Chronic neuropathic pain is more than a perception: Systems and methods for an integral characterization

Abstract

The management of chronic neuropathic pain remains a challenge, because pain is subjective, and measuring it objectively is usually out of question. However, neuropathic pain is also a signal provided by maladaptive neuronal activity. Thus, the integral management of chronic neuropathic pain should not only rely on the subjective perception of the patient, but also on objective data that measures the evolution of neuronal activity. We will discuss different objective and subjective methods for the characterization of neuropathic pain. Additionally, the gaps and proposals for an integral management of chronic neuropathic pain will also be discussed. The current management that relies mostly on subjective measures has not been sufficient, therefore, this has hindered advances in pain management and clinical trials. If an integral characterization is achieved, clinical management and stratification for clinical trials could be based on both questionnaires and neuronal activity. Appropriate characterization may lead to an increased effectiveness for new therapies, and a better quality of life for neuropathic pain sufferers.

Keywords: Allodynia; Central nervous system; Characterization; Chronic neuropathic pain; Diagnostic and evaluation questionnaires; EEG; Electrophysiology; Laser evoked potential; Linear and non-linear analysis of EEG; Neuronal oscillations; Neuroplasticity; Nociception; Pain experience; Pain management; Pain pathways; Patient stratification; Somatosensory evoked potential; Somatosensory nervous system; Stimulation; Thalamocortical dysrhythmia.