Stroke Research Center Bern

Research Fields

Pain

Chronic pain inflicts about 20-40% of patients with primary neurological diseases.

Stroke, spinal cord injury, Parkinson`s disease, traumatic brain injury or multiple sclerosis may be accompanied by central neuropathic pain. These pain syndromes are notoriously difficult to treat. Conventional pharmacological treatments not only fail to show clinically meaningful effects in central neuropathic pain conditions, but also have dose-limiting side effects.

Despite major advances in our understanding of the pathophysiology of peripheral neuropathic pain syndromes, there remain fundamental knowledge gaps regarding the pathophysiology of central neuropathic pain. To complicate matters, musculoskeletal, spasticity-related and neuropathic pain may overlap, thus challenging the clinical diagnosis.

Multimodal assessments are used as part of the research projects. Patients with brainstem, thalamic and cortical strokes or spinal disorders are examined according to state-of-the-art clinical guidelines. Pain-related evoked potentials, sensory perception and pain thresholds are part of a comprehensive neurophysiological testing battery in order to assess the integrity of thermo-nociceptive afferents, e.g. the spinothalamic tract (STT). Structural and functional neuroimaging are employed to track lesion- and pain-related cerebral changes.

The overarching aim of the research field “PAIN” is to improve our current understanding of the clinical phenotype and potential underlying mechanisms of central neuropathic pain. We aim to leverage this knowledge to inform phenotype-stratified trials on pharmacotherapy and neuromodulation of pain.