PAINSTORM Dundee Epidemiology

Neuropathic pain (NeuP) is caused by direct damage to the nerves1. This can be induced by diseases such as diabetes mellitus, physical trauma such as surgery and chemically such as through chemotherapy treatment for cancer. However, 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 study 4, 5, which identified factors linked with the presence, onset and outcome of NeuP in the general population 5–7. We need to confirm these findings in specific populations and we will follow these people up for longer.

Dundee is leading 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 are focusing 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.