PAIN – from phenotypes to mechanisms

Interpatient variability in the outcomes of pain treatment is impressively large and has led to calls for “precision medicine” employing pain phenotyping. Beyond the clinical phenotyping, a multi-modal neurophysiological approach serves as an objective measure of afferent integrity yielding insights into nociceptive processing and signal integration at several neural levels.

The main research question is in how far we can stratify patients across different chronic pain entities (see Figure 1) according to their distinct pain phenotype. This is achieved by deconstructing the clinical phenotype and attribute clinical signs and symptoms of the chronic pain condition to either common or disease-specific pathophysiological processes. The clinical presentation of chronic pain conditions will likely show distinct but also common pattern of sensory abnormalities, integrity of residual afferent tracts, nociceptive processing, as well as sensory-autonomic interaction.

Figure 1: Spectrum of pain disorders. Patients across different chronic pain entities (from neuropathic to nociceptive pain) can be stratified according to their distinct pain phenotype. This will be assessed using a common test battery including clinical phenotyping and multimodal neurophysiology.

Project partners:

Prof. Dr. Oliver Distler, Department of Rheumatology, University Hospital Zurich
Prof. Dr. Mazda Farshad, Department of Orthopedics, Balgrist University Hospital
PD Dr. Florian Brunner, Department of Physical Medicine and Rheumatology, Balgrist University Hospital
Dr. Petra Schweinhardt, Department of Chiropractic, Balgrist University Hospital

Funding:

Clinical Research Priority Program PAIN 2019-2021, University of Zurich
 

For further information please contact: Dr. Michèle Hubli