Friday, September 23rd
10:45am-12:15pm EDT


Topical Workshop


Assessment, Diagnosis & Measurement of Pain


701 B

Novel Biomarkers in Painful Neuropathies Recent Advances in Magnetic Resonance Imaging (MRI), Microneurography, and Non-Coding RNAs

This workshop focuses on novel biomarkers for peripheral neuropathy and neuropathic pain. In the first session Matthew Evans will discuss the development of MR neurography, and its application to some common neuropathies such as diabetic neuropathy. He will explore the current state of the art, share experience with high field (7 Tesla) imaging of peripheral neuropathies, and some recent application of these techniques to neuropathic pain. Andreas Themistocleous will then discuss how microneurography allow us to obtain functional data on small, nociceptive fibres, a population of nerve fibres which cannot be assessed by more traditional neurophysiological techniques. He will discuss how abnormalities in nociceptive fibres can be demonstrated in peripheral neuropathies and other painful conditions such as fibromyalgia. We finish with a talk by Michaela Kress on the differential expression of non-coding RNAs (ncRNA) and their potential roles in neuropathic pain and regenerative processes.


10:45am EDT12:15pm EDT

Magnetic Resonance Imaging Biomarkers in Painful Neuropathies: A Focus on Diabetic Neuropathy and other Symmetrical Polyneuropathies

Tracks: Assessment, Diagnosis & Measurement Of Pain
Categories: Topical Workshop
Presented By: Dr. Matthew C. Evans

Peripheral neuropathies are common; diabetes mellitus alone affects around 8.8% of the world population, with around half developing neuropathy and a quarter of these having significant neuropathic pain which causes disability and reduced quality of life. However the pathomechanisms which lead to development of neuropathy and pain are incompletely understood. There are numerous techniques used to investigate these conditions, including neurophysiology and quantitative sensory testing, each of which has its advantages and drawbacks.

Despite widespread use of magnetic resonance imaging (MRI) in studying central nervous system (CNS) disease, the use of MRI to investigate peripheral neuropathies is still in its infancy, largely due to technological challenges including spatial resolution, although this has changed in recent years with the increased availability of 3 Tesla (T) and 7T systems. MRI at higher field strength can offer fascicular level resolution in peripheral nerves, offering the exciting possibility of developing MRI as a “virtual biopsy”. In MR neurography, combinations of T1, T2 and diffusion sequences are used to image peripheral nerves and has now been applied to numerous peripheral conditions including inflammatory, metabolic, infective, traumatic and compressive neuropathies. Here we review recent work on some common peripheral neuropathies, including applications to neuropathic pain.

10:45am EDT12:15pm EDT

Microneurography to Study Nociceptive Fibre Changes in Painful Peripheral Neuropathies

Tracks: Assessment, Diagnosis & Measurement Of Pain
Categories: Topical Workshop

Microneurography is the only neurophysiological technique that records neuronal activity directly from nerves in awake patients. The thin myelinated and unmyelinated nociceptive fibres, tested by microneurography, are not assessed by conventional nerve conduction studies and are responsible for sensing pain. Nociceptive fibres are heterogenous, they show different stimulus-response functions and some are mechanically-insensitive in the naive state. Recording from nociceptive fibres provides unrivalled insight into peripheral neuronal activity and how it can relate to chronic neuropathic pain; for example, study of nociceptive fibres in fibromyalgia patients identified hyperexcitability in C fibres and a possible new mechanisms for chronic pain in these patients.

10:45am EDT12:15pm EDT

Non-Coding RNAs as Hub Regulators of Neuropathic Pain and Neuroregeneration

Tracks: Assessment, Diagnosis & Measurement Of Pain
Categories: Topical Workshop

Nerve injuries activate inherent transcriptional programs in primary afferent neurons residing in the dorsal root ganglia (DRG), which are critical for the initiation of neuropathic pain. Members of the non-coding RNA (ncRNA) family, specifically the short microRNAs (miRNA) act as master switches orchestrating biological processes in both the immune as well as nervous system. Since miRNAs are emerging as important regulators of the reaction to injury it is important to understand the precise contribution and role of specific miRNAs associated with the pathogenesis of neuropathic pain vs. regenerative processes. As miRNAs promise unique and specific advantages for therapeutic interventions, the identification of specific miRNAs promoting or preventing neuropathic processes and the unraveling of their target genes and mechanisms of action are of critical importance and offer novel therapeutic perspectives for pain resulting from nerve injuries. Benefit for the patient may also emerge from the presence of disease related ncRNAs in blood cells and extracellular vesicles which may be exploited as liquid biopsies for diagnostic purposes. Studies exploring the potential of specific ncRNAs signatures as biomarkers indicative of neuropathic pain disorders are discussed.


Dr. Matthew C. Evans

Clinical Lecturer
Imperial College London

Professor Michaela Kress

Professor, Department Head
Medical University Innsbruck

Dr. Andreas C. Themisticleous

Clinical lecturer in neurophysiology
University of Oxford