Pain-autonomic interaction as a surrogate marker for central sensitization in neuropathic pain after spinal cord injury

Maladaptive plasticity and sensitization processes within the spinal cord, brainstem and brain are believed to contribute to the development and maintenance of neuropathic pain after SCI. While a variety of subjective tools to assess signs of such sensitization processes exist (i.e., psychophysics), an objective approach is still lacking in humans.

For decades, the structural and functional connection between the nociceptive and autonomic nervous system is known. Hence, this project targets pain-autonomic interaction as a surrogate marker for sensitization at spinal and brain levels. Beyond state-of-the-art pain phenotyping, we test autonomic responses to noxious heat and pinprick stimuli measured by electrodermal activity, blood pressure, heart rate, and pupil dilation.

The multimodal experimental protocol employs neuroimaging, neurophysiology, autonomic measures, psychophysics and clinical assessments to investigate pain processing and modulation in individuals with chronic pain, such as neuropathic pain after spinal cord injury. We assess the pain phenotype, pain sensitivity, endogenous pain modulation, and cardiovascular function. CHEPs, contact heat evoked potentials; SSRs, sympathetic skin responses (created by J. Metzger).

The overarching aim of the project is to use readouts of pain-autonomic interaction in order to dissect mechanisms and map topography of central sensitization along the nociceptive neuraxis in neuropathic pain after SCI.

Publications:

• Scheuren PS, Boesch S, Rosner J, Allmendinger F, Kramer JLK, Curt A, Hubli M. Priming of the autonomic nervous system after experimentally-induced central sensitization. J Neurophysiology. 2023 Aug 1;130(2):436-446.
• Lütolf R, Rosner J, Curt A, Hubli M. Indicators of central sensitization in chronic neuropathic pain after spinal cord injury. Eur J Pain. 2022 Nov;26(10):2162-2175.
• Lütolf R., De Schoenmacker I, Rosner J, Sirucek L, Schweinhardt P, Curt A, Hubli M. Anti- and Pro-Nociceptive mechanisms in neuropathic pain after human spinal cord injury. Eur J Pain. 2022 Nov;26(10):2176-2187.
• De Schoenmacker I, Leu C, Curt A, Hubli M. Pain-autonomic interaction is a reliable measure of pain habituation in healthy subjects. Eur J Pain. 2022 Sep;26(8):1679-1690.
• Luetolf R, Rosner J, Curt A, Hubli M. Identifying discomplete spinal lesions: New evidence from pain-autonomic interaction in spinal cord injury. J Neurotrauma. 2021 Dec;38(24):3456-3466.
• Scheuren PS, Rosner J, Curt A, Hubli M. Pain-autonomic interaction: a surrogate marker of central sensitization. Eur J Pain. 2020 Nov; 24(10):2015-2026.