A5077860334- Pain Mechanisms and Treatments
- Musculoskeletal pain and rehabilitation
- Pain Management and Placebo Effect
- Botulinum Toxin and Related Neurological Disorders
- Pain Management and Opioid Use
- Health Systems, Economic Evaluations, Quality of Life
- Meta-analysis and systematic reviews
- Animal testing and alternatives
- Pain Management and Treatment
- Health and Medical Research Impacts
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Ethics in Clinical Research
- Cancer Treatment and Pharmacology
- Veterinary Pharmacology and Anesthesia
- Anesthesia and Pain Management
- Computational Drug Discovery Methods
- Opioid Use Disorder Treatment
- Complementary and Alternative Medicine Studies
- Peripheral Nerve Disorders
- Acupuncture Treatment Research Studies
- Pediatric Pain Management Techniques
- Health Sciences Research and Education
- Empathy and Medical Education
- Anesthesia and Sedative Agents
- Hereditary Neurological Disorders
University of Exeter
2023-2025
Imperial College London
2018-2024
University Hospital Schleswig-Holstein
2015-2023
Heidelberg University
2015-2023
University Hospital Heidelberg
2015-2023
University of Lübeck
2015-2023
University Hospital Münster
2021-2023
Bernstein Center for Computational Neuroscience Heidelberg-Mannheim
2020-2023
University Medical Centre Mannheim
2015-2023
Chelsea and Westminster Hospital
2021
Abstract Patients with neuropathic pain are heterogeneous in etiology, pathophysiology, and clinical appearance. They exhibit a variety of pain-related sensory symptoms signs (sensory profile). Different profiles might indicate different classes neurobiological mechanisms, hence subgroups respond differently to treatment. The aim the investigation was identify large sample patients using hypothesis-free statistical methods on database 3 multinational research networks (German Research...
The sodium channel blocker oxcarbazepine is efficacious in peripheral neuropathic pain patients, with preserved thermal sensation and some gain of sensory function, that is, the "irritable nociceptor" phenotype. In it has been suggested phenotype based on putative mechanisms may predict response to treatment. This was a randomised, double-blind, placebo-controlled, phenotype-stratified study 2 6-week treatment periods (1800-2400 mg) placebo. primary efficacy measure change median intensity...
Abstract In a recent cluster analysis, it has been shown that patients with peripheral neuropathic pain can be grouped into 3 sensory phenotypes based on quantitative testing profiles, which are mainly characterized by either loss, intact function and mild thermal hyperalgesia and/or allodynia, or loss of detection mechanical allodynia. Here, we present an algorithm for allocation individual to these subgroups. The is nondeterministic—ie, patient sorted more than one phenotype—and separate...
Control interventions (often called "sham," "placebo," or "attention controls") are essential for studying the efficacy mechanism of physical, psychological, and self-management in clinical trials. This article presents core recommendations designing, conducting, reporting control to establish a quality standard non-pharmacological intervention research. A framework additional considerations supports researchers' decision making this context. We also provide checklist enhance research...
In neuropathic pain with irritable nociceptor (IN) phenotype, upregulation of sodium channels on nociceptors is supposed to be an important mechanism that may targeted by topical channel blockade. This randomised, double-blind, phenotype panel, crossover study 4-week treatment periods lidocaine 5% patch and placebo was performed search for differences in effect. The primary efficacy measure the total intensity 11-point numeric rating scale, objective compare effect patients without IN as...
Abstract As an indirect approach to relate previously identified sensory phenotypes of patients suffering from peripheral neuropathic pain underlying mechanisms, we used a published sorting algorithm estimate the prevalence denervation, and central sensitization in 657 healthy subjects undergoing experimental models nerve block (NB) (compression topical lidocaine), primary hyperalgesia (PH) (sunburn capsaicin), or secondary (intradermal capsaicin electrical high-frequency stimulation), 902...
Stratification of patients according to the individual sensory phenotype has been suggested a promising method identify responders for pain treatment. However, many state-of-the-art testing procedures are expensive or time-consuming.Therefore, this study aimed present selection easy-to-use bedside devices.In total, 73 (39 m/34 f) and 20 controls (11 m/9 received standardized laboratory quantitative (QST) bedside-QST. In addition, 50 were tested by group nonexperienced investigators address...
While high risk of failure is an inherent part developing innovative therapies, it can be reduced by adherence to evidence-based rigorous research practices. Supported through the European Union’s Innovative Medicines Initiative, EQIPD consortium has developed a novel preclinical quality system that applied in both public and private sectors free for anyone use. The Quality System was designed suited boost innovation ensuring generation robust reliable data while being lean, effective not...
Artificial intelligence (AI) is often used to describe the automation of complex tasks that we would attribute to. Machine learning (ML) commonly understood as a set methods develop an AI. Both have seen recent boom in usage, both scientific and commercial fields. For community, ML can solve bottle necks created by complex, multi-dimensional data generated, for example, functional brain imaging or *omics approaches. here identify patterns could not been found using traditional statistic...
The personal, social and economic burden of chronic pain is enormous. Yet patients with pain, clinicians the public are often poorly served by an evidence architecture that contains multiple structural weaknesses which reduce confidence in treatment practice. Weaknesses include incomplete research governance, a lack diversity inclusivity, inadequate stakeholder engagement, poor methodological rigour reporting, data accessibility transparency, failure to communicate findings appropriate...
Quantitative sensory testing (QST) in accordance with the DFNS (German Research Network on Neuropathic Pain) protocol assesses function of afferent nerve fibers basis 13 parameters. Within consortia IMI (Innovative Medicines Initiative) Europain and Neuropain, QST results from pain research units experienced across Europe can be compared for first time. Aim this analysis was to identify possible biases assessment between 10 centers 8 different European countries. In total, 188 healthy...
Inherited erythromelalgia, the first human pain syndrome linked to voltage-gated sodium channels, is widely regarded as a genetic model of pain. Because inherited erythromelalgia was gain-of-function changes channel Na v 1.7 only decade ago, literature has mainly consisted reports and/or clinical characterization individual patients. This paper describes pattern pain, natural history, somatosensory profile, psychosocial status and olfactory testing 13 subjects with primary mutations SCN9A ,...
Objective quantification of small fiber neuropathy in patients with human immunodeficiency virus (HIV)-associated sensory (HIV-SN) is difficult but needed for diagnosis and monitoring. In vivo corneal confocal microscopy (IVCCM) can quantify damage.To establish whether IVCCM identify an abnormality nerve fibers Langerhans cells without HIV-SN.This prospective, cross-sectional cohort study was conducted between July 24, 2015, September 17, 2015. Twenty who were HIV positive recruited from...
Abstract The pathophysiology of pain in neuropathy is complex and may be linked to sensory phenotypes. Quantitative testing, a standardized method evaluate profiles response defined stimuli, assesses functional integrity small large nerve fiber afferents central somatosensory pathways. It has revealed detailed insights into mechanisms neuropathy, yet it remains unclear if directly affects profiles. main objective this study was investigate patients with various neuropathic conditions,...
Over the last two decades, awareness of negative repercussions flaws in planning, conduct and reporting preclinical research involving experimental animals has been growing. Several initiatives have set out to increase transparency internal validity studies, mostly publishing expert consensus experience. While many points raised these various guidelines are identical or similar, they differ detail rigour. Most them focus on reporting, only few cover planning studies. The aim this systematic...
Many questions regarding the clinical management of people experiencing pain and related health policy decision-making may best be answered by pragmatic controlled trials. To generate clinically relevant widely applicable findings, such trials aim to reproduce elements routine care or are embedded within workflows. In contrast with traditional efficacy trials, intended address a broader set external validity critical for stakeholders (clinicians, healthcare leaders, policymakers, insurers,...
BackgroundChronic pain after injury poses a serious health burden. As result of advances in medical technology, ever more military personnel survive severe combat injuries, but long-term outcomes are unknown. We aimed to assess rates representative sample UK with and without injuries.MethodsWe used data from the ADVANCE cohort study (ISRCTN57285353). Individuals deployed as armed forces Afghanistan were recruited include those physical frequency-matched uninjured comparison group....
Abstract We assessed pain characteristics and sensory profiles of a large extensively phenotyped cohort patients with polyneuropathies (PNPs) small fiber neuropathy (SFN) using quantitative testing (QST). Our aim was to detect potentially discriminative QST patient subgroups determined by pain, etiology, or skin innervation. prospectively recruited 350 painful painless PNPs SFN at 1 neuromuscular center. After neurological work-up, underwent the dorsal foot 5-mm punch biopsy lower leg upper...