Research project

PAINSTORM Dundee Epidemiology

PAINSTORM is a group of research centres from the UK and Belgium. Our aim is to understand the disease processes of NeuP

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Status

Active

Start date

August 2021

Completion date

July 2025

Neuropathic pain (NeuP) is caused by direct damage to the nerves1. Not everyone with a disease or trauma which can cause NeuP goes on to develop NeuP. People who do develop NeuP have a wide range of severities and outcomes. Unfortunately, the management of NeuP is inadequate due to poor efficacy and tolerability of current therapies2. First-line NeuP medications provide greater than 50% pain relief in less than half of those treated. This difference in onset, severity and outcome is due to a complex interaction between genetic and environmental factors3. The exact contribution and interaction of these factors is currently unknown but is vital to understand to inform treatment and prevention.

PAINSTORM is a group of research centres from the UK and Belgium. Our aim is to understand the disease processes of NeuP. We also want to use this knowledge to improve the outcome for people with NeuP. Our research follows on from the successful DOLORisk study4, 5, which identified factors linked with the presence, onset and outcome of NeuP in the general population5–7. We need to confirm these findings in specific populations and we will follow these people up for longer.

Dundee will lead a part of PAINSTORM (PAINSTORM Dundee Epidemiology) that aims to test the findings from DOLORisk and seek other previously unidentified associations with NeuP. The study will address the following research question:

In people with diabetes, and/or who have received potentially neurotoxic chemotherapy, what clinical, psychological, social/lifestyle, demographic and genetic factors are associated with the presence of NeuP at baseline and onset, worsening or remission of NeuP after follow-up of up to 5 years?

We will focus on two conditions that have a high risk of developing NeuP – diabetes and chemotherapy treatment. We will obtain existing and new data on NeuP and related characteristics (genetic and non-genetic) in three groups. (1) UK Biobank8, which has recently been surveyed for NeuP. (2) SHARE: Scottish Health Research Register9. Participants with diabetes and/or chemotherapy will be surveyed at the beginning and after 18 months. (3) The Genetics of Diabetes Audit and Research in Tayside Study (GoDARTS)10. Existing DOLORisk data will be combined with new data collected by our survey at 72 months follow-up.

Through statistical analysis we will validate existing and identify novel risk factors for NeuP in diabetes and chemotherapy treatment.

References

  1. Treede RD, Jensen TS, Campbell JN, et al. Neuropathic pain: Redefinition and a grading system for clinical and research purposes. Neurology 2008; 70: 1630–5
  2. Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis. Lancet Neurol 2015; 14: 162–73
  3. von Hehn CA, Baron R, Woolf CJ. Deconstructing the neuropathic pain phenotype to reveal neural mechanisms. Neuron 2012; 73: 638–52
  4. Pascal MMV, Themistocleous AC, Baron R, et al. DOLORisk: Study protocol for a multi-centre observational study to understand the risk factors and determinants of neuropathic pain. Wellcome Open Res 2019; 3: 63
  5. Hébert HL, Veluchamy A, Baskozos G, et al. Cohort profile: DOLORisk Dundee: a longitudinal study of chronic neuropathic pain. BMJ Open 2021; 11: e042887
  6. Veluchamy A, Hébert HL, Van Zuydam NR, et al. Association of Genetic Variant at Chromosome 12q23.1 With Neuropathic Pain Susceptibility. JAMA Netw Open 2021; 4: e2136560
  7. Veluchamy A, Hébert HL, Meng W, Palmer CNA, Smith BH. Systematic review and meta-analysis of genetic risk factors for neuropathic pain. Pain 2018; 159: 825–48
  8. Sudlow C, Gallacher J, Allen N, et al. UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age. PLoS Med 2015; 12: e1001779
  9. McKinstry B, Sullivan FM, Vasishta S, et al. Cohort profile: The Scottish Research register SHARE. A register of people interested in research participation linked to NHS data sets. BMJ Open 2017; 7: e013351
  10. Hébert HL, Shepherd B, Milburn K, et al. Cohort profile: Genetics of Diabetes Audit and Research in Tayside Scotland (GoDARTS). Int J Epidemiol 2018; 47: 380-381j

Project type

Research project