Assessing the Feasibility of a Multimodal Approach to Pain Evaluation in Early Stages after Spinal Cord Injury

Int. J. Mol. Sci., 2023 · DOI: 10.3390/ijms241311122 · Published: July 5, 2023

Spinal Cord Injury Pain Management Bioinformatics

Simple Explanation

This study checks if it's possible to use several methods to assess pain in people who have recently suffered a spinal cord injury (SCI). These methods include clinical workup, sensory tests, psychological evaluations, and blood tests. The goal is to understand how pain changes over time in these patients and to find possible markers in the blood that could help predict who will develop long-term pain. The research found that while using all these methods is doable, it's difficult to recruit enough patients and that some adjustments to the testing procedures are necessary.

Study Duration

September 2017 to December 2018

Participants

117 spinal cord injury (SCI) patients were screened, with varying participation in different assessments (neurological/pain evaluation, blood donation, PSF assessment).

Evidence Level

Not specified

Key Findings

1
The SCI Pain Instrument (SCIPI) was efficient in distinguishing between nociceptive and neuropathic pain, showing a progressive increase in severity over time.
2
Higher concentrations of osteopontin and cystatin-C were found in SCI patients compared to healthy controls, indicating their potential as biomarkers.
3
Six pain trajectories were identified between timepoints T2 and T3.

Research Summary

This research evaluates the feasibility of a multimodal pain assessment protocol during rehabilitation following spinal cord injury (SCI). The protocol amalgamates clinical workup (CW), quantitative sensory testing (QST), and psychosocial factors (PSF) administered at 4 (T1), 12 (T2), and 24 (T3) weeks post injury and at discharge (T4). The findings emphasize the need for the careful consideration of recruitment setting and protocol adjustments to enhance the feasibility of multimodal pain evaluation studies post SCI.

Practical Implications

Personalized Integrative Care Models

The five patients who underwent the entire protocol provide key insights into the therapeutic prospects that arise from such a comprehensive approach. This knowledge can guide the development of personalized, integrative care models for SCI-related pain, and potentially improve patient outcomes.

Early Intervention Strategies

The identiﬁed trajectories may suggest changes in pain pathways in the early stage of SCI, highlighting the potential for early intervention strategies.

Future Therapeutic Targets

Promising molecules that may serve as future therapeutic targets or diagnostic tools were identified. Notably, IL-10, CCL3, MCP1, IL-6, CRP, calprotectin, cystatin-C, OPN, and ICAM-1 exhibited signiﬁcant alterations.

Assessing the Feasibility of a Multimodal Approach to Pain Evaluation in Early Stages after Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Personalized Integrative Care Models

Early Intervention Strategies

Future Therapeutic Targets

Study Limitations

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Assessing the Feasibility of a Multimodal Approach to Pain Evaluation in Early Stages after Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Personalized Integrative Care Models

Early Intervention Strategies

Future Therapeutic Targets

Study Limitations

Your Feedback

Was this summary helpful?