaging/function and possible of the self-report of pain.

How was the study done?
The study measured many aspects of pain sensitivity as well as brain activity in people who are healthy (as a control measure) and in people with different types of chronic pain. Data was also collected from people undergoing treatment for chronic pain to identify links between how well the treatment alleviated pain and the brain and pain sensitivity measures.
For the neuroethics study, a survey is being used to determine the opinions of key stakeholders (people with pain, the general public, healthcare providers) in adopting a brain-based “painometer” test.

What were the study results?
Although the study is not yet complete, early findings indicate that there are several abnormalities in brain function and pain sensitivity measures that are commonly found in people with chronic pain. Some of these abnormalities are related to the type and severity of pain, some are related to whether a treatment will be effective, and some normalize after an effective pain treatment. Individual factors are also emerging including sex differences in brain circuitry.



Recent Updates:

  • Identified abnormal brain activity and connectivity in patients with neuropathic pain.
  • Characterized how abnormal brain activity associated with chronic pain can be impacted and reversed by effective treatment, as well as the variability across individuals in their ability to modulate pain.

Last updated: January 2021


Selected Publications:
  • Kisler LB, Kim JA, Hemington KS, Rogachov A, Cheng JC, Bosma RL, Osborne NR, Dunkley BT, Inman RD, Davis KD. Abnormal alpha band power in the dynamic pain connectome is a marker of chronic pain with a neuropathic component. Neuroimage Clin. 2020 Mar 13;26:102241. doi: 10.1016/j.nicl.2020.102241
  • Firouzian S, Osborne NR, Cheng JC, Kim JA, Bosma RL, Hemington KS, Rogachov A, Davis KD. Individual variability and sex differences in conditioned pain modulation and the impact of resilience, and conditioning stimulus pain unpleasantness and salience. Pain. 2020 Mar 5. doi: 10.1097/j.pain.0000000000001863. [Epub ahead of print]
  • Kim JA, Bosma RL, Hemington KS, Rogachov A, Osborne NR, Cheng JC, Oh J, Dunkley BT, Davis KD. Cross-network coupling of neural oscillations in the dynamic pain connectome reflects chronic neuropathic pain in multiple sclerosis. Neuroimage Clin. 2020 Feb 26;26:102230. doi: 10.1016/j.nicl.2020.102230. [Epub ahead of print]
  • Davis KD, Cheng JC. Differentiating trait pain from state pain: a window into brain mechanisms underlying how we experience and cope with pain. Pain Rep. 2019 Aug 7;4(4):e735. doi: 10.1097/PR9.0000000000000735. eCollection 2019 Jul-Aug.
  • Davis KD. Imaging vs quantitative sensory testing to predict chronic pain treatment outcomes.Pain. 2019 May;160 Suppl 1:S59-S65. doi: 10.1097/j.pain.0000000000001479
  • Rogachov A, Bhatia A, Cheng JC, Bosma RL, Kim JA, Osborne NR, Hemington KS, Venkatraghavan L, Davis KD. Plasticity in the dynamic pain connectome associated with ketamine-induced neuropathic pain relief. Pain. 2019 Jul;160(7):1670-1679. doi: 10.1097/j.pain.0000000000001545.