Models of Nociceptive Plasticity in Chronic Pain (MoNoPly)
Research type
Research Study
Full title
Models of Nociceptive Plasticity in Chronic Pain (MoNoPly)
IRAS ID
235689
Contact name
Christopher Brown
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
3 years, 6 months, 1 days
Research summary
Research Summary
Many patients with musculoskeletal disorders (e.g. arthritis, AR; fibromyalgia, FM) suffer severe pain that, for a number of possible reasons, is poorly managed with drugs or surgery. It is thought that in some cases, changes in brain structure and function ("neuroplasticity") may contribute to pain and treatment resistance. Such changes can occur in response to how the brain processes sensations such as pain (nociception). New technologies are needed to detect these changes and to target treatment appropriately. We aim to test new methods for detecting pain-related changes in the brain. We will investigate whether differences between individuals in brain structure and function, and how the brain processes pain, can be understood in terms of mathematical models describing the mechanisms by which the brain learns and adapts to pain sensing (nociception) over time – a phenomenon we term “nociceptive learning”. This will involve comparing a number of mathematical models of nociceptive learning and associated brain changes to see which provides the best explanation (according to the statistics of the modelling) of participants’ perception of pain and of their brain structure and function. We will also seek preliminary evidence of clinical validity, asking whether these models can differentiate individuals into clinically meaningful subgroups. If successful, future projects will evaluate the clinical utility of the findings, which we envisage will fall into two categories: 1. an improved ability to detect mechanisms of chronic pain for treatment stratification/optimisation; 2. new knowledge about the contribution of brain changes to chronic pain that can be used to improve the educational aspects of multi-disciplinary treatment.
Summary of Results
This study investigated how our brains learn to anticipate and respond to pain, especially in people with chronic pain conditions like fibromyalgia and arthritis. When we experience pain, our brains adapt and adjust our expectations of pain based on past experiences. This study examines how three types of brain learning influence these pain responses:
1. Repetition Priming - When pain is repeatedly experienced, the brain becomes quicker at detecting it.
2. Temporal Statistical Learning - The brain notices patterns over time, learning to predict when pain might occur based on prior experience.
3. Associative Learning - Our brains link certain sounds, sights, or other cues to pain, influencing our expectation and perception of pain.
The study looked at these learning types and their effects on people’s pain sensitivity. Some participants became more sensitive to pain, while others found it harder to distinguish painful from non-painful sensations, during the experiment. These changes were linked to which types of learning their brains relied on.
The research team also examined MRI data from the same participants to understand how chronic pain might alter brain structure and connectivity. Previous research has shown that chronic pain can lead to changes in specific brain areas linked to emotion, memory, and stress, such as the hippocampus and amygdala. This study found that some of these brain regions show distinct structural differences in people with chronic pain, with variations between fibromyalgia and arthritis patients.
The team plans to continue this work, combining data from brain scans and learning models to explore how different learning processes might affect brain structure and function. This could help us understand why chronic pain can be persistent and lead to treatment strategies that directly target the brain mechanisms involved.
These insights open doors to more personalised approaches for managing chronic pain. By linking brain learning processes to structural and functional changes in the brain, this research could help doctors design treatments tailored to each person’s unique pain response patterns. In the future, techniques that retrain the brain to better differentiate painful from non-painful sensations or reduce fear-based reactions to pain could be developed.REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
18/NW/0044
Date of REC Opinion
26 Feb 2018
REC opinion
Favourable Opinion