Technologies for Investigating Pain

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Abstract

This refresher course focuses on technologies used to assess normal and altered somatosensory sensitivity and pain mechanisms, as well as neurophysiological techniques for studying central nervous system manifestations of pain. 

Quantitative Sensory Testing (QST) has advanced the standardisation of somatosensory assessment in pain research since the early 2000s. QST technologies provides a structured evaluation of somatosensory function across different fibre classes and sensory modalities through patient-reported responses, capturing parameters that are difficult to assess using objective neurophysiological methods. Dr. Magerl presents the development and application of these QST techniques, now widely used in patient group studies and individual diagnostics. 

QST has largely been developed for assessing superficial structures, although manifestations of sensitisation in pain mechanisms associated with deeper tissues are of considerable clinical importance. Dr. Graven-Nielsen introduces the assessment of pain sensitivity, temporal summation of pain, and conditioned pain modulation relevant to deep tissues (e.g. muscle), as well as pain referral. 

Resting-state electroencephalography (EEG) has emerged as a valuable tool for investigating the neural mechanisms underlying pain and chronic pain conditions. Capturing spontaneous brain activity without experimental stimulation, resting-state EEG provides insights into altered brain function, network dynamics, and potential pain biomarkers. Dr. Ploner presents the rationale for using resting-state EEG in pain research, outline common methodological approaches, summarise key findings, and discuss current challenges and future directions for its clinical and research use. 

Complementing the resting-state EEG session, Dr. Mouraux introduces event-related potentials (ERPs) recorded with non-invasive EEG to characterise nociceptive processing and its modulation in healthy individuals and clinical populations. This lecture will guide participants through the methodological requirements for recording brain responses to sensory stimuli and the available stimulation modalities, including infrared laser, contact heat and cold, and mechanical pinprick stimulation. The lecture discusses interpretation of responses, highlighting key limitations and pitfalls, and concludes with emerging approaches to distinguish EEG activity linked to sustained versus transient nociceptive input. 

Dr. Moayedi will cover the basic principles of structural and functional neuroimaging, focusing on magnetic resonance imaging (MRI). Specifically, the lecture will summarise key findings from MRI studies relevant to pain and related conditions. The session will highlight how neuroimaging has advanced understanding of brain pain mechanisms in health and disease. It will also provide an overview of their strengths and current limitations in research and clinical contexts. 

Faculty List  

  • Walter Magerl (Department of Neurophysiology, Universität Heidelberg, Heidelberg, Germany.) “Quantitative Sensory Testing: Methods and Interpretations” 
  • Thomas Graven-Nielsen (Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark) “Deep-tissue Quantitative Sensory Testing: Methods and Interpretations” 
  • Markus Ploner (Center for Interdisciplinary Pain Medicine, Technical University of Munich, Munich, Germany) “Resting-state Electroencephalography in Pain Research: Methods and Interpretations” 
  • André Mouraux (Institute of Neuroscience (IoNS), UCLouvain, Brussels, Belgium) “Evoked Brain Potentials in Pain Research: Methods and Interpretations” 
  • Massieh Moayedi (Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, Canada)” Pain NeuroImaging with MRI: Methods and Interpretations” 


Educational objectives 

  • To provide an understanding of somatosensory function and neurophysiologically informed assessment using QST. 
  • To introduce the assessment of pain sensitivity, temporal summation, conditioned pain modulation, and pain referral in deep tissues using QST-based approaches. 
  • To develop an understanding of the potential of resting-state EEG for investigating pain mechanisms, as well as its key methodological and interpretative challenges. 
  • To understand the potential and limitations of event-related brain potentials in human pain research and to gain knowledge of their implementation and analytical tools required. 
  • To understand the principles, applications, strengths, and limitations of structural and functional MRI in pain research. 
Massieh Moayedi, PhD

Massieh Moayedi, PhD

Research Chair

University of Toronto Centre for the Study of Pain

Massieh Moayedi is a Canada Research Chair in Pain Neuroimaging, a University of Toronto Centre for the Study of Pain scientist, and co-director of the Multimodal Sensorimotor and Pain Research. Moayedi received his PhD under the supervision of Karen Davis and completed a postdoctoral fellowship at University College London under the supervision of Giandomenico Iannetti. He is Secretary of the Canadian pain Society, and Councilor of the International Association for the Study of Pain. Moayedi's interest in pain research is borne out of personal lived experience with pain. His work uses brain imaging and behavioral paradigms to delineate the mechanisms of acute and chronic pain, with a goal of identifying novel therapeutic targets. He has an extensive collaborative network of clinicians and scientists with expertise to answer complex questions in pain physiology.

Markus Ploner

Markus Ploner

Professor

Technical University of Munich

Professor Markus Ploner investigates how the human brain generates the experience of pain. His interdisciplinary research group employs methods such as electroencephalography (EEG) and non-invasive brain stimulation to understand how the brain processes pain in healthy individuals and in people with chronic pain. The aim is to develop new approaches for the diagnosis and treatment of chronic pain. His research is guided by the principles of open, reproducible science and actively involves people with chronic pain in the research process.

Professor Ploner studied medicine in Cologne and Vienna and received his doctorate from the University of Cologne. He began his research career at the University Hospital Düsseldorf, where he also completed his specialist training in neurology. In 2007/2008, he conducted research at the University of Oxford as a Feodor Lynen Fellow of the Alexander von Humboldt Foundation. Since then, he has been working at the Department of Neurology at TUM. In 2014, he was appointed Professor of Human Pain Research, and in 2024, he became Head of the Center for Interdisciplinary Pain Medicine at the TUM University Hospital.

Thomas Graven-Nielsen, PhD

Thomas Graven-Nielsen, PhD

Director at

Center for Neuroplasticity and Pain, Aalborg University.

Thomas Graven-Nielsen acquired his PhD within Biomedical Science and Engineering in 1997 (Aalborg University, Denmark). In 2006 he obtained a Doctoral degree in Medical Science (DMSc, Copenhagen University). He is Director at Center for Neuroplasticity and Pain (CNAP), Aalborg University, Denmark (since 2015), and Full Professor in Pain Neuroscience since 2008. The Danish National Research Foundation inaugurated CNAP. He is also Councillor in the International Association for the Study of Pain.

The research focuses on translational studies of pain bridging the gap between basic animal findings and clinical manifestations of pain. The scope is to identify and modulate key features of human pain neuroplasticity leading to prevention of maladaptive neuroplasticity and promote advantageous neuroplasticity. The core areas are musculoskeletal pain, referred pain, localised and widespread deep-tissue hyperalgesia, pain modulatory mechanisms, pharmacological screening, and electrophysiological techniques to assess pain physiology and neuroplasticity. Novel pain models, bio-markers, assessment and neuro-modulatory technologies are key biomedical tools for the translational studies.

A core research philosophy in his work is that pain research by nature is multidisciplinary, hence interdisciplinary and intersectorial collaboration is a key concept, as is collaboration with excellent researchers and students. Thomas has published 385+ peer-reviewed scientific papers (H-index: 78, approx. 20.000 citations) and received several awards, most notably the Knight of the Order of Dannebrog (2020). He reviews papers on a regular basis for high ranked journals, has presented as keynote speaker at several international conferences, and organised scientific workshops and symposia at international meetings. Multiple national and international collaborations on translational pain research have been established. Moreover, advocacy for pain research has been a cornerstone activity via dedicated involvement.

 

André Mouraux MD, PhD

André Mouraux MD, PhD

Full Professor

UCLouvain Institute of Neurosciences (IoNS)

André Mouraux (MD, PhD) is Full Professor at the UCLouvain Institute of Neurosciences (IoNS). As a neuroscientist trained as a clinical neurologist, his research focuses on the cerebral mechanisms underlying nociception and pain perception in humans, using electroencephalography (EEG) – including intracerebral EEG – combined with techniques to selectively activate distinct classes of nociceptive afferents. A central theme of his work is understanding the changes in nociceptive processing induced by inflammation, injury, or sustained nociceptive input that drive peripheral and central sensitization, and may contribute to the transition from acute to chronic pain. He has contributed to the development of pharmacodynamic biomarkers of nociceptive processing within large European collaborative projects, including IMI2-PAINCARE and H2020-QSPainRelief, and is currently involved in MSCA-FRESCO4NoPain, which explores non-invasive brain stimulation as a means to modulate pain.  

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Quantitative Sensory Testing: Methods and Interpretations
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Deep-tissue Quantitative Sensory Testing: Methods and Interpretations
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Resting-state Electroencephalography in Pain Research: Methods and Interpretations
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Evoked Brain Potentials in Pain Research: Methods and Interpretations
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Pain NeuroImaging with MRI: Methods and Interpretations
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