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No pain no gain

Exploration and validation of experimental pain models in human healthy volunteers for applications in drug development and implications of quantitative sensory testing in neuropathic pain patients
PhD ceremony:Mr M. (Marten) Harbers
When:June 20, 2016
Supervisor:prof. dr. J.A. (Johan) den Boer
Co-supervisors:dr. W. Timmerman, dr. R. Kortekaas
Where:Academy building RUG
Faculty:Medical Sciences / UMCG

Pain management is a major challenge in modern medicine. It is estimated that the prevalence of chronic pain could be as high as 35 %. Consequently, 1 in 3 people will experience a period of chronic pain during their lifetime. This societal burden underlines the importance of developing effective analgesic therapies.

As a hypothesis we tested if Quantitative Sensory Testing (QST) measures for acute and neuropathic pain in healthy volunteers and patients would improve the reliability of efficacy studies. Furthermore we aimed to develop a robust topical capsaicin model for neuropathic pain to achieve reliable hyperalgesia and allodynia. Our results showed that the heat pain threshold, the pressure pain threshold and the cold pressor test are reliable measures to test analgesic efficacy in acute pain. In general, the high test-retest reliability in our studies supports the use of a standardized QST battery for testing novel analgesics and can improve assay sensitivity of clinical trials.

Furthermore, our QST database demonstrated that many patients with chronic pain not only have abnormal somatosensory functioning at their painful pathological body side but also on the contralateral (non-painful) body side. Also, our Heat Capsaicin Warmth (HCW) model for neuropathic pain using continuous pain with capsaicin cream combined with continuous warmth demonstrated that this is a reliable method to induce allodynia, a key symptom of neuropathic pain. Overall, the results from our studies contribute to the selection of appropriate pain tests and models and can improve clinical trials of pain treatments.