Mechanisms of Neuropathic Pain after Spinal Cord Injury
Research type
Research Study
Full title
Mechanisms of Neuropathic Pain after Spinal Cord Injury and the role of the Spinothalamic tract
IRAS ID
260052
Contact name
Margaret Purcell
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
7 years, 0 months, 1 days
Research summary
Neuropathic pain after spinal cord injury affects around 50% of patients, severely impacts quality of life, and is difficult to treat. The mechanisms underlying this type of pain are poorly understood and this limits development of more effective therapies. In particular, it is not clear where the main pain generators are located, whether sites above (brain) and below (spinal cord and peripheral nervous system) the injury level are important or the extent to which this depends on injury type (e.g. complete vs incomplete). Pre-emptive treatments which block the mechanisms leading to development of chronic pain are likely to be more effective than attempting to treat symptoms. However, not all patients develop pain and there is currently no way of predicting those that are at risk. In this study we will recruit patient volunteers from the National Spinal Injuries Unit at the QEUH, Glasgow to investigate the following:
1) Whether below level pain in patients with complete injuries depends on sparing of ascending pain pathways (the spinothalamic tact) and below level pain generators. This will be investigated using a set of sensitive tests which we have developed on healthy volunteers.
2) Whether development of pain can be predicted in complete patients by spinothalamic sparing (as above) and in incomplete patients by increased sensitivity to touch or cold stimuli (allodynia).
3) Whether changes in brain circuits involved in pain processing can be identified using non-invasive brain imaging techniques that measure synchronous brain activity (brain oscillations, detected using electroencephalography) and changes in brain connectivity (investigated using functional MRI).
The purpose of the work is to determine whether pain drivers below the injury level represent an important target for therapies aimed at preventing or relieving pain and to identify predictors of pain that could be used in pre-emptive treatment strategies.REC name
Wales REC 5
REC reference
20/WA/0278
Date of REC Opinion
21 Dec 2020
REC opinion
Further Information Favourable Opinion