Recent years have witnessed a large number of failed analgesic drug trials, and in
the subsequent soul-searching, 2 potential (and likely mutually exclusive) explanations
have gained traction: either that clinical trials are failing to show efficacy of
actually effective compounds,
3
or that preclinical pain science's almost exclusive focus on reflexive withdrawal
measures has failed to accurately model clinical pain, leading to the development
of largely ineffective compounds.
- Dworkin R.H.
- Turk D.C.
- Peirce-Sandner S.
- Burke L.B.
- Farrar J.T.
- Gilron I.
- Jensen M.P.
- Katz N.P.
- Raja S.N.
- Rappaport B.A.
- Rowbotham M.C.
- Backonja M.M.
- Baron R.
- Bellamy N.
- Bhagwagar Z.
- Costello A.
- Cowan P.
- Fang W.C.
- Hertz S.
- Jay G.W.
- Junor R.
- Kerns R.D.
- Kerwin R.
- Kopecky E.A.
- Lissin D.
- Malamut R.
- Markman J.D.
- McDermott M.P.
- Munera C.
- Porter L.
- Rauschkolb C.
- Rice A.S.
- Sampaio C.
- Skljarevski V.
- Sommerville K.
- Stacey B.R.
- Steigerwald I.
- Tobias J.
- Trentacosti A.M.
- Wasan A.D.
- Wells G.A.
- Williams J.
- Witter J.
- Ziegler D.
Considerations for improving assay sensitivity in chronic pain clinical trials: IMMPACT
recommendations.
Pain. 2012; 153: 1148-1158
7
,
9
A solution to the latter problem is to instead measure “spontaneous pain,” and a
number of new methodologies to accomplish this have been recently developed or rediscovered.
4
,
5
In his Focus Article, my colleague Gary Bennett examines the concept of spontaneous
pain, and advances the highly intriguing notion that what we call spontaneous pain
might actually be temporally summated hypersensitivity (allodynia and hyperalgesia)
from activities of daily life.
- Langford D.L.
- Bailey A.L.
- Chanda M.L.
- Clarke S.E.
- Drummond T.E.
- Echols S.
- Glick S.
- Ingrao J.
- Klassen-Ross T.
- LaCroix-Fralish M.L.
- Matsumiya L.
- Sorge R.E.
- Sotocinal S.B.
- Tabaka J.M.
- Wong D.
- van den Maagdenberg A.M.J.M.
- Ferrari M.D.
- Craig K.D.
- Mogil J.S.
Coding of facial expressions of pain in the laboratory mouse.
Nat Meth. 2010; 7: 447-449
2
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References
- The cortical rhythms of chronic back pain.J Neurosci. 2011; 31: 13981-13990
- What is spontaneous pain and who has it?.J Pain. 2012; 13: 921-929
- Considerations for improving assay sensitivity in chronic pain clinical trials: IMMPACT recommendations.Pain. 2012; 153: 1148-1158
- Unmasking the tonic-aversive state in neuropathic pain.Nat Neurosci. 2009; 12: 1361-1363
- Coding of facial expressions of pain in the laboratory mouse.Nat Meth. 2010; 7: 447-449
- Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes.Pain. 2010; 150: 439-450
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- A novel tool for the assessment of pain: Validation in low back pain.PLoS Med. 2009; 6: e1000047
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© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
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- What Is Spontaneous Pain and Who Has It?The Journal of PainVol. 13Issue 10
- PreviewSpontaneous pain is often discussed in the context of both chronic inflammatory and neuropathic pain conditions, and it has been suggested that spontaneous pain, rather than stimulus-evoked pain, may be the more significant clinical problem. The following issues are discussed here. First, it is suggested that the concept of spontaneous pain makes no sense when the pain is the result of an ongoing inflammatory reaction. Evidence is reviewed that indicates that spontaneous pain is present in patients with neuropathic pain, but perhaps only in a subset of such patients.
- Full-Text
- Preview
- Reply to Drs. Loeser and MogilThe Journal of PainVol. 13Issue 10
- PreviewI thank my colleagues for their remarks and I am pleased that we agree on the usefulness of reassessing our terminology and for the need for research into the question of the role of stimulus-evoked pain and its summation as potential contributors to the pain patient's experience of persistent daily pain.
- Full-Text
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